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Forty-eight patients with acute bronchitis and four with pneumonia were randomly assigned to receive five doses (500 mg on day 1, plus 250 mg/day on days 2-5) of azithromycin; 54 patients with acute bronchitis and four with pneumonia were assigned 30 doses (625 mg every eight hours for ten days) of amoxicillin/clavulanic acid (CA). The two regimens were equally effective, with clinical improvement or cure in 92% and 87% of patients respectively, bacteriological cure in 89% and 86%, with 91% and 89% of pathogens eliminated. Minor side effects occurred in 6% and 12% of patients in the two groups, respectively. No major abnormalities in laboratory safety parameters were seen in either group.

Phosphorylated metabolites concentrations and creatine kinase kinetics are measured by 31P NMR in solution and in isovolumic perfused rat hearts submitted to hypo- and hyperthermia as well as to acidosis (37 degrees C). In the organ, temperature variation from 40 to 25 degrees C induces an increase of phosphocreatine (PCr) stores, a decrease of Pi and ADP concentrations, but does not affect the ATP pool. Creatine kinase forward flux (Vfor) is gradually reduced when the temperature is lowered both in vitro and in perfused heart. In normothermic and hypothermic conditions, a relationship is found between cardiac performance (rate pressure product, RPP), Vfor and ATP synthesis estimated through the myocardial oxygen consumption rate (MVO2). At 40 degrees C however, the RPP is reduced although both Vfor and MVO2 increase. In vitro experiments show an optimum pH of 7.7 for the forward creatine kinase reaction. In perfused heart submitted to acidosis, a decrease of PCr concentration is observed, whereas ATP and ADP contents remain unchanged. Heart creatine kinase flux increased as in hyperthermia. These high fluxes are attributed to the coupling of the creatine kinase reaction with energy consuming or producing reactions: the increase of energy demand related to non-contractile processes could explain the high MVO2 and Vfor observed in those conditions.

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