Phenoxymethylpenicillin two or three times daily for tonsillitis with beta-haemolytic streptococci group A: a blinded, randomized and controlled clinical study.

In relation to compliance problems it was investigated whether phenoxymethylpenicillin dosed twice or 3 times daily was equally effective in tonsillitis due to beta-haemolytic streptococci group A. In a randomized, controlled and single blind multicentre study 206 patients older than 5 years with a positive culture of group A streptococci were treated with phenoxymethylpenicillin for 7 days. 101 patients received the daily dosage divided in 2 doses and 105 patients divided in 3 doses a day. The cure rate (a combination of bacteriological and clinical cure) was 82.0% in the 2-dosage regimen, and 88.2% in the 3-dosage regimen. The difference was not statistically significant. In conclusion, phenoxymethylpenicillin dosed 2 or 3 times daily seems to be equally effective in tonsillitis due to group A streptococci.

Postpartum bacteriuria. A multicenter evaluation of different screening procedures and a controlled short-course treatment trial with amoxycillin.

A total of 10,909 puerperal women from 6 different hospitals were screened for bacteriuria by culture of voided midstream urine (MSU), and a significant growth was found in 881 patients (8.1%). In 731 cases the urine was reexamined by using suprapubic aspiration (SPA), and in only 354 (48%) of the samples the diagnosis of bacteriuria was confirmed. The contamination rate of the MSU samples varied from 46 to 69% between the different hospitals, indicating that in the postpartum period positive MSU findings would necessitate more thorough examination in order to confirm the diagnosis of urinary tract infection. In our study, suprapubic aspiration was found to be a simple and acceptable method without any side effects. Confirmed bacteriuria occurred in 3.2% of the women. Operative delivery (Cesarean section, forceps and vacuum extractor delivery), epidural anesthesia and bladder catheterization increased the risk of bacteriuria in the postpartum period. Only 27% of the women with positive bladder urine complained of dysuria and this symptom was significantly more common in women who had been catheterized. 230 patients with confirmed bacteriuria with amoxycillin-sensitive bacterias participated in a randomized short-course treatment trial: 114 women received 3 days treatment with amoxycillin (1.5 g/day), 116 received the traditional 10 days therapy (750 mg amoxycillin/day). Both antibiotic regimens were observed to be effective with a cure rate of 96 and 98%, respectively. Short-course antibiotic treatment should thus be recommended to puerperal women with urinary tract infections since this avoids prolonged drug exposure to the lactating mother.

Clinical experience with a triphasic oral contraceptive.

A triphasic combined oral contraceptive containing fluctuating amounts of ethinylestradiol and levonorgestrel was tested clinically in a multicenter trial at six hospitals in Norway. 367 women were included in the study, 3 588 cycles were studied, and the follow up period was 12 months. The one year continuation rate was 67%. Five pregnancies occurred during the study period. All of them had to be considered as patient failures. The causes for stopping medication were side effects in about 50% and the rest for personal reasons. The cycle control taking into account duration of bleeding, amount of flow, and intermenstrual bleeding was good and comparable to the low-dose monophasic combined pills. The incidence of side effects was low. One woman had an increase in systolic blood pressure to more than 140 mmHg. Thrombophlebitis was not registered. In conclusion the triphasic oral contraceptive was effective and had a good cycle control and low incidence of side effects.

PIP: A triphasic combined oral contraceptive (OC) containing fluctuating amounts of ethinyl estradiol and levonorgestrel was tested clinically in a multicenter trail at 6 hospitals in Norway. 367 women were included in the study, 3588 cycles were studied, and the follow-up period was 12 months. The 1 year continuation rate was 67% 5 pregnancies occurred during the study period. All were considered patient failures. The causes for stopping medication were side effects in about 50% and the rest for personal reasons. The cycle control taking into account duration of bleeding, amount of flow, and intermenstrual bleeding was good and comparable to the low-dose monophasic combined pills. The incidence of side effects was low. 1 woman had an increase in systolic blood pressure to more than 140 mmhg. Thrombophlebitis was not registered. In conclusion, the triphasic OC was effective and had good cycle control and low incidence of side effects.