Clinical study of miconazole on deep-seated fungal infections]

An investigation was made on the efficacy and the safety of miconazole (MCZ) in the treatment of deep seated mycosis. The drug was administered through intravenous drip infusion at dose levels of 800 to 2,000 mg/day to 21 cases of confirmed mycosis for which causative organisms was identified and to 32 cases to which other antibiotics considered to be appropriate had been administered at febrile stages but had failed to take effect, hence mycoses were strongly suspected. The overall clinical efficacy rate was 84.3% (43/51). Treatments were "remarkably effective" in 6 cases, "effective" in 37, "not effective" in 8 and "indeterminable" in 2. The efficacy rates were 100% (21/21) in the confirmed mycosis cases and 73.3% (22/30) in the suspected mycosis cases. The mycological efficacies in the cases for which causative strains were identified were: disappeared in 14 (66.7%), decreased in 4 (19%), unchanged in 2 (9.5%) and unknown in 1 (4.8%), thus the overall disappearance ratio was 70% (14/20). Chest X-ray showed the disappearance of shadow in 1 patient and improvements in 14 of 23 patients examined. Adverse reactions were observed in 5 of the 53 cases (9.4%). From these results, MCZ may be considered as a highly useful drug not only in the treatment of deep mycosis but also in cases for which mycosis is strongly suspected.     

Therapeutic efficacy of ceftibuten in chronic respiratory tract infections

We evaluated the therapeutic efficacy of ceftibuten (CETB, 7432-S), a new cephem antibiotic for oral use, in chronic respiratory tract infections. A daily dose of 400 mg (b.i.d.: 15 cases) or 600 mg (t.i.d.: 5 cases) of CETB was given orally for 3-14 days (mean: 10.6 days) to 20 patients: 9 with infected bronchiectasis, 3 with infection supervened on pulmonary emphysema, 3 with acute pneumonia (supervened on bronchiectasis in 2 of 3 cases), 2 with infected bronchial asthma, 1 each with infection supervened on old pulmonary tuberculosis, chronic bronchitis and pulmonary fibrosis. The clinical effects were excellent in 3, good in 11, fair in 3 and poor in 3. Eighteen strains were identified as causative organisms. Eight of 15 strains for which bacteriological responses were evaluable were eradicated by the use of CETB. Eosinophilia in 2 patients and an elevation of S-GPT value was observed in 1 patient. These adverse reactions disappeared after the completion of the therapy. From the above results, we conclude that CETB is one of the most useful antibiotics for oral use as a first choice in chronic respiratory tract infections.     

Clinical study of fluconazole on deep-seated fungal infections

Fluconazole is a novel antifungal agent, available in oral and intravenous forms, which was developed by Pfizer Central Research. It is characterized by its long serum half-life (approximately 30 hours) to allow once-a-day dosing and favorable safety profile. Fluconazole was administered orally or intravenously to 166 patients with deep-seated mycosis and it was possible to evaluate clinical efficacies in 99 patients. Clinical cures were obtained in 41 (87.2%) out of 47 cases of candidiasis, in 10 (66.7%) out of 15 cases of cryptococcosis, in 17 (48.6%) out of 35 cases of aspergillosis and in 1 case each (100%) of mucormycosis and mycosis due to an unspecified yeast. Side effects were observed in 10 cases (rash 2, fever 2, abdominal discomfort 1, nausea 1, edema 1, edema/pleural effusion/oliguria 1, finger stiffness 1, hiccup 1) with incidence rate of 6.0%. Drug administrations were discontinued in 4 cases. In general, however, fluconazole was well tolerated. Abnormal changes in laboratory test values due to the drug were observed in 32 cases and incidence rate was 19.3%. These were, however, slight and temporary changes and most of them were in parameters of liver function. It is not clear if these changes were related to the fluconazole administration, because other drugs were concomitantly administered to these cases. These results indicate that fluconazole is an agent with very good potential for the treatment of the systemic deep-seated mycoses.     

Clinical efficacy of fluconazole in urinary tract fungal infections

Fluconazole, a new antifungal agent was administered to 7 patients with complicated urinary tract fungal infections. Patients were 6 males and 1 female with ages of 29 to 83 years, with underlying conditions of bladder tumor (3 patients), neurogenic bladder (3 patients) and hydronephrosis (1 patient). Urinary fungi identified were Candida albicans in 5 patients and Candida tropicalis in 2 patients over 10(4) CFU/ml. These fungi were isolated at least twice in intervals of 5 to 7 days before treatment. Fluconazole was given either orally (4 patients) or intravenously (3 patients) in a dose of 50 mg per day. Clinical efficacies were excellent in 3 patients, moderate in 3 patients and poor in 1 patient, showing an efficacy rate of 85.7%. Mycologically, 6 Candida out of the 7 were eliminated. No side effects nor abnormal laboratory data were observed. In conclusion, fluconazole is effective and safe in the treatment of urinary tract fungal infections.     

Therapeutic efficacy of imipenem/cilastatin sodium on respiratory tract infections in lung cancer patients]

Imipenem/cilastatin sodium (IPM/CS) was used to treat respiratory tract infections (RTI) in 54 patients with lung cancer. Out of the 54 patients studied, 53 were evaluable for the utility of IPM/CS; 42 had pneumonia, 9 had obstructive pneumonia, 1 had a lung abscess and 1 had acute bronchitis. The efficacy rate was 71.7%. Seventeen causative organisms were isolated from 14 patients. They included Staphylococcus aureus 5 strains, Staphylococcus epidermidis 4 strains, Staphylococcus sp. 2 strains, Enterococcus faecalis 1 strain, Pseudomonas aeruginosa 2 strains, Pseudomonas fluorescens 2 strains, Acinetobacter sp. 1 strain, and the eradication rate was 81.8%. Clinical adverse effects (nausea and vomiting) were observed in 1 patient. Abnormalities in laboratory test results were observed in 3 patients. They disappeared or returned to normal values after completion of therapy or discontinuation of IPM/CS administration. IPM/CS appears to be a useful antibiotic for RTI in patients with lung cancer.     

Therapeutic effect of miconazole on fungal infection in patients with hematological malignancies

The effectiveness of miconazole was evaluated in 9 documented fungal infections, 4 of which were candidal sepsis. All patients were receiving therapy for hematological malignancies. Miconazole revealed the excellent effect in 3 patients with candidal esophagitis and 1 patient with candidal sepsis and esophagitis. Twelve patients who received miconazole for presumed or documented fungal infection were evaluated for toxicity. No particular side effects, except for only 1 case of mild hepatic dysfunction, were observed. Miconazole is apparently an effective antifungal agents for treatment of systemic fungal infection in patients with hematological malignancies.     

氟氧头孢对呼吸道感染疗效的临床观察

观察了氟氧头孢（ＦＭＸ）与对照药头孢美唑（ＣＭＺ）对呼吸道感染患者的临床疗效和不良反应。尽管随机分组中ＦＭＸ组患者年龄偏大，基础疾病相对较多，但ＦＭＸ组痊愈率为６３．６％，有效率为９０．９％，与ＣＭＺ组无显著差异；尤其ＦＭＸ对金葡球菌感染最有效（１００％痊愈），细菌清除率（１００％）亦比ＣＭＺ组（８８．９％）高，未见任何不良反应。从而提示ＦＭＸ为一安全有效的新抗生素。     

Therapeutic potential of the new quinolones in the treatment of lower respiratory tract infections

The impact of respiratory infections on public health is increasing and lower respiratory tract infections are a major cause of morbidity and mortality. We are also facing a worldwide burst of antibiotic bacterial resistance. The new fluoroquinolones have an excellent spectrum covering the most important respiratory pathogens, including atypical and 'typical' pathogens. Pharmacokinetic and dynamic properties of the new fluoroquinolones have a significant impact on their clinical and bacteriological efficacy. They cause a concentration-dependent killing with a sustained postantibiotic effect. Fluoroquinolones combine exceptional efficacy with cost-effectiveness. Not surprisingly, different guidelines have inserted these agents among the drugs of choice in the empirical therapy of community-acquired pneumonia. This review discusses the more recent data on bacteriological and clinical activity and critically analyses the risks of a potential overuse of this valuable new class of drugs.     

Therapeutic potential of the new quinolones in the treatment of lower respiratory tract infections

The impact of respiratory infections on public health is increasing and lower respiratory tract infections are a major cause of morbidity and mortality. We are also facing a worldwide burst of antibiotic bacterial resistance. The new fluoroquinolones have an excellent spectrum covering the most important respiratory pathogens, including atypical and ‘typical’ pathogens. Pharmacokinetic and dynamic properties of the new fluoroquinolones have a significant impact on their clinical and bacteriological efficacy. They cause a concentration-dependent killing with a sustained postantibiotic effect. Fluoroquinolones combine exceptional efficacy with cost-effectiveness. Not surprisingly, different guidelines have inserted these agents among the drugs of choice in the empirical therapy of community-acquired pneumonia. This review discusses the more recent data on bacteriological and clinical activity and critically analyses the risks of a potential overuse of this valuable new class of drugs.     

硫酸依替米星对泌尿生殖系统感染的临床疗效

观察硫酸依替米星对泌尿系统感染的临床疗效。 5 6例泌尿系统疾病合并感染病人 ,应用硫酸依替米星 2 0 0 mg加于 5 %葡萄糖注射液 10 0 ml中静脉滴注 ,每日 1次 ,疗程 5～ 10 d。结果 :有效率 87.5 % ,细菌清除率 82 .2 %。除 1例肝功能 (AL T)轻度增高、1例眩晕外 ,未发现其它不良反应及耳肾毒性。结论 :硫酸依替米星对泌尿系统感染有效 ,不良反应轻。     

头孢氨苄缓释胶囊治疗呼吸道感染的疗效观察

目的：观察头孢氨苄缓释胶囊治疗呼吸道感染的临床疗效。方法：头孢氨苄缓释胶囊0.5g,每天2次,7天为一个疗程,治疗1～2个疗程。结果：痊愈率71.7%,总有效率91.3%,细菌转阴率84.8%。结论：头孢氨苄缓释胶囊是治疗呼吸道感染的良好药物。     

头孢他啶对严重下呼吸道感染的临床疗效及药物动力学

用头孢他啶治疗严重下呼吸道感染10例(其中7例为绿脓杆菌感染)治愈5例,显效3例,有效1例,总有效9例,对G~-菌(尤其是绿脓杆菌)显示强大的抗感染效果。在使用中未发现明显毒副作用。从本药药物动力学测定结果看,作者推荐每12h静滴2g的投药方案。     

Clinical evaluation of the efficacy of cefmetazole in respiratory tract infections of patients with underlying respiratory diseases

Respiratory infections of 10 subjects with underlying respiratory diseases were treated with cefmetazole (CMZ) and its clinical effects were studied. Five subjects of them were respiratory tract infection, 3 subjects were pneumonia and 2 subjects were pneumonia followed by empyema. The underlying diseases were chronic pulmonary emphysema in 4 subjects, diffuse panbronchiolitis in 3, chronic bronchitis in 2 and bronchial asthma in 1. The doses of CMZ were 4 to 8 grams per day and the durations of administration ranged 3 to 39 days. The clinical effects were judged from the changes of fever, cough, amount of sputum, dyspnea, rale, chest X-ray, white blood cell counts, erythrocyte sedimentation rates, sputum culture and PaO2. The clinical effects of 6 subjects were evaluated as good, those of 3 were fair and that of 1 was poor. In 3 subjects H. influenzae in the sputum was eliminated and in 1 subject both H. aphrophilus and alpha-Streptococcus found in the pleural effusion were eliminated. In 1 subject Klebsiella in the sputum was eliminated and replaced by Enterobacter. No side effects were observed. We conclude that CMZ is considerably useful in the treatment of respiratory infections of the patients with underlying respiratory diseases.     

Moxifloxacin in respiratory tract infections

Moxifloxacin is a fourth-generation fluoroquinolone that has been shown to be effective against respiratory pathogens, including Gram-positive (Streptococcus pneumoniae), Gram-negative (Haemophilus influenzae, Moraxella catarrhalis), and atypical strains (Chlamydia pneumoniae, Mycoplasma pneumoniae), as well as multi-drug resistant S. pneumoniae, including strains resistant to penicillin, macrolides, tetracyclines, trimethoprim/sulfamethoxazole and some fluoroquinolones. Moxifloxacin is highly concentrated in lung tissue, and has demonstrated rapid eradication rates. The bioavailability and half-life of moxifloxacin provides potent bactericidal effects at a dose of 400mg/day. The ratio of the area under the concentration-time curve to MIC of moxifloxacin is the highest among the fluoroquinolones against S. pneumoniae. The clinical efficacy of moxifloxacin has been shown in controlled studies of community-acquired pneumonia (CAP), exacerbations of chronic bronchitis (CB) and acute bacterial rhinosinusitis. Moxifloxacin has demonstrated a faster resolution of symptoms in CAP and exacerbations of CB patients compared with first-line therapy. It has also demonstrated better eradication in exacerbations of CB compared with standard therapy, in particular the macrolides. Treatment guidelines should take into account the results of clinical trials with moxifloxacin in order to establish the role of this antimicrobial in the therapeutic arsenal against respiratory tract infections.     

Neonatal respiratory tract infections

Neonatal respiratory tract infections, in particular pneumonia, can be life-threatening. Lower respiratory tract infections may be acquired before, during, or after birth. Upper respiratory tract infections include otitis, sinusitis, rhinitis, laryngitis, tracheitis and bronchitis. Treatment of septicaemia and respiratory infections is based on the nature of the infection.     

头孢噻肟钠/舒巴坦钠治疗下呼吸道感染的疗效评价

目的 :评价头孢噻肟钠 /舒巴坦钠治疗下呼吸道感染的临床疗效和安全性。方法 :70例下呼吸道感染患者随机分为两组 ,治疗组 (35例 )给予头孢噻肟钠 /舒巴坦钠 2 .5g ,静脉滴注 ,每日 2次 ,对照组 (35例 )给头孢噻肟钠 2 .0g ,静脉滴注 ,每日 2次 ,疗程均为 7d～ 14d。观察并比较两组临床疗效、不良反应和细菌清除率。结果 :治疗组临床痊愈率 80 .0 % ,总有效率 91.4 % ,细菌清除率 90 .0 % ;而对照组分别为 5 7.1%、6 8.6 %和 6 4 .3%。两组间差异均有显著性。两组不良反应发生率均为 2 .9%。结论 :头孢噻肟钠 /舒巴坦钠治疗下呼吸道细菌感染临床疗效优于头孢噻肟钠 ,是广谱、高效、安全的抗菌药物     

呼吸系统侵袭性真菌感染的药物治疗

近年来呼吸系统侵袭性真菌感染率、耐药率均不断增高。新的治疗药物包括广谱三唑类药物如伊曲康唑、伏立康唑和泊沙康唑以及新型抗真菌药棘白菌素等的开发和应用,治疗原则的更新和实践是应对呼吸系统真菌感染新情况的关键。     

头孢克洛分散片治疗呼吸道感染120例疗效观察

目的：观察头孢克洛分散片治疗呼吸道感染的临床疗效。方法：给予120例呼吸道感染患者服用头孢克洛分散片治疗。轻度感染者每次口服250mg,中～重度感染者每次口服500mg,每天3次,疗程10～14天。结果：呼吸道感染的总有效率为87.5%,细菌清除率为83.8%,不良反应发生率为2.5%。结论：头孢克洛分散片是一种服用方便、安全、具有较好临床疗效的口服抗生素。     

Therapeutic targets in respiratory viral infections

Respiratory viral infections account for a substantial proportion of morbidity world wide and contribute notably to the socio-economic burden of diseases. Amongst the most important viruses identified so far are Rhinoviruses, Influenza A and Respiratory Syncytial Virus. The knowledge base has broadened at the clinical and experimental level in recent years. However, therapeutic options are still limited. This may be partly due to the multiplicity of infectious mechanisms and the complex underlying host/virus interactions. The aim of this article is to give an overview of the different respiratory viruses involved, their major principles of infection and the associated therapeutic targets and to review up-to-date virus-specific clinical trials.     

beta-Lactam antibiotics in respiratory tract infections

beta-Lactam antibiotics have played a major role in the treatment of respiratory infections for many years. The use of the three main groups of beta-lactam antibiotics-penicillins, cephalosporins and non-classical beta-lactams-in respiratory infections is reviewed. Their development and efficacy have more or less kept pace with the changes in microbial resistance, emergence of new pathogens and changes in medical practice. Consequently, beta-lactam agents continue to make a valuable contribution to therapy of respiratory tract infections.