扁桃酸栓与甲硝唑栓治疗阴道滴虫病的比较

目的：验证扁桃酸栓治疗阴道滴虫病的疗效。方法：阴道滴虫病病人１５０例，采用随机单盲法分成２组。治疗组１００例（年龄３４±ｓ６ａ）用扁桃酸栓（１００ｍｇ／粒），每晚临睡时放入阴道中１粒，疗程为４ｄ。对照组５０例（年龄３４±６ａ）用甲硝唑栓（２００ｍｇ／粒），每晚临睡时放入阴道中１粒，疗程为７ｄ．结果：治疗组痊愈６１％，显效２９％，有效１０％。对照组痊愈５２％，显效４０％，有效８％。２组疗效相似（Ｐ＞０．０５），且均未发现明显不良反应。结论：扁桃酸栓治疗阴道滴虫病疗效与甲硝唑栓相似。     

Metronidazole concentrations in plasma, saliva and periodontal pockets in patients with periodontitis

OBJECTIVES: Metronidazole is widely used antibacterial compound in the treatment of some types of periodontal disease. Pharmacokinetics of metronidazole in plasma has been well-described but few data exist about penetration of the drug to the gingival crevice fluid. The aim of the present study was to compare the concentrations of metronidazole in plasma, saliva and gingival crevice fluid in patients with periodontitis after multiple administration. MATERIALS AND METHODS: Eleven patients with severe generalised adult periodontitis participated in the study. Metronidazole, 500 mg, was administered orally two or three times per day for at least 2 days before sample collection. Samples were collected 2 h after last dose. Metronidazole concentrations in all fluids were measured with high-performance liquid chromatography. RESULTS: Mean drug concentrations in plasma, saliva and crevice fluid were 14.33, 15.15 and 12.86 microg/ml, respectively. Difference between plasma and crevice fluid or between plasma and saliva did not reach statistical significance. CONCLUSION: Present study revealed that metronidazole penetrates well into gingival crevice fluid and saliva. Metronidazole concentrations in crevice fluid are about equal to the protein unbound drug concentrations in plasma. Therefore, general pharmacokinetic data of metronidazole can be also applied in the treatment of periodontal disease and in the design of respective treatment regimens.     

泮托拉唑、阿莫西林和甲硝唑联合治疗幽门螺杆菌阳性消化性溃疡的疗效观察

目的观察并分析泮托拉唑、阿莫西林和甲硝唑联合治疗幽门螺杆菌阳性消化性溃疡的临床疗效,为临床治疗方案提供参考依据。方法将120例患者根据入选先后顺序进行随机分组,随机分为观察组(给予泮托拉唑、阿莫西林和甲硝唑联合治疗,n=60例)和对照组(给予泮托拉唑,60例),对比两组的疗效及并发症,以及随访3,6,12个月后对比其复发率情况。结果两组患者年龄、性别、病程等临床资料比较,差异无统计学意义(P>0.05),观察组的总有效率明显高于对照组(P<0.05),观察组随访3个月和12个月的复发率明显低于对照组(P<0.05)。结论泮托拉唑、阿莫西林和甲硝唑联合治疗幽门螺杆菌阳性消化性溃疡疗效确切、并发症少,复发率低,值得临床推广应用。     

阴道毛滴虫双链RNA病毒感染及其对甲硝唑耐药性的影响

目的调查河南地区阴道毛滴虫临床分离株阴道毛滴虫病毒感染情况,探索病毒感染对阴道毛滴虫甲硝唑耐药性的影响。方法 TYM(trypticase-yeast extract-maltose)无菌培养基培养阴道毛滴虫临床分离株,达到纯培养后提取虫体总核酸(DNA和RNA),进行1%琼脂糖凝胶电泳分析;连续稀释法测量每株虫体的甲硝唑最小致死浓度。结果对30株阴道毛滴虫总核酸进行电泳,其中6株有5.5 kb双链RNA病毒带,病毒感染率为20.0%。阴道毛滴虫病毒阴性组甲硝唑最小致死浓度为(24.27±20.899)μg/ml,病毒阳性组为(5.68±3.588)μg/ml,差异有统计学意义(t=2.143,P<0.05)。结论河南地区阴道毛滴虫临床分离株中检测到阴道毛滴虫病毒,无阴道毛滴虫病毒寄生的虫体易发生甲硝唑抵抗。     

Clostridium Difficile Infection in the "Oldest" Old: Clinical Outcomes in Patients Aged 80 and Older

OBJECTIVES: Clostridium difficile infection (CDI) represents a cause of substantial morbidity, particularly for older adults. Although older age is a risk factor for CDI, few studies have specifically focused on clinical outcomes in older adults, particularly the "oldest" old.
DESIGN: Retrospective review.
SETTING: University of Michigan Health System.
PARTICIPANTS: All patients aged 80 and older with a positive cytotoxin assay for C. difficile and a clinical course consistent with CDI during 2006.
MEASUREMENTS: Clinical data were recorded, including comorbid conditions and treatment regimens, as well as outcomes, including treatment failure, infection relapse, and 90-day mortality.
RESULTS: Seventy patients aged 80 and older (mean 84.0±4.1) with CDI were identified. Metronidazole was given as initial therapy in 65 (92.8%); 18 of these 65 (27.7%) experienced treatment failure, requiring subsequent use of oral vancomycin. Serious adverse events included three episodes of toxic megacolon, two requiring colectomy. One death was directly attributable to CDI. All-cause mortality was 8.6% at 30 days and 17.1% at 90 days. Higher white blood cell (WBC) counts were independently associated with treatment failure ( P =.02) and coronary artery disease with 90-day mortality ( P =.02).
CONCLUSION: In older adults with CDI, treatment failure on metronidazole occurred frequently and was associated with higher WBC count. Larger prospective studies are needed to determine risk factors for treatment failure and relapse in order to develop better paradigms for CDI treatment in older adults. Initial therapy with vancomycin may be appropriate for elderly patients, especially those with elevated WBC counts.     

Simultaneous determination of metronidazole and spiramycin in bulk powder and in tablets using different spectrophotometric techniques

Metronidazole (MZ) is an anti-infective drug used in the treatment of anaerobic bacterial and protozoa infections in humans. It is also used as a veterinary antiparasitic drug. Spiramycin (SP) is a medium-spectrum antibiotic with high effectiveness against Gram-positive bacteria. Three simple, sensitive, selective and precise spectrophotometric methods were developed and validated for the simultaneous determination of MZ and SP in their pure form and in pharmaceutical formulations. In methods A and B, MZ was determined by the application of direct spectrophotometry and by measuring its zero-order (D(0)) absorption spectra at its λ(max) = 311 nm. In method A, SP was determined by the application of first derivative spectrophotometry (D(1)) and by measuring the amplitude at 218.3 nm. In method B, the first derivative of the ratio spectra (DD(1)) was applied, and SP was determined by measuring the peak amplitude at 245.6 nm. Method C entailed mean centering of the ratio spectra (MCR), which allows the determination of both MZ and SP. The methods developed were used for the determination of MZ and SP over a concentration range of 5-25 μg ml(-1). The proposed methods were used to determine both drugs in their pure, powdered forms with mean percentage recoveries of 100.16 ± 0.73 for MZ in methods A and B, 101.10 ± 0.90 in method C, 100.09 ± 0.70, 100.02 ± 0.88 and 100.49 ± 1.26 for SP in methods A, B and C, respectively. The proposed methods were proved using laboratory-prepared mixtures of the two drugs and were successfully applied to the analysis of MZ and SP in tablet formulation without any interference from each other or from the excipients. The results obtained by applying the proposed methods were compared statistically with a reported HPLC method and no significant difference was observed between these methods regarding both accuracy and precision.     

中西医结合治疗滴虫性阴道炎60例临床观察

目的：探讨口服甲硝唑联合蛇床子散中药熏洗治疗妇女滴虫性阴道炎的疗效。方法：将120例滴虫性阴道炎患者随机分为2组。治疗组60例患者采用口服甲硝唑联合蛇床子散中药熏洗治疗,对照组60例患者口服甲硝唑加阴道塞甲哨唑栓。结果：治疗组总有效率98.33%,明显优于对照组的85.00%（P〈0.01）。结论：口服甲硝唑联合蛇床子散中药熏洗是更为有效的治疗妇女滴虫性阴道炎的方法。     

甲硝唑注射液无菌检查方法的验证

目的：确定甲硝唑注射液的无菌检查方法。方法：按中国药典2005年版二部无菌检查法[1]（附录XIH）中薄膜过滤法进行验证。结果：采用薄膜过滤法细菌以500ml/筒冲洗量、真菌以300ml/筒冲洗量检查,在规定条件下敏感菌可正常生长。结论：甲硝唑注射液的无菌检查可采用薄膜过滤法检查（500ml/筒冲洗量）。     

高效液相色谱法同时测定复方参芷痤疮酊中甲硝唑和氯霉素含量

目的建立可同时测定复方参芷痤疮酊中甲硝唑和氯霉素含量的高效液相色谱（HPLC）法。方法采用Thermo BDS HypersilC18色谱柱（250mm×4.6mm,5μm）,流动相为甲醇-0.05mol/LK2HPO4（26∶74）,检测波长为277nm,流速为1.0mL/min。结果甲硝唑进样量在79.28～951.36μg（r=0.9999）范围内与峰面积线性关系良好,平均回收率为99.80%,RSD=0.46%（n=6）;氯霉素进样量在82.88～994.56μg（r=0.9999）范围内与峰面积线性关系良好,平均回收率为99.60%,RSD=0.78%（n=6）。结论 HPLC法准确可行,重复性好,能有效控制复方参芷痤疮酊的质量。     

Designing of the mucoadhesive intravaginal spermicidal films

A mucoadhesive drug delivery system for local delivery of metronidazole through vaginal route was formulated. Films were prepared by solvent evaporation method using various compositions of Carbopol, hydroxypropylmethylcellulose, chitosan, Polyox and propylene glycol. The films were evaluated for their weight, thickness, surface pH, folding endurance, mechanical, drug content uniformity, in vitro drug release, swelling, gelling and mucoadhesion property. All the films possess satisfactory film characteristics. Films made of Polyox found to possess acceptable, physicochemical, mechanical, gelling and mucoadhesion property for delivery of metronidazole.