[Treatment effects of co-amoxiclav (Amoxiclav 2x) in acute exacerbation of severe chronic obstructive pulmonary disease: clinical evaluation].

INTRODUCTION: The exacerbation of chronic obstructive pulmonary disease is most often induced by an infection of bacterial origin in over 50% of the cases (or mixed bacterial and viral infection). This study was aimed at evaluating clinical effects of antibiotics co-amoxiclav. Amoxiicillin with clavulanic acid in the treatment of patients with severe chronic obstructive pulmonary disease exacerbation. MATERIAL AND METHODS: The investigation included 38 patients with severe chronic obstructive pulmonary disease exacerbation hospitalized at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica. The patients were randomly selected for the antibiotic treatment with Amoxiclav twice a day in 12 hour intervals. The clinical effects of the applied treatment were evaluated by analyzing certain laboratory findings, microbiological sputum findings and improvement of subjective symptoms. RESULTS: Of the examined subjects, 65% were males and 35% were females, their mean age being 66.4 +/- 8.86, and who were mostly smokers (73%). After the completion Of Applied antibiotic treatment, a significant reduction and normalization of all inflammation markers were recorded, as well as a significant improvement of the patients' subjective symptoms. The positive microbiological sputum findings (Haemophilus influenzae, Pseudomonas aeruginosa and Streptococcus pneumoniae) were recorded in 13.58% of the patients. The bacterial agent was eradicated on the third day of the applied treatment. The mean length of the treatment was 7.07 +/- 0.91 days, with no undesirable treatment side effects observed CONCLUSION The antibiotic therapy is justifiable as the initial treatment regimen of severe chronic obstructive pulmonary disease exacerbation and amoxicillin with clavulanic acid is reported as the first-line antibiotic drug in most pharmacotherapy guidelines.

[Influence of dexamethasone on appetite and body weight in lung cancer patients].

INTRODUCTION: Anorexia and cachexia are the most common symptoms in cancer patients. They increase morbidity and mortality among cancer patients as well as complications of surgery, radiotherapy and chemotherapy. The most common drugs for treatment of cancer cachexia are corticosteroids and megestrol acetate. MATERIAL AND METHODS: The purpose of this study was to determine the influence of dexamethasone on appetite loss and weight loss in lung cancer patients treated with chemotherapy. Group A (30 patients) was treated with cisplatin, etoposide and standard supportive therapy, while group B (30 patients) received, in addition to this treatment, dexamethasone in the dose of 8 mg intravenously per day (1-3 day of chemotherapy). RESULTS: There was a statistically significant difference in appetite loss between two groups after the second chemotherapy cycle favouring group A. The analysis of weight loss showed a statistically significant difference between two groups after both chemotherapy cycles, once again in favour of group A. Concerning the impovement of appetite and weight gain, there was no statistically significant difference between two groups after both chemotherapy cycles. DISCUSSION: Many double-blind randomized controlled studies showed beneficial symptomatic effect of corticosteroids in cancer cachexia, especially on the improvement of appetite, food intake and performance status. In most of the studies the weight gain was not recorded The most effective type of corticosteroids, dose and route of administration have not been established. CONCLUSION: Dexamethasone significantly decreases appetite loss and weight loss in lung cancer patients treated with chemotherapy, while it has no influence on appetite impovement and weight gain.