Chemotherapy
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In order to potentiate the efficacy of antiemetic drugs such as metoclopramide (MCP) and the new drug GR 38032F, adjuvant antiemetic drugs such as benzodiazepines are used in cancer patients receiving chemotherapy. The purpose of our prospective study was to investigate the efficacy of alprazolam (APZ), a newer diazepam, as an adjuvant antiemetic drug, when combined with MCP, in carboplatin (JM8)-based chemotherapy. Thus, 42 patients entered this study. ⋯ Secondary effects such as appetite (p less than 0.04), diarrhea (p less than 0.064), diaphoresis (p less than 0.085) and headache (p less than 0.024) were worst in arm A. We conclude that APZ increases the antiemetic effect of MCP on JM8. APZ is a useful adjuvant antiemetic drug, especially against the development of anticipatory anxiety, nausea and vomiting that many cancer patients presented during chemotherapy.
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Parenteral ceftriaxone was administered as a once-daily outpatient treatment to a selected low-risk population of neonates, infants, and children with moderate to severe bacterial infections. No incidences of treatment failure were seen in 200 children with uncomplicated infections responsive to ceftriaxone therapy. The mean period of outpatient treatment in initially hospitalized children with non-CNS infections, excluding endocarditis, was 1-3 days. Ceftriaxone outpatient management was successful in the control of organisms causing meningitis (n = 54), periorbital facial cellulitis (n = 16), sinusitis (n = 10), arthritis (n = 6), endocarditis (n = 4), and other infections.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparative double-blind randomised study of single dose fosfomycin trometamol with trimethoprim in the treatment of urinary tract infections in general practice.
A double-blind, double-dummy trial comparing a single dose treatment with fosfomycin trometamol (FT, 3 g) versus trimethoprim (TMP, 200 mg) was carried out in women with uncomplicated urinary tract infections. From 51 clinically evaluable patients, 44 were bacteriologically assessable at the 6-week follow-up. ⋯ For the TMP group (n = 22) the results were: eradication in 12 (54.5%); recurrence in 1 (4.5%); reinfection in 1 (4.5%), and persistence in 8 (33.3%). There were no significant adverse events reported with either agent.
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A total of 33 patients with bacterial meningitis were treated with single daily doses of ceftriaxone (CTR 100 mg/kg/day i.v.) for a median duration of 13 days. Pathogens isolated by culture and/or determined by latex agglutination were 15 Haemophilus influenzae b, 7 Neisseria meningitidis, 2 Streptococcus pneumoniae, 1 group B streptococcus, 2 Streptococcus viridans and 2 Staphylococcus epidermidis. In 4 cases a diagnosis of purulent meningitis could only be made by means of the inflammatory liquor parameters. ⋯ One patient developed a biliary concrement. No patient died; 5 patients had prolonged fever (greater than 5 days), and 2 were left with persistent hearing deficiencies. CTR can be recommended as a safe and effective antibiotic agent for once daily treatment of bacterial meningitis in children.
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The objective of this study was to assess the impact of intravenous infusion systems on the pharmacokinetic parameters of tobramycin in newborn infants. Thirty infants (gestational age 28-38 weeks; birth weight 0.8-3.5 kg; postnatal age 4-10 days) with presumed or proven gram-negative infection were studied. Tobramycin (2.5 mg/kg) was administered every 12 h over 0.5 h using two of four infusion systems at similar flow rates in a crossover fashion: syringe pump (auto syringe) versus either IVAC-y site, IVAC-flashball or IMED-y site. ⋯ The apparent distribution volume of tobramycin was 1.02 +/- 0.68 with IVAC-y and 0.65 +/- 0.22 l/kg with auto syringe (p less than 0.05). The elimination half-life was 10.4 +/- 6.9 h with IVAC-y and 6.6 +/- 2.3 h with auto syringe (p less than 0.05); other systems and parameters were not different. These data demonstrate that the type of infusion system can markedly influence the estimation of certain pharmacokinetic parameters of tobramycin in newborn infants.