Low dose interferon alfa-2b for chronic hepatitis B in Asian countries.

In a study of low dose interferon alfa-2b in 587 patients expected to show a good response to treatment, 76-87% patients in different countries had alanine amino-transferase activities returned to normal after four months' treatment, 49-72% were negative for hepatitis B virus (HBV)-DNA, 51-66% were negative for hepatitis B e antigen (HBeAg), and 44-62% were anti-HBe positive. These effects were maintained after nine to 12 months' follow up. Side effects were mild, but led to discontinuation of treatment in 12 patients.

Comparison of once-daily and thrice-daily netilmicin regimens in serious systemic infections: a multicenter study in six Asian countries.

Patients with serious systemic infections admitted to eight medical centers in six Asian countries were treated with 300 mg of netilmicin given once daily (group A: 92 patients) or 100 mg of netilmicin given three times daily (group B: 93 patients). Netilmicin was administered by intramuscular injection or slow intravenous infusion until clinical, laboratory, and bacteriologic measures were normalized and for not more than two additional days. A clinical cure was achieved in 88% of the patients from group A and in 68% from group B. The causative micro-organisms were eliminated or infection site healed in 90% of group A and in 88% of group B. The mean treatment duration was 6.9 days in group A and 8.8 days in group B. Two patients in each group developed symptoms of nephrotoxicity; the pretreatment serum creatinine levels in all four patients were in the high borderline range. No other serious side effects were found. It is concluded that netilmicin administered once daily is safe and more effective than netilmicin administered three times daily.

Once daily administration of netilmicin compared with thrice daily, both in combination with metronidazole, in gangrenous and perforated appendicitis.

The safety and efficacy of a single daily dose of netilmicin plus metronidazole after appendicectomy for gangrenous and perforated appendicitis was compared with the traditional thrice daily dosage. Twenty patients were enrolled in each group. The antibiotics were given intramuscularly for seven days after operation. Eradication of infection was observed in all patients and the postoperative wound sepsis was the same for each group. A significantly higher peak serum netilmicin level was achieved in the group receiving a single daily dose but nephrotoxicity was not observed. We concluded that the single daily dose of netilmicin was well tolerated and was as efficacious in this small series as the thrice daily regimen. The single-dose regimen has the advantage of simplicity and potentially increased bactericidal activity.

Oxymetazoline ophthalmic solution versus naphazoline solution in non-infectious conjunctivitis.

A double-blind, randomized study was carried out in 38 adult patients with non-infectious conjunctivitis to compare the efficacy and tolerance of oxymetazoline (0.025%) ophthalmic solution with that of naphazoline (0.04%) solution. Treatment was continued for 7 to 8 days and severity of symptoms was recorded before, during and at the end of therapy. At the end of the study period, 11 (69%) of 16 patients treated with oxymetazoline demonstrated a good to excellent response to therapy compared with 8 (53%) of 15 patients in the naphazoline-treated group. A statistically significant difference favouring oxymetazoline was observed in duration of action and the mean number of applications needed. No adverse reactions were reported in either treatment group.

An antihistamine/decongestant formulation ('Disophrol' Syrup) for relief of symptoms in children with seasonal rhinitis.

An open study was carried out in 30 children with seasonal allergic rhinitis to evaluate the efficacy and tolerance of treatment with a dexbrompheniramine maleate (1.5 mg/5 ml) and pseudoephedrine sulphate (30 mg/5 ml) syrup formulation ('Disophrol' Syrup). Each patient was given 2.5 to 5 ml 4-times daily during the 14-day study period. Relief from signs and symptoms associated with seasonal rhinitis was evaluated on Days 7 and 14 of therapy. By Day 7, 5 patients were considered cured, 22 showed marked improvement and 3 patients had improved. At the Day 14 evaluation, 27 patients had complete clearing of signs and symptoms, 2 patients showed a marked improvement while the remaining patient was considered a treatment failure. Body weight and vital signs remained unaffected. Incidence of adverse reactions was limited to one occurrence of extreme fatigue, which did not necessitate termination of therapy.

[Netilmicin in refractory urinary tract infections. Good therapeutic effect in spite of long dosage intervals]. / Netilmicin bei hartnäckiger Harnweginfektion. Guter therapeutischer Effekt trotz langen Dosierungs-intervallen.

Aminoglycoside antibiotics are useful--despite potential toxicity--for treating urinary tract infection when other antibacterial agents have failed to eradicate bacteriuria. That this is true of the recently introduced aminoglycoside netilmicin was shown by 16 cases of tenacious and frequently recurring urinary tract infection. In contrast to previous recommendations, but relying on well known pharmacokinetic data which show prolonged urinary excretion of aminoglycosides, netilmicin was administered according to the following dosage schedule: Intramuscular injections of 3 mg/kg in cases where renal function was unimpaired, and of 2 mg/kg where it was reduced, were administered at dosage intervals of 1 to 4 days. Peak serum levels of netilmicin measured 1 hour after intramuscular injection were within the expected range of 8-14 micrograms/ml (3 mg/kg) and 6-10 micrograms/ml (2 mg/kg). As a result of the long dosage intervals the serum trough levels were usually far below 1 microgram/ml except in patients with moderate renal failure. Urinary concentrations of netilmicin, however, remained for the most part above the limit of antibacterial activity throughout the dosage intervals of 1 to 4 days. One week after the usual three weeks treatment course, urinary concentrations were still between 1 and 5 mcg/ml, and slowly decreasing amounts of the drug could be detected at least in traces up to 3 months beyond the last dose. Considering the type of urinary tract infections selected to receive netilmicin, the response to treatment was satisfactory and seemed unaffected by the long dosage intervals. Bacteriological cure was achieved in 5 of 11 infections associated with chronic pyelonephritis or analgesic nephropathy and in 4 of 5 urinary infections in patients with renal transplants. Treatment failures could be accounted for by obstructive lesions, stones, and in one transplanted patient by infection localized to her own shrunken kidneys. No instance of ototoxicity or nephrotoxicity due to netilmicin could be detected. Netilmicin administered according to the dosage schedule described can be recommended for ambulatory treatment of tenacious, recurring urinary tract infections due to gram-negative bacteria and refractory to cure by the usual oral antibiotic therapy.

[Folic acid and pregnancy, a real problem?]. / Acide folique et gravidité, problème réel?

The efficacy of prophylactic treatment with ferrous sulfate (80 mg Fe++) and the combination of ferrous sulfate with folic acid (80 mg Fe++ and 350 microgram folic acid) were studied in a double blind trial in the 20th, and again in the 30th and 36th week of pregnancy (29 patients). At the beginning of the treatment (20th week) 29% of the patients showed a pathologically reduced serum folic acid level. Combined therapy has a favorable effect on the folic acid levels in the serum and red blood cells; this was confirmed statistically. At the end of pregnancy, 69% of the patients of the control group (ferrous sulfate) showed a pathologically reduced serum level and 23% a subnormal level in erythrocytes. These results unquestionably justify the prophylactic prescription of folic acid during pregnancy.

[Treatment of essential hypertension with Transicor 80 and Esidrex K under medical practice conditions]. / Behandlung der essentiellen Hypertonie mit Trasicor 80 und Esidrex-K unter Praxisbedingungen

This study was designed to obtain information under general practice conditions on the efficacy and tolerability of a fixed combination of the beta-blocking agent oxprenolol 80 mg (Trasicor 80) and hydrochlorothiazide + KCl (Esidrex-K) in the treatment of moderate essential hypertension. Patients with a diastolic pressure of 100 to 130 mm Hg were covered by the study. The dosage of Trasicor was kept relatively low and at a constant level, i.e. one tablet twice daily throughout. In the group of 370 patients whose record had been completed according to the treatment plan, the systolic and diastolic pressures fell on the average by 28 and 17 mm Hg respectively. After 10 weeks of therapy, the diastolic pressure was normalized (i.e. below 95 mm Hg) in 226 patients. The mean decreases in pressure were statistically significant after two weeks' treatment. The mean pulse rate fell from 79 to 73. Tolerance of the regimen was very good in 75% of patients; 57 patients were withdrawn from the study for various reasons.