Drugs online research references
Akush Ginekol (Sofiia). 1998;37(3):58-62.
[A new therapeutic approach in the treatment of genital chlamydial infections. Azithromycin (Sumamed)]
[Article in Bulgarian]
Borisov I.
Azithromycin is a member of a new class of macrolides called azalydes. Although azithromycin resembles erythromycine there are significant differences in antibacterial activity and pharmacokinetic profile. Azithromycin is taken up by cells and the intracellular concentrations are significantly higher than serum concentrations. After a single oral dose of Ig, azithromycin has a long lasting effect--the tissue concentrations in the uterine and cervical tissues are kept above the minimal inhibitory concentration for Chlamydia trachomatis for more than 10 days. In order to achieve the maximal bioavailability and avoid side effects (gastrointestinal discomfort), azithromycin should be taken apart from meals (one hour before or two hours after meals). Azithromycin has no hepatotoxic potential and the possibility for drug interactions is not apparent. It is also recommended for use in pregnant women--FDA category B. A single oral dose of Ig azithromycin is the reasonable choice for the treatment of uncomplicated genital chlamydial infection.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10204275&dopt=Abstract
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Drugs. 2000 Sep;60(3):597-605.
Treatment of Chlamydia trachomatis infections in pregnant women.
Miller JM, Martin DH.
Department of Obstetrics and Gynecology, Louisiana State University Medical Center, New Orleans 70112, USA.
The intent of this article is to provide an overview of the epidemiology and pharmacotherapy, including cost analyses, of Chlamydia trachomatis infections in pregnant women. Chlamydia is a common sexually transmitted infection. For pregnant women, there are concerns both for the mother (post-partum endometritis, horizontal transmission) and the newborn (conjunctivitis, delayed pneumonia). Therapeutic options are restricted because of the fetus and include multi-day treatment with erythromycin, amoxicillin, clindamycin or single dose azithromycin. Clinical cure rates with these options are 86, 92, 93 and 95%, respectively. Pharmacoeconomic analyses have been conducted to determine if the initial increase in acquisition cost of azithromycin (approximately 3-fold higher than erythromycin or amoxicillin) is offset by improvement in compliance and drug efficacy. Clindamycin has received little attention because of its expense (4-fold more than azithromycin). Analyses have been retrospective. As models incorporate more complications of failure to cure, azithromycin increasingly becomes more cost effective and is our recommended treatment.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11030469&dopt=Abstract
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Int J Antimicrob Agents. 1999 Mar;11 Suppl 1:S7-14; discussion S31-2.
Pharmacological considerations in the emergence of resistance.
Amsden GW.
The Clinical Pharmacology Research Center and Department of Pharmacy, Bassett Healthcare, Cooperstown, NY 13326, USA.
Resistance to macrolides in vitro is increasingly being reported. However, there has been no corresponding increase in clinical failures noted. Lack of clinical failures due to resistance is most likely the result of the high intracellular concentrations that these drugs achieve in phagocytes. In the case of clarithromycin, concentrations in both monocytes and granulocytes fluctuate between peaks of approximately 22-25 mg/l and troughs of approximately 5 mg/l during a standard dosing interval. In contrast, azithromycin attains concentrations of over 60 mg/l in granulocytes and at least 100 mg/l in monocytes. After 7 days, azithromycin concentrations of >32 mg/l are still observed. These data also imply that against pathogens with increasing minimum inhibitory concentrations (MICs), macrolides with relatively lower or less sustained intracellular concentrations will become ineffective clinically much sooner than compounds, such as azithromycin, that concentrate to a high degree and are retained in white blood cells for prolonged periods.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10204634&dopt=Abstract
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