Drug utilisation pattern in sexually transmitted diseases and its economic considerations--a prospective study.

OBJECTIVES: WHO regularly revises guidelines for the treatment of these. There are very few studies reported on the drug utilization pattern of STD's in India. METHODS: In the present study, 325 patients attending the STD clinic of Lok Nayak Hospital were analysed over a period of six months. RESULTS: The demographic pattern of the patients was similar to those of studies reported earlier. Syphilis was the commonest of the STD's encountered; followed by viral STD's (c. acuminata and herpes progenitalis); gonorrhoea; chancroid and genital candidiasis. Out of a total of 409 drugs prescribed, the average number of drugs per prescription was 1.25. Sixty seven percent of the drugs were available in essential drug list of the hospital and 60% were prescribed in generic name. Ninety seven percent of the prescriptions were in accordance with WHO treatment guidelines. The cost of the drug treatment was comparable for c.acuminata, syphilis and chancroid while it was less for herpes progenitalis (HPG) due to acyclovir not being prescribed. However, it was more for gonorrhoea and candidiasis because of additional drugs. CONCLUSIONS: The present study shows a trend towards rational prescribing. It would be interesting to compare the results with a non teaching hospital.

Modification of antihistaminic activity of cetirizine by nimesulide.

OBJECTIVE: To study the effect of nimesulide (4-nitro-2-phenoxymethane sulfonanilide) a non-steroidal anti-inflammatory drug, on antihistaminic activity of cetirizine. METHOD: A randomized, double blind, cross over study was conducted in ten healthy male volunteers. Wheal and flare responses to histamine were measured by performing intradermal injection of histamine (2 micrograms base) diluted in 100 microliters volume of saline on the volar surface of forearm, on four occasions (0, 2, 4, and 6 hrs. post-dosing). Each volunteer was randomized to receive either treatment A (cetirizine 10 mg + placebo) or treatment B (cetirizine 100 mg + nimesulide 100 mg), with one week wash out period in between each administration. Wheal and flare responses were measured ten minutes after each histamine injection. RESULTS: Both cetirizine 10 mg alone and cetirizine 10 mg + nimesulide 100 mg, decreased wheal and flare responses significantly at 2 hrs. and this continued till 6 hrs. post-dosing. This decrease was highly significant when cetirizine was given along with nimesulide. CONCLUSION: The results suggest a synergistic effect exhibited by the combined use of cetirizine with nimesulide.

A comparative study of anxiogenic effects of fluoroquinolones in rats.

The present study compares the anxiogenic effects of three fluoroquinolones namely ciprofloxacin, ofloxacin and pefloxacin in rats using elevated plus-maze. The rats were treated with 12.5 mg/kg and 25 mg/kg of ciprofloxacin, ofloxacin or pefloxacin and then tested in elevated plus-maze half an hour later, for a period of 5 min. All the three fluoroquinolones decreased the time spent in open arm considerably. This decrease was statistically significant only with the higher doses of ciprofloxacin and ofloxacin (P < 0.05). Mean time spent in closed arm was increased by all the test drugs in both the doses. Increase was statistically significant with both the doses of ofloxacin (P < 0.05). Mean time spent in closed arm was increased by all the test drugs in both the doses. Increase was statistically significant with both the doses of ofloxacin (P < 0.05, P < 0.01 respectively) and higher doses of ciprofloxacin and pefloxacin (P < 0.01, P < 0.05 respectively). The number of entries in open arm and closed arm were decreased by both the doses of the three fluoroquinolones used in the study. The reduction in total number of arm entries by ciprofloxacin, ofloxacin and pefloxacin in both the doses was highly significant. The results suggest definite anxiogenic potential of fluoroquinolones.