A comparative study of amoxicillin, erythromycin, cefadroxil, and gatifloxacin in treatment of acute lower respiratory tract infections

Introduction: Community-acquired acute lower respiratory tract infection (LRTI) incorporates a spectrum of diseases from acute bronchitis, acute exacerbation of chronic obstructive pulmonary disease (COPD) and pneumonia. It is the most common cause for consulting general practice and OPD. This study was undertaken to compare older and newer antimicrobials in terms of clinical efficacy, tolerability and cost for the initial treatment for OPD management of LRTI in a government medical college setup. This randomized, prospective study was conducted in theMaterial And Methods: Medicine OPD of a government medical college, over a period of one year.Patients of either sex, aged between 16-60 yrs satisfying following definitions of acute bronchitis (with secondary bacterial infection), acute exacerbation of COPD and community acquired pneumonia were selected for the study. Patients were randomly assigned to one of the following treatment groups: Ÿ Group I- Amoxicillin 500 mg three times a day for 7 days. Ÿ Group II - Erythromycin 500mg four times a day for 7 days Ÿ Group III - Cefadroxil 500mg two times a day for 7 days Ÿ Group IV-Gatifloxacin 400mg once a day for 7 day Efficacy and safety of all antimicrobials were assessed and compared Results: Satisfactory clinical outcome as cure and improvement was obtained in 48 % and 36% in amoxicillin, 52% and 33% in erythromycin 49% and 38% in cefadroxil, 64% and 27% in gatifloxacin group respectively. Unsatisfactory clinical outcome as failure was recorded in 16%, 15%, 13% and 9% of amoxicillin, erythromycin, cefadroxil and gatifloxacin groups respectively. All the four drugs were equally effective with more than 80% efficacy in treatment ofConclusions: LRTI. The treatment groups did not differ in incidence of adverse events. All the adverse effects were mild and did not require cessation of therapy.

Folie a deux in a 13 year old girl and her elder sister

Folie a deux, is a rare delusional disorder shared by two or more people in close emotional ties, so that delusion of the primary patient is adopted by other person. We are presenting a rare case in our clinical practice of a thirteen year old female from ethnic minority with shared psychotic disorder, with her twenty three year old elder sister. In this case of Folie a deux the 13 year old girl was the passive psychotic partner and her 23 year old elder sister was the dominant psychotic partner