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  • 1
    Electronic Resource
    Electronic Resource
    Outbreaks of Staphylococcus aureus infections during treatment of late onset pneumonia with ciprofloxacin in a prospective, randomized study (1998)
    Springer
    Intensive care medicine 24 (1998), S. 1327-1330 
    Details
    ISSN: 1432-1238
    Keywords: Key words Nosocomial pneumonia ; S. aureus ; Superinfection ; Ciprofloxacin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We carried out a prospective, randomized four-center study in nosocomial pneumonia to evaluate the clinical and microbiological efficacy and safety of different treatment regimens in adult intensive care patients. During the randomized treatment of 18 patients with late onset pneumonia, ciprofloxacin (CIP) was compared to ceftazidim plus gentamicin (CAZ/GM), outbreaks of Staphylococcus aureus infections occurred in center 1. This article reports the unexpected findings. In the CIP group six out of ten patients were superinfected or reinfected with ciprofloxacin-resistant pathogens at the follow-up on day 5 after treatment. Four out of these six patients were superinfected with methicillin-susceptible or methicillin-resistant S. aureus (MRSA). Four superinfected patients died with pneumonia during treatment or before the follow-up. In the CAZ/GM group one out of eight patients was superinfected with MRSA. One patient died with pneumonia during treatment. There was no problem with multiresistant S. aureus or MRSA before the study period in center 1. In conclusion, we observed outbreaks of S. aureus infections during the treatment of late onset pneumonia with ciprofloxacin, which were associated with a high mortality. These superinfections occurred in mechanically ventilated, postoperative cardiac surgical patients after 13 days in the intensive care unit (ICU). We recommend combining ciprofloxacin with an antibiotic agent active against gram-positive bacteria in ventilator-associated pneumonia after a prolonged ICU stay. Selective pressure of ciprofloxacin could have played a role in these superinfections.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050770
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  • 2
    Electronic Resource
    Electronic Resource
    234. Zur Prognose des perforierten Magen-Duodenal-Ulcus (1979)
    Springer
    Langenbeck's archives of surgery 349 (1979), S. 581-581 
    Details
    ISSN: 1435-2451
    Keywords: Gastric ulcer ; Duodenal ulcer ; Simple closure ; Magenulcusperforation ; Duodenalulcusperforation ; Übernähung
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 82 Patienten wurden zwischen 1968 und 1974 wegen Magen-Duodenal-Ulcusperforation durch Übernähung versorgt. Die postoperative Letalität betrug 12,2 % und zeigte deutliche Abhängigkeit von Lebensalter, Perforationszeit und Dauer der Ulcusanamnesse. Durch den mindestens 3 Jahre zurückliegenden Eingriff wurde bei 59,7 % der Patienten völlige Beschwerdefreiheit erzielt. 17,5 % geben noch Beschwerden an. Bei 22,8 % wurde seitdem eine Magenresektion wegen stärkerer Beschwerden, Magenausgangsstenose und Reperforation durchgeführt.
    Notes: Summary Between 1968 and 1974, 82 patients suffering from gastric or duodenal ulcer perforation, have been attended by simple closure. The postoperative mortality was 12.2 % and was clearly dependent on age, time elapsed since perforation and history of the ulcer. By means of the procedure, which had been carried out at least three years previously, 59.7 % of the patients were completely cured. 17.5 % still have symptom. In 22.8 % of the patients suffering from major complaints, pylorostenosis and reperforation, gastric resection was performed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01729694
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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