[Antibiotic prophylaxis and reconstructive operations in patients with burn sequelae]. / Antibiotikoprofilaktika pri rekonstruktivnykh operatsiiakh u bol'nykh s posledstviiami ozhogov.

The results of the clinicolaboratory investigation of the efficacy of antibiotic prophylaxis in 215 patients subjected to reconstructive operations for postburn scars are presented. The biological investigation of the postburn scars revealed the presence of microflora in about half of the patients. The microflora was mainly represented by Staphylococcus aureus and S. epidermidis. The level of the dissemination was not high. Ulcerated scars had higher levels of the bacterial contamination. The pharmacokinetic study of cefazolin, carbenicillin, aztreonam and gentamicin showed that the release of the first three drugs to the scar tissues was good. The clinical observations demonstrated that purulent inflammatory complications developed in patients with risk factors (ulceration of the scar, necrotic foci in the wound, involvement of the oral cavity and nasal passages to the operation), not treated with the antibiotics or treated with the drugs not inhibiting the microflora of the operation wounds (gentamicin, aztreonam). The results permitted to recommend the use of the antibiotic prophylaxis in reconstructive operations only in risk patients with burn consequences. With this purpose it is advisable to use antibiotics satisfactorily penetrating to the tissues of the postburn scars and active against the microflora vegetating in them (cefazolin and carbenicillin).

[A new method of antibiotic prophylaxis in liver surgery]. / Novyi sposob antibiotikoprofilaktiki v khirurgii pecheni.

Ninety patients with focal affections of the liver were followed up. The patients were operated on the liver and treated therapeutically and prophylactically by means of the target-aimed release of antibiotics in erythrocyte ghosts. The antibiotics used were gentamicin and aztreonam. The results of the clinico-laboratory examinations showed that the target-aimed transport of the antibiotics in erythrocyte ghosts provided a 9-fold increase of the antibiotic level in bile and its 2-fold increase in the liver tissue. The time of the drug retention in the body fluids and tissues increased 2 times as compared to that provided by the routine treatment. The incidence of the postoperative purulent complications decreased 3 times. Such an effect is likely due not only to the target-aimed release of the drugs but also to the possible immunomodulating action of the prophylactic procedure used for preventing the complications that prevented as well the development of severe postoperative immune deficiency. Aztreonam proved to be more efficient in the prophylaxis of the postoperative complications.

[Ciprofloxacin in the prevention and treatment of surgical infections]. / Primenenie tsiprofloksatsina v profilaktike i lechenii khirurgicheskikh infektsii.

A clinico-laboratory study on ciprofloxacin made by Bayer (Germany) was applied to patients with extended posttraumatic wounds and performed with the aim of preventing postoperative purulent complications in patients operated on the organs of the gastrointestinal tract. In the both groups ciprofloxacin was administered orally in doses of 500 and 1000 mg and intravenously in a dose of 200 mg. The results of the assay on ciprofloxacin sensitivity of the isolates from the wound excretion and urine showed that they were more sensitive to ciprofloxacin than to aminoglycosides and cephalosporins. 15 minutes after the intravenous administration the serum concentration of ciprofloxacin amounted to 7.5 +/- 0.9 micrograms/ml and in 6 hours it was equal to 0.45 +/- 0.45 micrograms/ml, the mean concentrations of ciprofloxacin being attained in the bile (8.7 +/- +/- 3.9 micrograms/ml), gallbladder wall (5.5 +/- 3.8 micrograms/g), liver (0.73 micrograms/g), muscles (1.93 micrograms/g) and tendon (0.15 microgram/g). After the oral administration in a dose of 500 mg ciprofloxacin was detected in the blood serum in an amount of 2.0 +/- 0.7 micrograms/ml in 1 hour and in an amount of 0.9 +/- 0.13 micrograms/ml in 6 hours. After the drug oral administration in a dose of 1000 mg the maximum concentrations were: 6.34 +/- 4.2 micrograms/ml on the average and 2.1 +/- 0.8 micrograms/ml in 6 hours (0.4 micrograms/g in the muscles, 1.4 micrograms/g in the skin and 0.34 micrograms/g in the bones). The study showed that ciprofloxacin was a highly efficient antimicrobial agent in the treatment of the complicated wound infections and the prophylaxis of the purulent complications during the postoperative period in the patients operated on gastrointestinal organs.

[Pharmacokinetics of kanamycin during targeted delivery to the liver in erythrocyte ghosts in animals with experimental acute cholecystitis]. / Farmakokinetika kanamitsina pri napravlennom transporte v pechen' v teniakh éritrotsitov u zhivotnykh s éksperimental'nym ostrym kholetsistitom.

Pharmacokinetics of kanamycin was studied after its targeted delivery to the liver in autological erythrocyte ghosts on 25 noninbred dogs with experimental acute cholecystitis in comparison to the routine intravenous administration of the antibiotic in solution. Kanamycin concentrations in the tissues of the liver, pancreas, spleen, kidneys and lungs as well as in bile and blood serum were determined by the agar diffusion method 24, 48 and 72 hours after the last administration. It was found that the targeted delivery of kanamycin in blood shadows made it possible to provide high concentrations of the antibiotic for prolonged periods in the liver and biliary ducts and to more efficiently arrest the clinical manifestations of acute cholecystitis as well as normalize the laboratory indices. The data showed that using blood shadows as a reliable system for targeted delivery of antibiotics to the liver was advisable in purulent inflammatory affections of the biliary ducts.

[Features of incorporation of several antibiotics into erythrocyte ghosts--a system of targeted delivery of chemotherapeutic drugs]. / Osobennosti vkliucheniia nekotorykh antibiotikov v éritrotsitarnye teni--sistemu tselenaproavlennoi dostavki khimioterapevticheskikh preparatov.

Features of incorporation of cefazolin, ampicillin, kanamycin and gentamicin into erythrocytic shadows in patients with abdominal diseases and apparently healthy persons during hypoosmotic hemolysis were studied. The highest percentage of kanamycin and gentamicin incorporation into the erythrocytic shadows was observed. The parameter of the antibiotic incorporation from the incubation fluid into the erythrocytic shadows depended on the antibiotic type and dose. Rather significant resistance of the erythrocytic carriers with incorporated gentamicin to possible desorption and excretion of the antibiotic from the shadows into the blood flow was revealed which made their use possible for target release of antibiotics in the liver.

[Experimental bases of directed transport of antibiotics in suppurative-inflammatory diseases of the liver and biliary tract]. / Eksperimental'noe obosnovanie napravlennogo transporta antibiotikov pri gnoino-vospalitel'nykh zabolevaniiakh pecheni i zhelchnykh putei.

The possibility of use and effectiveness of directed transport of antibiotics in erythrocyte carriers in the treatment of suppurative-inflammatory diseases of biliary ducts has been studied on dogs. It has been found that erythrocyte carriers were resistant to desorption of antibiotics in the blood circulation. Pharmacokinetic investigation has shown the more prolonged collection of antibiotics in hepatic tissue in comparison with traditional intravenous route. The results of clinical, pharmacokinetic and morphological investigation have shown more effectiveness of directed transport of antibiotics to the liver in autologous erythrocyte carriers in treatment of suppurative diseases of biliary ducts in comparison with traditional methods of infusion of antibiotics. For reasons given it is recommended to use this method in clinical practice.

[Therapeutic activity of Oriprim in bronchopulmonary diseases]. / Izuchenie terapevticheskoi aktivnosti Oriprima pri bronkholegochnykh zabolevaniiakh.

A new chemotherapeutic drug oriprim was used for therapy of 36 patients with bronchopulmonary pathology. Its therapeutic efficacy was noted in 83.3% of the cases. In 6 patients oriprim therapy turned out to be ineffective as a result of early side-effects. The drug was effective in pneumococcal infection. In suspicion of anaerobic infection (B. fragilis, etc) oriprim was given in combination with metronidazole.

[Clinico-laboratory evaluation of the effectiveness of the new aminoglycoside antibiotic brulamycin (tobramycin) in treating surgical infections]. / Kliniko-laboratornaia otsenka éffektivnosti novogo antibiotika-aminoglikozida brulamitsina (tobramitsin) v lechenii khirurgicheskoi infektsii.

The clinico-laboratory estimation of brulamycin in the treatment of 50 patients with severe wound infections showed its high efficacy with respect to gram-negative microflora and in particular Ps. aeruginosa (94 per cent of the sensitive strains). Satisfactory into the affection foci and a long-term maintenance of its therapeutic levels in the host allowed one to recommend the antibiotic for the treatment of patients with complicated purulent affections and first of all systemic infections.

[Comparative sensitivity of the main causative agents of suppurative infection to antibacterial preparations and their combinations]. / Sravnitel'naia chuvstvitel'nost' osnovnykh vozbuditelei gnoinoi infektsii k nekotorym antibakterial'nym preparatam i ikh sochetaniiam.

Sensitivity of 492 microbial strains to 9 antibacterial drugs and their double combinations was studied. The MTC was determined with the method of serial dilutions in an apparatus MIC-2000 (Austria). The apparatus provides determination of the MTC simultaneously to 12 antibiotics in 8 dilutions or to 8 antibiotics in 12 dilutions.

[Antibiotic sensitivity of Acinetobacter calcoaceticus in patients with infected burns]. / Antibiotikochuvstvitel'nost' Acinetobacter calcoaceticus u bol'nykh s infitsirovannymi ozhogami.

Sensitivity of Acinetobacter calcoaceticus var. anitratum isolated from infected burn wounds was studied with respect to 24 antibiotics. It was found that the isolates were multiple drug resistant. Sensitivity was observed at least to 8 out of 24 antibiotics. The majority of the isolates were resistant to 10--15 drugs. Many strains were resistant to 16--17 antibiotics. 11 antibacterial drugs, i. e. tobramycin, sisomicin, gentamicin, amicacin, neomycin, carbenicillin, polymyxin M, erythromycin, tetracycline, rifampicin and dioxidine proved to be most active against Acinetobacter calcoaceticus. The strains were resistant to 6 antibiotics, i. e. penicillin, oxacillin, lincomycin, ceporin, fusidin and ristomycin. The activity of streptomycin, ampicillin and levomycetin was negligible.

[Lincomycin concentration in the blood and tissues when administered by electrophoresis in children with acute and chronic hematogenic osteomyelitis]. / Kontsentratsiia linkomitsina v krovi i tkaniakh pri vvedenii ego metodom élektroforeza u detei s ostrym i khronicheskim gematogennym osteomielitom.

Twenty five children suffering from acute and chronic hematogenic osteomyelitis were subjected to lincomycin therapy in addition to surgical and general tonic treatment. The antibiotic was administered by means of electrophoresis in 15 children and by means of electrophoresis together with intramuscular injections in 10 children. It was found that administration of the drug by means of electrophoresis 1 hour after its intramuscular injection provided the highest lincomycin levels in the bone cavity favourable for the disease treatment.

[Clinical effectiveness of carbenicillin in suppurative inflammatory processes of varying localization]. / Klinicheskaia éffektivnost' karbenitsillina pri gnoino-vospalitel'-nykh protsessakh razlichnoi lokalizatsii.

The study on sensitivity of clinical strains of the causative agents of purulent infections to carbenicillin showed that 34.6% of the staphylococcal strains, 48.1% of the E. coli strains and 40.3% of the Proteus strains were sensitive to the antibiotic. The strains of Ps. aeruginosa were characterized by moderate sensitivity to carbenicillin. The MTC for most of the isolates ranged within 25-128 microgram/ml. High therapeutic efficacy of carbenicillin in treatment of cases with purulent inflammatory processes of various localization was shown. Positive results were obtained in 82.5% of the adults and 76.2% of the premature infants treated with carbenicillin. A satisfactory therapeutic effect was observed in the cases with sepsis, diffuse purulent peritonitis and abscessing pneumonia treated with carbenicillin in combination with gentamicin.

[Pharmacokinetics of rifampicin in single and repeated administration to patients with inflammatory processes in the lungs of nontuberculotic etiology]. / Farmakokinetika rifampitsina pri odnokratnom i povtornom vvedenii bol'nym s vospalitel'nymi protsessami netuberkuleznoi étiologii v legkikh

Rifampicin is a broad spectrum semisynthetic antibiotic of the group of rifampicins. It is active against both grampositive and gramnegative organisms and mycobacteria. The studies on the pharmacokinetics of rifampicin showed that the drug was well absorbed from the gastro-intestinal tract. After a single administration of rifampicin in a dose of 150 mg its maximum concentration in the blood was registered in an hour. This concentration was preserved at the therapeutic level for 5 hours. Practically no accumulation of rifampicin was observed in its use in a dose of 150 mg 4 times a day for 5 days. Perspectivity of rifampicin use in the treatment of patients with inflammatory processes in the lungs of non-tuberculosis etiology was shown.