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二氧嗪与β-内酰胺类抗生素联合应用在预防和治疗化脓性炎症并发症中的疗效

[Efficacy of a combination of dioxidine with beta-lactam antibiotics in the prevention and treatment of purulent-inflammatory complications].

作者信息

Bogomolova N S, Bol'shakov L V, Drachennikova A A

出版信息

Antibiot Khimioter. 1990 Nov;35(11):47-51.

PMID:2128733
Abstract

Schemes for prevention and treatment of purulent inflammatory complications were developed on the basis of in vitro studies on antimicrobial activity of dioxidine and 7 beta-lactam antibiotics such as mezlocillin, carbenicillin, ampicillin, cefotaxime, cefoxitin, cefuroxime and cephalothin under conditions of aero- and anaerobiosis with an account of the isolated microflora, its sensitivity to antibacterial agents and conditions required for vital activity of obligate anaerobes in humans, i.e. decreased partial oxygen pressure, low oxidation-reduction potentials and high tissue concentrations of carbon dioxide. The use of dioxidine in combination with the antimicrobial drugs enabled one to decrease the number of cases with purulent inflammatory complications after large intestine esophagoplasty to 30.4 per cent against 67.5 per cent in the control group of the patients untreated preventively with the antibacterial drugs. The number of cases with similar complications after gastrectomy amounted to 16.1 per cent against 62 per cent in the control. The use of dioxidine+ in combination with ampicillin and cefotaxime in treatment of purulent necrotic affections of the foot in patients with diabetes mellitus enabled one to increase the number of satisfactory outcomes by 32 per cent, to decrease the number of high amputations by 21.9 per cent and to lower the number of deaths more than 2-fold as compared to the results in the control group of the patients subjected to chemotherapy based on sensitivity of the aerobic microflora alone.

摘要

基于在需氧和厌氧条件下对二氧嗪和7种β-内酰胺抗生素(如美洛西林、羧苄西林、氨苄西林、头孢噻肟、头孢西丁、头孢呋辛和头孢噻吩)抗菌活性的体外研究,并考虑到分离出的微生物群落、其对抗菌剂的敏感性以及人类体内专性厌氧菌生存所需的条件(即降低的氧分压、低氧化还原电位和高组织二氧化碳浓度),制定了化脓性炎症并发症的预防和治疗方案。在大肠食管成形术后,将二氧嗪与抗菌药物联合使用,使化脓性炎症并发症的病例数从预防性未使用抗菌药物的对照组患者的67.5%降至30.4%。胃切除术后类似并发症的病例数为16.1%,而对照组为62%。在治疗糖尿病患者足部化脓性坏死性病变时,将二氧嗪与氨苄西林和头孢噻肟联合使用,与仅基于需氧微生物群落敏感性进行化疗的对照组患者相比,可使满意结果的数量增加32%,高位截肢数量减少21.9%,死亡人数降低超过两倍。

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