1.
[Cefodizime increases peripheral blood CD4/CD8 and Th1/Th2 ratios in senile patients with bacterial pneumonia].
Wang, B, Bian, R, Wei, C, Sun, S, Gao, P
Xi bao yu fen zi mian yi xue za zhi = Chinese journal of cellular and molecular immunology. 2015;(4):528-31
Abstract
OBJECTIVE To explore the influence of cefodizime on CD4/CD8 and T helper 1(Th1)/Th2 cell ratios in peripheral blood of the senile patients with bacterial pneumonia. METHODS Sixty-three senile patients with bacterial pneumonia were enrolled and divided into two groups randomly. Patients in the control group (n=31) were given intravenous infusion of ceftriaxone sodium, and patients in the observation group (n=32) were given intravenous infusion of cefodizime. The fasting venous blood was taken before and after treatment to detect CD4/CD8 and Th1/Th2 cell ratios with flow cytometry. At the same time, the serum interleukin-2 (IL-2), interferon γ (IFN-γ), IL-4 and IL-10 contents were also detected with ELISA. RESULTS Before treatment, there was no significant difference in the above indexes between the two groups. After treatment, CD4⁺ cells and Th1 cells of the observation group increased while Th2 cells decreased; as a result, the CD4/CD8 and Th1/Th2 cell ratios of the observation group were significantly higher than those of the control group. At the same time, serum IL-2 and IFN-γ contents of the observation group were significantly higher than those of the control group, while serum IL-4 and IL-10 contents were significantly lower than those of the control group. CONCLUSION Cefodizime can improve the cellular immune function and rectify CD4/CD8 and Th1/Th2 imbalance in peripheral blood of the senile patients with bacterial pneumonia.
2.
A randomized trial comparing gentamicin/citrate and heparin locks for central venous catheters in maintenance hemodialysis patients.
Moran, J, Sun, S, Khababa, I, Pedan, A, Doss, S, Schiller, B
American journal of kidney diseases : the official journal of the National Kidney Foundation. 2012;(1):102-7
Abstract
BACKGROUND Central venous catheters (CVCs) are used for vascular access in hemodialysis patients who have no alternative access or are awaiting placement or maturation of a permanent access. The major complications of CVCs are catheter-related bloodstream infection and clotting in the catheter lumen. STUDY DESIGN Parallel-group, randomized, multicenter clinical trial, with patients blinded to study intervention. SETTING & PARTICIPANTS 16 free-standing dialysis facilities in Northern California belonging to a single provider. 303 adult maintenance hemodialysis patients who were using a tunneled cuffed CVC for vascular access. INTERVENTION The treatment group received an antibiotic lock containing gentamicin 320 μg/mL in 4% sodium citrate, whereas the control group received the standard catheter lock containing heparin 1,000 U/mL. Both groups received triple-antibiotic ointment on the catheter exit site during dressing changes at each dialysis treatment. OUTCOMES Catheter-related bloodstream infection and catheter clotting. MEASUREMENTS Catheter-related bloodstream infection was defined as the occurrence of symptoms consistent with bacteremia together with positive blood culture results in the absence of another obvious source of infection. Catheter clotting was measured as the rate of thrombolytic agent use required to maintain adequate blood flow. A single patient could contribute more than one infection or clotting episode. RESULTS The rate of catheter-related bloodstream infection was 0.91 episodes/1,000 catheter-days in the control group and 0.28 episodes/1,000 catheter-days in the treatment group (P = 0.003). The time to the first episode of bacteremia was significantly delayed (P = 0.005). The rates of tissue plasminogen activator use were similar in the treatment and control groups: 2.36 versus 3.42 events/1,000 catheter-days, respectively (P = 0.2). LIMITATIONS The requirement for dialysis facility staff to prepare the treatment intervention prevented a completely blinded study. CONCLUSION Gentamicin 320 μg/mL in 4% sodium citrate used as a routine catheter lock in CVCs in patients on maintenance hemodialysis therapy markedly decreases the incidence of catheter-related bloodstream infection and is as effective as heparin 1,000 U/mL in preventing catheter clotting.