摘要:

A multicentre prospective randomised open-label controlled trial was conducted to compare the efficacy and safety of aztreonam (1 to 2g every 8 hours) plus cefazolin (1g every 8 hours) with that of ceftazidime (1 to 2g every 8 hours) in patients with nosocomial pneumonia. 66 adults were enrolled who had a presumptive diagnosis of pneumonia made at least 48 hours after hospitalisation. Patients exhibited the classic clinical picture of pneumonia and/or fever and/or leucocytosis and a newly developed or expanding infiltrate on chest x-ray.Among 48 evaluable patients treated, clinical cure or improvement was reported in 18 of 20 (90%) aztreonam patients as compared with 24 of 28 (85.7%) patients treated with ceftazidime. Bacteriological eradication or presumptive eradication was reported in 11 of 13 (84.6%) aztreonam patients and 15 of 19 (78.9%) ceftazidime recipients. Five patients with positive blood cultures prior to therapy (2 aztreonam, 3 ceftazidime) had negative blood cultures at study completion.Superinfection was reported in 2 patients randomised to aztreonam (bothStaphylococcus aureus) and in 3 ceftazidime patients (2 withPseudomonas aeruginosaand 1 with &bgr;-haemolyticStreptococcus). Colonisation was observed following ceftazidime (n = 4) and aztreonam (n = 2) therapy. Six aztreonam and 3 ceftazidime recipients experienced adverse events, which were possibly related to study therapy.Aztreonam plus cefazolin appears to be as effective as ceftazidime for the treatment of adults with nosocomial pneumonia.

ISSN:0114-2402    

出版商:ADIS    

年代:1994

数据来源: ADIS

摘要:

Ten healthy male volunteers not previously exposed to hirudin participated in an open trial to evaluate the effects on platelet function and coagulation of recombinant hirudin (rec-hirudin) CGP 39393 1 mg/kg administered intravenously as a bolus injection.The activated partial thromboplastin time (APTT) at 90 minutes, 8 hours and 12 hours after administration, was prolonged by 2.3, 1.4 and 1.3 times the baseline value, respectively. The APTT was closely correlated with the plasma concentration of rec-hirudin CGP 39393, and was doubled at plasma concentrations of about 60 nmol/L (400 ng/ml).Ex vivoplatelet aggregation stimulated by a variety of inducers (except thrombin) was not inhibited. Serum thromboxane B2and &bgr;-thromboglobulin levels decreased 20 minutes after injection, the reduction being significant only for serum thromboxane B2.

ISSN:0114-2402    

出版商:ADIS    

年代:1994

数据来源: ADIS

摘要:

This study was carried out to assess the efficacy and safety of combined therapy with pravastatin and gemfibrozil in patients with severe refractory familial combined hyperlipidaemia.26 patients (18 men and 8 women) with a mean age of 50 years (range 32 to 65 years) were included in the study. Patients with secondary forms of dyslipoproteinaemia were excluded. All patients had been following a phase II American Heart Association hypolipidaemic diet plus placebo for 1 month. Beginning at month 0, the patients received 4 months of combined treatment with a fixed dosage of gemfibrozil 1200 mg/day (divided into 2 equal doses), and pravastatin 20 mg/day. The dosage of pravastatin was increased to 40 mg/day after 1 month.At months -1, 0, 1, 2, 3 and 4 the following parameters were measured: total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), and apoproteins B and A-I. In the 17 patients free of coronary heart disease (CHD) at baseline, the effect of treatment on the risk of myocardial infarction (MI) was calculated.Before treatment initiation, the mean values (± SD) of the measured parameters were: TC = 309 ± 23 mg/dl, TG = 253 ± 35 mg/dl, LDL-C = 221 ± 21 mg/dl, VLDL-C = 49 ± 7 mg/dl, HDL-C = 34 ± 5 mg/dl, apoprotein B = 170 ± 10 mg/dl and apoprotein A-I = 118 ± 11 mg/dl. After 4 months of combined treatment the following percentage changes were recorded: TC-31%, LDL-C -35%, VLDL-C-51%, HDL-C+20%, TG-47%, apoprotein B-34%, apoprotein A-I+11%, LDL-C to HDL-C ratio -45%, and apoprotein B to A-I ratio -41%. The relative risk of MI was reduced by 58%. All changes were significant (p < 0.001).No patient was withdrawn from the study because of treatment-induced adverse effects. Five patients exhibited a moderate transient serum enzyme elevation: 2 in creatinine kinase and 3 in transaminase. Myopathy or rhabdomyolysis, major gastrointestinal symptoms, deterioration of renal function, or insomnia were not recorded in any patients.Combined treatment with gemfibrozil and pravastatin is safe and effective, but should be administered only in selected patients with severe combined hyperlipidaemia.

ISSN:0114-2402    

出版商:ADIS    

年代:1994

数据来源: ADIS

摘要:

The pharmacokinetics of zidovudine in 7 haemophiliac children with symptomatic human immunodeficiency virus disease were assessed after administration of oral dosages of 150 and 180 mg/m24 times daily separated by at least 2 weeks. The mean duration of zidovudine treatment was 3 months (range 2 to 5 months). The following mean (± SD) pharmacokinetic parameters were determined with the lower and higher doses, respectively; maximum plasma zidovudine concentration 6.34 ± 3.06vs7.09 ± 3.56 μmol/L, terminal half-life 0.84 ± 0.10vs0.94 ± 0.25h, and appararent oral clearance 48.8 ± 5.7vs54.2 ± 11.3 ml/min/kg. Plasma concentrations of the metabolite 3′-azido-3′-deoxy-5′-&bgr;-D-glucopyranosyl thymidine (GZDV) were 2- to 3-fold greater than those of zidovudine, and the terminal portion of the plasma concentration profile of GZDV declined in parallel with that of zidovudine. The pharmacokinetic parameters of zidovudine in these children were very similar to those previously observed in adults. However, there is a suggestion that the apparent oral clearance may be slightly greater in children (present study 49 to 54 ml/min/kg) than in adults (approximately 40 ml/min/kg).

ISSN:0114-2402    

出版商:ADIS    

年代:1994

数据来源: ADIS

摘要:

Terfenadine is a nonsedating histamine H1-antagonist that, when given with ketoconazole, results in accumulation of parent terfenadine and altered cardiac repolarisation in susceptible individuals. This prospective cohort study, designed to assess macrolide effects on terfenadine pharmacokinetics and electrocardiogram (ECG) parameters, evaluated 18 healthy male and female volunteers who received terfenadine to steady-state. Equal numbers (6) were randomised to receive either erythromycin, clarithromycin or azithromycin at recommended doses while continuing terfenadine. Macrolide monotherapy effects on the ECG were also investigated. Pharmacokinetic profiles for terfenadine were performed before and after the addition of macrolide therapy, and ECGs were obtained at baseline and predose on days of blood sampling.Erythromycin and clarithromycin significantly affected the pharmacokinetics of terfenadine. Three of 6 volunteers receiving erythromycin and 4 of 6 receiving clarithromycin demonstrated accumulation of quantifiable unmetabolised terfenadine that was associated with altered cardiac repolarisation. Azithromycin had no effect on terfenadine pharmacokinetics or cardiac pharmacodynamics.

ISSN:0114-2402    

出版商:ADIS    

年代:1994

数据来源: ADIS

ISSN:0114-2402    

出版商:ADIS    

年代:1994

数据来源: ADIS

ISSN:0114-2402    

出版商:ADIS    

年代:1994

数据来源: ADIS

ISSN:0114-2402    

出版商:ADIS    

年代:1994

数据来源: ADIS