Comparison of effects of cholecystokinin and erythromycin on bile chemistry and gallstone formation in aged guinea pigs.

BACKGROUND: There has been considerable interest in gall bladder motility in recent years. We compared the effects of cholecystokinin (CCK) and erythromycin on bile chemistry and gallstone formation in aged guinea pigs. METHODS: Two groups of guinea pigs (1-mo and 3-y old; n=40 each) were studied. Each group was divided into four subgroups of 10 animals each; one subgroup received lithogenic diet, one each received CCK or erythromycin daily in addition to lithogenic diet for 4 weeks, and one received normal diet. After 4 weeks, the presence of gallstones or sludge was recorded and bile composition including concentrations of bile acid, cholesterol, lecithin and protein concentrations was studied. RESULTS: No gallstones were observed in the 1-mo-old animals. In the 3-year-old animals, 9 of 10 guinea pigs on lithogenic diet and 4 of 10 in each treatment subgroup and the normal diet subgroup developed gallstones. CCK and erythromycin had similar effects on bile chemistry and stone formation. CONCLUSIONS: Aging increases the formation of gallstones in guinea pigs. Erythromycin is as effective as CCK in reducing gallstone formation by improving gall bladder motility.

A comparative efficacy and safety study of clarithromycin, roxithromycin and erythromycin stearate in mild pneumonia

The efficacy and safety of clarithromycin, roxithromycin and erythromycin stearate in mild pneumonia were compared in an open randomized trial. Eighty-six male patients, doing their obligatory military service, ranging between 19 and 24 years of age (mean 20), were randomly treated: 29 with clarithromycin 500 mg 12-hourly, 30 with roxithromycin 150 mg 12-hourly, and 27 with erythromycin stearate 500 mg 6-hourly, each course being administered for 10 days. Seventy-eight patients were able to be evaluated for efficacy, 28 receiving clarithromycin, 28 roxithromycin, and 22 erythromycin stearate. There were no significant differences among the groups in terms of clinical success rates (clinical cure or improvement: 89% for clarithromycin, 82% for roxithromycin, and 73% for erythromycin stearate, p = 0.32). However, we found that there were significant differences among the groups in terms of clinical cure rates (75% for clarithromycin, 64% for roxithromycin, and 41% for erythromycin stearate, p = 0.04). Adverse events, mostly gastrointestinal, caused discontinuation of treatment in 3.4% of the patients in the clarithromycin group, in 6.6% of the patients in the roxithromycin group, and in 18.5% of the patients in the erythromycin stearate group. The results indicate that there were no statistically significant differences among the three treatment groups in terms of clinical success rates, but that clarithromycin and roxithromycin were better tolerated.

3 days azithromycin in treatment of adults with lower respiratory tract infections

Forty three patients of both sexes were enrolled in this study. They were 28 males and 15 females. Their ages ranged between 18 and 63 years with a mean age of 39.7 years. They suffered from different acute lower respiratory tract infections including acute bronchitis, acute tracheobronchitis, pneumonia and bronchiectasis. They were given azithromycin 500 mg [2 capsules X 250 mg] orally as a single daily dose for 3 successive days. There was complete cure of 39 patients [90.69 percent], improvement in 3 patients [6.97 percent] and failure in one patient [2.33 percent]. Bacteriological evaluation showed that the causative organisms were, streptococcus pneumoniae, haemophilus influenzae and staphylococcus aureus. Causative organisms were eradicated in 42 patients [97.67 percent] and persistence occured in one patient [2.33 percent]. Adverse events were reported in 5 cases [11.62 percent] and were mild and tolerated by the patients. They included loose stools in 3 patients, gastric upset in one patient and nausea in one patient. Therapy did not induce any significant changes in the mean values of blood count, liver and renal function tests. The study showed that azithromycin is an effective, safe and well tolerated therapy for adult patients suffering from acute lower respiratory tract infections

Utilidad clínica de la azitromicina en infecciones de vía respiratoria superior / Clinical usefulness of azthromuycin in upper respiratory tract infections

La azitromicina pertenece al grupo de los azálidos y tiene una mayor penetración tisular, así como una vida media más prolongada que la eritromicina. Es activa contra patógenos intracelulares debido a su captación y acumulación en células fagocíticas y fibroblastos. Ha mostrado mayor actividad in vitro contra H. influenzae, N. gonorrhoeae, M. hominis y Citrobacter diversus que la eritromicina. Se estudiaron 20 pacientes adultos ambulatorios (12 mujeres y ocho varones), con diagnóstico de infección aguda de vía respiratoria superior, quienes recibieron 500 mg de azitromicina por vía oral, en dosis única durante tres días. Se evaluaron antes del tratamiento, 48 h y siete días postratamiento. Los diagnósticos establecidos fueron: faringoamigdalitis aguda (8), sinusitis aguda (4), amigdalitis aguda (4), faringitis aguda (1), faringolaringotraqueitis aguda (1), laringitis aguda (1) y exacerbación de sinusitis crónica (1). Las bacterias encontradas en el pretratamiento fueron: S. aureus (5), M. catarrhalis (2), H. influenzae (2), estreptococo grupo D (1), estreptococo spp (1), K. oxytoca (1), Acinetobacter spp (1), E. coli (1) y Klebsiella spp (1). Todas las bacterias resultaron susceptibles a azitromicina, excepto K. oxytoca y estreptococo grupo D. Desde el punto de vista bacteriológico, la respuesta a las 48 h postratamiento se obtuvo curación en 14, mejoría en dos, y falla en cuatro, mientras que a los siete días postratamiento se obtuvo curación en 16 y falla en cuatro. Desde el punto de vista bacteriológico, la respuesta a las 48 h postratamiento fue: erradicación en 13, persistencia en cuatro y superinfección en uno, y a los siete días fue: erradicación en 13 y no evaluable en siete. Las cuatro bacterias persistentes fueron: S. aureus, estreptococo grupo D, K. oxytoca y H. influenzae, K. pneumoniae fue responsable de la superinfección. No se observaron efectos indeseables.

Antibióticos macrolídicos - retorno à vista? / Macrolide antibiotics, a return in sight?

O autor apresenta as perspectivas de progressos, no campo da terapêutica antimicrobiana, representadas pelo aparecimento de novos antibióticos macrolídicos com propriedades que os diferenciam, e muitas vezes os tornam mais atraentes, relativamente aos membros mais antigos da família. Compara esses novos antibióticos com a eritromicina, destacando as diferenças de propriedades farmacocinéticas e de espectro antimicrobiano. Por fim, apresenta as indicaçöes terapêuticas especiais que esses medicamentos poderäo vir a ter

Estudo sobre a prevalência de germes e a eficácia clínica e bacteriológica do estearato de eritromicina em amigdalites purulentas de crianças do Estado de Säo Paulo / Prevalence of germs and the bacteriological and clinical efficacy of erythromycin stearate in purulent tonsillitis of children in the of Säo Paulo

Foram estudados 62 casos de crianças menores de 12 anos portadoras de amigdalite aguda, presumivelmente bacteriana. Somando-se os resultados da cultura do material de amígdala e os casos com erupçäo escarlatiniforme, obteve-se uma prevalência de 30% de estreptococo beta-hemolítico. Resultados clínicos satisfatórios foram encontrados em pelo menos 87% dos casos tratados com eritromicina (30-50 mg/kg/dia) durante 10 dias. Efeitos colaterais (diarréias, vômitos e cólicas) ocorreram em 13% dos pacientes, sendo em um único caso necessária a interrupçäo do tratamento

Rifampicin-erythromycin combination for the treatment of gonococcal urethritis in men.

A total of 184 men with uncomplicated gonococcal urethritis were treated with a single oral dose of rifampicin 900 mg and erythromycin stearate 1 gm. The cure rate on day 3 was 95.1%, 175 were cured and 9 failed (4.9%). Of all the Neisseria gonorrhoeae isolated, 86 were PPNG (46.7%). There was no difference in failure rate among patients with PPNG or with non-PPNG. With the exception of self-limited gastrointestinal disturbance, side effects were minimal. The value of this combination for the treatment of uncomplicated gonococcal urethritis in men is promising and deserves further study.