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Biomedical subjects

I Francetić

Publications and source records attributed to I Francetić.

At least 19 recordsLinked to original sources
PubMed2005

Antimicrobial drug use in hospitalised paediatric patients: a cross-national comparison between Germany and Croatia.

PURPOSE: To compare the utilisation of systemic antimicrobials at the paediatric units of the university hospitals in Marburg (Germany) and Rijeka (Croatia). METHODS: A prospective, observational analysis of hospital records from 300 incident users of antimicrobials in each study centre that were younger than 19 years. Antimicrobial utilisation was analysed in six gender-specific age groups with respect to drug choice, duration of treatment and hospital stay, indication and route of administration. The extent of antimicrobial drug use was assessed by the number of treatment courses. RESULTS: In each hospital, more than 1/3 of the patients were younger than 1 year. The duration of hospital stay was about two-fold longer in Rijeka (18.5 +/- 5.8 days) than in Marburg (8.6 +/- 3.8 days). Pneumonia and other respiratory tract infections were the most common indications in Marburg (38.6%) and Rijeka (58.7%). The cumulative percentage of patients treated with an equal number of different antimicrobials was lower in Rijeka than in Marburg. The most commonly used antimicrobials were ampicillin (40.3%) and cefuroxim (35.9%) in Marburg, but ceftriaxone (43.3%) and cefotaxim (14.0%) in Rijeka. CONCLUSIONS: A shorter treatment duration, less variation in the prescribing pattern and a greater adherence to the use of recommended antimicrobials argue for a more rational antimicrobial drug use in Marburg than in Rijeka. However, a further identification of drug choice determinants is warranted.

Adolescent↗
PubMed2001

Duration of clinical symptoms in female patients with acute urethral syndrome caused by Chlamydia trachomatis treated with azithromycin or doxycycline.

One hundred fifty-one female patients with acute urethral syndrome caused by Chlamydia trachomatis were examined. First, patients were divided into two groups, those with clinical symptoms present < 3 weeks before the start of treatment, and those with clinical symptoms > or = 3 weeks prior to the beginning of therapy. Then patients were further divided into groups and randomized to receive azithromycin once daily in a single dose of 1.0 g or 500 mg once daily for 6 days, or to receive doxycycline 100 mg b.i.d. for 14 days or 100 mg b.i.d. for 7 days (8 study groups in all). Clinical and bacteriological efficacy was evaluated 3 weeks after the end of therapy. In the group of patients with disease symptoms lasting for 3 weeks or longer, the eradication and clinical cure rates were significantly higher after administration of azithromycin in a dose of 1x500 mg/6 days than after a single dose of 1.0 g (p<0.01), and after administration of doxycycline 2x100 mg/14 days than by using doxycycline 2x100 mg/7 days (p<0.05).

Administration, Oral↗
PubMed2001

Oral antibiotic prescription in ambulatory care in 1999--a contribution to the development of methods for drug consumption and prescription surveillance monitoring.

The aim of the study was to estimate the consumption of antibiotic in ambulatory care. Oral antibiotic consumption in 1999 was analyzed in four pharmacies in the Zagreb area. The use of oral antibiotics in comparison with total drug consumption, the share of individual subclasses of oral antibiotics and the respective shares of individual products were also analyzed. The results obtained were expressed in terms of both the defined daily doses (DDD) and US$, and were compared with available national and international data. The study demonstrated a high share of oral antibiotics in the overall drug consumption, especially of newer and more expensive agents within individual subclasses of antibiotics. Further research is required to assess the rationale of such prescribing practices, especially in view of the current financial pressure on the Croatian health care system.

Administration, Oral↗
PubMed1996

Determination of bioequivalence of two furosemide preparations; the effect of high doses of furosemide on some pharmacokinetic parameters.

The bioequivalence of two oral preparations of the diuretic furosemide, namely (i) a Croatian pharmaceutical product (test preparation A) and (ii) a reference preparation B, both in a dose of 500 mg was assessed in an open, cross-over, randomized trial in 15 healthy male volunteers, in whom the HPLC method with a fluorescent detector was used to determine its concentrations. The test preparation (A) was found to achieve a considerably higher concentration (17.2 +/- 9.304 mg/l) than the reference preparation (11.1 +/- 6.484 mg/l); the time to peak concentrations was statistically significantly shorter for the test preparation (1.033 +/- 0.743 h) than for the reference preparation (1.656 +/- 0.586), and the areas under the concentration curves were statistically significantly greater for the examined preparation (65.9 mg.h/l) than for the reference preparation (46.845 mg.h/l). The relative bioavailability of the test preparation was 129%, i.e. it was not bioequivalent with the reference preparation. This finding was consistent with the previously performed laboratory quality testing in vitro, where the release of the reference preparation was found to be considerably slower and weaker than that of the test preparation. High doses of furosemide exemplified by 500 mg were found to affect only some of the pharmacokinetic parameters, i.e. they induce an accelerated absorption, an increase in serum concentration, and a prolongation of its half-life.

Adult↗
PubMed1993

Impact of ampicillin and cefuroxime on bacterial colonization and infection in patients on a neonatal intensive care unit.

The impact of ampicillin and cefuroxime on the bacterial flora of neonates was examined in a neonatal intensive care unit (NICU). For the first period of study (January-September 1989), ampicillin plus gentamicin were used as empirical therapy of infection. During this time, 92.6% of all Gram-negative bacilli (GNB) were resistant to ampicillin and 56.6% to cefuroxime. These percentages decreased significantly (P < 0.05) to 60.0% and 16.2% respectively, over the next period of study (October 1989-October 1990) when cefuroxime+gentamicin were used. A decrease in the number of cases of GNB from bacteraemia and meningitis was also significant (from 21.2% to 11.2%), and this correlated with a decline in the occurrence of Klebsiella pneumoniae. However, the number of enterococcal isolates and cases of enterococcal bacteraemia increased. These observations underline the important effect of ampicillin and cefuroxime in modulating the bacterial flora and its antibiotic resistance in patients on a NICU.

Ampicillin↗
PubMed1990

Combination of cyclosporin and methotrexate for prophylaxis of acute graft-versus-host disease after allogeneic bone marrow transplantation for leukemia.

From May 1985 to July 1989, 76 patients with leukemia (30 acute myelogenous leukemia, 24 acute lymphoblastic leukemia and 22 chronic myeloid leukemia) were randomized to receive either cyclosporin (CSP) alone (n = 39) or CSP combined with methotrexate (CSP + MTX, n = 37) for graft-versus-host disease (GVHD) prophylaxis. Patients were conditioned with total body radiation and cyclophosphamide followed by bone marrow infusion from an HLA-identical sibling. Engraftment of the transplanted bone marrow was similar in both groups. The incidence of moderate to severe acute GVHD was significantly higher in the CSP group compared with the CSP + MTX group (20 (51%) versus 9 (25%), chi 2 = 4.76, p less than 0.02). There was no significant difference in the incidence of chronic GVHD. Survival was significantly better for the CSP + MTX group (63 +/- 16%) compared to CSP alone (42 +/- 18%). Leukemia-free survival tended to be better for the CSP + MTX group (55 +/- 17% versus 32 +/- 16%).

Adolescent↗
PubMed1990

Drug trials on healthy volunteers in Yugoslavia.

Ninety-seven healthy volunteers who participated in different clinical trials (phases III and IV) in a clinical pharmacology unit were interviewed over the period December 1988-February 1990 using questionnaire method. The aim of the investigation was to analyze the examinees' occupational distribution, the degree of insight in the trials they participated in, their opinion about the remuneration they get and their estimate of the importance or inconveniences of numerous trial elements. Only 39 volunteers (40.2%) were members of medical staff: 17 (17.5%) physicians, 17 (17.5%) medical students and 5 (5.2%) nurses. The volunteers assessed the importance of different elements related to the trial marking them from 1-5. They were more afraid of possible adverse drug reactions (ADR) occurring during the trial (median 3.87) than of those that might occur afterwards (2.94). Significant was their concern about the kind of investigated drug (3.49). "Potential contribution of the trial to the medicine and society" (3.30) and "length of time spent in the laboratory" (3.17) followed. The conduct of clinical trials on healthy volunteers in Yugoslavia and legal regulations are discussed at the end of the paper.

Adult↗
PubMed1986

Dose-dependent bioavailability of propranolol.

The pharmacokinetics of orally administered propranolol in doses of 10, 40, 80 and 160 mg was studied in eight healthy volunteers in a cross-over trial. The analytical method applied made possible a parallel determination of propranolol and of 4-OH propranolol. The dose-dependent kinetics of orally administered propranolol was demonstrated. In our study linear dependence could be established only within a dosage range of 40 mg to 160 mg. Both substances determined in plasma, propranolol as well as 4-OH propranolol, show a tendency toward non-linearity, particularly at the lower dosage range between 10 and 40 mg.

Adult↗
PubMed1980

Tiopinac in rheumatoid arthritis: a three-phase dose-ranging, efficacy, and aspirin-withdrawal protocol.

We designed a clinical trial to obtain dose-ranging, efficacy, and aspirin-withdrawal data on tiopinac in patients with rheumatoid arthritis. To accomplish this without exposing the patients to risk of disease exacerbation and avoiding type II error, we used a 3-phase protocol adding tiopinac to current therapy. The 3 phases-open-label dose ranging, double-blind tiopinac versus placebo, and aspirin withdrawal-began after a single-blind run-in period. The manufacturer withdrew tiopinac from investigation because of toxicity at higher doses, but with only 13 patients we found that tiopinac (up to 300 mg/day) decreased walking time, painful joints, and morning stiffness and increased grip strength (p less than 0.05). Both the global evaluation by the investigators and patient ratings of their activity showed superiority of tiopinac (tiopinac: 5 better, 1 worse; placebo: 1 better, 6 worse; p = 0.028 by Fisher's exact test). Complete aspirin withdrawal could be accomplished in only 3 patients, although in 10 of 13 the dose could be reduced 50% of baseline or less. The 3-phase protocol indicated effectiveness, a dose range, and partial aspirin replacement with minimal patient risk.

Adult↗
PubMed1980

Prescription prices under the New York generic substitution law.

We evaluated the New York State generic substitution law. This law mandates substitution of a less expensive product if the physician signs the prescription for an eligible brand name drug on the line marked "subsitution permissible." We purchased drugs by brand name and generically before the law went into effect. Later, we purchased the same drugs in the same stores using the formats "brand-dispense-as-written," "brand-substitution-permissible," and "generic." Mean savings from generic prescribing or substitution increased from 12.1% +/- 20.4% before the law to 26.2% +/- 10.5% (brand-substitution-permissible) and 27.2% +/- 14.2% (generic). Prices for the same drug written the same way varied enormously among pharmacies. Brand-dispense-as-written, brand-subsitution-permissible, and generic prices in the same store varied substantially and unpredictably. Savings were not passed on to consumers in 29% of postlaw comparisons. Assuring maximal savings requires extensive comparison shopping.

Drug Labeling↗