Summary:We have used cyclosporin to treat patients with acute steroid-resistant ulcerative colitis since the beginning of 1991. Of the 55 patients so far elected for treatment, 40 received the drug intravenously at 2 mglkglday for 14 days, with the responders being maintained on traditional soft-gelatincapsule cyclosporin at a dose of 6-8 mg/kg/day for 6 months; the remaining 15 received oral microemulsion cyclosporin, 5 mgkg/day, for 3 months. The doses were titrated to ensure whole-blood drug concentrations of 60-240 ng/ml, with levels of -200 ng/ml being attained by both regimens. One-hundred percent of the patients receiving oral microemulsion cyclosporin and 6570 of those receiving the intravenous regimen achieved a short-term response (p = 0.011). Both the responder subsets received additional azathioprine and relapsed on treatmcnt with the same frequency of 40%. Howcvcr, 17% of the patients who received intravenous cyclosporin developed major toxicity (including one fatality), whereas no major toxicity was observed in the oral microemulsion cyclosporin group. The microemulsion formulation was thereforc more effective thari intravenous cyclosporin in achieving the Shortterm remission of steroid-unresponsive ulcerative colitis. As the maintenance drug, it led to the same frequency of disease relapse as traditional oral cyclosporin. However, because it did not involve invasive in-hospital procedures or cause major toxicity, it was more elficient than the combination of the intravenous and traditional oral drug. Key Words: Oral microcmulsion cyclosporin-Steroid-refractory ulcerative colitisImmune suppressors-Inflammatory bowel disease.Because of its low bioavailability of 25%, we and others have administered cyclosporin (CsA) as a continuous infusion to patients with severe attacks of steroidresistant ulcerative colitis (UC) in the hope that plateau blood concentrations would ensure remission of the acute episode and avoid emergency colectomy. The use of this administration route has led to an immediate I-csponse rate of 70-80% in a number of studies (1-4), and an overall rate of response of 68% was reported in a recent review of 185 patients enrolled in 20 studies (5).However, these results must be balanced against the risks of hospital confinement and the requirements of venous catheter care. In an effort to reduce the drawbacks of the treatment and increase its efficiency, we recently took

In our study there were no significant differences in vancomycin Cmax, AUC0-8, Vd, and Cl between the on-pump and off-pump groups. CPB does not seem to significantly modify intraoperative vancomycin pharmacokinetics in patients undergoing cardiac surgery. The results of this study may contribute to increased knowledge of vancomycin pharmacokinetics.

No abstract

approach has been to use larger pore membranes than those currently used in hemofiltration. Lee et al sug