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

The difficulties encountered in the treatment of onychomycosis are primarily related to the necessity of prolonged systemic therapy. Many of these difficulties could, then, be avoided by the use of an effective local treatment. The present study compared the effectiveness and tolerability of two topical ungual preparations: a 28% solution of tioconazole and a 2% tincture of miconazole. The therapeutic results and tolerability of both preparations were found to be satisfactory. The tioconazole preparation proved to be slightly more effective although the difference was not statistically significant.

The antitumor activity of hexamethylmelamine (HMM) was tested in various mouse tumor models in the presence or absence of host-vs-tumor graft responses. The drug was moderately active against Sarcoma-180 growing in different strains of non-sensitized mice. Strong protection was afforded when recipients were preimmunized with irradiated tumor cells 15 days before tumor challenge followed by HMM treatment. The drug did not show antitumor activity against two radiation-induced lymphomas of congenic mice of B10 background, inoculated into H-2 compatible hosts, or into mice incompatible for subregions of H-2. In this model HMM increased mortality of allogeneic mice presumably through impairment of host-vs-lymphoma graft resistance. In conclusion this study shows that synergistic or antagonistic effects can be obtained by combining chemotherapy with antitumor immune responses.

In hamsters the administration of clindamycin provokes a fatal diarrhea and death in 1-2 days. This study was performed in order to assess the possible protective effect of three cephalosporins in clindamycin-induced enterocolitis in these laboratory animals. The efficacy of cefotetan was compared with that of cefoxitin and latamoxef: the hamsters were treated twice daily for 5 days with clindamycin (10 mg/kg) by oral route, and cefotetan, cefoxitin and latamoxef (100 mg/kg) were given subcutaneously. All animals developed "wet-tail syndrome", but cefotetan and latamoxef were able to protect a large percentage of hamsters from death and to prolong the survival time.

Twenty ambulatory patients, living in kibbutzim (communal villages, which have a permanent medical staff) were treated with ceftriaxone 1 g daily I.M. for ten days. These patients suffered from moderate to severe infections which were not life-threatening. Twelve had urinary tract infections (UTI), 3 of which were positive blood cultures. Four patients had soft tissue infections (one with a Group A beta-hemolytic Streptococcus bacteremia). Three patients had respiratory infections, and one elderly patient had Salmonella typhimurium gastroenteritis. All the patients in this series were clinically cured. Three patients with a UTI experienced reinfection. The woman with S. typhimurium gastroenteritis had persistent positive fecal cultures, but was asymptomatic. These 4 patients did not require further antibiotic therapy. The only side effect observed was mild diarrhea in one patient. Two other ambulatory patients with typhoid fever were treated with ceftriaxone 2 g daily I.V. for 10 days with excellent results. Our work showed that ceftriaxone 1 g daily can be a safe and inexpensive antimicrobial choice to shorten or prevent hospitalization.

Male Wistar rats received adriamycin, aclacinomycin or thepirubicin at a dose of 4 mg/kg b.w. by slow infusion. Cardiac tissue sections were examined by fluorescence microscopy to evaluate the distribution of the three anthracyclines. The nuclei regularly exhibited a stronger coloring with respect to the cytoplasm for all three drugs. Adriamycin cytoplasm fluoresced intensely, unlike aclacinomycin and thepirubicin. Our results indicate a lower uptake of these last two molecules into cardiac tissue, thus suggesting a different pharmacokinetic profile which might account for their lower cardiotoxicity.

The aim of the present paper is to investigate the influence of the infusion rate on doxycycline concentrations in rat body fluids (serum and experimental pleural exudate) and tissues (muscle). The same dose of antibiotic (30 mg/kg) was given both as a bolus and by drip-infusion over 30 min. The drug concentrations in serum samples and tissue specimens were measured by a microbiological method. The highest serum levels and the optimal penetration into muscle and pathological fluids were obtained following drip-infusion.

Imipenem/cilastatin as a single agent or in combination with amikacin was used as empirical treatment of severe hospital infections. Twenty-five patients were evaluable for efficacy and the overall response rate was 62% with imipenem/cilastatin alone and 80% with imipenem/cilastatin in combination with amikacin. The highest response rate was obtained in urinary tract infection (75%) and in pneumonia (70%) and the lowest response rate (50%) was observed in bacteremia of unknown origin and in skin and soft tissue infections. Eight failures were observed and seven of them occurred in patients treated with imipenem/cilastatin alone. Two deaths occurred, both in patients with bacteremia. Imipenem/cilastatin treatment was interrupted early in 3 patients because the pathogen developed resistance during therapy and in 2 other patients because of side effects. In our study imipenem/cilastatin proved to be efficacious and well tolerated. The addition of an aminoglycoside to imipenem/cilastatin might improve its efficacy and prevent pathogens from becoming resistant during therapy. Therefore this association would seem to be advisable for the therapy of bacteremic infections and for those caused by difficult pathogens.

The effect on long-term survival of immunomodulation adjuvant to various cytotoxic chemotherapy regimens in non-small cell lung cancer (NSCLC) was evaluated in 669 patients followed up between 1974 and 1987. Four hundred seventeen patients were treated only by cytotoxic chemotherapy and served as controls. Two hundred fifty-two patients received warfarin (W), levamisole (L) and tranexamic acid (T) for adjuvant immunomodulation. These drugs, especially when given in combination (W + L + T), led to a significant (p less than 0.05) enhancement of survival in patients with advanced NSCLC, independent of the cytotoxic regimen used.

Thirty patients with advanced and mainly pretreated breast cancer were treated with a combination of premarin, prednimustine, high-dose folinic acid and 5-fluorouracil. Among the 30 evaluable patients, 9 (30%) achieved an objective response (median duration: 9 months). Oral mucositis was the limiting toxicity, while myelosuppression was quite mild. In spite of considerable activity as salvage regimen, these results do not seem better than those achieved in our Institute with high-dose folinic acid and 5-fluorouracil alone.

The bactericidal activity of cefuroxime, cephaloridine and cephalexin is evaluated in an in vitro model. The inocula are derived from an overnight static culture, or after a pre-incubation period of 1 or 2 hours to allow cell re-growth. The early bactericidal effect of the antibiotics is more evident using pre-incubated cells, especially for Staphylococcus aureus 663. At hour 8, with Escherichia coli 851/E, there is re-growth using the static inoculum, while the antibiotic effect is still evident using the pre-incubated one. The importance arises therefore for considering the phase of growth of the inoculum as a critical parameter when using in vitro models with varying concentrations of beta-lactam antibiotics.