17,244 pathogens isolated from clinical specimens of 24 hospitals in the Moers area (North-Rhine Westphalia, FRG) were tested in regard to their susceptibility to Augmentin® (amoxicillin and clavulanic acid). For this purpose, minimal inhibitory concentrations were determined by use of microbroth dilution technique. 80% of Gram-negative, 98% of Gram-positive and 97% of anaerobic isolates were susceptible to Augmentin® (breakpoint 4 mg/l amoxicillin in the presence of 2.5 mg/l clavulanic acid). In a second part of the study the susceptibility to Augmentin of 4.137 Gram-negative and 10.958 Gram-positive pathogens was compared to their sensitivity against benzylpeni-cillin, flucloxacillin, mezlocillin, erythromycin, clindamycin, fusidic acid, ampicillin, cefaclor and doxycyclin.

Severe intra-abdominal infection is associated with a high mortality rate. In addition to risk factors in the patients, the causal pathogens and the selection of appropriate therapeutic procedures play an essential part in the course of these conditions. In the majority of intra-abdominal infections mixed aerobic/anaerobic infections, mostly with some involvement of enterobacteria and also of enterococci and staphylococci can be demonstrated. In addition to surgical intervention a calculated antimicrobial initial treatment of intra-abdominal infections with an antibiotic with an adequate effect to combat the pathogen concerned can contribute to improving the patient's prognosis. A calculated antibiotic treatment can only be effectively and reliably carried through if the frequency of the pathogen and the resistance situation are known. Retrospective evaluations of data on the sensitivity and frequency of pathogens from a defined group of subjects allow conclusions on the epidemiological situation in a particular catchment area or in a medical sector and thus make it possible to calculate the appropriate therapy for infections. In 1996 a total of 2,779 bacterial isolates from the intra-abdominal infection sector were examined: 935 Enterobacteriaceae, 83 nonfermenters, 177 Staphylococcus spp., 211 Enterococcus spp., 39 Streptococcus spp., and 1334 different anaerobic bacteria. Fresh clinical isolates were available for all pathogens tested. The most frequent gram-negative pathogen was E. coli (60%) and the most frequent gram-positive pathogen, E. faecalis (44%); the most frequent anaerobic pathogen was B. fragilis (39%). Taurolodine had the lowest resistance rate against gram-negative and anaerobic pathogens. Teicoplanin had the highest activity against gram-positive pathogens.

No abstract

No abstract

An 2545 frischen klinischen Isolaten, vorwiegend von chirurgischen Abstrichen stammend, wurde die In-vitro-Aktivität von Taurolidin bestimmt. Bei den getesteten Stämmen handelte es sich um Enterohacteriaceae (29%), grampositive Kokken (36%), Anaerobier (27%) und Pilze (8%). Es erfolgten Bestimmungen der minimalen Hemmkonzentration (MHK) im Mikrobouillondilutionstest bei Bakterien bzw. Bouillondilutionstest bei Pilzen, alle nach DIN 58940. Die MHK₉₀-Werte waren bei grampositiven Kokken und Anaerobiern mit 0,125-0,25 mg/ml am niedrigsten und waren auch bei Enterohacteriaceae mit 0,25-0,5 mg/ml niedrig. Lediglich Candida albicans und Pseudomonas aeruginosa wiesen einen MHK₉₀-Wert von 2 mg/ml auf. 99,3% aller getesteten Stämme waren «sensibel» gegen Taurolidin, die restlichen Stämme können als «intermediär» eingestuft werden. Gegen alle getesteten Stämme zeigte Taurolidin in den therapeutisch anzuwendenden Konzentrationen (5-20 mg/ml) eine bakterizide Wirkung. Im Vergleich zu den getesteten Antibiotika erwies sich Taurolidin als das Chemotherapeutikum mit dem breitesten Wirkungsspektrum.