The effectiveness and safety of ceftriaxone and cefotaxime in the short-term treatment of primary bacterial meningitis were compared using a prospective, randomized, multicenter study design. Children between the ages of 6 weeks and 16 years received either ceftriaxone as a single dose (100 mg/kg on the first day followed by 75 mg/kg/day) or cefotaxime as four divided doses (200 mg/kg/day) for 4–7 days. A total of 82 patients (44 ceftriaxone, 38 cefotaxime) with documented bacteria in the CSF were studied. In patients receiving ceftriaxone, full recovery occurred in 79.5% while a further 13.7% recovered with neurologic sequelae. Full recovery was observed in 71.1% of children treated with cefotaxime with sequelae in a further 23.6% (no statistically significant differences between drugs). The time to clinical improvement and resolution of fever (3–4 days) was also similar for both drugs. All but 1 of the 82 patients studied had negative CSF cultures within 24 h of the beginning of therapy consistent with the excellent penetration into the CSF (trough concentrations of 2.7 mg/l for both drugs at the end of therapy). No differences were observed in the incidence of clinically significant adverse events. Ceftriaxone and cefotaxime are both effective in the treatment of bacterial meningitis. Ceftriaxone offers an advantage in ease of administration since it is administered as a single daily dose.
In a double-blind multicentre study the efficacy and safety of a single-dose treatment with pefloxacin (800 mg) was compared with a five-day treatment regimen of 960 mg co-trimoxazole twice daily in the therapy of acute uncomplicated cystitis in women. In order to maintain blindness, patients in the pefloxacin group received placebo to complement the full number of tablets. Nine centres were involved; 155 patients received pefloxacin and 161 patients received co-trimoxazole. Of these, 140 patients treated with pefloxacin and 145 with co-trimoxazole were considered valid for efficacy and safety analysis. At the first follow-up, after seven to ten days, 97.1% of the pefloxacin group and 95.2% of the co-trimoxazole group were bacteriologically cured. At the second follow-up visit, after 28 to 42 days, the urine culture was negative in 95.0% of the pefloxacin group and 90.3% of the co-trimoxazole group. A single dose of 800 mg pefloxacin was demonstrated to be as safe and at least as effective as a five-day regimen of co-trimoxazole in the treatment of uncomplicated cystitis.
An 85 erwachsenen Patienten mit akùter myeloischer Leukämie wurde geprüft, ob zwischen den Kranken mit (n = 31) und ohne Auer-Stähchen in den Blasten (n = 54) Unterschiede in der Vorgeschichte, dem Auf nahmebef und, den Laboratoriumswerten und der Prognose bestehen. Vorgeschichte, Auf nahmebef und und Laboratoriumswerte ließen keine Unterschiede erkennen. Während sich die Remissionsquote in beiden Gruppen gleichfalls nicht unterschied, war die mittlere Uberlebenszeit bei den Kranken mit Auer-Stäbchen mit 120 Tagen günstiger als bei der Gruppe ohne Auer-Stäbchen mit 66 Tagen. Die Kranken mit Auer-Stäbchen hatten jedoch ein jüngeres Alter. Mit der Peroxidase-Reaktion werden anderthaibmal mehr Blasten mit Auer-Stäbchen dargestellt als mit der Pappenheim-Färbung (p <0,001). * Diese Arbeit enthält wesentliche Teile der Inaugural-Dissertation von cand. med. H. Gerdes.
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