Vancomycin wound penetration in open-heart surgery patients receiving negative pressure wound therapy for deep sternal wound infection.

Introduction: It is hypothesized that systemically administered antibiotics penetrate wound sites more effectively during negative pressure wound therapy (NPWT). However, there is a lack of clinical data from patients who receive NPWT for deep sternal wound infection (DSWI) after open-heart surgery. Here, we evaluated vancomycin penetration into exudate in this patient group.

Liquid chromatography-tandem mass spectrometry methods for quantification of total and free antibiotic concentrations in serum and exudate from patients with post-sternotomy deep sternal wound infection receiving negative pressure wound therapy.

Background: Systemically administered antibiotics are thought to penetrate the wounds more effectively during negative pressure wound therapy (NPWT).To test this hypothesis total and free antibiotic concentrations were quantified in serum and wound exudate.

Methods: UHPLC-MS/MS methods were developed and validated for the determination of ceftazidime, cefepime, cefotaxime, cefuroxime, cefazolin, meropenem, oxacillin, piperacillin with tazobactam, clindamycin, ciprofloxacin, sulfamethoxazole/trimethoprim (cotrimoxazole), gentamicin, vancomycin, and linezolid.

Therapeutic drug monitoring guided fluconazole therapy in a patient with cholangitis sepsis.

and other fungal species play an increasing role in nosocomial infections, including cholangitis and cholangiosepsis. Early diagnosis and prompt treatment are essential in successful patient outcomes. Fluconazole is an antifungal of choice in fluconazole-sensitive infections.

Therapeutic monitoring of amiodarone: pharmacokinetics and evaluation of the relationship between effect and dose/concentration.

Amiodarone is the most effective agent in the therapy of arrhythmias. However, the clinical effect of acute and chronic treatment is unclear and there are differences irrespective of comparable plasma/myocardial amiodarone and its metabolite desethylamiodarone concentations as well. Its unusual pharmacokinetics results in interindividual variation in plasma levels.

Cytochrome P450 2D6 phenotype and genotype in hypertensive patients on long-term therapy with metoprolol.

Objective: The aim was to compare cytochrome P450 2D6 phenotype and genotype using metoprolol as a probe drug. Further, to investigate the influence of P450 2D6 activity on metoprolol pharmacokinetics and pharmacodynamics in patients on metoprolol therapy.

Background: Cytochrome P450 2D6 is a highly polymorphic enzyme that contributes to the variability of metoprolol.

Assessment of the indoor environment and implications for health in Roma villages in Slovakia and Romania.

Objectives: The objective of this paper is to provide information on indoor air quality and on the quality of the broader indoor environment of the houses in Roma villages in Slovakia and Romania and to discuss possible implications for health.

Methods: Indoor air was sampled in 11 houses in a Romanian Roma village and in 19 houses in a Slovakian Roma village. Levels of carbon monoxide (CO), carbon dioxide (CO2), total particulate matter (PM), temperature and humidity were measured.

Vancomycin pharmacokinetics during high-volume continuous venovenous hemofiltration in critically ill septic patients.

Aims: To assess the influence of continuous venovenous hemofiltration (CVVH) at a filtration rate of 45 mL/kg/h on vancomycin pharmacokinetics in critically ill septic patients with acute kidney injury (AKI).

Methods: Seventeen adult septic patients with acute kidney injury treated with CVVH and vancomycin were included. All patients received first dose of 1.

[An effect of continuous and intermittent renal replacement therapy on antibiotic treatment in critically ill patients with sepsis - a practice-based perspective of vancomycin and gentamycin therapies].

Sepsis and septic shock are common cause of hospitalisation in intensive care unit. Acute kidney injury is an accompanying manifestation of sepsis/septic shock leading to worsening of morbidity and also mortality and requiring use of intermittent or continual renal replacement therapy. Life saving effect is attributed to early and effective antibiotic therapy.

Vancomycin removal during low-flux and high-flux extended daily hemodialysis in critically ill septic patients.

Aims: To determine the extent of vancomycin removal and vancomycin pharmacokinetics in septic patients with AKI using daily hemodialysis with polysulphone high-flux and low-flux membrane.

Methods: Five patients received 6 h daily dialysis with low-flux polysulphone membrane, four patients with high-flux polysulphone membrane. Vancomycin was administered over the last hour of dialysis.

Gentamicin pharmacokinetics during continuous venovenous hemofiltration in critically ill septic patients.

Objective: Current dosing recommendations for administration of gentamicin to septic patients with acute kidney injury (AKI) on continuous venovenous hemofiltration (CVVH) at a filtration rate of 45 ml/kg/h are missing.

Aim: To describe gentamicin pharmacokinetics and to find an optimal dosing regimen in patients on CVVH.

Methods: Seven adult patients were included.

[Clinical significance of cytochrome P450 genetic polymorphism--part IV. Cytochrome P450 3A4 and 3A5].

The enzymes of cytochrome P450 3A subfamily are responsible for the metabolism of about 50% of commonly used drugs. High inter-individual variability in the activities of these enzymes has been described. The last fourth part of this review focuses on the influence of genetic polymorphism of CYP3A4 and CYP3A5 enzymes on drug effect.

[Clinical significance of cytochrome P450 genetic polymorphism--part I. Enzymatic system of cytochrome P450 and cytochrome P450 1A2].

Inter-individual variability in drug response is a major clinical problem. Much of the variability has been observed in drug metabolism, particularly in the enzymes of cytochrome P450. Genetic polymorphism in these enzymes may influence a patient's response to commonly prescribed drugs.

Screening of binding activity of Streptococcus pneumoniae, Streptococcus agalactiae and Streptococcus suis to berries and juices.

Antiadhesion therapy is a promising approach to the fight against pathogens. Antibiotic resistance and the lack of effective vaccines have increased the search for new methods to prevent infectious diseases. Previous studies have shown the antiadhesion activity of juice from cultivated cranberries (Vaccinium macrocarpon Ait.

Binding of Neisseria meningitidis pili to berry polyphenolic fractions.

Blocking bacterial adhesion to host surfaces provides novel potential to control infections. The present study was directed to binding and inhibitory activity of different fresh berries and berry and fruit juices against Neisseria meningitidis . Berries and juices were fractionated according to their molecular size into three fractions.

[Cytochrome P450 3A polymorphism and its importance in cyclosporine and tacrolimus therapy in transplanted patients].

The calcineurin inhibitors cyclosporine (CsA) and tacrolimus (Tac) are widely used in the prevention of acute rejection after solid organ transplantation. However, their clinical use is associated with many adverse reactions. The calcineurin inhibitors CsA and Tac have a narrow therapeutic index and show highly variable pharmacokinetics.