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Biomedical subjects

J Culig

Publications and source records attributed to J Culig.

At least 19 recordsLinked to original sources

Outpatient use of systemic antibiotics in croatia.

OBJECTIVE: The aim was to estimate the outpatient utilization of antibacterials for systemic use in Zagreb, Croatia, and to define the antibiotic utilization characteristics and consequences. METHOD: Using the WHO ATC/DDD methodology, the number of defined daily doses per 1000 inhabitants per day (DDDs/TID) was calculated for each individual antibiotic and ATC system levels were calculated from data collected on the number and size of packages prescribed and dispensed from pharmacies. The Drug Utilization 90% (DU90%) method was used to evaluate the quality of drug prescribing. RESULTS: The total utilization of antibiotics was found to be extremely high, 55.0 DDDs/TID. The leading antibiotic was amoxicillin + clavulanic acid with 14.7 DDDs/TID. Penicillins accounted for the highest utilization (46.3%) expressed in DDDs/TID (25.4), followed by cephalosporins and macrolides 25 and 12.5% of utilization, respectively expressed in DDDs/TID), tetracyclines, quinolones, aminoglycosides and other agents. Nine of 27 antibiotics fell within the DU90% segment. The cost/DDD foldrugs within DU90% segment was 1.2 EUR, for drugs beyond DU90% segment was 1.4 EUR, and the average was 1.2 EUR. CONCLUSION: Irrational prescribing and preference to more expensive drugs have been reported in Zagreb. Therefore, the risk of resistance of microorganisms to beta-lactamase antibiotics, macrolides and quinolones could be expected. Prescribing patterns should be changed by introducing national guidelines on rational antibiotic prescribing, monitoring and evaluation of their implementation. Additional continuing education of physicians and pharmacists from independent sources should be organized and proper education should be provided to patients.

Anti-Bacterial Agents↗

General practitioners' patterns of antimicrobial drugs prescription in the therapy of acute pharyngitis.

OBJECTIVE: To analyse the patterns of antibiotic prescription in the treatment of acute pharyngitis among a group of general practitioners (GPs). DESIGN: From the records of their patients, 11 specialists in general practice have collected post hoc data on their patients and on acute pharyngitis in the period from October 1, 1994 to September 30, 1995. SETTING: 11 teaching practices in four health centres in Zagreb, Croatia. SUBJECTS: GPs grouped according to whether they had pre-school children in their care. MAIN OUTCOME MEASURES: The choice and cost of the prescribed antimicrobial drug, and the impact of the characteristics of the population in care to the prescription rate and structure. RESULTS: An antimicrobial drug was prescribed in 784 (72.1%) cases of pharyngitis. Two groups of GPs have shown significant differences in the prescription rate (p < 0.001), and in the choice of antimicrobial drugs (p < 0.001). CONCLUSION: GPs with a larger number of patients in their care suffering from chronic diseases tend to prescribe antimicrobial drugs more often in the treatment of acute pharyngitis.

Acute Disease↗

Short-term treatment of pertussis with azithromycin in infants and young children.

A prospective, open, noncomparative study was conducted to assess the efficacy and safety of azithromycin given once daily for 3 or 5 days to eradicate Bordetella pertussis from the upper respiratory tract of infants and young children. Seventeen children received azithromycin in a dose of 10 mg/kg on day 1 followed by 5 mg/kg once daily for four consecutive days, and 20 were given 10 mg/kg once daily for 3 days. Seven days after the initiation of therapy, 33 of 35 (94.3%) patients had negative cultures for Bordetella pertussis. On day 14, cultures from all 34 evaluable patients were negative. These findings suggest that a controlled, comparative study of erythromycin versus short-term administration of azithromycin is justified.

Anti-Bacterial Agents↗

Azithromycin in the treatment of pneumonias caused by Chlamydia spp: a retrospective study.

A retrospective study was undertaken in order to compare the efficacy and safety of azithromycin and doxycycline in the treatment of pneumonias caused by Chlamydia spp. Patients with radiologically confirmed pneumonia and positive complement fixation test for chlamydial infection who were hospitalized in the University Hospital of Infectious Diseases, Zagreb during the years 1989-1992 were reviewed. Among them, 83 were treated with azithromycin, given in a total dose of 1.5 g over 5 days (500 mg once daily at day 1 followed by 250 mg at days 2-5, 60 patients) or 3 days (500 mg once daily, 23 patients). Twenty-two patients were treated with doxycycline (100 mg b.i.d. for 10 days). Treatment groups were comparable with respect to age, sex, and severity of signs and symptoms of illness. All the patients were cured. There were no differences in duration of fever after treatment initiation between patients treated with azithromycin (whether pretreated with beta-lactam antibiotics or not) and doxycycline (p > 0.05). In addition, 3- and 5-day azithromycin courses were equally effective (p > 0.05). Both drugs were well tolerated, and only two patients treated with azithromycin reported nausea. It may be concluded that in the treatment of pneumonias caused by Chlamydia spp. azithromycin is as effective and well tolerated as doxycycline.

Adolescent↗

Azithromycin for treatment of community acquired pneumonia caused by Legionella pneumophila: a retrospective study.

A clinical, retrospective and non-comparative study was undertaken to assess the clinical efficacy and tolerability of azithromycin in the treatment of community-acquired pneumonia caused by Legionella pneumophila. A total of 16 patients with a serologically confirmed diagnosis of Legionnaires' diseases were included. Azithromycin was administered orally at a total dose of 1.5 g for either 3 or 5 days. All patients were no side-effects requiring discontinuation of the treatment. Further increase of abnormal baseline liver function was recorded in 2 patients and in 1 patient mild, transient eosinophilia. Equal clinical efficacy and tolerability were observed with the 3- and 5-day dosage regimen. These results indicate that azithromycin given at a standard dose of 1.5 g is effective and well tolerated in the treatment of Legionnaires' disease.

Adult↗

Gastric lesion development in normal and pylorus ligated rats after cervical vagotomy.

The main purpose of this study was to further investigate the effects of vagotomy on gastric lesion development. In contrast to the usual subdiaphragmal vagotomy, a different vagotomy at the level of the trigonum caroticum was used both alone and in combination with pylorus ligation (done immediately after vagal transection). The animals were killed 15 min, 30 min, 1 h and 6 h following vagotomy. No damaging effects of sham-vagotomy, or obvious negative effects of cervical vagotomy were noted. Prominent lesions appeared after 1 h in rats subjected to cervical vagotomy and significantly increased lesions in the early period of pylorus ligation were noted. No further aggravation in pylorus ligated rats (even an apparent amelioration at 1-h interval) and no lesions in rats with cervical vagotomy in the latter period could be explained in terms of a lack of reactivity due to exhaustion preceding fatal outcome. Consistent with this, the rats subjected to cervical vagotomy died shortly after the 6-h period.

Animals↗

Determination of serum diclofenac by high-performance liquid chromatography by electromechanical detection.

Diclofenac was isolated from plasma by double extraction with organic solvent. Chromatography was performed on Lichrosorb NH2 column with acetonitrile and perchloric acid (0.0025 mol/l; 35:65, v/v) as the mobile phase (flow rate 0.9 ml/min). The electrochemical detector was operated at +900 mV and sensitivity of 5-10 nA. The sensitivity of the method was 10 micrograms/l and the coefficients of variation below 10% in the entire range of the concentration in a dose interval.

Chromatography, High Pressure Liquid↗

HPLC method for determination of ergot alkaloids and some derivatives in human plasma.

Ergot alkaloids and their dihydrogenated methanesulphonate (ms) salts were determined and measured in human plasma. High-performance liquid chromatography (HPLC) with fluorometric detection was used for separation of ergot alkaloids in plasma. Several ergot alkaloids and their derivatives, including lysergide (LSD), can be identified in cases of poisoning.

Chromatography, High Pressure Liquid↗

A clinical pharmacological comparison of diclofensine (Ro 8-4650) with nomifensine and amitriptyline in normal human volunteers.

1 Ten healthy male volunteers participated in a double-blind placebo-controlled crossover comparison of the pharmacodynamic profiles of single oral doses of diclofensine 25 mg and 50 mg, nomifensine 75 mg and amitriptyline 50 mg. 2 Diclofensine did not influence salivary flow or consistently affect pupil diameter and had no significant effect on subjective measurements of sedation and mood. It had no effect on reaction time, or on critical flicker frequency. 3 By contrast, amitriptyline significantly reduced salivary flow, produced significant sedation and impairment of mood, prolonged reaction time, and appeared to decrease (but not significantly) critical flicker frequency. 4 Nomifensine significantly reduced (i.e. improved) reaction time, and inhibited salivary flow. 5 Diclofensine did not significantly influence heart rate, blood pressure, systolic time intervals or high speed electrocardiogram. 6 No significant treatment-related differences were observed in serum prolactin, cortisol or growth hormone levels.

Adolescent↗