Fourteen of 156 renal-transplant recipients treated with cyclosporine and steroids developed Pneumocystis carinii-related pneumonia (PCP) over a 19-month period. This was a significant change from past experience with this disease in renal-transplant patients receiving azathioprine and steroids (six cases among 179 patients from 1977 to 1981). Epidemiological investigation failed to implicate either person-to-person or nosocomial spread of infection. Cases of PCP occurred more frequently in males. Twelve patients (86%) had onset of disease in the third or fourth months after transplantation. Comparison of cases to matched controls revealed that the cases had received lower doses of steroids and had a higher incidence of cytomegalovirus infection. This suggested that the cases may have been more effectively immunosuppressed than the controls. After institution of prophylaxis with trimethoprim-sulfamethoxazole, no further cases of PCP developed.

One hour after intravenous doses of 50 mg/d fluconazole for 6 days or 100 mg/d for seven days to healthy subjects, the cerebrospinal fluid concentrations of fluconazole were 1.26 mg/L and 2.74 mg/L, respectively. These values were approximately 52% and 62% those of serum. Four patients with an initial clinical diagnosis of meningitis also had significant concentrations of fluconazole in the cerebrospinal fluid.

A 3-day regimen of clindamycin, given as intravaginal ovules, was as effective as and better tolerated than a 7-day regimen of oral metronidazole 500 mg, given twice daily, for treatment of bacterial vaginosis.

Introduction No validated instrument exists for measuring female sexual well-being (FSWB™) in women without medical/psychosocial conditions. Aims To develop and psychometrically validate a self-administered Female Sexual Well-Being Scale™ (FSWB Scale™) for assessing sexual well-being in sexually functional women. Methods Important aspects of FSWB™ were identified via focus groups, debriefing interviews, and administration of an initial scale to 111 US women aged 21–72 years reporting normal sexual function (Female Sexual Function Index >26). Principal components analysis and psychometric validity testing of a FSWB Scale™ were conducted in a second study of 332 women. Main Outcome Measures To develop a FSWB Scale, based on qualitative input from women reporting normal sexual function, and determine its factor structure and psychometric validity. Results Four aspects of FSWB were identified from the qualitative research. Women’s preferred language to describe sexual well-being and preferred response formats were incorporated into the scale. A principle components analysis of quantitative study data from 332 women aged 21–72 years reporting normal sexual function identified 5 factors with eigenvalues >1: interpersonal domain (6 items), cognitive-emotional domain (5 items), physical arousal domain (3 items), orgasm-satisfaction domain (3 items), and external lubrication domain (2 items). The external lubrication domain did not demonstrate strong positive correlations with the other 4 domains, so it was not retained in the final scale. A high degree of internal consistency was demonstrated for the 4 domains (Cronbach’s alpha values: 0.84–0.92). Test-retest reliability over a 2-week period was high (r > 0.80) or moderately high (r > 0.70) for the 4 domain scores. Correlation coefficients between FSWB Scale domain scores and standardized scale scores for female sexual function, depression, and social desirability demonstrated the construct validity of the FSWB Scale. Conclusion A 17-item FSWB Scale was developed and psychometrically validated as a reliable, multidimensional, self-administered instrument for assessing sexual well-being in women of different ages.

Objective:To compare the efficacy and safety of a 3-day regimen of clindamycin vaginal ovules with a 7-day regimen of clindamycin vaginal cream for the treatment of bacterial vaginosis (BV). Methods: Women with a clinical diagnosis of BV were treated with a 3-day course of clindamycin ovules or a 7-day course of clindamycin cream administered intravaginally. Three hundred and eighty-four patients received study drug and were included in the evaluable patient population (ovule group, n = 204; cream group, n = 180). Assessments included pelvic examination and diagnostic testing. Primary efficacy endpoints were a resolution of two of three diagnostic criteria at the first follow-up visit and three of three diagnostic criteria at the second. Results: Cure rates in the evaluable patient population were similar between treatment groups: 53.7% (109/204) for the ovule group and 47.8% (85/180) for the cream group (p = 0.2471, 95% CI 4.1-16.0%). The most commonly reported medical event, vulvovaginal pruritus, had similar incidence in both treatment groups. Conclusions: A 3-day course of clindamycin vaginal ovules is as effective and well-tolerated as a 7-day course of clindamycin vaginal cream in the treatment of BV.