cefotaxime and Burns

The results of the clinical and laboratory study of the efficacy of the prophylactic and therapeutic use of cefodizime (modivid) in patients with chronic calculous cholecystitis and burns are presented. Expediency of the preoperative prophylactic use of the drug and its significance in the treatment of infectious complications of the burn disease were verified. The immunological investigation gave evidence of an increase of the phagocytosis functional activity when cefodizime (modivid) was used prophylactically in cholecystectomy.

Topics: Adolescent; Adult; Aged; Antibiotic Prophylaxis; Antibody Formation; Burns; Cefotaxime; Cephalosporin Resistance; Cephalosporins; Cholecystitis; Cholelithiasis; Colony Count, Microbial; Humans; Immunity, Cellular; Male; Middle Aged; Surgical Wound Infection

Three of seven clonally related Pseudomonas aeruginosa strains isolated from a burn patient produced the extended-spectrum beta-lactamase (ESBL) SHV-12. Its gene was flanked by two IS26 elements with a large transposon (>24 kb). The transposon also contained at least five IS26 elements and a gene encoding the amikacin resistance determinant aminoglycoside 6'-N-acetyltransferase type Ib [aac(6')-Ib]. It was inserted into the gene PA5317 in the P. aeruginosa chromosome.

Topics: Adult; beta-Lactamases; Burns; DNA Transposable Elements; Female; Humans; Microbial Sensitivity Tests; Polymerase Chain Reaction; Pseudomonas aeruginosa

Antibiotic prophylaxis is a routine procedure in management of burns. As such it is a safe practice, yet unusual complications can occur with the use of even safest antibiotics and their emergency management may be life saving. Here we present a case of 35% second and third degree burns who was taken for a second sitting of stamp grafting for remnant raw areas, who was administered intraoperative prophylactic antibiotic, developed a series of unusual complications sequentially, which were life threatening. Prompt recognition of signs and symptoms of adverse reactions of the drug used and timely management resulted in the successful outcome. A good team effort by surgeon, anaesthetist and the physician was mandatory.

Topics: Adult; Anaphylaxis; Antibiotic Prophylaxis; Burns; Cefotaxime; Cephalosporins; Disseminated Intravascular Coagulation; Drug Hypersensitivity; Female; Humans; Injections, Intravenous; Postoperative Hemorrhage; Skin Transplantation

To investigate bacterial resistance to antimicrobial agents in the background of extensive employment of third-generation cephalosporins in the treatment of burn infection.. Bacterial susceptibility testing was carried out using Kirby-Bauer method.. Out of 259 Gram negative bacilli isolates, 31% of these strains were all resistant to cefotaxime, ceftriaxone, cefoperazone and ceftazidime. In vitro test, susceptibility of 52% third-generation cephlosporins resistant strains were restored by cefoperazone/sulbactum. 23.8% of P. aeruginosa were resistant to imipenem, 51.2% to ciprofloxacin. 28.6% of A. anitratum were resistant to imipenem, 21.4% to ciprofloxacin. 9.9% of enterobacteriaceae were resistant to imipenem, 20.4% to ciprofloxacin. 26.9% of MRSA were resistant to imipenem, 73% to ciprofloxacin. No norvancomycin resistance was detected. 2.7% of E. faecalis were resistant to norvancomycin.. It is likely that the observed resistance to third-generation cephalosporins may be partially due to chromosome-mediated type-1 beta- lactamase.

Topics: Burns; Cefoperazone; Cefotaxime; Ceftriaxone; Cephalosporins; Drug Resistance, Microbial; Humans; Pseudomonas aeruginosa; Wound Infection

The concentrations of tobramycin (TOB) or cefmenoxime (CMX) in serum and burn blister fluid of 51 burn patients (21 for TOB, 30 for CMX) after an i.v. or i.m. injection were determined to find the optimal administration of TOB (2 mg/kg) or CMX (50 mg/kg). Among the various protocols tested, we found from the values of tAUC for TOB that a bolus i.v. injection, or 1-h drip infusion, or i.m. injection are recommended for systemic sepsis, however, the 1-h drip infusion is strongly suggested for treating wound surface infection. It has also been found that with CMX a bolus i.v. injection with a long period of efficacy is recommended for treating systemic sepsis, while a 1-h drip infusion or bolus i.v. injection was the best method for treating wound-surface infection.

Topics: Adult; Aged; Bacterial Infections; Burns; Cefmenoxime; Cefotaxime; Female; Humans; Infusions, Parenteral; Injections, Intramuscular; Injections, Intravenous; Male; Middle Aged; Tobramycin

Pharmacokinetic and clinical studies on cefotaxime (CTX) in plastic and reconstructive surgery field were carried out. The results obtained are summarized as follows. Two grams of CTX was administered intravenously by single bolus injection to each of 4 patients with burn blisters and mean levels of CTX concentration in blister exudates were investigated. Thirty minutes after administration, the mean level of CTX in the exudates was 3.90 micrograms/ml and it reached a peak of 9.81 micrograms/ml in 2 hours. The clinical efficacy rate for 30 patients with burn infections and postoperative infections was 73.3%, and the efficacy rate for 29 patients in prophylactic use was 72.4%. A side effect (eruption) and abnormal laboratory findings were observed in each one case out of 59. From the above results, CTX may be considered to be useful in plastic and reconstructive surgical treatments.

Topics: Adolescent; Adult; Aged; Bacteria; Bacterial Infections; Burns; Cefotaxime; Child; Drug Resistance, Microbial; Exudates and Transudates; Female; Humans; Kinetics; Male; Middle Aged; Postoperative Complications; Surgery, Plastic

Transfer of cefmenoxime (CMX) into the burn blister fluids was studied in 10 burned patients with 2 administrated doses (25, 50 mg/kg). CMX concentrations in serum and burn blister fluid after 1 hour intravenous drip infusion were measured using Proteus mirabilis ATCC 21100 as the test organism grown in the DST agar medium. In the case of CMX 25 mg/kg dose, the peak serum concentration was observed 61.5 micrograms/ml at 1 hour, while the peak burn blister fluid concentration was observed 15.2 micrograms/ml at 2 hours. Pharmacokinetic parameters of serum concentration calculated were 1.02 hours as half-life (beta) and 0.42 L/kg as distribution volume, respectively. In the case of CMX 50 mg/kg dose, the peak serum concentration was observed 122.0 micrograms/ml at 1 hour and the peak burn blister fluid concentration was observed 40.8 micrograms/ml at 2 hours. Pharmacokinetic parameters of serum concentration calculated were 1.27 hours as half-life (beta) and 0.55 L/kg as distribution volume. From this study, the dose dependency between 25 mg/kg dose and 50 mg/kg dose in serum and in burn blister fluid is recognized.

Topics: Adolescent; Adult; Blister; Burns; Cefmenoxime; Cefotaxime; Dose-Response Relationship, Drug; Exudates and Transudates; Female; Humans; Infusions, Parenteral; Kinetics; Male; Middle Aged; Models, Biological

Effective and safe antibiotic control combined with surgical measures is the mainstay of the management of serious sepsis in burn wounds. To determine the effects of the third-generation cephalosporins on the clinical and bacteriological course of burn sepsis, 30 adult patients with a comparable degree of burn sepsis were treated with cefatriaxon (Ro 13-9904 (Rocephin); Roche). No significant side-effects were observed, and clinical observation showed a marked to moderate improvement in wound sepsis in 26 cases. Of 61 wound cultures obtained after completion of the course of cefatriaxon, only 19 yielded a positive growth. The beneficial role of the third-generation cephalosporins indicated by this prospective trial could be very important in the management of extensive burn wound sepsis.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Burns; Cefotaxime; Ceftriaxone; Female; Humans; Male; Middle Aged

Topics: Burns; Cefotaxime; Cephalosporins; Child; Drug Resistance, Microbial; Endocarditis, Bacterial; Enterobacteriaceae Infections; Female; Humans; Sepsis; Serratia marcescens; Tricuspid Valve