Treatment of Severe Pseudomonas Infections of the Bronchi

Pines, A.; Raafat, H.; Siddiqui, Ghulam; Greenfield, J.S.B.

doi:10.1136/bmj.1.5697.663

Cited by 47 publications

(17 citation statements)

References 7 publications

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“…Generally, however, it has been believed that ototoxicity is related to the maximum blood levels of the antibiotics. This was supported by clinical reports according to which many of the patients who were affected with hearing impairment following intravenous injection of GM, the maximum antibiotic blood level exceeded 10-12 pg/ml [Jao and Jackson, 1964;Pines et al, 1967Pines et al, , 1970Arcieri et al. 1970], Consequently, rapid intravenous injection of antibiotics was deemed more dangerous than intramuscular injection because of the higher peak blood levels attained after intravenous injections.…”

Section: Discussionmentioning

confidence: 52%

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Ototoxicity of Aminoglycoside Antibiotics by Rapid Intravenous Injection

Ohtani¹,

Ohtsuki²,

Aikawa³

et al. 1982

ORL

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The ototoxicity and nephrotoxicity of aminoglycoside antibiotics (dibekacin, gentamicin and kanamycin) administered to rabbits by rapid intravenous or intramuscular injections were histopathologically compared. Comparative evaluations between the two routes were further made concerning the levels of the antibiotics in serum and in perilymph. The results revealed that, although the peak serum level after a rapid intravenous injection was significantly higher than that observed after an intramuscular injection, no differences in the transfer into the perilymph, and in inner ear or renal damage were seen between the two different routes. In other words, the results of the present study did not support the conventional idea that the higher the peak blood levels of the aminoglycoside antibiotics, the greater the risk of damage to the inner ear or kidney.

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Section: Discussionmentioning

confidence: 52%

“…Both the ototoxicity and nephrotoxicity of aminoglycoside antibiotics have been thought to be related to their maximum blood levels and, there fore, the rapid intravenous injection of these antibiotics has been deemed dangerous [Jao and Jackson, 1964;Pines et al" 1967Pines et al" , 1970Jackson. 1967;Arcieri et al, 1970].…”

Section: Introductionmentioning

confidence: 99%

Ototoxicity of Aminoglycoside Antibiotics by Rapid Intravenous Injection

Ohtani¹,

Ohtsuki²,

Aikawa³

et al. 1982

ORL

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“…Patients receiving aerosol therapy alone or in combination with intramuscular gentamicin had no greater clinical response than those treated with intramuscular gentamicin alone. In 1970 the same group reported that the most effective therapy was a combination of intramuscular gentamicin and carbenizone and that there was little evidence of any advantage of adding aerosol treatment (Pines et al, 1970). The investigation of Hoff et al in 1974, however, showed that cystic fibrosis patients treated with aerosolized antibiotics in addition to systemic therapy had a better bacteriological response.…”

Section: Volume Of Secretionsmentioning

confidence: 95%

Nebulizer Therapy with Antibiotics in Chronic Suppurative Lung Disease

Eldin

Palmer²,

Eltayeb³

et al. 1994

Journal of Aerosol Medicine

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Aerosolized antibiotics have been shown to be a useful modality of treatment in patients with cystic fibrosis. In this investigation we examined the utility of this treatment in patients with other chronic suppurative lung disorders. These included forty patients, thirty men and ten women with chronic airway infection (27 with bronchiectasis, 6 with chronic abscess and 7 with chronic suppurative bronchitis). Pathogenic organisms were isolated from the affected part of the lung by a fiberoptic bronchoscopy using a sterile disposable bronchial microbiology brush. Cultures from these specimens were used to determine the appropriate antibiotic. A second control group of 20 patients was treated with systemic antibiotics alone. Both systemic and aerosolized antibiotics were administered in 20 patients. A statistically significant improvement in clinical, and ventilatory functions was recorded in the first group compared to the second. Nebulized antibiotics used as adjunctive therapy in association with systemic antibiotics may offer a therapeutic advantage in chronic suppurative lung diseases.

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“…The high proportion of success in these difficult conditions suggests that ticarcillin is an exceptionally powerful antibiotic. In the small group of patients with Pseudomonas infection, ticarcillin seemed es pecially effective; though on the base of previous experience, it might be advisable to combine it with gentamicin, to obtain even better effect and to prevent the emergence of resistant strains [Pines et al, 1970].…”

Section: Discussionmentioning

confidence: 99%

“…Of the 101 patients, 57 had purulent exacerbations of chronic bronchitis and on clinical grounds were thought to be moderately or severely ill. 21 had severe puru lent exacerbations of infection in bronchiectasis, and a further six were dangerously ill with Pseudomonas aeruginosa infection [for criteria see Pines et al, 1970]. 17 patients had bronchial carcinoma with severe secondary infection.…”

Section: The Patientsmentioning

confidence: 99%