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Biomedical subjects

F Sanz Sanz

Publications and source records attributed to F Sanz Sanz.

9 recordsLinked to original sources

[Current treatment of candidemia in non-neutropenic patients. Amphotericin B or fluconazole? A retrospective study of 62 consecutive patients].

BACKGROUND: To analyze the epidemiologic characteristics of non-neutropenic patients with candidemia in a general hospital and the advantages and disadvantages of treatment with amphotericin B or fluconazole. PATIENTS AND METHODS: A total of 62 adult non-neutropenic patients with candidemia and treated with amphotericin B (n = 35) or fluconazole (n = 27) were studied. All episodes were considered to be associated with infection in a vein catheter. The demographic characteristics, risk factors for the development of candidemia, Candida species recovered from blood culture, underlying diseases, and clinical manifestations in both groups were compared. The evolution regarding secondary effects developed with both drugs, therapy failures, long term complications, and overall mortality rate associated with candidemia were analyzed. RESULTS: Both groups were comparable with the exception of the percentage of patients infected with species different from Candida albicans, which was higher in the group of patients who received amphotericin B (57%) than in the fluconazole group (26%) (p = 0.02), and in that patients with severe renal failure or AIDS had received preferentially fluconazole. There were no statistically significant differences regarding the evolution of patients treated with amphotericin B or fluconazole with the following factors: therapy failure (27% versus 19%; p = 0.7), overall mortality rate (40% versus 44%; p = 0.6), and mortality directly related to candidemia (33% versus 30%). Mortality was significantly higher among patients who had not their vein catheters removed early (78%) compared with those who had their vein catheters removed early (34%) (p = 0.01). Sixty-six percent of patients treated with amphotericin developed some severe secondary effect, whereas no patient in the fluconazole group developed such effects. CONCLUSIONS: Both amphotericin B and fluconazole seem to be effective drugs for the treatment of vein catheter related candidemia in the non-neutropenic patient, although fluconazole is far less toxic. The early removal of the vein catheter plays a prognostic role with at least the same relevance than the type of antifungal therapy chosen.

Adult↗

Double-blind randomized comparative trial: ornidazole (Tiberal) versus tinidazole (Fasigin) for the treatment of non-specific vaginitis.

In a double-blind, randomized trial 60 patients with demonstrated bacteriological and clinical non-specific vaginitis were treated with tinidazole versus ornidazole. Thirty patients received tinidazole 2 g daily taken orally in two separate doses for two consecutive days. Twenty-three patients (76%) were cured, 3 patients (10%) relapsed and 4 patients were therapeutic failures. Thirty patients received ornidazole with the same regimen. Twenty-eight patients (93%) were cured, 1 patient (3.3%) relapsed and 1 patient had intolerance to the medication.

Double-Blind Method↗

Nosocomial infection by Rhizomucor pusillus in a clinical haematology unit.

Three patients suffering from acute leukaemia were treated with cytotoxic agents and broad-spectrum antibiotics and received blood transfusion and nasal packing for severe epistaxis. All developed necrosis of nasal and facial tissues, with facial swelling an oedema; two biopsies showed typical phycomycete mycelium, and Rhizomucor pusillus was grown from one biopsy. Air and surfaces in the unit and the air intake and ducting were all heavily colonized by Rh. pusillus and other phycomycetes. It is suggested that Rh. pusillus spores from the air invaded the tissues in the conditions promoted by the nasal packing in these patients with impaired defences.

Adult↗

Randomized comparative trial of three regimens of itraconazole for treatment of vaginal mycoses.

A randomized comparative study of three treatment regimens with itraconazole was carried out in 60 nonpregnant women with acute vaginal candidosis. Vaginitis was demonstrated by both a positive culture and positive findings on microscopic examination of a vaginal smear as well as by the presence of clinical symptoms. Sixty patients seen over a three-month period were randomly allocated to receive one dose of 200 mg daily for two consecutive days (regimen A), 200 mg twice a day for one day (regimen B), or 200 mg once a day for three consecutive days (regimen C). Each group comprised 20 patients. In group A, 65% were clinically and microbiologically cured, 5% were clinically but not microbiologically cured, and 30% relapsed. In group B, 55% were clinically and microbiologically cured, 10% were clinically but not microbiologically cured, 15% did not respond to treatment, and 20% relapsed. In group C, 75% were clinically and microbiologically cured, 10% did not respond, and 15% relapsed.

Adult↗