Journal of chemotherapy
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Journal of chemotherapy · Feb 2003
Disseminated aspergillosis in intensive care unit patients: an autopsy study.
Disseminated aspergillosis is an uncommon but frequently fatal disease in critically ill populations. With studies suggesting that the incidence of this disease is increasing, and with relatively few epidemiological data available in this population, we evaluated cases of disseminated aspergillosis identified at autopsy over a one-year period on a 31-bed mixed medico-surgical intensive care unit (ICU) of an academic university hospital. In 1999, there were 489 deaths out of 2984 ICU admissions, and 222 autopsies were performed. ⋯ In each patient, sputum and bronchoalveolar lavage (BAL) cultures had been positive for Aspergillus fumigatus after ICU admission but this was considered as colonization and the patients were given fluconazole for suspected candidal infection. In conclusion, COPD patients treated with corticosteroids and presenting with pulmonary infection should be considered at risk for disseminated aspergillosis. The rapidly fatal outcome after ICU admission suggests that colonization with Aspergillus can occur before ICU admission.
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Journal of chemotherapy · Aug 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialAmoxicillin/clavulanic acid versus cefotaxime for antimicrobial prophylaxis in abdominal surgery: a randomized trial.
Amoxicillin/clavulanic acid (amoxicillin 2 g/clavulanic acid 200 mg) has been administered in comparison to cefotaxime (2 g) for antimicrobial prophylaxis in 476 evaluable patients undergoing abdominal surgery at high risk of septic complications. Both antibiotics were administered as a single infusion. 205 evaluable patients (110 in amoxicillin/clavulanic acid group and 95 in cefotaxime group) underwent upper gastrointestinal surgery (including gastroduodenal and biliary surgery). The wound infection rate was 4.5% for amoxicillin/clavulanic acid and 7.4% for cefotaxime, with no significant differences. ⋯ No serious adverse events and no cases of diarrhea were observed. In conclusion, in our experience amoxicillin/clavulanic acid proved to be as effective as cefotaxime in protecting patients from surgical infections in abdominal surgery. Its use in surgical prophylaxis may help decrease the cost of treatment and reduce the risk of resistance to antibiotics and superinfections.
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Journal of chemotherapy · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialComparative analysis of azithromycin and clarithromycin efficacy and tolerability in the treatment of chronic prostatitis caused by Chlamydia trachomatis.
A total of 123 patients, older than 18 years of age, with symptoms of chronic prostatitis and inflammatory findings as well as the presence of Chlamydia trachomatis confirmed by DNA/RNA DIGENE hybridization method in expressed prostatic secretion or in voided bladder urine collected immediately after prostatic massage, were examined. The patients were randomized to receive a total of 4.5 g of azithromycin for 3 weeks, given as a 3-day therapy of 1 x 500 mg weekly or clarithromycin 500 mg b.i.d. for 15 days. ⋯ In the group of patients with chronic chlamydial prostatitis the eradication rates (azithromycin 37/46, clarithromycin 36/45) and the clinical cure rates (azithromycin 32/46, clarithromycin 32/45) were not significantly different with regards to the administered drug (p > 0.05). In the group of patients with asymptomatic chlamydial prostatitis the eradication rates (azithromycin 11/16, clarithromycin 10/15) were not significantly different with regards to the administered drug (p = 1.00, OR = 1.1).
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Journal of chemotherapy · Apr 2002
Clinical TrialGabapentin for relief of neuropathic pain related to anticancer treatment: a preliminary study.
The aim of our study was to explore a potential analgesic effect of gabapentin in patients with neuropathic pain caused by anticancer treatment. A total of 23 outpatients without active disease and with chronic, treatment-related pain were included in this single-center, open-label, exploratory, non-controlled study. The primary end-points were pain intensity and pain relief following a 4-week treatment period. ⋯ Pain relief increased from 8.33% (+/- 13.64) to 66.58% (+/- 18.35) (p <0.01). Somnolence, mental clouding, and headache were the most frequently reported adverse events. We concluded that gabapentin should be accepted for further investigation in this important setting of supportive care.
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Journal of chemotherapy · Apr 2002
Multicenter StudyPhysicians' antibiotic prescribing habits for upper respiratory tract infections in Turkey.
The aim of this study was to evaluate the antibiotic prescription rates for upper respiratory tract infections (uRTIs) by primary care physicians in Samsun, Turkey. Data were obtained from the records of 2,083 visits to 8 primary care areas. Trained research students were stationed on site at each of the 8 primary care areas during the study period. ⋯ Errors were frequent in relation to dosage, dosage interval and duration of therapy. Overuse of antibiotics is widespread in our geographic area. Both administrative and educational intervention should be implemented to improve antibotic prescribing habits at the primary health care level to reduce the unnecessary use of antimicrobial agents.