Research Interests:
Research Interests:
A multicentre, non-comparative study evaluated the efficacy and safety of the new aminoglycoside isepamicin in hospitalised patients with various infections. Isepamicin was administered once daily with the daily dosage stratified... more
A multicentre, non-comparative study evaluated the efficacy and safety of the new aminoglycoside isepamicin in hospitalised patients with various infections. Isepamicin was administered once daily with the daily dosage stratified according to the severity of infection: 15 mg/kg isepamicin for severe potentially systemic infections (53 patients) or 8 mg/kg isepamicin for less severe and localised infections (56 patients). The largest groups of patients had urinary tract infection (n = 54) or lower respiratory tract infection (n = 31); smaller numbers of patients were enrolled with skin and soft tissue infections (n = 9), intra-abdominal infections (n = 8) or obstetric and gynaecological infections (n = 7). In the patients receiving 15 mg/kg isepamicin, clinical cure or improvement occurred in 19/21 patients with lower respiratory tract infections, 8/13 patients with urinary tract infections, 6/6 patients with skin infections, 5/6 patients with intra-abdominal infections and 6/7 patients with obstetric gynaecological infections. In the patients receiving 8 mg/kg isepamicin, 40 out of 41 patients with urinary tract infections were considered cured or improved as were 8/10 patients with lower respiratory tract infections, 1/3 patients with skin infections and 1/2 patients with intra-abdominal infections. Nine per cent of patients reported at least on adverse event during the study. Two patients (one from each dosage group) discontinued treatment because of adverse events, respiratory disorder and erythematous rash, but neither event was considered to be severe of life threatening No patients had evidence of ototoxicity by pure-tone audiometry and no patients had potentially significant increases in serum creatinine which were considered to be treatment related. The results of this study indicate that treatment with isepamicin once daily is effective and well tolerated in hospitalised adults with various infections.
Research Interests:
Research Interests: Genetics, Microbiology, Molecular Biology, Medical Microbiology, Biology, and 12 moreMedicine, Sequence Analysis, Gene, Plasmids, High Pressure Liquid Chromatography, Serratia marcescens, Serratia, Base Sequence, Plasmid, DNA probes, Molecular Sequence Data, and Pharmacology and pharmaceutical sciences
Research Interests:
Research Interests:
In immunocompromised patients with serious gram-negative aerobic infections of the oral cavity, it is necessary to treat with antibiotics that possess a broad spectrum of activity and that display satisfactory kinetic properties. The... more
In immunocompromised patients with serious gram-negative aerobic infections of the oral cavity, it is necessary to treat with antibiotics that possess a broad spectrum of activity and that display satisfactory kinetic properties. The purpose of the present study was to determine the serum and salivary pharmacokinetics of four new beta-lactam antibiotics: cefoxitin, cefotaxime, moxalactam and aztreonam. A total of 20 adult surgical in-patients (14 males and 6 females) were randomly assigned treatment by one of the four antibiotics. Each antibiotic was administered IV at a dose of 2 g IV every 8 hours. Serum and saliva levels were measured by the agar diffusion method .5, 2, 4, 6 and 8 hours after the third dose. The salivary concentrations of the four antibiotics were low, but, with the exception of cefoxitin, would be adequate to treat most infections of the oral cavity caused by enterobacteriaceae. No correlation was found between the antibiotic levels in the serum and the levels in the saliva.
Research Interests:
Mucormycosis is an invasive fungal infection caused by fungi of the order Mucorales, mainly affecting immunocompromised patients. Cutaneous mucormycosis is the third most common clinical form of the disease, after pulmonary and... more
Mucormycosis is an invasive fungal infection caused by fungi of the order Mucorales, mainly affecting immunocompromised patients. Cutaneous mucormycosis is the third most common clinical form of the disease, after pulmonary and rhino-cerebral. The usual factors predisposing to this infection are hematological malignancies and diabetes mellitus, but a significant proportion of patients are immunocompetent. The agents of mucormycosis are ubiquitous in nature and are transmitted to the skin by direct inoculation, as a result of various types of trauma. These include needle sticks, stings and bites by animals, motor vehicle accidents, natural disasters, and burn injuries. The typical presentation of mucormycosis is the necrotic eschar, but it can present with various other signs. The infection can be locally invasive and penetrate into the adjacent fat, muscle, fascia, and bone, or become disseminated. Diagnosis is difficult because of the nonspecific findings of mucormycosis. Biopsy and culture should be performed. The treatment of mucormycosis is multimodal and consists of surgical debridement, use of antifungal drugs (amphotericin B and posaconazole), and reversal of underlying risk factors, when possible. Mortality rates, although lower than in other forms of the disease, are significant, ranging from 4% to 10% when the infection is localized.
Research Interests:
Ro 13-9904, a new broad-spectrum, beta-lactamase-resistant, cephalosporin, was given as a single i.m. injection at doses of 500, 250, and 125 mg in 3 groups of male patients each consisting of 10, 6, and 6 patients respectively, suffering... more
Ro 13-9904, a new broad-spectrum, beta-lactamase-resistant, cephalosporin, was given as a single i.m. injection at doses of 500, 250, and 125 mg in 3 groups of male patients each consisting of 10, 6, and 6 patients respectively, suffering from uncomplicated acute but recurrent gonococcal urethritis. All patients were cured both clinically and bacteriologically without relapsing after a 7-day follow-up. 11 patients suffering from chronic urinary tract infections without flow obstruction but with underlying chronic pyelonephritis in 6, were treated for 7 days with 500 mg of Ro 13-9904 i.m., every 12 h. E. coli and P. mirabilis were the main isolated pathogens. Treatment was successful in all with only one bacteriological relapse during the follow-up period. The drug's tolerance was satisfactory except for moderate local pain in most of the patients.
Research Interests: Chemotherapy, Medicine, Humans, Escherichia coli, Chronic Disease, and 15 moreMale, Klebsiella, Pseudomonas, Cephalosporins, Antibiotics, Aged, Antibacterial activity, Middle Aged, Adult, Microbial Sensitivity Tests, Bacterial infections, Bacteroides Fragilis, Proteus, Pharmacology and pharmaceutical sciences, and gonorrhea
Research Interests:
ABSTRACT This study investigated the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in infected and uninfected diabetic foot ulcers of 84 patients with the two types of diabetes. S. aureus was the most common pathogen... more
ABSTRACT This study investigated the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in infected and uninfected diabetic foot ulcers of 84 patients with the two types of diabetes. S. aureus was the most common pathogen among the Gram-positive bacteria isolated from ulcers, and almost 50% of S. aureus isolates were MRSA. The prevalence of MRSA was significantly higher in patients with infected foot ulcers. MRSA infection or colonisation was not associated with factors (previous hospitalisation, use of antibiotics, etc.) known to predispose to MRSA colonisation or infection. The high prevalence of MRSA in patients with foot ulcers may reflect the increased prevalence of MRSA in the community.
Research Interests:
Research Interests:
Research Interests: Microbiology, Medical Microbiology, Medicine, Humans, Internal Medicine, and 15 moreFemale, Pneumonia, Male, Pseudomonas aeruginosa, Antibiotics, Aged, Middle Aged, Anti-Bacterial Agents, Adult, Time Factors, Bacterial infections, Pseudomonas Aeruginosa, Aztreonam, Exacerbation, and Pharmacology and pharmaceutical sciences
A three day oral antibiotic course was given to 71 elderly bacteriuric subjects with no or only moderate mobility problems. Seven of 17 men (41%) and 34 of 54 women (63%) had strongly positive antibody coated bacteria (ACB) in the urine.... more
A three day oral antibiotic course was given to 71 elderly bacteriuric subjects with no or only moderate mobility problems. Seven of 17 men (41%) and 34 of 54 women (63%) had strongly positive antibody coated bacteria (ACB) in the urine. Following sensitivity tests and randomization one of the following agents was given: cefadroxil 1 g tid (13 subjects): co-trimoxazole 160/800 mg bd (23 subjects); or norfloxacin 400 mg bd (35 subjects). One week after therapy urines were negative in 13 men (76.5%) and 37 women (68.5%). Patients who were fully mobile and/or were ACB(-) responded better than those with moderate mobility problems or who were ACB(+). At six months, urines were negative in six (40%) of 15 men and 15 (33.3%) of 45 women. Two men and six women of these 21 subjects had a positive urine at one month. Of the three agents tested cefadroxil was less effective in women. The study indicates that a three day course will clear bacteriuria in about 70% of patients at one week, but only about 25% will remain free of infection at six months; these are usually patients with adequate mobility and normal renal function.
Research Interests: Microbiology, Medical Microbiology, Medicine, Greece, Humans, and 15 moreInternal Medicine, Old Age, Escherichia coli, Female, Male, Urine, Antimicrobial chemotherapy, Renal Function, Antibiotics, Aged, Anti-Bacterial Agents, Norfloxacin, Skilled Nursing Facilities, Pharmacology and pharmaceutical sciences, and Antibiotic Therapy
Research Interests:
Research Interests:
The pharmacokinetics of the maxillary sinus fluid were studied in 42 patients (26 males and 16 females), suffering from chronic maxillary sinusitis, after oral administration of 0.5g or 1g cefaclor. A thin plastic catheter, for sinus... more
The pharmacokinetics of the maxillary sinus fluid were studied in 42 patients (26 males and 16 females), suffering from chronic maxillary sinusitis, after oral administration of 0.5g or 1g cefaclor. A thin plastic catheter, for sinus secretion sampling, was inserted in the sinus cavity and remained in place throughout the study. Sinus fluid levels of cefaclor (0.5g), measured by agar and well-diffusion microbiological method, ranged between 0.17-0.19, 0.28-0.42, 0.18-0.22 and 0.12-0.16 microgram/ml at 2, 4, 6 and 8 hour intervals respectively. Levels ranging between 0.15-0.26, 0.37-0.90, 0.23-0.27 and 0.16-0.19 microgram/ml were found after the administration of 1g cefaclor at the same time intervals respectively. Higher levels were found in purulent nasal material than in cystic fluid aspirates.
Research Interests:
Research Interests:
Research Interests: Expert testimony, Evidence Based Medicine, Adolescent, Humans, Child, and 15 moreEurope, Candida, Fluconazole, Candidiasis, Clinical Sciences, European, Adult, Antifungal Agents, Aspergillosis, GuideLine, Echinocandin, Hematopoietic Stem Cell Transplantation, Haematopoietic stem cell transplantation, Child preschool, and Hematologic neoplasms
Research Interests:
In an open randomized study the safety, efficacy and kinetics of a twice-daily amikacin (7.5 mg/kg bd) regimen (group A) was compared with a once-daily dosage (15 mg/kg) schedule (group B). Thirty patients were enrolled in each group.... more
In an open randomized study the safety, efficacy and kinetics of a twice-daily amikacin (7.5 mg/kg bd) regimen (group A) was compared with a once-daily dosage (15 mg/kg) schedule (group B). Thirty patients were enrolled in each group. They were suffering from urinary tract infections (37), respiratory tract infections (17), soft-tissue infections (3), exacerbation of chronic prostatitis (1), acute cholangitis (1) and abdominal abscess (1). Aggravating factors were present in 77% and 60% of the groups respectively. The pathogens isolated included strains of various Enterobacteriaceae (53) and Pseudomonas aeruginosa (10) In 76.7 vs 97% (P less than 0.05) the clinical result was satisfactory with pathogen eradication in 80 vs 86.7%. However, there were proportionately more patients in the 7.5 mg/kg bd regimen with respiratory tract infection (40 vs 13%) and fewer patients with urinary tract infections (40 vs 80%). Mild and transient nephrotoxicity and ototoxicity was observed in five and three patients respectively. More patients in group B had amikacin trough concentrations less than or equal to 5 mg/l and peak levels greater than 40 mg/l (P less than 0.001) as well as serum bactericidal titres greater than or equal to 1:16 (P less than 0.05) without significant serum amikacin accumulation over time. It is concluded that amikacin administered once daily is well tolerated and provides better serum bactericidal activity than the twice-daily regimen.
Research Interests: Microbiology, Gastroenterology, Medical Microbiology, Medicine, Hearing, and 15 moreHumans, Internal Medicine, Kidney, Female, Male, Enterobacteriaceae, Antimicrobial chemotherapy, Aged, Middle Aged, Adult, Microbial Sensitivity Tests, Bacterial infections, Pseudomonas Aeruginosa, Exacerbation, and Pharmacology and pharmaceutical sciences
Research Interests: Expert testimony, Evidence Based Medicine, Adolescent, Medicine, Clinical Microbiology, and 15 moreHumans, Child, Europe, Candida, Candidiasis, Infant, Antifungal, Clinical Sciences, Adult, Antifungal Agents, Microbial Sensitivity Tests, Intensive Care Medicine, Biological markers, GuideLine, and Child preschool
Research Interests:
Research Interests:
Research Interests:
The in vivo interactions of the aminoglycosides gentamicin and amikacin with the newer cephalosporins cefotaxime, ceftriaxone, ceftazidime and moxalactam were studied in 48 volunteers (28 males, 20 females, median age 54) who consented to... more
The in vivo interactions of the aminoglycosides gentamicin and amikacin with the newer cephalosporins cefotaxime, ceftriaxone, ceftazidime and moxalactam were studied in 48 volunteers (28 males, 20 females, median age 54) who consented to participate in the trial. Patients were divided in eight groups according to all possible aminoglycoside/cephalosporin combinations. The in vivo trial was developed in two phases: aminoglycoside alone vs. aminoglycoside/cephalosporin. Each patient served as his own control. The differences in the aminoglycoside blood levels between the two phases were not statistically significant, except at the first post-dose hour in the gentamicin-ceftriaxone combination and at the first and sixth post-dose hours in the amikacin-moxalactam combinations. The in vitro interactions of the same combinations were partly correlated with the in vivo findings.
Research Interests: Pharmacology, Drug interactions, Medicine, Humans, Female, and 12 morePubmed, Male, Cephalosporins, Antibiotics, Aged, Middle Aged, In Vivo, Adult, Cefotaxime, Gentamicins, Ceftazidime, and Gentamicin
Research Interests:
Research Interests:
Research Interests:
Research Interests:
There are concerns that the financial crisis in Greece negatively affected the management of invasive fungal infections (IFIs) among patients with hematological malignancies (HM). A working group (WG) was formed to explore the situation... more
There are concerns that the financial crisis in Greece negatively affected the management of invasive fungal infections (IFIs) among patients with hematological malignancies (HM). A working group (WG) was formed to explore the situation and make recommendations. A questionnaire was created and distributed to physicians caring for patients with HM, to gather information in a standardized manner on prescribing physicians, patient characteristics, availability of diagnostics, antifungal treatment practices and the conditions and particularities of Greek hospitals. A total of 141 physicians from 36 hematology units and laboratories located in 26 Greek hospitals participated. Regarding hospitalization conditions, only 56% reported that their patients were treated in isolated single or double bed rooms, 22% reported availability of HEPA filters, 47% reported construction works in progress, and an alarming 18% reported the presence of birds on open windows. Regarding diagnosis, only 31% re...
Research Interests:
Research Interests: Psychology, Education, Family Medicine, Standards, Medicine, and 15 moreCurriculum, Competency, Antimicrobial Stewardship, Europe, Consensus, Delphi, Clinical microbiology and infection control, Prescription, Clinical Sciences, Delphi method, Clinical Competence, Professional Competence, Elsevier, Likert Scale, and Drug prescriptions
To test whether longer duration of treatment of asymptomatic bacteriuria in old age could improve the efficacy of cotrimoxazole therapy, three regimens were given to 75 ambulant bacteriuric residents of a retirement home, aged greater... more
To test whether longer duration of treatment of asymptomatic bacteriuria in old age could improve the efficacy of cotrimoxazole therapy, three regimens were given to 75 ambulant bacteriuric residents of a retirement home, aged greater than or equal to 68 years. The groups and regimens were: A:23 subjects (160/800 mg b.i.d. orally x 3 days). B: 24 subjects (160/800 mg i.m. x 10 days); C: 28 subjects (160/800 mg b.i.d. orally x 20 days). One week, one month and five months post-therapy urines were negative in 78.3% vs 52.9% vs 42.9% of group A, in 54.2% vs 56.5% vs 50% of group B and in 57.1% vs 60.7% vs 68% of group C subjects respectively. The data indicate that: 1) the efficacy of any schedule is only moderate irrespective of the presence of antibody-coated bacteria in urine; 2) a 3-day course appears more effective at one week post-therapy; 3) at one and five months greater than or equal to 50% of the subjects were infection-free, the 20 day treatment resulting in fewer failures; 4) subjects with long-term eradication had no mobility problem, low serum creatinine and a normal urinary tract as seen by ultrasound.
Research Interests:
Research Interests:
Infections caused by carbapenemase-producing Enterobacteriaceae are increasing worldwide, especially in ICUs, and have been associated with high mortality rates. However, unequivocally demonstrating causality of such infections to death... more
Infections caused by carbapenemase-producing Enterobacteriaceae are increasing worldwide, especially in ICUs, and have been associated with high mortality rates. However, unequivocally demonstrating causality of such infections to death is difficult in critically ill patients because of potential confounding and competing events. Here, we quantified the effects of carbapenemase-producing Enterobacteriaceae carriage on patient outcome in two Greek ICUs with carbapenemase-producing Enterobacteriaceae endemicity. Observational cohort study. Two ICUs with carbapenemase-producing Enterobacteriaceae endemicity. Patients admitted to the ICU with an expected length of ICU stay of at least 3 days were included. None. Carbapenemase-producing Enterobacteriaceae colonization was established through screening in perineum swabs obtained at admission and twice weekly and inoculated on chromogenic plates. Detection of carbapenemases was performed phenotypically, with confirmation by polymerase chai...
Research Interests: Epidemiology, Critical Care Medicine, Colonization, Humans, Female, and 15 moreEnterobacteriaceae, Clinical Sciences, Apache, Aged, Age Factors, Acinetobacter baumannii, Intensive Care Units, Hospital Mortality, Critical Illness, Beta Lactamases, Cohort Studies, Competing risks, Carrier state, Klebsiella pneumonia, and Cross Infection
1-Cyclopropyl-6-fluoro-1-dihydro-4-oxo-7-(1-piperazinyl)-1,4-dihydro-3- quinolinecarboxylic acid (ciprofloxacin, Bay-o 9867) a new quinoline carboxylic acid derivative, was tested in vitro against 233 various Gram-negative microorganisms,... more
1-Cyclopropyl-6-fluoro-1-dihydro-4-oxo-7-(1-piperazinyl)-1,4-dihydro-3- quinolinecarboxylic acid (ciprofloxacin, Bay-o 9867) a new quinoline carboxylic acid derivative, was tested in vitro against 233 various Gram-negative microorganisms, mostly resistant to nalidixic acid. Minimal inhibitory concentrations (MIC) against the Enterobacteriaceae and P. aeruginosa ranged between less than 0.003 to 1 mg/l and less than 0.003 to 8 mg/l respectively with MIC90 of 2 mg/l. However, when sensitivities were repeated with an acid broth they were increased by greater than or equal to 32 fold. This effect was more prominent when as nutrient pooled human urine was used and particularly for P. aeruginosa strains. Ciprofloxacin at a dose of 250 mg, or 500 mg, 12-hourly for 10 days was randomly given to 40 patients aged 23-76 years, suffering from upper (27) and lower (13) urinary tract infections (UTI) as proved from the "antibody coated bacteria" (ACB) test. Pathogens included E. coli (2...
Research Interests: Microbiology, Medicine, Drug, Humans, Female, and 15 moreMale, Bacteria, Enterobacteriaceae, Pseudomonas aeruginosa, Antibiotics, Aged, Middle Aged, Adult, Microbial Sensitivity Tests, Bacterial infections, Pseudomonas Aeruginosa, Ciprofloxacin, Nalidixic acid, Pharmacology and pharmaceutical sciences, and In Vitro Techniques
Ceftriaxone (Ro 13-9904, Rocephin) was given to 67 patients suffering from 74 various infections. Patients had infections of the urinary tract (36), soft tissue phlegmon (12), infections of the respiratory tract (13), osteomyelitis (7),... more
Ceftriaxone (Ro 13-9904, Rocephin) was given to 67 patients suffering from 74 various infections. Patients had infections of the urinary tract (36), soft tissue phlegmon (12), infections of the respiratory tract (13), osteomyelitis (7), abscesses (5) and meningitis (1). Infecting organisms were E. coli (26), Proteus spp. (20), P. aeruginosa (7), H. influenzae (6), Enterobacter spp. (6), K. pneumoniae (3), C. freundii (2), S. marcescens (1), S. aureus (4), S. pneumoniae (2), Peptostreptococcus spp. (4) and Clostridium spp. (1). The organisms were often multiresistant. Dosage ranged from 1-2 g once or twice daily i.m. or i.v. The clinical response was excellent in 56 infections (75.6%) while 13 (17.6%) infections were improved and in 5 (6.8%) treatment failed. The pathogen was eradicated in 63 (85.1%), and relapsed in 3 (4.0%) while bacteria persisted in 11 (14.9%). No appreciable side effects or toxicity were observed. Sputum, bile, cerebrospinal fluid and prostatic fluid kinetics re...
Research Interests:
In 1979, seven years after introduction of gentamicin into the greek market, resistance in Pseudomonas aeruginosa rose in Laiko General Hospital to an incidence of 55% of the isolates. Gentamicin then was the first line antibiotic. In... more
In 1979, seven years after introduction of gentamicin into the greek market, resistance in Pseudomonas aeruginosa rose in Laiko General Hospital to an incidence of 55% of the isolates. Gentamicin then was the first line antibiotic. In 1983, three years after amikacin was brought onto the market and while it represented 3/5 of all aminoglycoside consumption, resistance against it in strains of Pseudomonas rose suddenly to 23%. However, amikacin prescription was not restricted and, in 1985, resistance rate, including all aminoglycosides and the 3rd generation cephalosporins, exceeded 50%. By analysing all available data, it was evident that: Urine predominates in the isolation of multiresistant strains, while in 1/2 of bacteraemias amikacin-resistant strains are implicated. The ICU is the most common source of isolation and similar strains are spread in all hospital wards. Multiresistant strains are virulent since they were incriminated for a 11% death rate. In 60% of amikacin resista...
Research Interests:
Research Interests:
Research Interests: Pharmacology, Microbiology, Medical Microbiology, Biology, Infectious Diseases, and 13 moreMedicine, Antibiotic Resistance, Journal Article, Antimicrobial chemotherapy, Pulsed field gel electrophoresis (PFGE), Medical Pharmacology, Population Study, Carbapenemases, ESBLs, Klebsiella pneumoniae, Multilocus sequence typing, Enterobacter cloacae, and Pharmacology and pharmaceutical sciences
A total of 132 infections of Pseudomonas aeruginosa (including 112 imipenem resistant, 32 of them producing VIM-2 beta-lactamase) were identified during a one-year period (June 2002-June 2003). PFGE molecular typing revealed that P.... more
A total of 132 infections of Pseudomonas aeruginosa (including 112 imipenem resistant, 32 of them producing VIM-2 beta-lactamase) were identified during a one-year period (June 2002-June 2003). PFGE molecular typing revealed that P. aeruginosa clinical isolates sensitive to imipenem, P. aeruginosa isolates resistant to imipenem but VIM-negative, and P. aeruginosa-resistant and VIM-positive isolates could be allocated to three different clusters with approximately 70% similarity. A case control study of patients infected with an MBL-producing imipenem-resistant P. aeruginosa isolate and controls (patients hospitalized in the same time period with no infection), revealed that only the number of catheters present at the time of the infection was strongly associated with the development of infection due to VIM-producing P. aeruginosa (OR 4.83, 95% CI: 1.94-12.0). In conclusion, the results of the molecular typing combined with the results of the case control study indicate that in the specific hospital setting, infection control, addressed specifically to critically ill patients, is an important part of any strategy to reduce imipenem-resistant infections.
Research Interests: Microbiology, Chemotherapy, Medicine, Molecular Epidemiology, Greece, and 13 morePhylogeny, Humans, TYPING, Pseudomonas aeruginosa, Anti-Bacterial Agents, Pulsed field gel electrophoresis (PFGE), Pseudomonas Aeruginosa, Imipenem, Beta Lactamases, Case Control Studies, beta-Lactam Resistance, Pharmacology and pharmaceutical sciences, and Cross Infection
Research Interests:
Research Interests: Microbiology, Medicine, Humans, Female, Gynecology and Obstetrics, and 10 morePolymerase Chain Reaction, Obstetrics and Gynaecology, Mycoplasma, Bacterial Vaginosis, Ureaplasma Urealyticum, Mollicutes, Cross Sectional Studies, Predictive value of tests, Ureaplasma, and Paediatrics and reproductive medicine
Research Interests:
Research Interests:
The ability of oral pefloxacin to penetrate into maxillary sinus cavity and nasal secretions was studied in 39 patients suffering from an exacerbation of chronic maxillary sinusitis. The mean levels of pefloxacin in sinus aspirate fluid... more
The ability of oral pefloxacin to penetrate into maxillary sinus cavity and nasal secretions was studied in 39 patients suffering from an exacerbation of chronic maxillary sinusitis. The mean levels of pefloxacin in sinus aspirate fluid 0, 3, 6, 9 and 12 h after the second oral dose of 400 mg were 2.30, 6.92, 3.74, 3.47 and 2.82 mg/l respectively. In sinus cystic fluid (macroscopically non-purulent) the mean pefloxacin levels were 2.30, 7.15, 4.20 and 4.15 mg/l respectively, and in nasal secretion 1.90, 9.05, 3.71, 3.20 and 2.85 mg/l respectively. The mean pefloxacin levels in serum obtained simultaneously were 1.50, 5.00, 3.10, 2.70 and 2.20 mg/l respectively. It is concluded that pefloxacin accumulates in inflamed sinus fluid at concentrations exceeding blood levels.
Research Interests: Medicine, Biological Sciences, Humans, Chronic Disease, Female, and 15 moreMale, Middle Aged, Sinusitis, Adult, Nasal cavity, Maxillary Sinus, Streptococcus, Staphylococcus, Nasal Mucosa, Mucociliary Clearance, Haemophilus influenzae, maxillary sinusitis, Exacerbation, Pefloxacin, and Medical and Health Sciences
Research Interests:
Research Interests: Incidence Geometry, Adolescent, Greece, Humans, Internal Medicine, and 15 moreHospitalization, Female, Candida, Clinical microbiology and infection control, Clinical Sciences, Aged, Candida parapsilosis, Adult, Antifungal Agents, Candidemia, Elsevier, Central Venous Catheters, Case Control Studies, Agammaglobulinemia, and Hematologic neoplasms
In a prospective randomized study ofloxacin (400 mg orally once daily) versus co-trimoxazole (320/1,600 mg orally once daily) were given for 3 weeks in 30 and 22 elderly semimobile patients respectively, suffering from asymptomatic... more
In a prospective randomized study ofloxacin (400 mg orally once daily) versus co-trimoxazole (320/1,600 mg orally once daily) were given for 3 weeks in 30 and 22 elderly semimobile patients respectively, suffering from asymptomatic bacteriuria. From the obtained results it was evident that: (a) ofloxacin was superior to co-trimoxazole regarding eradication of bacteriuria (p less than 0.05) particularly in patients with a positive antibody-coated bacteria test; (b) a high rate of superinfections and reinfections with strains resistant to co-trimoxazole was observed in both groups indicative of hidden underlying conditions predisposing to urinary tract infections and (c) ofloxacin did not accumulate in serum during prolonged therapy but the half-life ranged between 8.3 and 10.2 h.
Research Interests:
Temafloxacin is a new antibacterial agent of the fluoroquinolone group. In comparison with ciprofloxacin, the current leading quinolone, temafloxacin shows higher and longer lasting plasma concentrations after equivalent doses due to an... more
Temafloxacin is a new antibacterial agent of the fluoroquinolone group. In comparison with ciprofloxacin, the current leading quinolone, temafloxacin shows higher and longer lasting plasma concentrations after equivalent doses due to an almost complete gastrointestinal absorption and a lower total clearance. Temafloxacin absorption is little influenced by food intake. Concomitant administration of antacids should be avoided; a time interval of at least 2 hours should elapse between intake of either quinolone and an antacid. Both quinolones are excreted mainly by the kidney. They differ in tubular secretion, which is high for ciprofloxacin and low for temafloxacin. The overall nonrenal elimination is similar for both compounds. Ciprofloxacin has a slightly higher extent of metabolism, while temafloxacin probably has a higher transintestinal elimination. The biliary excretion of both compounds is in the same range. The longer half-life of temafloxacin enables a once-daily dose regimen, whereas the usual recommended dosage of ciprofloxacin is twice daily. For both quinolones the apparent volumes of distribution per body weight are significantly above unity, indicating good tissue penetration with intracellular uptake. The concentrations in the extracellular fluids are directly related to the corresponding plasma concentrations. The penetration of temafloxacin into the body fluids investigated--tears, nasal secretion, saliva, sweat, prostatic and seminal fluid--in general exceeds that of ciprofloxacin (with the exception of seminal fluid). Unlike ciprofloxacin, there is no drug interaction with methylxanthines. Comparative clinical studies reflecting the complex interrelating factors of host and pathogens are needed to demonstrate the significance of the pharmacokinetic differences between temafloxacin and ciprofloxacin.