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 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two different doses of cefaclor advanced formulation (AF), a new sustained-release formulation of cefaclor, were compared with the regular formulation of cefaclor for efficacy and safety in the treatment of uncomplicated cystitis and asymptomatic bacteriuria. A 7-day course of treatment was used, and the trials were double-dummy and double-blind. In one trial, cefaclor AF 500 mg once daily (at night) was compared with cefaclor 250 mg three times a day. Satisfactory clinical and bacteriological responses were found in 179/189 (94.7%) and 160/191 (83.8%) patients, respectively, given cefaclor AF and in 82/87 (94.3%) and 74/90 (82.2%) patients given cefaclor, 5-9 days after the end of treatment. In the other trial, cefaclor AF 375 mg twice daily was compared with cefaclor 250 mg three times a day. Satisfactory clinical and bacteriological responses were obtained in 164/180 (91.1%) and 156/184 (84.8%) patients, respectively, given cefaclor AF, and in 86/92 (93.5%) and 81/93 (87.1%) patients taking cefaclor, 5-9 days after the end of treatment. Very similar results were found in both studies in those patients who were assessable 3-5 weeks later. Only 4.3% and 2.4% of patients treated with cefaclor AF (375 mg and 500 mg, respectively) and 2.2% of cefaclor patients discontinued therapy due to adverse events. The three most commonly reported events were vaginal moniliasis or vaginitis (8.6%), headache (5.0%) and nausea (4.8%). No significant differences were found between clinical efficacy and safety parameters in the different study groups, and it was concluded that cefaclor AF in a twice-daily or once-daily dosage is as effective and as safe as the currently recommened three-times-a-day dosage of cefaclor.
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PMID:Comparative trials of cefaclor AF in uncomplicated cystitis and asymptomatic bacteriuria. 128 20

The Norplant System consists of 6 capsules each containing 36 mg of crystal line levonorgestrel (LNG), for a total dose of 216 mg LNG. The capsules are inserted subdermally in the mid-upper arm, and LNG diffuses continuously through the capsule walls for 5 years. In the United States the Norplant System was approved in December 1990. The initial rate of hormone delivery is about 85 mcg/day, then decreases over the next 9 months to 5 mcg/day, and over the ensuing 9 months to 35 mcg/day. Thereafter, the diffusion rate levels off for the next 3.5 years, averaging around 30-35 mcg/day. Removal results in a drop in the plasma concentration of levonorgestrel to below contraceptive levels within 24 hours and below the detectable limit of .1 pg/ml at 96 hours. Preliminarily data from 402 users over 5 years show improvements of Norplant produced better efficacy in all weight classes and a lowered cumulative rate of 1.1 pregnancies of 100 users. The pregnancy rate for the first year of use is 02., better than for oral contraceptives. Side effects include headache, nervousness, nausea, dizziness, dermatitis, acne, change of appetite, breast tenderness, minimal weight gain, some change in hair distribution, and adnexal enlargement. Adverse reactions include breast discharge, possible cervicitis, musculoskeletal pain, abdominal discomfort, leukorrhea, and vaginitis. More than the usual number of bleeding days occurred in slightly more than one fourth of the patients, prolonged bleeding in 27.6% spotting in 17.1% and amenorrhea in 9.4% of patients. Hyperlipidemic users should be observed for possible low-density lipoprotein elevations. The cumulative discontinuation rate for pregnancy was 3.9 per 100 users; for bleeding irregularities the rate was 25.1 per 100 users, and for other medical results it was about 22.4 per 100 users. Personal reasons for discontinuation accounted for 38.7 per 100 users, equivalent to a cumulative continuation rate of about 30 per 100 users over the 5-year duration.
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PMID:The NORPLANT system of contraception. 168 4

Fluconazole is a new oral triazole antifungal with good activity against Candida spp. In this study, we investigated the effectiveness and tolerability of a three-day course of treatment with fluconazole compared with clotrimazole vaginal tablets in nonpregnant women with acute Candida vaginitis. Of the 90 evaluable patients who received fluconazole, 76 (84 percent) were asymptomatic seven to ten days after treatment compared with 84 of 95 (88 percent) treated with clotrimazole. An additional ten patients in the fluconazole group (11 percent) and seven in the clotrimazole group (7 percent) had improvement in their signs and symptoms. Only four patients in each group (4 percent) were considered treatment failures. Mycological cures were obtained in 89 and 93 percent of patients treated with fluconazole and clotrimazole, respectively, seven to ten days posttreatment. Clinical cure rates remained high one month posttreatment: 79 percent in the fluconazole group and 83 percent in the clotrimazole group. Both therapies were well tolerated. One patient discontinued treatment after she developed diarrhea while receiving fluconazole. The most common adverse effects associated with fluconazole use were nausea (six percent) and diarrhea (three percent). No clinically significant laboratory abnormalities were observed. In this investigation, oral fluconazole therapy was found to be as safe and effective as clotrimazole vaginal tablets in women with acute vulvovaginal candidiasis.
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PMID:Comparative study of fluconazole and clotrimazole in the treatment of vulvovaginal candidiasis. 187 64

Two multicenter trials compared single-dose oral therapy with 400 mg of ofloxacin or 3 g of amoxicillin plus 1 g of probenecid in the treatment of uncomplicated gonorrhea in 160 men and 102 women. Patients with a known diagnosis of Chlamydia trachomatis infection were excluded. All pretreatment isolates of Neisseria gonorrhoeae were susceptible to ofloxacin (minimal inhibitory concentration less than or equal to 2 micrograms/ml), whereas roughly 50 percent exhibited intermediate susceptibility to ampicillin (minimal inhibitory concentration, 0.125 to 2.0 micrograms/ml). Post-treatment culture results showed that ofloxacin had eradicated N. gonorrhoeae in 97.5 percent (41 men) of 42 men and all 28 women evaluated. Amoxicillin-probenecid achieved microbiologic cures in 92.7 percent (51 men) of 55 men and 92.6 percent (25 women) of 27 women evaluated. Clinical cure rates among initially symptomatic patients were 84.6 percent (33 men) of 39 men and 81.8 percent (nine women) of 11 women with ofloxacin and 83.0 percent (44 men) of 53 men and 66.7 percent (10 women) of 15 women with amoxicillin-probenecid. No drug-related adverse effects were noted in ofloxacin-treated patients. One patient each in the amoxicillin-probenecid group reported nausea, diarrhea, and vaginitis. These results demonstrate that single-dose ofloxacin is as effective as amoxicillin-probenecid in eradicating N. gonorrhoeae and relieving clinical signs and symptoms of gonococcal infections in both men and women.
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PMID:Single-dose efficacy of ofloxacin in uncomplicated gonorrhea. 251 17

In a double-blind randomized study, amoxicillin-clavulanic acid (AM-CL) was compared with cefaclor for the treatment of acute urinary tract infections in 107 college women. A total of 53 patients received amoxicillin (250 mg) and clavulanic acid as the potassium salt (125 mg), and 54 received cefaclor (250 mg); each drug was administered every 8 h for 10 days. The cure rates at 1 and 4 weeks after treatment were 96 and 78%, respectively, in the AM-CL group and 92 and 75%, respectively, in the cefaclor group (P greater than 0.10). After AM-CL treatment, the prevalence of amoxicillin-resistant Escherichia coli significantly increased in the rectal flora. Also, the frequency of bacterial resistance to amoxicillin, AM-CL, and cefaclor increased among the urinary pathogens causing subsequent urinary tract infections (P less than 0.05). There were no adverse reactions in the cefaclor group; however, six patients in the AM-CL group (12%) experienced diarrhea, nausea, or vomiting (P less than 0.05). Elevated transaminase enzyme levels were observed in 23% of the patients in the AM-CL group and in 6% of the patients in the cefaclor group (P less than 0.05). Symptomatic Candida vaginitis developed in 16 and 13% of the patients in the AM-CL and cefaclor groups, respectively (P greater than 0.10).
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PMID:Amoxicillin-clavulanic acid versus cefaclor in the treatment of urinary tract infections and their effects on the urogenital and rectal flora. 352 18

Twenty six children with candidiasis, aged between 5 months and 14 years, were treated with different formulations and regimens of ketoconazole. Fifteen children had alimentary tract candidiasis, two had oesophagitis, one had urinary tract candidiasis, two vaginitis, two septicaemia, one endo-ophthalmitis, and three had chronic pulmonary illness with persistence of Candida albicans in sputum. Daily drug doses ranged from 3 to 13 mg/kg and duration of treatment from seven days to 18 months. Pharmacokinetic studies in 22 of the children are reported. A total of 3 mg/kg/day given in three divided doses did not yield sufficiently high concentrations, which were achieved with a daily dose of 8 to 10 mg/kg. The effectiveness of treatment was proved by negative mycological tests (cultures or specific antibodies, or both) in 88%, by cure in 73%, and improvement in 11%. In three patients evaluation was not possible due to an insufficiently proved diagnosis. Nausea and pyrosis in four patients were the only side effects noted and no laboratory abnormalities were found. To achieve therapeutic concentrations of ketoconazole in children we suggest a daily dosage of 7 to 10 mg/kg in two or three divided doses.
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PMID:Pharmacokinetics of ketoconazole and treatment evaluation in candidal infections. 609 71

Twenty-one children, age range 5 mo - 14 yrs, affected by candidosis, were treated with ketoconazole (tablets or suspension). Patients had alimentary tract involvement (12), oesophagitis (1), urinary tract candidosis (3), vaginitis (2), septicaemia (1), endophtalmitis (1) and chronic pulmonary illness with persistence of Candida albicans in sputum (3). Daily drug doses ranged from 3 to 13 mg/Kg and treatment period from 7 days to 14 months. Pharmacokinetic study in 15 children showed large individual variability of drug serum levels. Pharmacokinetic parametres, related to different schedules of the two ketoconazole formulations (tablets and suspension) are reported; drug levels after chronic administration are also evaluated. A daily dose of 3 mg/Kg of ketoconazole suspension, given in 3 administrations, did not result in sufficiently high levels, which indeed were obtained with a daily dose of 10 mg/Kg (3.3 X 3). The effect of treatment is proven by negativization of cultures in 90% of patients, by disappearance of clinical signs in 67% by improvement in 9%. The therapeutic effect on the remaining 24% (5 patients) is not evaluable. Adverse effects were only nausea and pyrosis in four cases; no laboratory abnormalities were found. A daily dosage from 7 to 10 mg/Kg, in two or three administrations, is suggested to obtain therapeutic levels in children.
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PMID:[Ketoconazole treatment of candidiasis in children: clinico-pharmacokinetic study]. 631 89

This article, arguing that consumers have a right to be informed about the dangers of health care measures, discusses the health risks of oral contraceptives (OCs) and IUDs. In a brief review of the history of contraceptive development and use, it is stated that the 1st OC was tested on only 132 women in Puerto Rico before being approved for commercial use. OCs, which inhibit ovulation, sperm penetration, and implantation of the egg, represent the surest and most convenient contraceptive yet developed. Despite their advantages, pills may cause various secondary effects such as spotting, water retention, irritability, nervousness, nausea, vaginitis, migraine headaches, hypertension, and others, whose alleviation is responsible for large additional profits to the pharmaceutical industry. Although results are difficult to interpret and the passage of time may not have been sufficient, disquieting indications of a possible carcinogenic effect of OCs have been noted. The pill has been implicated in an elevated incidence of thromboembolism and is known to influence the metabolism of some substances, and the list of contraindications for pill use is long. Women wishing to use pills should consult a conscientious physician who will take a complete medical history, perform a thorough physical, and furnish complete information on the risks of pill use. IUD mode of action is incompletely understood. Fewer than 2/3 of women accepting IUDS are able to tolerate them for more than 1 year, from 7 to 20% of IUDs are spontaneously expelled, and from 3-35% are removed at the request of the client for pelvic pain and bleeding. Another 4-15% are removed each year for other medical reasons. IUD related mortality is less than that related to OCs, but a series of secondary effects and contraindications are associated with their use. If a woman chooses to use an IUD despite everything, she should choose a physician experienced in IUD insertion who is not experimenting with a new type of device. The preference for powerful contraceptives has caused women to excuse men from sharing in the responsibility for birth control, among other deleterious effects.
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PMID:[Contraception: yes, but at what cost?]. 675 25

In a multicenter, randomized, open, comparative trial, patients with uncomplicated gonorrhea were treated with 400 mg of oral fleroxacin or 250 mg of intramuscular ceftriaxone. A total of 458 men and 447 women were enrolled. Of these, 312 men (68%) and 245 women (55%) were evaluable for efficacy. The treatment groups were demographically similar. Among evaluable men, fleroxacin eradicated 154 of 155 (99%; 95% confidence interval [CI]: 98.1-100%) urethral and 2 of 2 pharyngeal infections, while ceftriaxone eradicated 156 of 156 (95% CI: 99.4-100%) urethral and 5 of 5 pharyngeal infections. Among evaluable women, fleroxacin eradicated 127 of 128 (99%; 95% CI: 97.7-100%) cervical, 20 of 20 anorectal, 16 of 16 urethral, and 7 of 7 pharyngeal infections, while ceftriaxone eradicated 108 of 108 (95% CI: 99.1-100%) cervical, 24 of 24 anorectal, 25 of 25 urethral, and 9 of 9 pharyngeal infections. Adverse events were reported by 68 (16%) of 426 subjects in the fleroxacin group and 20 (5%) of 380 in the ceftriaxone group (p < 0.0001). The most common adverse events reported by the patients who received fleroxacin were nausea (5%), headache (3%), and vaginitis (3%). One patient had severe vomiting, 19 participants had adverse reactions classified as moderate, and 48 patients had mild adverse reactions. Fleroxacin was highly effective in the treatment of uncomplicated gonorrhea and represents an oral alternative to ceftriaxone. Adverse events were more common with fleroxacin than with ceftriaxone.
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PMID:Multicenter trial of fleroxacin versus ceftriaxone in the treatment of uncomplicated gonorrhea. 845 87

Trovafloxacin is a fluoroquinolone antibacterial agent with a broad spectrum of activity. Trovafloxacin has similar or 2-fold lower activity than ciprofloxacin against Enterobacteriaceae and Pseudomonas aeruginosa. Against Haemophilus influenzae and Moraxella catarrhalis, trovafloxacin has similar activity to ciprofloxacin. Other susceptible Gram-negative pathogens include Neisseria gonorrhoeae, Chlamydia trachomatis and mycoplasmas. The drug is active against Gram-positive bacteria and consistently displayed greater activity (2- to 8-fold) than ciprofloxacin against all staphylococci and streptococci tested; activity included methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae. Trovafloxacin has some activity against vancomycin-resistant enterococci. Anaerobes such as Bacteroides and Clostridium spp. are also susceptible to trovafloxacin. Preliminary clinical data suggest that trovafloxacin is effective in the treatment of patients with upper and lower respiratory tract and uncomplicated urinary tract infections and infections caused by C. trachomatis or N. gonorrhoeae. The most frequently noted adverse event with trovafloxacin is dizziness which is reported in 11% of patients versus 3% of those receiving comparator agents. Other commonly reported events (> 1% of patients) are nausea, headache, vomiting, vaginitis and diarrhoea.
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PMID:Trovafloxacin. 927 5


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