Cost-effectiveness comparison of single and multiple-dose antibiotic treatment of lower uncomplicated urinary tract infections.

This study analyzed the cost-effectiveness of antibiotic treatments of different durations for acute cystitis in non-pregnant females. Questionnaires were sent to 400 practitioners evenly distributed throughout Italy. Data are reported from 2,069 patients. The clinical bacteriological efficacy at 10-15 days was 86.4% for single-dose treatment with fosfomycin-trometamol (FT), and 81.8% for the multiple-dose antibiotics group (MDAG). Disappearance of symptoms occurred in 2.1 days with FT and 3.4 days with MDAG. With FT 93.8% of patients were free of adverse events and 86.9% with MDAG. Analysis of the cost-effectiveness indicators for cure rate and absence of adverse events showed that treatment costs were similar for all antibiotics. FT needed less time interval for symptoms to disappear with a slightly higher cost than for MDAG, which had a better cost/effectiveness ratio.

Susceptibility of frequent urinary pathogens to fosfomycin trometamol and eight other antibiotics: results of an Italian multicenter survey.

In order to assess the resistance profile for fosfomycin trometamol after several years of clinical use in Italy, this study has explored the susceptibility to fosfomycin and eight other antibacterial drugs of 6,021 strains isolated from 23,816 urines during 1990 in three teaching hospitals located in Genoa, Parma and Catania. Gram-negative strains, notably Escherichia coli (41.6%), were primarily involved. Amoxicillin was the least active compound with resistance in 41.4% of the isolates. Fosfomycin showed the lowest rate of resistance in both gram-negative (2.8%) and gram-positive (2.1%) pathogens. This was followed by norfloxacin with a resistance rate of 11.8% and netilmicin with 12.2%. These results indicate that fosfomycin-trometamol may continue to be used in single-dose treatment of urinary tract infections even in the absence of microbiological data since the prevalence of resistance to the drug is, at present, so low that therapeutic failure is highly improbable.

[Myasthenia gravis and thymectomy in a 2 year old girl (author's transl)]. / Myasthénie grave juvénile et thymectomie. A propos d'une observation chez une enfant de 2 ans.

The case of a 2 year old girl with myasthenia gravis is reported. Immunological investigations did not show any major abnormalities of the thymocytes. High levels of acetylcholine receptor antibodies were present before thymectomy. After surgery they decreased significantly and there was a clear clinical improvement.