Stressresponse, Mastzellaktivierung und Verlauf perioperativer chirurgischer Infektionen: Einfluss einer perioperativen Antihistaminikaprophylaxe in Klinik modellierenden randomisierten Tierstudien
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Philipps-Universität Marburg
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Abstract
This studie was designed to discover the
influence of a perioperative prophylaxis with H1 and H2
receptor antagonists on postoperative abdominal infection.
Studies were performed with large samples of rats following the
concept of clinic modelling randomised trials (CMRT).
?Clinic modelling? means not only modelling medical
details like drug regimes or surgical procedures but also
consideration of rules for performance of prospective
randomised trials. The CMRT?s are a new approach to analyse
drugs and therapies in an intermediate stage between
preclinical and clinical studies.The results of the studies
show a optimum combination of dimetinden and cimitidin as
antihistamines, in the next series there was a slight tendency
towards higher survival in the single shot group compared with
the group who got antihistamines on the following days, too.
This result appeared under low and high mortality rate.
Prophylaxis with cimetidin alone without H1-antagonist could
not show a improvement of survival. The results of the
definitive studies show a significant higher survival of the
antihistamine-group compared with the placebo-group. This
result was found with low and high mortality of placebo-group.
The antibiotic in all studies above was co-amoxiclav. The
surprising result of another studie with exactly the same
setting but levofloxacin and metronidazol as antibiotics failed
to show a gain in survival but showed a higher mortality
compared with the placebo-group. This result may be caused due
to interactions between the antibiotics and immune system or
due to different pattern in LPS liberation. Ther were found
similar differences between various antibiotics and
immunemodulation with G-CSF,too. As a result of the studies the
CMRT seem to be a promising new approach to analyse drugs and
therapies in an intermediate stage between preclinical and
clinical studies. A prophylaxis with a combination of cimetidin
and dimetinden in exactly predefined clinical settings may show
an advantage, but a prophylaxis with antihistamines can not be
recommended in general.This studie was designed to discover the
influence of a perioperative prophylaxis with H1 and H2
receptor antagonists on postoperative abdominal infection.
Studies were performed with large samples of rats following the
concept of clinic modelling randomised trials (CMRT).
?Clinic modelling? means not only modelling medical
details like drug regimes or surgical procedures but also
consideration of rules for performance of prospective
randomised trials. The CMRT?s are a new approach to analyse
drugs and therapies in an intermediate stage between
preclinical and clinical studies.The results of the studies
show a optimum combination of dimetinden and cimitidin as
antihistamines, in the next series there was a slight tendency
towards higher survival in the single shot group compared with
the group who got antihistamines on the following days, too.
This result appeared under low and high mortality rate.
Prophylaxis with cimetidin alone without H1-antagonist could
not show a improvement of survival. The results of the
definitive studies show a significant higher survival of the
antihistamine-group compared with the placebo-group. This
result was found with low and high mortality of placebo-group.
The antibiotic in all studies above was co-amoxiclav. The
surprising result of another studie with exactly the same
setting but levofloxacin and metronidazol as antibiotics failed
to show a gain in survival but showed a higher mortality
compared with the placebo-group. This result may be caused due
to interactions between the antibiotics and immune system or
due to different pattern in LPS liberation. Ther were found
similar differences between various antibiotics and
immunemodulation with G-CSF,too. As a result of the studies the
CMRT seem to be a promising new approach to analyse drugs and
therapies in an intermediate stage between preclinical and
clinical studies. A prophylaxis with a combination of cimetidin
and dimetinden in exactly predefined clinical settings may show
an advantage, but a prophylaxis with antihistamines can not be
recommended in general.
Review
Metadata
Contributors
Supervisor:
Dates
Created: 2003Issued: 2003-12-22Updated: 2011-08-10
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
Stressresponsestressresponse , infectionAntihistaminika , SepsisMastzelle , neuroendokrine Immuninteraktionenmastcell , neuroendocrine immune interactionantihistamines
DFG-subjects
Komplikation / Perioperative PhaseInfektion , Bakterielle Infektion
DDC-Numbers
610
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Krackrügge, Dieter (128603801): Stressresponse, Mastzellaktivierung und Verlauf perioperativer chirurgischer Infektionen: Einfluss einer perioperativen Antihistaminikaprophylaxe in Klinik modellierenden randomisierten Tierstudien. : Philipps-Universität Marburg 2003-12-22. DOI: https://doi.org/10.17192/z2003.0714.
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This item has been published with the following license: In Copyright