Chemioterapia : international journal of the Mediterranean Society of Chemotherapy最新文献

The in vitro activities of cefixime and seven comparative oral antimicrobials were studied. MIC90S of cefixime were 0.015-1 micrograms/ml for Haemophilus influenzae, Branhamella catarrhalis, Escherichia coli, Klebsiella, Citrobacter diversus, Proteus, Providencia, Aeromonas hydrophila and Streptococcus. MIC90S for other Enterobacteriaceae were greater than or equal to 2 micrograms/ml; 44% of those strains were inhibited by less than or equal 1 microgram/ml. Staphylococcus, Psuedomonas aeruginosa and Enterococcus faecalis were resistant to cefixime.

Twenty-five children (16 females and 9 males) aged from 8 months to 10 years with clinical and laboratory evidence of UTI were treated with sulbactam + ampicillin (SBT/AMP). Twenty-four of them were suffering from cystitis and one from pyelonephritis. Four of them were treated unsuccessfully prior to entry in the trial. The mean final dose of SBT/AMP was 47.69 mg/kg/die (ratio of SBT-AMP was 1:2). The patients were treated for 3 to 8 days (mean: 4.76 days). 84% were treated by i.m. route. No side effects or adverse experience were reported. Clinical cure was achieved in 25 patients (100%).

alpha-Interferon and beta-interferon have been used therapeutically in chronic hepatitis B virus (HBV) infection for more than a decade. It is now clear that alpha-interferons are an effective therapy for a proportion of chronic HBV carriers. A course of at least three, and possibly as long as 4 months is required at a dose of 5-10 MU three times a week. Those responding to therapy usually develop a marked hepatitis in the second and third months of therapy, which precedes permanent loss of markers of viral replication. In a proportion of patients, not only are HBe antigen and HBV DNA cleared from serum, but HBsAg may also be cleared, albeit over a longer time course; anti-HBs develops in a few of these patients. Although close to being an established form of therapy for chronic HBV infection, the responsive subgroups remain to be defined. Studies over the next few years will be directed at identifying those groups responsive, or not responsive, to alpha-interferons and thereafter seeking other antiviral agents that could be used in combination with alpha-interferon to augment the response rate.

Between January, 1974 and July, 1985 66 patients with non-metastatic malignant fibrous histiocytoma (MFH) of bone in the estremities were surgically treated with amputation (34 cases) or resection (32 cases) according to the extension of the tumor. With the exception of 3 patients, who had severe medical contraindications to the chemotherapeutic drugs, all the patients were offered, in addition to the surgery, adjuvant chemotherapy (patients treated before 1983) or neoadjuvant chemotherapy (patients treated after 1983). 33 patients accepted, while 30 wanted to be treated with surgery alone. At median follow-up of 7 years (3-14) 25 patients remained continuously disease-free and 41 relapsed (27 with metastatic disease, 1 with local recurrence and 13 with both metastases and local recurrence). The percentage of patients who remained continuously disease-free was 12.1% (4:33) in the group of patients treated with surgery alone and 63.5% (21:33) in the group treated with surgery plus adjuvant or neoadjuvant chemotherapy. Although the two groups of patients were not completely superimposable (the patients treated with surgery alone were older and more often the MFH arose in pre-existing bone lesions) these results seem to suggest the usefulness of adjuvant and neoadjuvant chemotherapy for this tumor.

This work was carried out to study the pattern of use of antimicrobial agents in Egypt. 2034 files were selected from two general hospitals by a systematic random sampling method, and the data concerning the antimicrobials were collected from each file. The results of this study showed that there was misuse of these agents both in therapy and prophylaxis. Antibiotics were prescribed to 80.17% of admitted patients. In most of the cases they were prescribed without documented proof of infection and were prescribed for conditions in which antimicrobial use is not justified for either therapy or prophylaxis. Among patients who received antibiotics, 30.8% received repeated courses, in most of whom there was no reasonable indication.

The cost of antimicrobial chemotherapy is a major part of the total hospital pharmacy cost. Parenteral administration is considerably more expensive than oral and until recently was the only available therapy for nosocomial and resistant bacterial infections. Apart from the cost of the antimicrobial agent itself, many other factors such as the infusion sets, catheters and cannulae, monitoring of blood to avoid toxicity and other laboratory investigations will influence the costs. The introduction of ciprofloxacin, a new quinolone, with a wide range of bacterial activity which can be prescribed orally, will have economic advantages in the treatment of hospital infections.

We treated 21 patients with advanced breast cancer with buserelin, aminoglutethimide and cortisone acetate in an attempt to obtain a complete estrogen blockade both in premenopausal and postmenopausal patients. Ten patients (47%) obtained an objective response without any relevant side-effects. Dealing with hormonal data, it must be outlined that serum testosterone levels decreased significantly in postmenopausal patients, suggesting a possible explanation for the activity of luteinizing hormone-releasing hormone analogue in this group of patients.

The efficacy of human lymphoblastoid interferon (Wellferon) was studied in 25 patients with anti-HBe positive, HBV DNA positive chronic hepatitis B. The patients were randomized to receive 5 MU/m2, three times weekly or no treatment for 6 months. The study is ongoing and to date 19 patients have been followed up for more than 3 months and 14 for more than 6 months. At 9 months, serum HBV DNA had become negative and ALT levels normalized in 57% of interferon-treated patients. This compared with 33% becoming serum HBV DNA negative and 16% with ALT normalization in the untreated group. Clearance of HBV DNA in interferon treated patients was not consistently associated with the appearance of transaminase peaks during therapy, in contrast with those seen in HBeAg positive patients. The preliminary results of this trial suggest that interferon reduces HBV replication in anti HBe/HBV DNA positive patients with chronic hepatitis B.

The aim of this study was to evaluate the efficacy of human lymphoblastoid interferon (Wellferon) in the treatment of chronic hepatitis B virus (HBV) infection. To date 70 patients have entered the study, 33 randomized to receive interferon at doses of 5 MU/m2 i.m. daily for the first 4 weeks and three times weekly for 5 months thereafter and 31 acted as controls. Seventy-nine per cent of the treated group permanently cleared HBV DNA compared with 48% of the control group (p = 0.01): 69% of the treated patients and 38% of the controls who eliminated HBV DNA cleared HBeAg, HBeAb (p = 0.02). Twenty-four per cent of the treated patients and 3% (p = 0.01) of the control group had clearance of HBsAg and seroconversion to HBsAb. From these results it was concluded that interferon had a therapeutic effect on Italian heterosexual patients with chronic hepatitis B viral replication.