Single-dose cefixime 800 mg plus doxycycline 100 mg twice a day for 7 days compared with single-dose ceftriaxone 1 g plus single-dose azithromycin 2 g for treatment of urogenital, rectal, and pharyngeal gonorrhoea: a randomised clinical trial.

OBJECTIVES: To evaluate the efficacy and tolerability of a single dose of oral cefixime 800 mg plus oral doxycycline 100 mg twice a day for 7 days, compared with a recommended single dose of ceftriaxone plus single dose of oral azithromycin, for treatment of uncomplicated urogenital, rectal, or pharyngeal gonorrhoea. METHODS: A noninferiority, open-label, multicentre randomized controlled trial was conducted in Prague, Czech Republic. Some 161 patients, 18-65 years of age diagnosed with uncomplicated urogenital, rectal, or pharyngeal gonorrhoea by nucleic acid amplification test (NAAT) were randomized to treatment with single dose of cefixime 800 mg plus doxycycline 100 mg twice a day for 1 week or a single dose of ceftriaxone 1 g intramuscularly plus single dose of azithromycin 2 g. The primary outcome was the number of participants with negative culture and NAAT at 1 week and 3 weeks, respectively, after treatment initiation. RESULTS: In all, 161 patients were randomized and 152 were included in per-protocol analyses. All 76 (100%; 95% CI, 0.95-1.00) patients treated with ceftriaxone plus azithromycin achieved negative cultures and NAAT after treatment. In the cefixime plus doxycycline arm at week 1, culture was negative in all 76 (100%) patients; at week 3, culture was negative in 70 of the 76 patients (92%; 95% CI, 0.84-0.97) and NAAT negative in 66 of the 76 patients (87%; 95% CI, 0.77-0.94). At week 3, culture and NAAT were negative in 65 of the 76 patients (86%; 95% CI, 0.76-0.93). Per-protocol risk difference was 14.5%; 95% CI, 6.56-22.38. All treatment failures observed in the cefixime arm were pharyngeal gonorrhoea cases. DISCUSSION: The combination of cefixime and doxycycline did not achieve noninferiority to ceftriaxone and azithromycin for treatment of gonorrhoea when including pharyngeal gonorrhoea. It did, however, show high efficacy for urogenital and rectal gonorrhoea.

The Optimization of Mechanical Alloying Conditions of Powder for the Preparation of a Fe-10Al-4Cr-4Y2O3 ODS Nanocomposite.

Mechanical alloying (MA) of powders represents the first processing step in the production of oxide dispersion-strengthened (ODS) alloys. MA is a time and energy-consuming process also in the production of Fe-10Al-4Cr-4Y2O3 creep and oxidation-resistant ODS nanocomposite, denoted as the FeAlOY, and it deserves to be optimized. MA is performed at two different temperatures at different times. The powder after MA, as well as the microstructure and high-temperature strength of the final FeAlOY, are characterized and the optimal MA conditions are evaluated. The obtained results show that the size distribution of the powder particles, as well as the dissolution and homogenization of the Y2O3, becomes saturated quite soon, while the homogenization of the metallic components, such as Al and Cr, takes significantly more time. The high-temperature tensile tests and grain microstructures of the secondary recrystallized FeAlOY, however, indicate that the homogenization of the metallic components during MA does not influence the quality of the FeAlOY, as the matrix of the FeAlOY is sufficiently homogenized during recrystallization. Thus, the conditions of MA correspond to sufficient dissolution and homogenization of Y2O3 and can be considered the optimal ones.

Substantial Improvement of High Temperature Strength of New-Generation Nano-Oxide-Strengthened Alloys by Addition of Metallic Yttrium.

Oxide-dispersion-strengthened (ODS) Fe-Al-Y2O3-based alloys (denoted as FeAlOY) containing 5 vol. % of nano-oxides have a potential to become top oxidation and creep-resistant alloys for applications at temperatures of 1100-1300 °C. Oxide dispersoids cause nearly perfect strengthening of grains; thus, grain boundaries with limited cohesive strength become the weak link in FeAlOY in this temperature range. One of the possibilities for significantly improving the strength of FeAlOY is alloying with appropriate elements and increasing the cohesive strength of grain boundaries. Nearly 20 metallic elements have been tested with the aim to increase cohesive strength in the frame of preliminary tests. A positive influence is revealed for Al, Cr, and Y, whereby the influence of Y is enormous (addition of 1% of metallic Y increases strength by a factor of 2), as it is presented in this paper.