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Dive into the research topics where Alain Astier is active.

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Featured researches published by Alain Astier.


Clinical Infectious Diseases | 1997

Reemergence of Gentamicin-Susceptible Strains of Methicillin-Resistant Staphylococcus aureus: Roles of an Infection Control Program and Changes in Aminoglycoside Use

Hélène Aubry-Damon; Patrick Legrand; Christian Brun-Buisson; Alain Astier; Claude-James Soussy; R Leclercq

The spread of methicillin-resistant Staphylococcus aureus (MRSA) in our hospital in the 1980s correlated with increasing acquisition of resistance to antibiotics including gentamicin, rifampin, and fluoroquinolones. During the period 1993-1995, there was a major change in clinical MRSA isolates: the percentage of aminoglycoside-resistant MRSA isolates decreased from 75% to 52%, while the proportion of heterogeneous MRSA strains susceptible to gentamicin, rifampin, and tetracycline increased gradually from 4.9% to 27.5%. We used five epidemiological markers (i.e., antibiotyping, phage typing, pulsed-field gel electrophoresis, and restriction analysis of PCR amplified coagulase and protein A genes) to characterize recent isolates. With use of these techniques, we confirmed the persistence of the aminoglycoside-resistant MRSA clone and identified a clone of erythromycin-susceptible strains among the gentamicin-susceptible isolates and found that the remaining strains were diverse. These changes were due to the introduction of various MRSA strains from outside the hospital, while implementation of infection control measures in 1991 could have led to reduced transmission of the aminoglycoside-resistant MRSA strain. Changes in antibiotic prescribing patterns that resulted in reduced selective pressure from gentamicin may have contributed to the spread of gentamicin-susceptible MRSA strains.


BMJ | 1996

Relation between plasma lactate and blood cyanide concentrations in acute cyanide poisoning.

Frédéric J. Baud; Stephen W. Borron; Eric Bavoux; Alain Astier; Jerome R. Hoffman

Cyanide poisoning produces rapid blockade of cellular respiration due to binding to cytochromeaa3, resulting in accumulation of lactate. Lactic acidosis is a recognised hallmark of acute cyanide poisoning in humans.1 2 The time course of lactic acidosis, however, has not been well described in relation to evolving blood cyanide concentrations. We studied the relation of blood cyanide to plasma lactate concentrations in a patient with pure acute cyanide poisoning. A 63 year old man called for help immediately after suicidal ingestion of a single potassium cyanide capsule. He was conscious on arrival of ambulance staff, but apnoea rapidly supervened, followed by cardiac arrest. Cardiopulmonary resuscitation, endotracheal intubation with 100% pure …


Infection Control and Hospital Epidemiology | 1997

Infection risk and cost-effectiveness of commercial bags or glass bottles for total parenteral nutrition.

Isabelle Durand-Zaleski; Laurent Delaunay; Olivier Langeron; Eric Belda; Alain Astier; Christian Brun-Buisson

OBJECTIVE To determine whether the greater daily expense of administering total parenteral nutrition (TPN) via plastic bags changed once daily, compared to glass bottles changed thrice daily, could be offset by savings from a reduction in nosocomial infections. DESIGN The costs and potential benefits of commercially available TPN bags and TPN in glass containers were compared. Costs were computed from the viewpoint of the hospital, first in a general model and then for two specific examples, Crohns disease and intensive-care unit (ICU) patients. The extra cost of using bags was


Clinical Toxicology | 2001

Treatment of methanol and isopropanol poisoning with intravenous fomepizole.

Rafik Bekka; Stephen W. Borron; Alain Astier; Pierre Sandouk; Chantal Bismuth; Frédéric J. Baud

20 per day. The total cost of nosocomial bacteremia was estimated at


Human & Experimental Toxicology | 1996

Complexation of intracellular cyanide by hydroxocobalamin using a human cellular model

Alain Astier; Frédéric J. Baud

6,000. The monetary benefits of using TPN bags were


Journal of Chromatography B: Biomedical Sciences and Applications | 1995

Simultaneous determination of hydroxocobalamin and its cyanide complex cyanocobalamin in human plasma by high- performance liquid chromatography Application to pharmacokinetic studies after high-dose hydroxocobalamin as an antidote for severe cyanide poisoning

Alain Astier; Frédéric J. Baud

6,000XT, where XT was the percentage of nosocomial infections averted. We also considered that reduction in intravenous (IV)-line manipulation could reduce bacteremia-related mortality and computed a cost-per-life-saved ratio. RESULTS Modeling showed that TPN in bags could yield a net benefit when the absolute reduction in the daily risk of nosocomial bacteremia reached the threshold value of 0.3%. Such a reduction could not be attained in patients with Crohns disease, and corresponded to a 50% to 60% reduction of infection rates in ICU patients. Varying the risk of mortality attributable to IV-line-related infection from 1% to 13% resulted in a cost effectiveness of using TPN bags ranging from


Annales pharmaceutiques françaises | 2010

Contrôle rapide et fiable des préparations de chimiothérapies à base d’anticorps monoclonaux à l’aide de l’automate Multispec®

C. Bazin; V. Vieillard; Alain Astier; Muriel Paul

90,000 to


Annales pharmaceutiques françaises | 2010

Article originalContrôle rapide et fiable des préparations de chimiothérapies à base d’anticorps monoclonaux à l’aide de l’automate Multispec®Reliable real-time analytical control of monoclonal antibodies chemotherapies preparations on Multispec® automaton

C. Bazin; V. Vieillard; Alain Astier; Muriel Paul

7,000 per life saved in ICU, assuming a two-thirds reduction in IV-line infections, and from


Drug Development Research | 1999

Preparation and physicochemical characterization of atovaquone-containing liposomes

E. Cauchetier; Hatem Fessi; Y. Boulard; Michèle Deniau; Alain Astier; Muriel Paul

180,000 to


Human & Experimental Toxicology | 1995

Fenoverine-induced rhabdomyolysis

P. Chariot; R. Ratiney; F. Le Maguet; V. Fourestié; Alain Astier; R. Gherardi

14,000 if the infection rate was reduced by one third. CONCLUSION The baseline cost-minimization analysis concluded that the extra cost of TPN bags was not justified by the extra savings. The cost-effectiveness analysis, however, found that the cost per life saved fell within the accepted range of public health interventions, provided a large fraction of infections are averted using TPN bags.

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Stephen W. Borron

Texas Tech University Health Sciences Center

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