Pneumococcal puerperal mastitis in a lactating mother.

INTRODUCTION: A case of pneumococcal mastitis in a breast-feeding mother 6 months postpartum is described. Mastitis is usually caused by Staphylococcus aureus . A review of the literature from 1950 to March 2018 revealed only four other cases in which the causative organism was Streptococcus pneumoniae . CASE PRESENTATION: The nursing mother presented with high fever and the four cardinal signs of inflammation of the left breast: calor, dolor, rubor, tumour. In milk culture Streptococcus pneumoniae was isolated in numbers exceeding 105 c.f.u. ml-1 . The strain was of polysaccharide serotype 11 not included in Prevnar-13. Susceptibility testing showed full sensitivity to ß-lactam antibiotics as well as to macrolides, lincosamides, vancomycin and tetracycline. CONCLUSION: Streptococcus pneumoniae should be considered as a possible causative agent of puerperal mastitis.

Bioequivalence evaluation of 2 brands of cefuroxime axetil 250 mg tablets in healthy human volunteers.

OBJECTIVE: To assess the bioequivalence of 2 oral cefuroxime axetil (250 mg) tablets formulation. The reference preparation was Zinadol/Glaxo Wellcome, England, while the test preparation was cefuroxime axetil/Pharmathen, Athens, Greece. SUBJECTS, MATERIAL AND METHODS: The study was an open, randomized, 2-period, 2-sequence, 2-treatment crossover, involving 24 healthy male and female volunteers. All volunteers completed the study. Cefuroxime axetil plasma concentrations were measured utilizing a sensitive, reproducible and accurate HPLC method. Care was taken through the collection and analysis of the samples due to instability of cefuroxime axetil in light. Pharmacokinetic parameters used to assess bioequivalence were AUC(0-last), AUC(0-inf) for the extent of absorption and Cmax and tmax for the rate of absorption. Statistical evaluation of Cmax, AUC(0-last), and AUC(0-inf) was done using 2-way analysis of variance (ANOVA) after semilogarithmic transformation. Tmax values were tested using the distribution-free Hodges-Lehman interval. RESULTS: The parametric 90% confidence intervals for ratio T/R ranged from 98.91-111.65% (point estimate 105.09%) for AUC(0-last), 99.41-111.78% (point estimate 105.41%) for AUC(0-inf) and 87.61-102.89% (point estimate 94.95%) for Cmax, respectively. Based on the results of tmax, K(el) and t(1/2) there were no statistically significant differences. CONCLUSION: The 2 cefuroxime axetil preparations, examined in accordance with the European Union bioequivalence requirements, are equivalent with respect to rate and extent of absorption.

Comparative bioequivalence study of two isotretinoin soft gel capsule formulations in healthy male volunteers.

OBJECTIVE: To assess the bioequivalence of 2 oral isotretinoin (20 mg) soft gel capsule formulations. The reference preparation was Roaccutan/Roche while the test preparation was A-Cnotren/Pharmaten, Athens, Greece. SUBJECTS, MATERIAL AND METHODS: The study was an open, randomized, 2-period, 2-sequence, 2-treatment crossover, involving 38 healthy male volunteer subjects. All volunteers completed the study. Isotretinoin plasma concentrations were measured by a fully validated HPLC method. Special care was taken through the collection and analysis of the samples due to instability of isotretinoin to light and temperature. Pharmacokinetic parameters used to assess bioequivalence were AUC(0-last), AUC(0-infinity) for the extent of absorption and Cmax and Tmax for the rate of absorption. Statistical evaluation of Cmax, AUC(0-last), AUC(0-infinity) was done after semi-logarithmic transformation by 2-way analysis of variance (ANOVA). Tmax values were tested using the distribution-free Hodges-Lehman interval. RESULTS: The parametric 90% confidence intervals for ratio T/R ranged from 95.20-103.20% (point estimate 99.10%) for AUC(0-last), 94.57-102.30% (point estimate 98.36%) for AUC(0-infinity) and 94.81-102.90% (point estimate 98.77%) for Cmax, respectively. Based on the results of Tmax, k(el) and t(1/2), too, there were no statistically significant differences. CONCLUSION: As a result, the 2 isotretinoin preparations in accordance with the European Union bioequivalence requirements, are equivalent with respect to rate and extent of absorption.