Surveillance of resistant pathogens should lead to improved treatment of patients and to a rational use of antibiotics. The process for decision making between microbiology, general practice and health policy is still to be documented with careful studies.
Antibiotics/therapeutic use* ; Drug Resistance, Microbial/physiology* ; Human

For infections in infants and children, the successful antibiotic treatment depends primarily on rapid diagnosis of the disease, identification of pathogenic microorganisms, and appropriate application of specialized pharmacokinetic and pharmacodynamic knowledge of antibiotics in children. In infants and children, the absorption, distribution, metabolism, and excretion of drugs may differ considerably in comparison with adults. Because of known toxicity, certain drugs such as chloramphenicol in high doses, the sulfonamides, and tetracycline should not be used in neonates. In this article, we describe these peculiarities of children and discuss the proper use of antibiotics in children.
Antibiotics/therapeutic use* ; Antibiotics/pharmacokinetics ; Antibiotics/metabolism ; Antibiotics/administration & dosage ; Child, Preschool ; Dose-Response Relationship, Drug ; Human ; Infant ; Pediatrics/methods* ; Time Factors

OBJECTIVETo explore the antitumor effect and toxicity of pegylated liposomal daunorubicin (PL-DNR) on leukemia.

METHODSPL-DNR was prepared by dry lipid hydration and remote loading, and its physicochemical indexes were analyzed. The inhibiting effect of PL-DNR on leukemia cells was observed in terms of in vitro cytotoxicity experiment. The therapeutic effect in vivo was assessed by tumor inhibition in leukemia L1210-bearing mice. Apoptosis in cardiomyocytes was detected using the terminal deoxynucleotidyl transferase mediated dUTP nick end labeling method (TUNEL staining).

RESULTSThe average diameter of PL-DNR was (110 ± 10)nm and the encapsulation efficiency was 94.21%. The in vitro cytotoxicity experiment showed that the inhibiting ability of PL-DNR in the treatment groups was continuously enhanced as the experiment proceeded. The in vivo pharmacodynamic experiment also indicated obvious tumor-inhibiting effect of PL-DNR. At the end of the experiment, the tumor volume of the PL-DNR group was (433.71 ± 234.77)mm(3), significantly smaller than that of (1 293.77 ± 381.26) mm(3) in the DNR group (P < 0.05). Moreover, the tumor weight of the PL-DNR group was (0.66 ± 0.29)g and that of the DNR group was (1.25 ± 0.43)g (P < 0.05). The myocardial toxicity experiment showed that the median apoptosis index of cardiomyocytes in the PL-DNR group was 13.83%, significantly lower than that of 42.67% in the DNR group (P < 0.05), indicating a lower toxicity of PL-DNR to the myocardium.

CONCLUSIONCompared with the free DNR, PL-DNR can improve the therapeutic effect on leukemia and reduce the.

Aged ; Antibiotics, Antineoplastic ; therapeutic use ; Breast Neoplasms ; drug therapy ; Epirubicin ; therapeutic use ; Female ; Humans ; Middle Aged

The prevalence rate of pterygium in Papua New Guinea (PNG) is as high as 15%. Recurrence rates up to 50% are encountered after primary excision. In a country such as PNG where resources in terms of funds and manpower are limited, a simple procedure had to be identified to reduce this alarmingly high rate of pterygium recurrence. This article compares the results of a randomized masked study involving the single intraoperative application of 0.02% mitomycin C solution in 65 eyes undergoing surgery for recurrent pterygium using the bare sclera technique with a similar group of 65 patients in which the drug was not used. The results indicate that a single intraoperative application of mitomycin C solution was enough to reduce the recurrence rate of pterygium to 3% in the treated group as compared to 48% in the untreated group at the end of a 12-month follow-up. In the study it was also seen that, in PNG, pterygia were more common in females and that recurrences tended to occur early and were obvious in the first few weeks following surgery.
Antibiotics, Antineoplastic - therapeutic use ; Combined Modality Therapy ; Follow-Up Studies ; Humans ; Intraoperative Care ; Mitomycin - therapeutic use ; Papua New Guinea ; Prevalence

No abstract available.
Animals ; Antibiotics, Antifungal/*therapeutic use ; Humans ; Immunosuppression/*methods ; Protein Structure, Tertiary ; T-Lymphocytes/*immunology ; *Transduction, Genetic

Helicobacter pylori (H. pylori) is currently considered the most important exogenous factor in the genesis of gastritis and peptic ulcer disease. However, the optimum regimen for the eradication of H. pylori remains unclear. The purpose of this study was to evaluate the eradication rate of H. pylori, the side effects, and the patients' compliance with regard to various drug regimens. We also analyzed factors influencing the eradication of H. pylori. One hundred and eighty patients were included and divided into four groups: 42 patients (Group I) received tripotassium dicitrato bismuthate (240 mg b.i.d.), metronidazole (250 mg t.i.d.) and amoxicillin (500 mg t.i.d.) for 14 days; 55 patients (Group 2) received omeprazole (20 mg b.i.d.) and amoxicillin (1000 mg b.i.d.) for 14 days; 36 patients (Group 3) were treated with omeprazole (20 mg b.i.d.), metronidazole (250 mg t.i.d.) and amoxicillin (500 mg t.i.d.) for 14 days; and 47 patients (Group 4) received omeprazole (20 mg q.d.) and amoxicillin (500 mg t.i.d.) for 14 days and then tripotassium dicitrato bismuthate(240 mg b.i.d.) and nizatidine (150 mg q.d.) for 14 days. The diagnosis of H. pylori was made by histology. The eradication of H. pylori was defined both by histology (H&E and Giemsa stain) and by rapid urease test (CLOR) showing negative for H. pylori 4 weeks after the completion of therapy. Of the 180 patients, 95 patients had non-ulcer dyspepsia, 40 patients had gastric ulcer and 45 patients had duodenal ulcer. The eradication rate of H. pylori was highest (89.3%) in Group 3, as compared with Group 1 (68.9%), Group 2 (65.4%), and Group 4 (48.9%). The eradication rate was significantly higher in Group 3 than in Groups 2 and 4 (p< 0.05). There was no significant difference in the eradication rate among clinical diagnosis, sex and age. But, in the conventional triple therapy (Group 1), the eradication rate was higher in male (78.6%) than in female (46.2%). The side effects in order, were nausea (22.1%), dizziness (19.5%), abdominal pain (11.6%) and diarrhea (97%), and there was no difference among the drug regimens. The compliance of the patients was good (more than 80% irrespective of drug regimen). On the basis of these findings, the side effects of the drugs seemed minimal, and the compliance of patients was good irrespective of the drug regimen. In conclusion, the triple therapy with omeprazole, metronidazole and amoxicillin was the most effective regimen and could be recommended for H. pylori eradication.
Adult ; Anti-Ulcer Agents/*therapeutic use ; Antibiotics/*therapeutic use ; Duodenal Ulcer/microbiology ; Dyspepsia/microbiology ; Female ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Human ; Male ; Middle Age ; Stomach Ulcer/microbiology

Various methods of treatment, other than antibiotic therapy, have been proposed for the treatment of female urethral syndrome; however, the results of these treatment methods are disappointing, due perhaps to the use of the wrong treatment approach. The aim of this study was to evaluate the effectiveness of external sphincter relaxant and biofeedback (BFB) with electrical stimulation therapy (EST) in patients who do not respond well to antibiotics. One hundred and five patients with a diagnosis of female urethral syndrome were entered into this study. Antibiotics were given as a first-line therapy for about 3 months. In cases of recurrent or incurable urethral syndrome, antibiotic therapy combined with external sphincter relaxant or BFB with EST were performed. External sphincter relaxant group was composed of 31 patients (29.5%) who showed functional urethral obstruction. Biofeedback group was composed of 41 patients (39.0%) who had severe pain or discomfort with irritative voiding symptoms. Subjective symptom was measured before and after therapy using the Bristol Female Lower Urinary Tract Symptoms questionnaire. Thirty-three patients (31.4%) were treated with antibiotic therapy alone and 7 (21.2%) of these patients recurred. The symptom score of this group changed from 10.51 to 2.85. In the antibiotics plus external sphincter relaxant group (N=31), the symptom score changed from 12.39 to 3.96. Five (16.1%) of these patients recurred and 3 of these 5 underwent urethral dilatation. In the antibiotics plus biofeedback group (N=41), the average urinary frequency changed from 12.2 to 7.7 times a day and nocturia changed from 2.4 to 0.6 times a night. The symptom score improved from 15.22 to 4.69 and the overall satisfaction rate was 87.8% (41.5%: very satisfied, 46.3%: satisfied, 12.2%: no response). Female urethral syndrome is not due to a single factor but is a complex disease due to various combined symptoms and mechanisms. This condition needs to be treated with an appropriate treatment protocol. We believe that satisfactory results could be obtained in female urethral syndrome, which has shown poor prognosis until now, by appropriately combining treatment methods, which include the use of external sphincter relaxants, biofeedback therapy and bladder training, according to indication, and depending on whether symptoms continue after initial antibiotic therapy.
Adult ; Aged ; Antibiotics/*therapeutic use ; Biofeedback (Psychology) ; Electric Stimulation Therapy ; Female ; Human ; Middle Age ; Parasympatholytics/therapeutic use ; Urethral Diseases/etiology/*therapy

Twenty four eyes from 23 neovascular glaucoma (NVG) patients, who underwent trabeculectomy with 0.2 or 0.4 mg/ml MMC in least the previous 6 months, were examined in order to evaluate the mid-term effects of a trabeculectomy with mitomycin C (MMC) in NVG. Success defined when an intraocular pressure (IOP) < 22 mmHg and > 5 mmHg with or without medication was observed. The mean IOP was reduced from 46.8+/-12.9 mmHg preoperatively to 18.2+/-12.0 mmHg at the last follow-up (mean = 25.8 months). The overall success rates at 1-, 3-, 6-, 9-, and 12-months after surgery were 71%, 58%, 50%, 29%, 29% respectively. The number of anti-glaucoma medications administered was significantly reduced from 2.6+/-0.7 preoperatively to 0.9+/-1.0 postoperatively (Wilcoxon signed rank test, p = 0.005). In addition both the intraoperative MMC concentration and application time had no influence on lowering the IOP (logistic regression analysis, p = 0.228, 0.910, respectively). There was a similar incidence of postoperative complications in both the success and failure group. These results suggest that a trabeculectomy with MMC is an effective surgical procedure in NVG patients and the MMC concentration is not crucial for reducing the IOP postoperatively.
Adult ; Aged ; Aged, 80 and over ; Antibiotics, Antineoplastic/*therapeutic use ; Female ; Glaucoma, Neovascular/*drug therapy/*surgery ; Human ; Male ; Middle Age ; Mitomycin/*therapeutic use ; Time Factors ; *Trabeculectomy ; Treatment Outcome

Enterococci recently became the second-to-third most commonly isolated organism from nosocomial infections. Enterococci are intrinsically more resistant to many antimicrobial agents and often show acquired resistance to many antimicrobial agents including high-level aminoglycosides. With the increased use of vancomycin, vancomycin-resistant enterococci (VRE) has become an important nosocomial pathogen. In Korea, the proportion of VRE among all enterococcal of VRE is no longer low in some settings and recent observations of a sudden increase of VRE isolation in several hospitals in Korea suggests that VRE infection may become a serious problem in the near future. The most important considerations are that vancomycin-resistant genes may spread to other highly virulent genera, such as MRSA, and that there are no approved and convincingly effective antibiotics for the treatment of VRE. Therefore, current efforts have concentrated on limiting the spread of these organisms within the hospital environment. Prudent use of antimicrobial agents and strict adherence to preventive measures such as aggressive communication, education, and infection control practices are essential to control the spread of this organism. However, hospital infection control protocols and the laboratory support they require are costly in terms of space and supplies, as well as in personnel resources. These factors add further pressure to already stretched hospital budgets. Nevertheless, policies or programs defining and managing VRE infection or colonization should be established and now is the time to enforce an overall management strategy against VRE.
Antibiotics, Glycopeptide/therapeutic use* ; Bacterial Infections/prevention & control ; Bacterial Infections/drug therapy* ; Drug Resistance, Microbial* ; Enterococcus/drug effects* ; Human ; Korea ; Microbial Sensitivity Tests ; Prevalence ; Vancomycin/therapeutic use*