Possibilities of extending the indications for application of single antibacterial doses in urological practice.

The authors report very good results of the application of single antibacterial doses in the therapy of acute bacterial cystitis and asymptomatic bacteriuria and point out that in addition to these already established indications, single doses can be applied successfully in some other forms of urinary infection, too. They share the clinical results and on the basis of some experiments maintain the standpoint that postoperative urinary infections are also suitable for this therapy (if no evidence of pyelonephritis is available), as well as the infections of the upper urinary tract (if the isolated microorganisms are not charged with antibodies). A scheme of the so-called "long-term therapy with single dose once a week" is proposed instead of the systematic 3-6 months therapy. The results are compared to the routine 7-10 day course of treatment; as a matter of fact, they are the same. The advantages of the single-dose therapy are discussed.

[Evaluation of immunostimulating agents used in pulmonologic practice]. / Otsenka na niakoi imunostimulirashti sredstva, prilagani v pulmologichnata praktika.

Several immunostimulating drugs--levamisole (decaris), Gamma-A, dipyridamole (Antistenocardin), Respivax--were included in the treatment of 161 patients with frequently recurring chronic nonspecific lung diseases and data for suppression of various components of the immune system. Levamisole and Respivax show marked antirelapse efficacy in chronic lung diseases. Gamma-A has a certain immunosubstituent action, dipyridamole exerts a moderate antirelapse action.

[Treatment of urinary infection with cephadroxyl (Pharmachem)--microbiological and clinical research]. / Lechenie na uroinfektsiiata s tsefadroksil (Farmakhim)--mikrobiologichni i klinichni prouchvaniia.

The bacteria isolated from the urine of renal patients were tested for sensitivity towards cephadroxyl (Pharmachem) and other beta-lactam antibiotics--altogether 654 examinations were made. It was established that the gram-positive bacteria (excluding the Enterococcus) are sensitive towards cephadroxyl. From the Gram negative bacteria E. Coli, Klebsiella sp., Enterobacter sp., P. mirabilis, Citrobacter sp. showed the greatest sensitivity towards cephadroxyl, while the indole positive Proteus were with low sensitivity and P. aeruginosa, Acinetobacter sp., Serratia were resistant towards cephadroxyl. 30 patients with persistent mainly secondary urinary infection were treated with cephadroxyl. The clinical symptoms disappeared in 63.3% of the patients and another 26.7% of them showed considerable improvement. Bacteriological sterility of the urine was achieved in 61.29% of the patients. The side effects were mild and rare, only in single cases.

[Treatment of urologic infections with cefamandole (Pharmachim)--the microbiological and clinical results]. / Lechenie na uroinfektsiite c tsefamandol (Farmakhim)--mikrobiologichni i klinichni rezultati.

The authors study the possibilities of cephalosporin antibiotic cefamandol, new for our clinical practice, in the treatment of uroinfections. The microbiological study on a total of 2301 bacterial strains, isolated from patients with uroinfections, reveals that cefamandol excels in its action against gram-positive microorganisms, all beta-lactam antibiotics, used in our country. As regards E. coli, Citrobacter, Klebsiella, Enterobacter, P. mirabilis and indole positive pro cefamandol is better than ampicillin, carbencillin and cefalotin. A resistance to the preparation showed the majority of the isolates of Enterococcus, Serratia, Acinebacter and Pseudomonas aeruginosa. Excellent result was attained in 60% of all the 35 patients with uroinfections treated, manifested in "sterilization" of urine and in 5.71% bacteruiria became insignificant. In parallel, the clinical and laboratory symptoms of uroinfection were favourably influenced. The preparation has a good tolerance. Finally it should be underlined that this antibiotic must be introduced in the routine clinical practice for the treatment of adequate forms of uroinfections.

[Treatment of acute and chronic urological infections with azlocillin--clinical and microbiological research]. / Lechenie na ostri i khronichni uroinfektsii s azlotsilin--klinichni i mikrobiologichni prouchvaniia.

The authors present their results from the treatment of urological infections with the new semisynthetic penicillin antibiotic azlocillin (acyl-ureide-penicillin) in 86 patients with various, in kind and clinical manifestations, infections of the urinary system. The susceptibility was determined of the isolated bacterial causative agents of the urological infections to azlocillin and to the other antibacterial preparations available in our country. It was established that 52,7% of Gram-negative microorganisms were susceptible to the preparation, and over 80%--of the Gram-positive microorganisms. The highest number of susceptible strains were established in pseudomonas, coli, enterobacter, klebsiella and proteus. The results from the clinical study reveal that 51,2% of the patients were cured by the end of the therapeutic course and abatement or considerable improvement, was observed in all, of the clinical and paraclinical indices, suggesting urological infection. No allergic or toxic manifestations were observed. The absence of nephrotoxicity makes that new, for our practice, antibiotic extremely valuable for the patients with renal insufficiency. The most general conclusion from that study is that azlocillin, with its effectiveness, comes close to the most potent modern antibacterial preparations, with no toxicity characteristic for aminoglucoside antibiotics.

[Pipemidinic acid as a urinary antiseptic--microbiological and clinical study]. / Pipemidinovata kiselina kato uroantiseptik--mikrobiologichni i klinichni prouchvaniia.

The authors present the results from the microbiological and clinical studies about the potentialities of pipemidinic acid in the treatment of uroinfections. Pipemidinic acid was established with the study on 375 bacterial strains, isolated from the urine of urological patients to have a very good in vitro effect as regards E. coli, Citrobacter, Proteus retgeri, Proteus mirabilis, Klebsiella and Enterobacter, and in case of those microorganisms, it gives way only to some aminoglucoside antibiotics. The admit that with those causative agents of uroinfections, the pipemidinic acid could be the agent of choice. The percentage of susceptible strains is low in case of Seratia, Proteus vulgaris, Pseudomonas and Acunetobacter. Sanation of the uroinfection was attained in 56.2 per cent of the patients from the 32 patients treated with persistent, most often nosocomial uroinfection, by the pipemidinic acid (in the form of the preparation palin), and a reduction of the bacterial number to insignificant values--in 12,6%. Obvious clinical improvement was established in almost all patients treated, manifested with fading or considerable reduction of the subjective and physical symptoms of the uroinfection, in parallel with a normalization or improvement of the paraclinical laboratory indices as well. In conclusion, it was emphasized that the introduction of that uroantiseptic in the practice will broaden the possibilities of effective treatment of uroinfections.

[Brulamycin in the treatment of urinary infections--microbiological and clinical research]. / Brulamitsin za lechenie na uroinfektsiite--mikrobiologichni i klinichni prouchvaniia.

The authors report the results frop microbiological and clinical studies of the new aminoglucoside antibiotic brulamycin. The susceptibility of 12 392 bacterial strains was determined versus brulamycin and the other routinely applied antibacterial preparations in our country and established that, according to that index brulamycin, in vitro, gives way only to amikin. Fifty two patients with severe uroinfections were treated (30 adults and 22 children) and healing (sterilization of urine) was attained in 10 per cent of the adults and 40,9 per cent of the children. Improvement (reduction of the bacterial number to insignificant value) was established in 42,3 per cent of all patients. In parallel with the favourable microbiological indices, improvement or normalization of the clinical and paracminical indices of the uroinfection were also established. The antibiotic is very well tolerated, by children one-year of age, including. With those properties brulamycin should widely be administered in the clinical practice of uroinfection treatment.

[Pleural effusions of neoplastic etiology]. / Plevralni izlivi s neoplastichna etiologiia.

A prospective analysis was made of 50 patients with neoplastic pleural exudation for the period 1977-1979. Twenty five of the patients (50%) are with advanced age (60-75). Bronchogenic carcinoma is the most often primary localization of the neoplastic exudates --26 patients (52%), followed by mammary carcinoma--10 cases (20%). In 76 per cent of the patients the pleural exudation is the first clinical manifestation of the neoplastic disease. In the rest of the cases, the metastatic exudation was manifested by the third year after the diagnosis of primary tumor. Dyspnea is outlined as a leading clinical symptom. The data from the biochemical and cytological studies of the pleural punctate were analyzed. The cytological finding is with the highest diagnostic value for the neoplastic pleural exudates.