[Microbiologic and clinical significance of cefotiam]. / Zur mikrobiologischen und klinischen Bedeutung des Cefotiams.

Modern cephalosporins are of considerable importance for the therapy of severe infections by multiresistant organisms. According to in-vitro-findings on ampicillin-resistant E. coli as well as Klebsiella spp., Proteus spp., and serratia spp., altogether 159 strains, instead of cefotaxime nearly always also cefotiam can be used. The two remedies are clearly superior to cephalothin. cefotiam is ineffective to Pseudomonas aeruginosa. But in this case also cefotaxime is clearly inferior to azlocillin. In 6 of 7 casuistic instances the clinical effectiveness of cefotiam could be confirmed with good tolerability. The contemporary establishment of staph. aureus in mixed infections of serratiastaphylococci proved as as particular advantage. A primary therapeutic failure referred to a necrotizing pancreatitis, when no causative organism was proved, in which case also cefotaxime remained without any effect. Despite the improved individual medical possibilities the control of the infectious hospitalism by critical administration of antibiotics and improved hospital hygiene, particularly strict non-infection, must remain the pre-eminent task.

[Bacampicillin in urinary tract infections tolerance in patients with impaired kidney and liver function]. / Bacampicillin bei Harnwegsinfektionen--Verträglichkeit bei gestörter Nieren- bzw. Leberfunktion.

The evaluation of a 10-day 3 x 800 mg dosage regimen was equivalent for bacampicillin to oral ampicillin therapy (using 3 or 4 g respectively per day) in patients with primary UTI (n = 50) in clinical and bacteriological respect. The cure rate amounted to 69 and 68,4% respectively 2 days after therapy. No differences could be assessed after a 2-, 4- and 6-week period. Frequency of diarrhoea was 3 times as high in the ampicillin group as in the bacampicillin group. The rate of exanthema was also 2,5 times as high. No differences existed between eosinophilia and pain complaints in the upper gastrointestinal tract. 10 patients with liver function disturbances and renal impairment respectively tolerated well bacampicillin treatment. Only in the patients with impaired liver function rise of BUN and urea was found in 3 cases, not related to rise of creatinine.

[The value of fosfomycin]. / Zur Bedeutung des Fosfomyzins.

After description of the most important properties of fosfomycin including pharmacokinetics, antibacterial activity and hitherto got clinical experiences the determinations of the resistance on frequent clinical pathogenic agents are reported. They were performed in the diffusion test in a platelet content of 20 micrograms with admixture of glucose-6-phosphate. High sensitivity rates showed E. coli, P. mirabilis, hemophiliacs and above all Staph. aureus, but also a large part of the Klebsiella and the Pseudomonas strains could be classified as sensitive. Streptococci, pneumococci and enterococci mostly proved as resistant. Thus, in an oral therapy the spectre is smaller than in a highly dosed parenteral supply. Nevertheless, fosfomycin in the two forms of application is to be regarded as an enrichment of the therapeutic possibilities and further should be tested clinically.

[Central venous long-term catheter in the treatment of acute leukemia: implantation of a modified Hickman technic]. / Zentralvenöse Langzeitkatheter in der Behandlung akuter Leukämien: Einführung einer Modifikation der Hickman-Technik.

Central venous catheters are an essential prerequisite for the supportive ascertainment of highly aggressive cytoreductive therapy programmes in patients with acute leukaemia. From the indications (parenteral nutrition, transfusions, blood taking a. o.) and the particular conditions of the patient with acute leukaemia (granulo- and thrombocytopenia) results the superiority of a subcutaneously tunnelled central venous catheter with a particular occlusion of the place of entry into the skin in contrast to usual techniques.