ABSTRACT
The authors describe 229 cases of carbapenem use in intensive care wards. Tienam was used in 205 cases since 1993, meronem in 24 cases since 1996. There were 149 men and 80 women aged 15-76 years (mean age 46.4 +/- 0.7 years). Carbapenemes were administered by 5-7-day courses in a daily dose of 2-6 g (2-4 g for tienam and 2-6 g for meronem). Carbapenemes were administered as monotherapy; in 196 cases nisoral was added to antibiotic therapy starting from day 3 as an antimycotic agent. Bacteriological studies were carried out in 367 patients (413 inoculations). Sensitivity of cultured microflora to disks with tienam (329 tests) and meronem (97 tests) showed their high activity towards gram-positive and gram-negative flora. The results were less demonstrative in cerebral abscesses, which is explained by specific pharmacokinetics of tienam. Analysis of the cost/efficacy ratio confirmed the economic efficacy of this group of drugs.
Subject(s)
Drug Therapy, Combination/therapeutic use , Thienamycins/therapeutic use , Adolescent , Adult , Aged , Cilastatin/adverse effects , Cilastatin/economics , Cilastatin/therapeutic use , Cilastatin, Imipenem Drug Combination , Cost-Benefit Analysis , Critical Illness , Drug Combinations , Drug Therapy, Combination/adverse effects , Drug Therapy, Combination/economics , Female , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/economics , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/economics , Humans , Imipenem/adverse effects , Imipenem/economics , Imipenem/therapeutic use , Male , Meropenem , Middle Aged , Thienamycins/adverse effects , Thienamycins/economics , Time FactorsSubject(s)
Blood Transfusion , Blood Volume , Hemorrhage/therapy , Plasma Substitutes/administration & dosage , Acute Disease , Adolescent , Adult , Aged , Anticoagulants/administration & dosage , Blood Coagulation Tests , Critical Care , Dextrans/administration & dosage , Female , Gelatin/administration & dosage , Hemodynamics , Hemorrhage/physiopathology , Humans , Hydroxyethyl Starch Derivatives/administration & dosage , Male , Middle Aged , Succinates/administration & dosageABSTRACT
A third-generation cephalosporin, Ceftriaxone, was used in intensive care of patients subjected to elective and urgent surgery in the Regional Clinical Hospital, St. Petersburg. A total of 105 patients were divided in 4 groups: 1) a course of ceftriaxone in combination with aminoglycosides started before the intervention; 2) the same, with the disease course complicated by peritonitis; 3) patients with neurosurgical diseases and brain injuries complicated by secondary meningoencephalitis; and 4) abdominal surgical patients in whom the severity of illness was determined by the abdominal process of different localization. The treatment included general and local use of ceftriaxone under ultrasonic control. The results indicate that ceftriaxone is a broad-spectrum drug effective in the treatment of nosocomial infections and neuroinfections; it can be applied locally and is economic.
