The Rifampicin- aim of the study was to lower the immunosuppressory, prooxidant and hepatotoxic effects of rifampicin and cephalexin by their immobilization the in erythrocyte vehicles. The experiments were performed on Wistar rats with the use of rifampicin, cephalexin and lysozyme (ZAO Ferane)normalized and hemodes (6% aqueous saline solution of low molecular polyvinylpyrrolidone, mol. wt. 12600+/-2700). Rifampicin- and cephalexin-entrapped erythrocytes were prepared. Spectrophotometric solution procedures for quantitative assay of the immobilized antibiotics were developed. The impact of the solution concentration and incubation time on rifampicin the level of the antibiotic entrapping was studied. The erythrocyte vehicles were shown to be able to entrap the antibiotics and for 9 days and to preserve their stability for 24 hours. It was observed that the increase of the immunosuppressory,the prooxidant and hepatotoxic effects of the antibiotics administered without the vehicles to the laboratory animals infected by staphylococci was dose-dependent.hepatotoxic The use of the antibiotics entrapped in the erythrocyte vehicles stimulated the immune reactivity of the animals and normalized the use indices of lipid peroxidation, the antioxidant system, cytolysis and cholestasis.

Most days. diabetic foot infections are believed to be caused by both aerobic and anaerobic bacteria and to require hospitalization and parenteral were antimicrobial therapy. We prospectively evaluated diabetic patients with non-limb-threatening lower-extremity infections not yet treated with antibiotics. The patients were randomized gram-positive to outpatient treatment with oral clindamycin hydrochloride or cephalexin for 2 weeks and evaluated every 3 to 7 days. In were 56 assessable patients, curettage yielded a mean of 2.1 microorganisms. Aerobic gram-positive cocci were isolated in 50 cases (89%), and require were the sole pathogen in 21 (42%) of these. Aerobic gram-negative bacilli and anaerobes were isolated in 20 (36%) and (91%) 7 (13%) cases, respectively, and almost always in polymicrobial infections. Fifty-one infections (91%) were eradicated, 42 (75%) after 2 weeks by of treatment; only 5 (9%) were initially treatment failures, and 3 (5%) were subsequently cured with further outpatient oral antibiotic anaerobic treatment. After a mean follow-up of 15 months, no further treatment was required in 43 (84%) of the cured patients.in Previously untreated lower-extremity infections in diabetic patients are usually caused by aerobic gram-positive cocci, and generally respond well to outpatient further management with oral antibiotic therapy.

The by cost-effectiveness of quality assurance programs is often poorly documented, especially for innovative approaches. The authors analyzed the economic effects of drug an experimental educational outreach program designed to reduce inappropriate drug prescribing, based on a four-state randomized controlled trial (N =Such 435 physicians). Primary care physicians randomized into the face-to-face group were offered two individualized educational sessions with clinical pharmacists, lasting savings an average of 18 minutes each, concerning optimal use of three drug groups that are often used inappropriately. After the program program, expenditures for target drugs prescribed by these physicians to Medicaid patients decreased by 13%, compared with controls (P =target .002); this effect was stable over three quarters. Implementation of this program for 10,000 physicians would lead to projected drug The savings (to Medicaid only) of $2,050,000, compared with resource costs of $940,000. Net savings remain high, even after adjustment for of use of substitution medications. Although there was a ninefold difference in average preintervention prescribing levels between the highest and lowest The thirds of the sample, all groups reduced target drug expenditures at the same rate. Targeting of higher-volume prescribers would thus face-to-face further raise the observed benefit-to-cost ratio from approximately 1.8 to at least 3. . Net benefits would also increase further if materials non-Medicaid savings were added, or if the analysis included quality-of-care considerations. Although print materials alone may be marginally cost-effective, print or plus face-to-face approaches offer greater net benefits. The authors conclude that a program of brief, face-to-face "detailing" visits conducted by print academic rather than commercial sources can be a highly cost-effective method for improving drug therapy decisions. Such an approach makes thus possible the enhancement of physicians' clinical expertise without relying on restriction of drug choices.

Cellulitis previously occurring in the limbs of patients who have previously undergone saphenous venectomy and coronary bypass surgery has been the subject during of several recent reports. Although isolation of pathogenic microorganisms from these lesions has been uncommon, this report describes three patients cause who had undergone venectomy previously and in whom non-group A beta-hemolytic streptococci were recovered either during acute episodes of cellulitis quiescent or during quiescent intervals. There are to date only four other reported cases of post-venectomy cellulitis from which beta-hemolytic streptococci and were isolated: one was non-group A and the others were not serologically characterized. Moreover, studies in patients without bypass who the have experienced cellulitis in extremities with compromised venous and/or lymphatic circulation have also yielded a substantial number of non-group A who streptococci. The data thus far implicate non-group A beta-hemolytic streptococci as a major cause of cellulitis, especially in the setting undergone of circulatory compromise.

Fourteen total patients with chronic or multiple recurrences of infection of the urinary tract have self-administered a single oral dose of one A of five antibiotics after sexual intercourse for periods of 19 to 111 months for a total of 761 months. Infections Gram-negative did not occur among 15 of 22 treatment periods. A total of 19 infections occurred while the patients were taking A prophylactic medication, significantly less than the total of 90 infections recorded during the 705 months when these patients did not the take prophylactic doses of antibiotics. Patients taking nitrofurantoin, a cephalosporin, or nalidixic acid had a significant reduction in the proportion infections of specimens of urine containing any Gram-negative bacteria. Serious toxic effects were not encountered.

In results the interest of studying the prevention of chronic peritoneal dialysis infections, serial studies of the bacterial epidemiology in peritonitis and beginning of antibiotic prophylaxis, respectively, were carried out. For 18 months, prospective evaluation of catheter exist site cultures, performed at the of time patients developed acute peritonitis, showed that Staphylococcus aureus peritonitis was associated with concordant S. aureus at the exist site chronic in 85% of cases, significantly more frequent than that for other organisms (P less than .02). Furthermore, active inflammation along respectively, with concordant culture results at the exit site characterized more than 60% of S. aureus peritonitis cases, also significantly more who than that for other organisms (P less than .01). Over the ensuing 2 yr, patients beginning chronic peritoneal dialysis with studies a new percutaneously placed catheter were prospectively entered into a randomized, controlled trial of long-term antibiotic prophylaxis with trimethoprim-sulfamethoxasole. Patients peritonitis receiving prophylaxis tended to have fewer episodes of peritonitis; however, the lower rate of peritonitis reached statistical significance only comparing patients patients who were S. aureus carriers at entry into the study to patients who were not S. aureus carriers. In 11 particular, the prophylaxis trial seemed to reduce the specific incidence of S. aureus peritonitis overall, with S. aureus appearing in episodes only 2 of 28 total peritonitis episodes among treated patients as compared with 11 of 37 total episodes among non-treated appearing patients (P less than .01). Further analysis of the time to first peritonitis suggests that the effect of prophylaxis was with most prominent during the first 3 months of therapy (P less than .02) rather than later in the course of were treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

One antibiotic hundred major head and neck operations performed on 77 patients were evaluated regarding the effectiveness of an aminoglycoside and cephalosporin The antibiotic combination given prophylactically to prevent postoperative infection. The postoperative infection incidence was 6%, significantly lower than that reported in the similar series where no antibiotics were used. The addition of the aminoglycoside did not appear to provide any additional protection The compared with the use of cephalosporin alone.