Asthma and allergy in Albania and the UK.

In the first phase of the International Study of Asthma and Allergies in Childhood, a large difference in occurrence of asthma symptoms was seen between children in Albania and the UK. We did skin-prick tests with various allergens and measured peak expiratory flow rate in about 1000 children from each country. A large difference in the proportion of exercise-induced bronchial reactivity was evident between children from Albania and the UK (0.8% vs 5.4%, respectively). However, the frequency of allergic sensitisation was closely similar (15.0% vs 17.8%, respectively). These results suggest that large geographical variations in asthma prevalence can arise without differences in frequency of atopy.

Antibacterial activity of gentamicin and ciprofloxacin against Gram-negative bacteria: interactions with pig and calf sera.

The antibacterial activity of pig and calf serum and its ability to interact with gentamicin and ciprofloxacin were studied in vitro using Escherichia coli K-12, Proteus rettgeri (Sanelli) and Klebsiella pneumoniae ATCC 10031. The antimicrobial activity of the above drugs, alone or in combination with serum, was investigated by the checkerboard method and expressed as the minimal inhibitory concentration (microg ml-1). Pig serum (25%) with gentamicin had a synergistic antibacterial effect against Escherichia coli K-12 and pig serum (25%) with ciprofloxacin against Proteus rettgeri (Sanelli) and Klebsiella pneumoniae ATCC 10031. Calf serum (25%) had a synergistic effect with gentamicin against Proteus rettgeri (Sanelli) and calf serum (25%) plus ciprofloxacin against Klebsiella pneumoniae ATCC 10031. The effects of these drugs may be enhanced by pig and calf sera.

Effects of cardio-pulmonary bypass on vancomycin plasma concentration decay.

The objective of the study was to investigate possible changes in vancomycin serum levels induced by cardio-pulmonary bypass (CPB). Ten cardiac patients (seven males, three females, aged between 56 and 81), who underwent cardiac surgery requiring CPB, took part in the study. Vancomycin (15 mg kg-1) was intravenously infused over 60 min before anaesthesia and blood samples were taken at appropriate times after drug administration (0, 0.5, 1, 6, 8 h), after starting CPB (0, 5, 30 and 60 min) and after aortic unclamping (0, 5, 30, 60, 120 min). Drug serum concentrations were determined by means of a fluorescence polarization immunoassay. The area under the concentration-time curve (AUC) measured during CPB were compared with the AUC extrapolated in the same interval by fitting a two-compartment pharmacokinetic model to drug concentrations obtained before and after CPB. Five minutes after starting CPB vancomycin serum levels decreased, on average, by 40.9% and remained steadily lower than the expected values over the next 60 min. In the same interval, the measured AUC was 31.7% lower than the expected AUC. In no instance did serum levels fall below the MIC for most common pathogens (1-2 mg l-1). At aortic unclamping serum levels slightly rebounded but tended to remain lower than the expected concentrations over the next 120 min. In conclusion, during CPB vancomycin serum levels invariably decreased but, at the dose employed (15 mg kg-1), remained in a potentially effective range for antimicrobial prophylaxis.