Cost evaluation of a new IV device in an Israeli hospital

A new device for IV admixtures has been developed in Israel, the Vialink minibag. It consists of a partly filled minibag, attached by rubber tubing to a sterile receptacle into which various types of vials containing drugs can be firmly inserted.Time and motion studies were conducted to determine the time and cost associated with the preparation, dispensing and administration of reconstituted parenteral antibiotics via CIVAS (within minibags or Vialink bags) and preparation by nurses in wards in minibags. CIVAS with minibags was least expensive, followed by Vialink minibags. Self preparation on the ward by nurses was found to be the most expensive system.Only 55 % of all IV admixtures can be prepared by the Vialink system.As only one hospital in Israel has CIVAS, the study provides a solid justification for implementing pharmacy intravenous admixture services in all Israeli hospitals. The advantages and disadvantages of each method are discussed.CIVAS (minibags and Vialink) permits the individualised preparation of sterile admixtures for each patient and provides advantages in terms of efficiency, economy and prevention of errors.Part of this study was published in Harefuah, the Journal of The Israel Medical Association, in September 1993 (Hebrew only; Evaluating CIVAS in Vialink against nurse preparation in wards.)     

Liposomes and Nanoparticles in the Treatment of Intracellular Bacterial Infections

The treatment of infections caused by obligate or facultative intracellular microorganisms is difficult because most of the available antibiotics have either poor intracellular diffusion and retention or reduced activity at the acidic pH of the lysosomes. The need for antibiotics with greater intracellular efficacy led to the development of endocytosable drug carriers, such as liposomes and nanoparticles, which mimic the entry path of the bacteria by penetrating the cells into phagosomes or lysosomes. This Review assesses the potential of liposomes and nanoparticles in the targeted antibiotic therapy of intracellular bacterial infections and diseases and the pharmaceutical advantages and limitations of these submicron delivery systems.     

住院病人抗生素的合理使用回顾与前瞻

本文报告我院抗生素的用药情况,发现抗生素使用面广,应用中存在问题较多,因此,我们采用“药历表”调查病历中抗生素的使用情况,并在提倡“围术期”预防用抗生素等方面做了一些工作。随机抽查1988年7月～1990年4月已出院病历710份,对使用过抗生素的病历进行了回顾性调查,发现抗生素使用率达到85％左右。前瞻性检查方式:参加对严重感染或混合感染病人的会诊用药,并追踪观察抗生素的使用效果;实地检查抗生素所用溶媒、给药间隔、给药方法、配伍变化及联合用药,并对其安全性、合理性进行了讲评,逐步改变目前带普遍性不合理使用的现象和预防性使用抗生素是否合理的问题。     

Structural Specificity of Mucosal-Cell Transport and Metabolism of Peptide Drugs: Implication for Oral Peptide Drug Delivery

The brush border membrane of intestinal mucosal cells contains a peptide carrier system with rather broad substrate specificity and various endo- and exopeptidase activities. Small peptide (di-/ tripeptide)-type drugs with or without an N-terminal -amino group, including -lactam antibiotics and angiotensin-converting enzyme (ACE) inhibitors, are transported by the peptide transporter. Poly-peptide drugs are hydrolyzed by brush border membrane proteolytic enzymes to di-/tripeptides and amino acids. Therefore, while the intestinal brush border membrane has a carrier system facilitating the absorption of di-/tripeptide drugs, it is a major barrier limiting oral availability of polypeptide drugs. In this paper, the specificity of peptide transport and metabolism in the intestinal brush border membrane is reviewed.     

抗生素后效应

抗生素后效应是近年来在抗生素化疗领域中受到重视的一种新理论。本文将各种抗生素的抗生素后效应加以综述。     

头孢类抗生素国内市场状况

目的为国内制药企业及相关科研单位的品种开发提供参考。方法根据所查阅的文献综述了近年来国内头孢类抗生素品种的发展状况、生产厂家、产量及医院用药情况。结果与结论提供了国内头孢类抗生素的开发品种及最新进展     

检测六种抗肿瘤抗生素对五种耐药细菌的杀灭效果

目的:研究抗肿瘤抗生素对耐药细菌的杀灭效果。方法:选用6种抗肿瘤抗生素平阳霉素、放线菌素D、丝裂霉素、柔红霉素、多柔比星和表柔比星,用微量方法检测其对临床常见的5种耐药细菌金黄色葡萄球菌、绿脓假单胞菌、粪肠球菌、阴沟肠杆菌和肺炎克雷伯菌的最低抑菌浓度(MIC)和最低杀菌浓度(MBC)。结果:6种抗肿瘤抗生素对耐药性金黄色葡萄球菌有较强的杀灭作用;对其他4种耐药细菌有不同程度的杀灭作用,MIC为:4.9×10-3～2.9×10-6mol/L;MBC为:7.5×10-4～2.9×10-6mol/L。结论:6种抗肿瘤抗生素抗耐药细菌的作用依次为:丝裂霉素>柔红霉素>平阳霉素>多柔比星>放线菌素D>表柔比星。     

Peritonsillar abscess – critical analysis of abscess tonsillectomy

The risk of secondary haemorrhage following abscess tonsillectomy is reported in the literature with differing rates. A retro‐ and prospective analysis of complication rates following abscess tonsillectomy was conducted in 142 patients (54 females, 88 males; mean age: 35 years). In 22% of patients, a secondary haemorrhage occurred. In half of these (11% of total), the haemorrhage had to be treated surgically. Secondary haemorrhage occurred most commonly on the 6th and 8th postoperative days. Reports in the literature are not in unison about the risk of secondary haemorrhage following abscess tonsillectomy and therefore allow no final judgement about an objective risk of this complication. This report strengthens the results of the ‘Comparative Audit Service’ analysis from 1997, which did show a high risk of secondary haemorrhage following tonsillectomy, as well as following abscess tonsillectomy.     

急性上呼吸道感染患儿外周血C-反应蛋白的测定及临床意义

目的　 探讨C 反应蛋白 (CRP)对急性上呼吸道感染患儿在诊断和治疗中的临床意义。 方法 　选择 373例在急诊科就诊的患儿 ,采集指端全血 40 μL ,进行血常规检查 ,同时用免疫比浊方法进行C 反应蛋白检测 ,将测定的CRP结果与WBC计数做比较 ;将第二次、第三次测定的CRP结果与前次的CRP做比较。 结果 　 373例血标本中CRP <8mg/L 341例 ,占 91 4 2 %;CRP >10 0mg/L 4例 ,占 1 0 7%;CRP在 8～ 10 0mg/L 2 8例 ,占 7 5 1%;WBC计数在 10× 10 9/L以下 318例 ,占 85 2 6 %;CRP <8mg/L ,同时WBC数在 10× 10 9/L以上 35例 ,占 9 38%;CRP≥ 8mg/L ,同时WBC数在 10× 10 9/L以下 12例 ,占 3 2 2 %;第二次测定C 反应蛋白的 32例中较前次降低的为 30例 ;另 2例经调整治疗后第三次复查也较前次降低。 结论 　CRP检测在急性上呼吸道感染患儿中对鉴别细菌或病毒感染以及判定抗生素疗效方面具有较高的价值 ,值得推广。     

吸附树脂及其在天然产物和抗生素中的应用

简要介绍了吸附树脂的概念、发展和最新的研究进展；药用吸附树脂的研究现状，以及在天然产物和抗生素分离纯化中的应用进展。