Economic analysis of antibiotic regimens used in the treatment pharyngitis: a prospective comparison of azithromycin versus roxithromycin.

The economic impacts in terms of cost and effectiveness (speed of resolution of symptoms) of 3- and 5-day courses of azithromycin and a 10-day course of roxithromycin were compared in a randomized, open study in patients with symptoms suggestive of beta-haemolytic streptococcal pharyngitis. Direct medical costs and absence from work were recorded and symptom scores and compliance were used to assess the effectiveness of therapies. Although no differences between treatment groups in terms of overall clinical response rates were detected 2 and 4 weeks after the start of treatment, more rapid resolution of symptoms was achieved with 3- and 5-day courses of azithromycin than with a 10-day course of roxithromycin. There was also a significant reduction in the time absent from work in the azithromycin treatment groups. The total costs of care over the 4-week evaluation period were lower for the 3- and 5-day azithromycin courses (US$193.60 and US$195.30 respectively) than for roxithromycin (US$202.10). The major cost components were absence from work (58.6%), visits to the physician (15.3%) and utilization of antibiotics (14.9%). Compliance was significantly better (P < 0.01) in patients prescribed azithromycin for 3 and 5 days (58.0% and 42.9% respectively) than in those who received roxithromycin (20.3%) and a significantly longer symptom-free period (P < 0.01) was reported in azithromycin- compared with roxithromycin-treated patients. These findings support the hypothesis that a 3- or 5-day course of azithromycin is as effective as a 10 day course of roxithromycin in the treatment of patients with pharyngitis and is associated with lower costs. Furthermore, azithromycin is associated with faster resolution of symptoms and improved patient compliance.

[Roles of arterial hypertension and diabetes mellitus in early nephropathy]. / Rôles de l'hypertension artérielle et du diabète dans la néphropathie débutante.

The aim of this study was to assess and compare microalbuminuria (mu Alb mg/24 h +/- SD) in populations with hypertension and or diabetes mellitus leading to determine the effects of each pathology and their association in nephropathy. In hospital population studies were (mean +/- S.D.): (table; see text) No other pathology was found. Creatinine was in normal limits and macroproteinuria less than 1 g/24 h. Microalbuminuria was measured with laser immunonephelemetry. Glucose tolerance was assessed by fructosaminemia values (N less than or equal to 2.8 mmol/l). Student's test and linear regression test were used. There was no correlation between microalbuminuria and the other parameters: fructosamine, creatinine, age, in the 5 groups. Early nephropathy defined as a value of microalbuminuria between 30 and 300 mg/24 h was found in 23 p. 100 (H), mean 64.4 mg/24 h +/- 44, 37 p. 100 (D1), mean 127.7 +/- 149, 29 p. 100 (D2) mean 95.5 +/- 88, 47 p. 100 (D1H) mean 96.8 +/- 72, 39 p. 100 (D2H) mean 90 +/- 70. Microalbuminurias in diabetic populations were upper than in hypertensive (NS). Early nephropathy was most frequent when hypertension was associated with diabetes. Follow-up and treatment of hypertension in populations at high risk of vascular disease, as diabetics, will probably decrease the prevalence of early nephropathy.