Scandinavian journal of infectious diseases. Supplementum
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Scand J Infect Dis Suppl · Jan 1985
Randomized Controlled Trial Comparative Study Clinical TrialAcyclovir versus vidarabine in herpes simplex encephalitis.
One hundred and twenty-seven patients with suspected herpes simplex encephalitis were entered in a randomised, controlled comparative study of therapy with acyclovir 10 mg/kg, 8-hourly, versus vidarabine, 15 mg/kg daily, for 10 days. Consecutive patients were included and nearly all diagnosed cases of HSV-encephalitis in Sweden were enrolled in the study. The diagnosis of HSV-encephalitis was verified by demonstration of intrathecal herpes simplex virus (HSV) antibody production and by HSV cultivation, or antigen detection, in brain biopsy or necropsy material. ⋯ Nineteen of 24 (79%) vidarabine-treated patients died or suffered severe sequelae, compared with 9 of 27 (33%) acyclovir-treated patients (p = 0.005). The effect of treatment was influenced by the level of consciousness at the start of therapy. The outcome for 20 vidarabine-treated patients above 30 years of age with HSE was similar to that for the 53 patients reported by an American collaborative study.
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Scand J Infect Dis Suppl · Jan 1984
Comparative StudyBeta-lactam antibiotics in lower respiratory tract infections.
Like in any infection, the choice of antibacterials in pulmonary infections of known bacterial etiology is simple. When etiology is not known, the choice must rest upon knowledge of the epidemiology of lower respiratory infections and the antibacterial spectrum of the antibiotics in question. The epidemiology of community-acquired lower respiratory infections is not too well studied. ⋯ However, most community-acquired infections in the lower respiratory tract respond to penicillin; tetracycline or erythromycin may be used for treatment when the clinical response is unsatisfactory. In patients who are known or suspected to have compromised host defense, beta-lactams such as ureido-penicillins and the new cephalosporins should be used as primary therapy. In hospital-acquired lower respiratory tract infections, the etiological diagnosis is more likely to be made.(ABSTRACT TRUNCATED AT 250 WORDS)
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Deaths in septic shock continue to occur at a high frequency despite current treatment programs. However, the mortality can be substantially decreased with a close bedside attendance of patients at risk and if the patient is transferred to an intensive care unit for intensive treatment and monitoring as soon as shock is suspected or established. The treatment program consists of adequate antibiotic administration in combination with massive doses of steroids and aggressive infusion therapy supplemented with cardiovascular drugs according to the hemodynamic response to the initial treatment.
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Scand J Infect Dis Suppl · Jan 1983
Comparative StudyClinical aspects on bacterial infections in the upper respiratory tract.
Acute respiratory tract infections represent the major cause of morbidity in younger age groups. Most of these infections involve the upper respiratory tract. The frequency of respiratory tract infections vary not only with age, but also with season of the year and the epidemiological situation. ⋯ In the latter case, Gram-negative bacteria seem to be more pathogenic than Gram-positive ones. The clinical differentiation between viral and bacterial upper respiratory tract infections is difficult and sometimes not possible. However, based on the knowledge that acute tracheitis, laryngitis and common cold are normally caused by viral agents, it seems reasonable not to use antibiotics for those patients.
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The anaerobic flora of the cervix undergoes cyclic change during menstruation and pregnancy. The etiopathogenesis of anaerobic infections of the female genital tract is described. The in vitro susceptibility of the cervical microflora to various antibiotics presented and treatment of anaerobic infections of the female genital tract briefly is discussed.