[1,200 mg rifampicin(Rimactan) as an oral one-dose treatment of uncomplicated gonorrhea in women]. / 1200 mg Rifampicin (Rimactan) als Einzeldosisbehandlung der unkomplizierten Gonorrhoe der Frau.

40 women were treated for uncomplicated genital gonorrhoea, verified by culture, with a single oral dose of 1,200 mg rifampicin (Rimactan). The ages ranged between 15 and 51 years. In 33 patients that could be evaluated, the gonorrhoea was cured. In 8 of 18 patients the preexistent vaginal discharge improved. 4 women experienced six different side effects which were probably related to rifampicin. The 1,200-mg rifampicin oral one-dose treatment is a reliable, efficient, and well-tolerated therapy of uncomplicated gonorrhoea in women.

Parenteral rifampicin in tuberculous and severe non-mycobacterial infections. Clinical data on 237 patients.

A parenteral formulation of rifampicin (Rimactan i.v., Ciba-Geigy, Basel, Switzerland) was administered to 237 critically ill or comatose patients, or patients with gastro-intestinal or absorption problems. There were 160 patients suffering from tuberculosis, 77 suffering from non-tuberculous (non-tb) infections including 30 cases of sepsis, 8 cases of bacterial meningitis and/or cerebral abscess and 9 patients with Legionnaires' disease. The usual daily dose of rifampicin was 450-600 mg, administered in most cases by i.v. bolus (122 cases) or i.v. drip infusion (79 cases) for a period of 1-113 days. Rifampicin was in all cases combined with one or more antimicrobial drug(s). The physicians considered the therapy as successful when the treatment with oral rifampicin could be instituted soon after parenteral administration or when the patients markedly improved their clinical condition. Of a total of 123 tuberculous patients for whom assessment of efficacy was possible, 100 (81.3%) showed favourable clinical results. Of 40 non-tb patients who could be analysed for clinical progress, 32 (80.0%) had a favourable outcome. Special attention should be drawn to the 11 patients with proven staphylococcal infections, of whom 10 were cured clinically and/or bacteriologically. Thrombophlebitis occurred in 10 out of the 237 (4.2%) patients, almost always in patients who were treated for more than 30 days. Systemic unwanted effects occurred in 14 (5.9%); the relationship to the treatment was not always established. Treatment was withdrawn due to unwanted effects in 5 (2.1%) of the 237 patients. Taking into account the severe, life-threatening infections reported, the results suggest that i.v. rifampicin is useful and in some critically ill patients even life-saving. Tolerability was good, even in long-term i.v. administration, although there seems to be the possibility that thrombophlebitis might develop if treatment is continued over 30 days.

Evaluation of the long-term efficacy and safety of indoprofen in rheumatoid arthritis and osteoarthritis patients.

Thirty-seven adult out-patients of both sexes, suffering from classical or definite rheumatoid arthritis (R.A.) or osteoarthritis (O.A.), were given indoprofen 600 mg/day for up to 5 months, in order to evaluate its effectiveness and safety. A significant improvement of joint tenderness (Ritchie) and of functional index (Lee) was rapidly achieved in R.A. patients (12 cases); objective signs of inflammation, moreover, were gradually relieved. In O.A. patients (25 cases) articular pain, motility and swelling all improved in about 90% of cases. A complete set of laboratory tests reflecting blood picture, liver and kidney function, carried out at monthly intervals during the study, failed to reveal any sign of toxicity. Clinical tolerance was generally good.

Rifampicin in free combination with other antimicrobial drugs in non-Tb infections. Clinical data on 650 patients (a review).

A review of the published literature has allowed the identification of a number of non-tubercular indications where rifampicin (trade mark Ciba-Geigy: Rimactane) has been successfully used in combination with other chemotherapeutic agents. The cases reviewed with regard to effectiveness sum 562. The most frequently combined drugs were aminoglycosides (mainly gentamicin), cotrimoxazole, colistine, vancomycin and fusidic acid, these two latter in cases due to Staphylococcus spp. The main indications where combined rifampicin treatment led to favourable results were UTI (success rate 64.9%), bone infections (86.9%), staphylococcal endocarditis (85.0%), respiratory tract infections often due to gram-negative rods (97.7%) as well as skin and soft tissue infections (83.3%), and bacterial meningitis (100%). Very favourable results were obtained in a non-life-threatening though epidemiologically important condition, i.e. salmonella carriers, where a 100% conversion rate was reached in an average period of 6 weeks. Special attention may deserve the combined treatment of fungal infections with rifampicin and amphotericin B. Tolerability was evaluated on a total of 650 cases. It appears to be good for daily doses up to 1,200 mg/day, even on long-term treatment; less so for the highest doses used (1,800 or 30 mg/kg a day). The clinical results, which are in good agreement with the results of the in vitro tests, indicate that rifampicin may have an important role in the combined treatment of severe non-mycobacterial infections. Further prospective, whenever possible, comparative studies are warranted for a thorough appraisal of its possible usefulness.

Clinical study of possible interactions between indoprofen and oral anticoagulants.

Possible interactions between indoprofen (IP) and Warfarin Na (W) were studied in 18 patients under chronic anticoagulant treatment, according to a cross-over, double-blind design, comparing 600 mg daily of IP with placebo (PL). In all subjects the dosage of W was kept constant throughout the study (21 days). No significant differences were found between IP and PL either on coagulation parameters or on platelet count and platelet adhesiveness. Afte IP a significant decrease in platelet aggregation (induced by ADP and adrenaline) was observed. The results suggest that indoprofen can be administered to patients under anticoagulant treatment, although frequent checks of the coagulation parameters are advisable in these cases.

Study of the possible interactions of indoprofen on the diuretic effect of furosemide.

Twelve elderly in-patients undergoing chronic furosemide treatment (25 mg/day), with stable diuresis, were admitted to a cross-over, double-blind study to investigate the possible interactions between indoprofen and the diuretic. Indoprofen (200 mg t.i.d.) and identical placebo tablets were administered in randomized sequences for 4 days each. The sequence were preceded by a 4-day run-in observation period and followed by a 4-day follow-up. 24-hour urinary volume and the excretion of Na, K and endogenous creatinine were monitored, with serum Na, K, creatinine and creatinine clearance. Blood pressure and heart rate were measured and routine clinical blood chemistry tests and urinalysis were made for safety. The findings of this pilot study suggest that indoprofen does not alter the natriuretic action of furosemide; a tendency was noted towards a reduction of glomerular filtrate and urine volume, but the values after indoprofen were not significantly different from those after placebo.

Double-blind cross-over investigation of the effectiveness and safety of two doses of indoprofen compared with an ASA preparation and placebo in patients suffering from osteoarthritis.

Eighty patients suffering from osteoarthritis of the large joints were admitted to the study and randomly allocated to a 4-treatment sequence, according to a multiple replication of a 4 x 4 Latin square design, with proper balancing of treatments, of periods and of the residual effects of drugs. Each treatment (indoprofen 300 or 600 mg/day, ASA 1500 + diazepam 6 mg/day, and matching placebo) was administered for 7 days. Examinations were carried out on admission, after a 3-4 day wash-out period, and then repeated at the end of each treatment period. Treatment with active drugs was significantly better than placebo in relieving overall pain, and in patient's and investigator's opinion on effectiveness. Treatment with indoprofen, at both dosages, was preferred more frequently than others. The incidence of adverse events during each period did not seem to depend either on the treatment being given during that period or on the previous one.