ISSN:0009-3157    

DOI:10.1159/000238806

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Several single dose regimens have been shown to cure 90 percent of women with acute cystitis in whom infection is confined to the bladder. About 25 percent of women with acute cystitis and approximately one-half with asymptomatic infection have organisms originating from one or both upper urinary tracts. Effective single dose regimens such as trimethoprim-sulfamethoxazole, amoxicillin, and trimethoprim alone, cure between 40 and 60 percent of upper tract infections in women with renal involvement, who present with acute cystitis or with asymptomatic bacteriuria. Five studies have shown that single dose failure in women with acute cystitis or asymptomatic bacteriuria is a specific predictor of upper tract infection. It is also sensitive (60–80 percent) in predicting upper tract pathology. The evidence to date favours the hypothesis that failure of single dose cure following treatment with an effective single dose regimen in adult women who have asymptomatic bacteriuria or acute cystitis, identifies a subset of women who require further investigation of the urinary trac

ISSN:0009-3157    

DOI:10.1159/000238807

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

A new controlled-release membrane infusion device has been developed which consists of a drug and a fluid chamber separated by a 0.2-μm proprietary membrane. Drug transfer is based on electrodiffusion across the membrane. The objective of this study was to determine the feasibility of using this device to achieve adequate serum concentrations of gentamicin in adult healthy volunteers. Ten subjects (age 20–40 years) received a single dose of gentamicin, 1.7 mg/kg through the device. Multiple blood samples were collected and gentamicin was measured by EMIT. Peak serum concentrations of gentamicin ranged from 4.8 to 10.5 μg/ml. The mean total clearance, apparent distribution volume and elimination half-life were 0.96 ml/min/kg, 0.161/kg and 1.9 h, respectively. No adverse events occurred. These data suggest that a simple membrane device can be used for gentamicin delivery using gravity flow. The device should be evaluated in patients to define its role in ther

ISSN:0009-3157    

DOI:10.1159/000238742

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The pharmacokinetic comparison of phosphonic acid derivatives is based upon a survey of available literature on the whole group of compounds and on our own studies on fosfomycin. All three clinically used compounds, fosfomycin, fosmidomycin, and alafosfalin, are available for both oral and parenteral administration. The highest bioavailability is observed for the trometamol derivative of fosfomycin (37–44%); the calcium salt of fosfomycin is 2–2.5 times less absorbed and fosmidomycin has a bioavailability of 20–30%. The peak serum concentration of fosfomycin when given as the trometamol salt is about 2 times higher than the one reached with fosfomycin calcium or fosmidomycin. Urine recovery of unchanged drug is comparable after intravenous doses of fosfomycin and fosmidomycin, 80–95%, whereas the figure is only 10–20% for alafosfalin because it is extensively metabolized. After oral administration, urine recovery is highest for fosfomycin trometamol, 35–60%, compared to approximately 25% (range 18–29%) for fosfomycin calcium, 26% for fosmidomycin, and 6–17% for alafosfalin. The serum half-life of fosfomycin is 2–4 h (higher, up to 5.5 h, for some formulations of the calcium salt), 1.5–2.0 h for fosmidomycin, and about 1 h for alafosfalin. Thus, among available phosphonic acid derivatives and formulations, the trometamol derivative of fosfomycin has the most favourable characteristics. This applies to both bioavailability and urinary recovery, while at the same time the medium long half-life renders moderate fluctuation of concentrations whereby longer dosage intervals are possible. The serum protein binding of fosfomycin and fosmidomycin is below 3% (below 10% for alafosfalin); the penetration of fosfomycin is good to extravascular sites like muscle and connective tissue, cerebrospinal fluid, fetuses, amniotic fluid, prostatic

ISSN:0009-3157    

DOI:10.1159/000238809

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

Quinolone-resistant clones were selected from clinical Escherichia coli, Citrobacter freundii and Serratia marcescens isolates in a frequency ranging from 10––8 to 10––6. The outer membrane proteins of quinolone-resistant E. coli clones remained unaltered, as was the case for 10 of 11 C. freundii and 4 of 11 S. marcescens clones (‘nal B’ type). There was no strong relation between alterations of outer membrane proteins and cross-resistance with chemically unrelated compounds such as tetracycline or chloramphenicol; however, tetracycline resistance was observed in some C. freundii clones with unaltered outer membrane proteins (‘mar A’). Most of the quinolone-resistant S. marcescens clones can be considered ‘nor B’ or ‘nor C’ mutants due to their cross-resistance with other compounds, their altered outer membrane proteins and changes of lipopolysaccharide. In a few cases, subinhibitory quinolone concentrations caused alterations of outer membrane proteins in S. marcescens during mid log phase without de

ISSN:0009-3157    

DOI:10.1159/000238743

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

A randomized trial comparing single-dose therapy with fosfomycin trometamol 3 g versus amoxycillin 3 g was carried out in four centers. There were 158 female patients between 18 and 65 years. The major infecting organism in both groups was Escherichia coli (80%). The overall evaluation showed that fosfomycin trometamol eradicated 81.2% of bacteria and amoxycillin 71.8%. In women younger than 45 years, the cure rate was 88.8% for fosfomycin trometamol and 72.9% for amoxycillin. There was more persistence in the amoxycillin group, but equal recurrence and reinfection for both agents. The most common failure was with E. coli for both agents. Side effects were minimal with 8.7% for fosfomycin trometamol and 11.5% for amoxycillin. Fosfomycin trometamol is effective therapy of acute urinary tract infections in adult females and in selected situations was superior to amoxycillin.

ISSN:0009-3157    

DOI:10.1159/000238810

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

A clinical trial comparing 5 days’ treatment with amoxycillin/clavulanate (group A) and a single dose of fosfomycin trometamol (group B) is presented. The study was done in symptomatic patients presenting to their family practitioner, with the microbiological testing being carried out in a university hospital laboratory. Of 62 patients with significant bacteriuria, 29 were given amoxycillin/clavulanate and 33 fosfomycin trometamol, in a randomized fashion. Cure rates 1 week and 5 weeks after the end of treatment were 72 and 65% in group A and 85 and 81% in group B. Adverse events assessed in 141 patients were unusual (10.1% in group A and 8.3% in group B) and were mild in nature. The results of this study suggest that single-dose treatment with fosfomycin trometamol is effective and acceptable as a conventional course of amoxycillin clavulanate for the treatment of simple acute dysuria and/or frequency with infectio

ISSN:0009-3157    

DOI:10.1159/000238811

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The published studies of the use of single-dose antimicrobial therapy for the treatment of urinary tract infection have been reviewed. In women a single dose of any of several antimicrobial agents is as effective as a course of treatment for uncomplicated urinary tract infections caused by Escherichia coli. Trimethoprim or co-trimoxazole are currently the preferred agents for single-dose therapy. Fosfomycin trometamol and the 4-quinolones are promising agents. Failure of single-dose therapy may prove to be a simple guide as to the need for further urinary tract investigation or more intensive therapy. Single-dose antimicrobial therapy is now the treatment of choice for uncomplicated urinary tract infections in general practice.

ISSN:0009-3157    

DOI:10.1159/000238812

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The in vitro susceptibilities of 703 clinical isolates of Salmonella to ciprofloxacin (CIP) and pefloxacin (PEF) were compared with those to trimethoprim-sulfamethoxazole (TMP-SMZ), chloramphenicol (CO) and ampicillin (AP). All isolates were susceptible to CIP, while PEF inhibited 90.7% of the strains. In contrast, resistance rates of 40, 29.2 and 27% were detected for AP, TMP-SMZ and CO, respectively. PEF resistance was detected in S.panama (1), S. typhi (3) and S. typhimurium (17), the latter representing the most frequently serovar isolated in our country. None of the S. typhi isolates was resistant to CO. Combined resistance was most frequently found among S. typhimurium isolates, with the patterns PEF-TMP-SMZ-AP (10) and PEF-TMP-SMZ-CO-AP (5) predominating.

ISSN:0009-3157    

DOI:10.1159/000238745

出版商:S. Karger AG    

年代:1990

数据来源: Karger

摘要:

The efficacy, tolerability and side effects of a ‘single-dose’ therapy for acute female lower UTIs in general practice with fosfomycin trometamol (3 g) or norfloxacin (800 mg) were compared in a randomized double-blind study. 89 patients were included in the trial; however, 36 (40.4%) did not present significant bacteriuria and were assessed mainly for tolerability. Of the 53, 28 patients in the fosfomycin trometamol group and 25 patients in the norfloxacin group, 21 (75%) had no bacteriuria at immediate follow-up after treatment with fosfomycin trometamol and 20 (84%) with norfloxacin. The tolerability of both drugs in single dose was absol

ISSN:0009-3157    

DOI:10.1159/000238813

出版商:S. Karger AG    

年代:1990

数据来源: Karger