儿童幽门螺杆菌感染患儿不同治疗方案的疗效观察

目的观察克拉霉素、阿莫西林、奥美拉唑三联短程疗法对幽门螺杆菌(Hp)感染的根除率,探讨初治失败后治疗方案的选择。方法经胃镜检查、组织活检确诊为Hp感染患儿86例,男50例,女36例。分为克拉霉素组62例,用克拉霉素、阿莫西林、奥美拉唑三联1周疗法;甲硝唑组24例,用甲硝唑、阿莫西林、奥美拉唑三联2周疗法。停药后4周,检测Hp根除率。对2组初治失败者进行复治,克拉霉素组增加克拉霉素剂量和延长奥美拉唑疗程;甲硝唑组采用克拉霉素三联1周疗法。复治再失败者采用铋剂四联疗法。结果克拉霉素组Hp根除率91.9%(57/62)较甲硝唑组75%(18/24)高,有显著性差异(χ2=4.448P<0.05)。本组共11例根除失败,采用3种复治方法后,根除率分别为80%(4/5)、66.7%(4/6)、100.0%(3/3)。结论克拉霉素三联1周短程疗法是根除儿童Hp感染的理想治疗方案。适当增加克拉霉素剂量和延长奥美拉唑疗程可提高根除率。采用铋剂四联法对克拉霉素耐药者有效。     

HPLC法测定新肤螨灵软膏中甲硝唑的含量

目的采用高效液相色谱法测定新肤螨灵软膏甲硝唑含量。方法色谱柱为Diamonsil-C18柱(250mm×4.6mm,5μm),甲醇-水(20∶80)为流动相,流速为1.0ml.min-1,检测波长为315nm。结果线性范围为7.614~38.07μg.ml-1(r=0.9996),甲硝唑的平均回收率为100.3%,RSD为0.66%。结论该法简便、灵敏、准确。     

幽门螺杆菌的耐药分析及对Hp根除的影响

目的探讨幽门螺杆菌(Hp)对常用抗菌药的耐药性及对Hp根除的影响,给临床提供合理用药的科学依据.方法采用用改良布氏活性炭培养基(平板)在微需氧环境中培养幽门螺杆菌,并利用琼脂稀释法行幽门螺杆菌的药敏试验.并用三联疗法对62例消化性溃疡进行Hp根除治疗.结果从112例消化性溃疡患者胃黏膜中培养出Hp 62株,对阿莫西林、四环素、克拉霉素、甲硝唑、替硝唑、呋喃唑酮的耐药率分别为1.61%、3.23%、11.2%、58.1%、3.23%、0%.7d根除治疗对Hp的总根除率为:对甲硝唑及克拉霉素敏感株根除率为91.5%,对甲硝唑耐药株根除率为52%,对克拉霉素耐药株根除率为0(P＞0.05).结论阿莫西林、替硝唑、四环素、呋喃唑酮的耐药率较低;而甲硝唑和克拉霉素耐药率较高.其耐药影响Hp根除.     

聚乙烯吡咯烷酮K30在甲硝唑片制备中的应用

目的研究辅料聚乙烯吡咯烷酮K30(PVPK30)对甲硝唑片质量的影响.方法依照中国药典2000年版二部测定甲硝唑片的溶出度.结果加入辅料PVPK30的甲硝唑片较原处方的溶出度明显加快,两者T50有显著差异(片1T50=11.5 min,片2T50=6.8 min).结论辅料PVPK30能提高甲硝唑片的质量.     

高效液相色谱法测定甲诺参洗剂中甲硝唑及诺氟沙星的含量

目的:建立同时测定甲诺参洗剂中甲硝唑和诺氟沙星含量的高效液相色谱法.方法:采用Kromasil C 18 色谱柱(250 mm× 4.6 mm,5 μm),0.7%三乙胺(以磷酸调pH至 3.0 )-甲醇(200∶300)为流动相,流速为 1.0 mL·min -1 ,检测波长为290 nm.结果:甲硝唑在 20.0 ～ 150.0 mg·L -1 范围内,峰面积与其浓度线性关系良好(r= 0.999 9 ),平均回收率为 100.4% ,重复性试验RSD为 0.4% (n=5),检测限为 4.0 ×10 -3 μg;诺氟沙星在 10.0 ～ 75.0 mg·L -1 的范围内,峰面积与其浓度线性关系良好(r= 0.999 9 ),平均回收率为 98.6% ,重复性试验RSD为 0.5% (n=5),检测限为 2.0 ×10 -3 μg.结论:本法准确、简便、快速,具有专属性强,灵敏度高的特点,适用于含甲硝唑及诺氟沙星制剂的含量测定.     

甲硝唑结肠定位肠溶片的制备及质量控制

目的:研制甲硝唑结肠定位肠溶片的制备工艺和处方,考察其体外释放度并制定该剂型的质量评价标准.方法:模拟服药后该剂型在胃肠道中的生理释药过程,用3种不同pH值的磷酸盐缓冲液作为释放介质,分别在其最大吸收波长277,321和317nm处检测甲硝唑的吸收度,并根据特定时间的药物吸收计算出累计释放度.结果:药片在人工胃液、pH 6.8人工肠液不释药;在pH 7.8人工结肠液中2～20μg穖L-1范围内线性良好,平均回收率104.8%,RSD为0.98%.结论:甲硝唑结肠定位肠溶片的体外释放度检测结果合格.     

头孢噻肟与甲硝唑注射液配伍的稳定性研究

目的研究头孢噻肟与甲硝唑注射液的配伍稳定性,为临床合理用药提供科学依据.方法选择10、25、37℃在24 h内观察配伍液的外观、pH值及头孢噻肟与甲硝唑紫外光谱的变化,用高效液相色谱法测定两者的含量.结果其稳定性与温度有关.结论头孢噻肟与甲硝唑注射液配伍液基本稳定,两药在温度为25℃以下时可合用;高温时配伍液不宜放置过久.     

Evolution of Helicobacter pylori susceptibility to antibiotics during a 10‐year period in Lithuania

The study evaluated the changes in the prevalence of Helicobacter pylori strains with primary resistance to antibiotics during the last 10 years in Lithuania. H. pylori susceptibilities to antibiotics were tested in 89 patients in 1998, in 81 patients in 2001 and in 90 patients in 2007/2008. Susceptibility to metronidazole, clarithromycin, amoxicillin and tetracycline was tested using E‐test or agar dilution method. Susceptibility to ciprofloxacin was only tested in 2007/2008. Data about utilization of all authorized and available on market macrolides and clindamycin in Lithuania during 2003–2007 were evaluated using WHO ATC/DDD methodology. A total of 260 H. pylori strains cultured from untreated adult patients were investigated. Primary resistance rates (1998, 2001 and 2007/2008) for metronidazole were 24.7%, 33.3%, and 35.6%, for clarithromycin 1.1%, 3.7%, and 3.3% and for tetracycline 0%, 2.5% and 0% respectively. No cases of amoxicillin resistance have been detected. The resistance rate for ciprofloxacin was 5.6% in 2007/2008. Data of total macrolides and clarithromycin utilization in Lithuania revealed that despite an increase of consumption of these drugs in Lithuania during 2003–2007 in 1.5 times, the total macrolide consumption remains one of the lowest in Europe. We have not observed any significant changes in the susceptibility of H. pylori to the most widely used antibiotics during the recent 10‐year period. The low resistance rate to clarithromycin might be related to the policy to avoid use of macrolides as first‐line treatment for pulmonary and other infections.     

Treatment of Giardiasis after Nonresponse to Nitroimidazole

During January 2008–October 2013, a total of 12 cases of giardiasis at the Chaim Sheba and Shaare Zedek Medical Centers, Israel, did not respond to nitroimidazole; 83.3% were associated with travel and 33% with immunoglobulin deficiency. Among 110 published cases, the most effective treatment was quinacrine (efficacy 90%–100%), but its availability is limited.