Drugs online research references
Scand J Gastroenterol. 2000 Sep;35(9):929-34.
Cure of Helicobacter pylori infection after failed primary treatment: one-center results from 120 patients.
Seppala K, Kosunen TU, Nuutinen H, Sipponen P, Rautelin H, Sarna S, Hyvarinen H, Farkkila M, Miettinen TA.
Dept. of Medicine, Helsinki University Central Hospital, University of Helsinki, Finland.
BACKGROUND: Treatment with a proton pump inhibitor (PPI) and antimicrobials cures Helicobacter pylori infection in about 90% of patients. This is a retrospective overview of our studies aiming to cure the infection in all compliant patients with failed initial therapy. METHODS: We retreated 120 (19% of 644) H. pylori-infected patients whose initial therapy had failed. The retreatments included (i) triple therapy (TT): colloidal bismuth subcitrate, metronidazole, amoxicillin (or tetracycline); (ii) quadruple therapy (QT): TT and a PPI; or (iii) high doses of both a PPI and clarithromycin combined with a further 1-3 individually selected antimicrobials. The eradication results were determined after 6-12 months. RESULTS: The 1st retreatment was successful in 70 of 120 patients. The 2nd retreatment cured 25 of the remaining 42 patients, the 3rd 13 of 17, and the 4th the last 4 patients. The cumulative eradication rate (ITT) was 93% (95% CI: 88.9%-97.9%; 8 patients withdrew after a failed 1st retreatment) and the rate was 100% in the remaining 112 patients who accepted several retreatments. The 1st retreatment with TT cured 23% (95% CI: 12%-34%) of 57 patients and QT 85% (95% CI: 74%-96%) of 41 patients who had initially undergone a failed metronidazole-based treatment. All retreatments were well tolerated. CONCLUSIONS: In this study, high doses of a PPI and clarithromycin combined with 1-3 antimicrobials according to susceptibility data proved to be the best drug combination in the cure of H. pylori infection after failed primary treatment. Giving imidazole- and bismuth-based QT (without clarithromycin) as the first-line treatment of H. pylori infection ensures that the number of failures remains low.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11063151&dopt=Abstract
girch1.med.uth.tmc.edu
Recombinant human lactoferrin possesses in-vitro antibiotic and anti-inflammatory activity similar to the native form. It was tested for in-vivo activity in mice infected with the gastritis-inducing bacterium Helicobacter felis. A two-week course of treatment with lactoferrin was sufficient to partially reverse both infection-induced gastritis and the infection rate, and fully reverse gastric surface hydrophobicity changes. A comparison of lactoferrin with amoxicillin and standard triple therapy revealed no differences in infection rate. These results show that recombinant human lactoferrin is effective in a mouse model of Helicobacter infection, and support further testing of this promising agent for this application.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11197084&dopt=Abstract
auckland.ac.nz
AIM: To assess General Practice (GP) description and management of upper respiratory tract infections (URTI), including conditions under which they prescribe antibiotics. METHOD: A telephone survey of a randomised sample of Auckland GPs. RESULTS: There was a 61% response rate. 82 of the 100 GPs interviewed agreed that most patients presenting with URTI expected antibiotics. Persistent symptoms and indication of specific infection (tonsillitis, otitis media, sinusitis, pharyngitis, purulent sputum) were common reasons for prescribing. Patients travelling overseas, expecting or requesting antibiotics and prior use of over-the-counter (OTC) medications increased antibiotic prescribing-rates. Most GPs (95%) issued as-needed prescriptions on occasion; 13% did this often. Amoxicillin and amoxicillin/clavulanic acid were most commonly used. Despite wide-ranging antibiotic use for URTI (0 to 90%), only 6% of GPs felt they prescribed more antibiotics than others. CONCLUSIONS: The results suggest over-prescription is common-place, but use of as-needed prescriptions to reduce antibiotic use is encouraging. Exploration of patient expectations in the consultation may assist in decreasing prescribing rates.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11198542&dopt=Abstract
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