Endotracheal antibiotics for the prevention of tracheobronchial infections in tracheotomized unconscious patients. A comparative study of gentamicin and aminosidin-polymyxin B combination.
Endotracheal administration of gentamicin has been compared to the endotracheal administration of aminosidin plus polymyxin B as a preventive measure against tracheobronchial infections in 25 and 22 tracheotomized patients respectively who had been admitted to a neurosurgical unit. Both series were comparable as far as underlying disease, duration of hospitalization, surgical therapy. Both regimens were similarly effective from the bacteriologic and clinical points of view. Both regimens were similarly effective in preventing colonization of bronchial secretions by potential pathogens and were associated with a similar frequency of infectious episodes (eight in each group). The use of aminosidin-polymyxin B combination was associated with a lower incidence of emergence of gentamicin resistant strains, but the endotracheal administration of gentamicin was better tolerated than that of the combination. It is concluded that the combination of aminosidin-polymyxin is a useful alternative to gentamicin for the prevention of bronchopulmonary infections in unconscious tracheotomized patients.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000517:prevention & control*; D002648:Child; D002986:Clinical Trials as Topic; D003128:Coma; D004338:Drug Combinations; D004341:Drug Evaluation; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D008171:Lung Diseases / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010303:Paromomycin / Q000627:therapeutic use*; D011113:Polymyxins / Q000009:adverse effects / Q000627:therapeutic use*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D014133:Tracheal Diseases / Q000517:prevention & control*; D014140:Tracheotomy
D004338:Drug Combinations; D005839:Gentamicins; D011113:Polymyxins; D010303:Paromomycin