netilmicin and Rectal-Diseases

Schönlein-Henoch purpura is a well known syndrome, rare in adults, and is seldom accompanied with extensive colorectal haemorrhage. In abdominal purpura, the small bowel is more frequently involved, but cases of oesophageal, gastroduodenal and colorectal localisation also have been reported. The cases with colorectal bleeding, appearing in adulthood and elderly patients, could cause differential diagnostic problems. Described endoscopic features of one patient, who was referred to our department, because of colorectal bleeding. The treatment, course of disease and endoscopic follow-up is presented. No previous endoscopic documentation of this type of localisation has been reported in Hungarian literature, so far.

Topics: Aged; Colonic Diseases; Colonoscopy; Doxycycline; Female; Gastrointestinal Hemorrhage; Humans; IgA Vasculitis; Methylprednisolone; Netilmicin; Rectal Diseases; Sigmoidoscopy

Pharmacokinetics and tissue penetration of netilmicin were studied after the use of a single dose (6 mg/kg) given for antibioprophylaxis in colo-rectal surgery. Thirteen patients, scheduled for elective surgery, were given 6 mg/kg IV netilmicin over 30 min, together with 1000 mg IV ornidazole. Netilmicin peak serum concentration (10 min after end of infusion) was 24.4 +/- 3.4 mg/l and trough level (24 h) was 0.9 +/- 0.5 mg/l. Plasma elimination half-life was 409 +/- 70 min, le volume apparent volume of distribution was 38 +/- 101 and total body clearance was 0.07 +/- 0.02 ml/min. Adequate netilmicin levels (5 greater than or equal to CMI 90 of involved pathogens Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus) were obtained in 100 per cent of patients in abdominal wall and epiploid fat, at time of opening, and in colonic wall at time of anastomosis. Adequate levels were obtained at time of closure in abdominal wall and epiploid fat in 92 to 100 per cent of patients. In situation of allergy to beta-lactam antibiotics, the use of netilmicin in combination with ornidazole may be recommended.

Topics: Aged; Bacterial Infections; Colonic Diseases; Female; Fluorescence Polarization; Humans; Male; Middle Aged; Netilmicin; Preoperative Care; Rectal Diseases; Surgical Wound Infection