RESUMEN
We evaluated the clinical efficacy of imipenem/cilastatin sodium (IPM/CS--a carbapenem antibiotic) against orthopedic infections, and the drug levels of the bone tissues were determined. The clinical efficacies for 6 patients in the infection group were good in 3 cases, and fair in the other 3; giving an efficacy rate of 50%. Bacteriologically, 8 strains were isolated from patients with the infection and an eradication rate of 87.5% was obtained upon the treatment. In 39 patients that were given the drug prophylactically, no postoperative infections occurred. Mean IPM levels in the bone and the bone marrow at 1 hour after administration in 5 patients of the prophylactic group were 17.3 micrograms/ml and 5.9 micrograms/g, respectively. The ratio of concentrations the bone to those in the bone marrow was 34.6%. The results of this study suggest that IMP/CS reaches to the bone tissue providing sufficient concentrations and that the drug is efficacious for the prophylaxis and the treatment of orthopedic infections.
Asunto(s)
Huesos/metabolismo , Quimioterapia Combinada/farmacocinética , Quimioterapia Combinada/uso terapéutico , Infección de la Herida Quirúrgica/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cilastatina/farmacocinética , Cilastatina/uso terapéutico , Combinación Cilastatina e Imipenem , Combinación de Medicamentos , Femenino , Humanos , Imipenem/farmacocinética , Imipenem/uso terapéutico , Masculino , Persona de Mediana Edad , Procedimientos Ortopédicos , Infección de la Herida Quirúrgica/microbiología , Infección de la Herida Quirúrgica/prevención & controlRESUMEN
We tried to apply the use of thermosplint to prevent or protect leprosy patient's wound from risky factors in their living environment. Among 40 patients of the use of thermosplint, 27 cases wore it on some places in their hands, and 17 cases did in feet. We observed that 31 cases of the wear of thermosplint had effect on prevention or improvement in their wound, but 3 cases did not. Particularly good effect was obtained in 23 cases of the wear in their hand and 8 cases in foot. In 10 cases, however, we had to stop wearing it because of another damage or patient's uneasy. We found it difficult to apply the use of thermosplint to the plantar ulcer. Some factors such as histological and anatomical ones should be considered in more detail. Several problems of hindrances or inconveniences for daily life in wearing the thermosplint should be solved by further studies including devices for better application of the technique to the leprosy patients. At any rate it should be stressed that both patients and nurses had taken interest in the cause of the injury and could had positively come to grips with prevent of it through this study.