[Chronic nonspecific lung diseases in persons clinically cured of tuberculosis].
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Adult↗
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Treatment of idiopathic thrombocytopenic purpura (ITP).
In summary, idiopathic thrombocytopenic purpura (as defined here) should be treated initially with glucocorticoids unless there is life-threatening hemorrhage (such as intracranial bleeding), in which case emergency splenectomy is indicated, since it generally gives the most prompt improvement in platelet count of all modes of the disease and to better define the cause of the thrombocytopenia. A complete, sustained remission following treatment with steroids may occasionally be obtained. In most cases the steroid response is transient, and splenectomy is the most definitive measure with respect to a lifelong cure. Complete clinical cure is obtained in 70-80% of instances following splenectomy, with a very low operative risk. The remainder either fail to respond or experience relapse. In this group of patients steroids should again be tried; if a good response is obtained, steroids should be given every second or third day to lessen long-term side effects. If these measures fail, the use of immunosuppressive agents is justified. Both vinca alkaloids and cyclophosphamide are especially useful. Vinca alkaloids act more promptly, but cyclophosphamide may have a more lasting effect. Azathioprine may also be used; however, it appears to yield a lower remission rate. Nonsteroidal immunosuppressive agents should not be used as the primary modality of therapy. And, due to their carcinogenic and teratogenic potential, they should be avoided, if possible, especially in children and in women during their childbearing years.
Androgens↗
Treatment of chancroid with Bactrim.
Bacterim in either oral or intramuscular injection forms were given to 67 patients with Chancroid. It was found that after one week of treatment, clinical cure rate was 46.3% and bacteriological cure rate was 73.1%. After two weeks, the clinical cure rate was 77.6%. Three patients (4.5%) had persistent sores at the end of two weeks and only one of these (2.5%) was bacteriologically active. Twelve patients defaulted. Adverse side-effects were observed in five patients. The effectiveness of Streptomycin, Sulphonamide and Tetracyclines, the other commonly used therapeutic agents, was discussed and compared with Bactrim. It was concluded that Bactrim was a safe and effective drug to use, and recommended as an alternative to Streptomycin and Sulphonamides in the management of Chancroid.
Administration, Oral↗
A double-blind comparative study of cimetidine and placebo in adult Nigerian duodenal ulcer patients with special reference to gastroduodenal mucosal morphology and intestinal bacterial activity.
Twenty-seven adult Nigerian patients with endoscopically proven active duodenal ulcers have received in a double-blind trial either the histamine H2 - receptor antagonist cimetidine 1g daily or placebo tablets of identical appearance for 4 weeks. Fifty-six per cent of the cimetidine patients and 18% of those receiving placebo had endoscopically completely healed ulcers and total pain relief at the completion of trial. This response amounted to clinical cure. An additional 19% of patients in the cimetidine group experienced clinical improvement either in endoscopic or symptomatic reassessment but not in both, thus leading to a disparity between clinical cure rate (56%), healing rate (69%), and pain relief (64%). Though therefore significantly better than placebo, this less favourable response to cimetidine in this study may be due to the short trial period, the disparity between healing and pain relief rates or to co-existing and persistent antroduodenitis in ulcer patients as shown on gastroduodenal mucosal biopsies taken at the time of the clinical investigation. There were no untoward clinical laboratory side effects with the exception of the one cimetidine patient who experienced diarrhoea and a small number who showed slight, asymptomatic rise in plasma creatinine level. Of particular interest to the reported occurrence of diarrhoea with cimetidine therapy is the finding in the bacteriological studies of intestinal aspirates and biochemistry estimations for indicanuria in the consenting patients which showed that orally administered cimetidine 1g daily for 4 weeks neither produced demonstratable alterations in the bacterial content of the small bowel not pathological indicanuria, thereby excluding bacterial overgrowth syndrome as a therapeutic hazard in the clinical application of cimetidine.
Adult↗
The efficacy of rifampin as adjunctive therapy in selected cases of staphylococcal endocarditis.
Three patients with bacterial endocarditis (one case due to Staphylococcus aureus and two to S epidermidis) failed to improve on standard therapeutic regimens which were judged adequate by in vitro testing for sensitivity. Rifampin was added to the regimen in each case and resulted in increased bactericidal activity in the serum, sterilization of the cardiac valves, and clinical cure. The apparent clinical success that was achieved suggests that further investigation of the effectiveness of therapy with rifampin in selected cases of staphylococcal endocarditis is warranted.
Adult↗
Therapeutic approaches for the treatment of bovine metritis: a systematic review of clinical, reproductive and productive outcomes.
Bovine metritis is a complex multifactorial disease associated with substantial clinical and economic impact due to reduced milk production, subfertility, and increased culling rates. Considerable uncertainty remains regarding the comparative efficacy of the many therapeutic strategies used to manage it. This systematic review aimed to summarize and critically evaluate the available evidence on therapeutic approaches for bovine metritis, with respect to clinical cure, reproductive performance, productive performance, and culling. A literature search conducted in PubMed, Web of Science and CABI Digital Library (2010-2025) identified 18 randomized controlled clinical trials eligible for inclusion. Risk of bias was assessed independently by two reviewers using the Cochrane RoB 2 tool. Given substantial clinical and methodological heterogeneity across studies, findings were synthesized narratively by outcome, without meta-analytic pooling, and the certainty of evidence was assessed using GRADE for the comparisons supported by more than one study. Overall, systemic antimicrobial therapies consistently improved short-term clinical cure rates, although their effects on long-term reproductive and productive performance remained inconsistent. In selected cases, nonsteroidal anti-inflammatory drugs (NSAIDs) showed clinical outcomes comparable to antimicrobial treatments, allowing reductions in antimicrobial use ranging from 50% to 92%. Alternative approaches, such as intrauterine flavonoid, chitosan or dextrose-based therapies, produced inconsistent results that appeared to correlate with disease severity and treatment protocol. The evidence base is limited by substantial heterogeneity in disease definitions, postpartum timing of diagnosis, and cure criteria across studies, and by the near-universal absence of allocation concealment in the primary literature; these limitations restrict the certainty of most conclusions to low or moderate. Therefore, effective metritis control should move beyond symptom resolution and incorporate integrated and preventive strategies targeting inflammatory and metabolic dysregulation during the transition period.
Animals↗
The comparative efficacy of cephalexin and sulfisoxazole in acute urinary tract infection in children.
A double blind, comparative study of the efficacy of cephalexin versus sulfisoxazole was conducted on 100 children with initial episodes of urinary tract infections. The overall bacteriologic and clinical cure rates were comparable for both antimicrobials. Children treated with cephalexin had a clinical cure rate of 86 per cent and a bacterial cure rate of 84 per cent, while those given sulfisoxazole were found to have rates of 82 and 92 per cent respectively. However, cephalexin was noted to have a rather high rate of failure in the therapy of Proteus micrabilis infections (4/8), casting some doubt on its use in urinary infections caused by the organism. Untoward effects associated with either medication were minimal.
Acute Disease↗
[Evaluation of econazol in 594 cases of skin mycosis (author's transl)].
A total of 594 patients were treated with the new antimycotic agent econazol (Pevaryl). The diagnosis was proven microscopically and on culture except in cases of pityriasis versicolor where it was proven microscopically only. Econazol was given to 130 patients as a 1% solution, to 128 patients as a 1% milk, and to 336 patients as a 1% spray solution. In 333 cases of foot mycosis or eczema marginatum econazol spray powder was given in addition. As measured by the cure rate the spray solution (92%) was not significantly more effective than the milk (89%) or the simple solution (87%). Criteria for cure included negative microscopy and fungal cultures a week after treatment had ceased as well as clinical cure. A total of 90% of all cases (n = 536) could be considered as cured microscopically and on culture after an average of 3.6 weeks (pityriasis versicolor) and 4.8 weeks (tinea pedis, manus, inguinocruralis). In a further 4.4% (n = 26) the fungus could be demonstrated microscopically despite a clinical cure and in 7 of these cases culture was also positive. The cure rate was independent of the responsible pathogen. The preparations were tolerated extremely well. In 7 cases, however, transient dermatitic irritations were seen in the inguinocrural region, mainly caused by the simple solution.
Aerosols↗
Amikacin in the treatment of genito-urinary tract infections in cancer patients.
Amikacin was used in the treatment of severe urinary tract infections in twenty-five seriously ill patients. In twenty-four of the patients, cystitis or pyelonephritis complicated carcinoma of the bladder. Structural changes in the urinary tract, resulting from schistosomiasis, presented additional obstacles to treatment in many of the patients. The most commonly isolated pathogens were Escherichia coli and Pseudomonas. Most patients received 500 mg of amikacin every twelve hours. Three patients experienced adverse renal reactions which showed subsequent improvement. Amikacin effected twenty-one (84%) complete cures and four (16%) clinical cures in the twenty-five patients. This represents 100% clinical success in this study.
Adult↗
Clinical experience with clindamycin hydrochloride: I. Treatment of streptococcal and mixed streptococcal-staphylococcal skin infections.
Two hundred and forty-four children were evaluated in a study comparing clindamycin hydrochloride, erythromycin, and phenoxymethyl penicillin for the treatment of streptococcal pyoderma. Similar numbers of patients were followed during (day 7) and after (day 14) therapy in each of the three treatment groups. All patients had skin lesions positive for group A streptococci with or without staphylococci; the percentage rate of pure and mixed cultures was similar for the three groups of patients. Both clindamycin and erythromycin proved somewhat superior to penicillin on the basis of effecting earlier clinical cures and sterilization of skin lesions. Streptococcal eradication rates by day 7 were as follows: clindamycin, 97%; erythromycin, 99%; and penicillin, 91%. By day 14, clinical and bacteriologic cure rates were essentially the same in each group: clindamycin, 99%; erythromycin, 99%; and penicillin, 97%. Persistence or reacquisition of a pyoderma strain in the upper respiratory tract was highest in that group treated with penicillin. There were no adverse reactions associated with clindamycin or the other antibiotic agents evaluated. However, clindamycin holds no advantage over erythromycin for treatment of streptococcal pyoderma, and additional clinical information will be required to determine whether the potential for toxicity in children will compromise the use of this newer antibiotic.
Cells, Cultured↗
Magnapen treatment of infections in the elderly.
Magnapen is a combination of two well-proven semi-snythetic penicillins which together offer the theoretical advantages of a broad spectrum of activity, good bioavailability and a low incidence of side-effects. It is of particular value in treating infections in the elderly. In this study the theory is borne out in practice in a population presenting special problems for which this combination seems particularly appropriate. Ninety-six patients have been treated with a course of Magnapen syrup. Of the total entered into the study, 73% of patients were clinically cured following therapy, with a further 19% improved. Clinical failure occurred in 8% of patients. Fifty-two patients were bacteriologically assessable, forty-seven of whom (90%) had infecting organisms cleared by therapy. Side-effects occurred in four patients (4%), one of whom had to discontinue therapy.
Administration, Oral↗
Otitis externa in the dog -- a clinical and microbiological study.
The effect on canine otitis externa of a topical preparation composed of Fucidin, Framycetin, Nystatin, and Prednisolone was evaluated in a clinical trial comprising 235 dog ears. Cases caused by parasites or foreign bodies and cases requiring systemic therapy were excluded. Swabs from these and an additional 434 affected ears were examined bacteriologically and the sensitivity to antibiotics of the bacteria isolated determined. The infection most frequently diagnosed was staphylococci plus yeasts (29 % of total material) followed by pure yeast-infections (19 %) and pure staphylococcus infections (16 %). Pseudomonas aeruginosa and/or Proteus mirabilis were found in 7 % of the ears, while no organisms could be isolated from 22 %. Sensitivity tests showed a satisfactory in vitro effect of Neomycin (Framycetin) on most of the bacteria commonly isolated, and a very good effect of Fucidin on the staphylococci. Approximately 91 % of the ears treated were clinically cured or improved very considerably; the relation between clinical response and type of infection is shown diagrammatically in Fig. 1. It was confirmed that infections with Ps. aeruginosa represent a special problem; the results of post-treatment sensitivity tests seem to suggest, however, that a longer or more intense course of treatment than the one used in the trial (two weeks) would provide the answer to this.
Animals↗
Treatment of acute and subacute gonococcal urethritis with fosfomycin.
70 patients, 69 male and 1 female, 23 suffering from subacute gonococcal urethritis and the other 47 suffering from acute gonococcal urethritis, have been treated with fosfomycin with the intramuscular method. The treatment was planned as follows: (1) in 12 patients a total dose of 4 g (2g/4h) was tried with 11 bacteriological and clinical cures (92%) and 1 failure; (2) in another 43 patients a single dose of 4 g was tried (2 g in each buttock), with 37 cures (86%) and 6 failures; (3) finally, in another group of 15 patients with subacute gonococcal urethritis, fosfomycin was administered at the rate of 2g/8h for 2 days, clinical and bacteriological cures being achieved in all patients (100%). The failures, a total of 7, are patients with subacute gonococcal urethritis who were given a single dose of 4 g.
Acute Disease↗
Cefaclor: clinical and bacteriological evaluation in 45 cases.
This report deals with studies of the effectiveness, tolerance and toxicity of cefaclor in the treatment of 45 patients with urinary tract infections (40 cases) and pneumonia (5 cases) caused by susceptible pathogens. Cefaclor was administered orally in a dosage of 1 to 3 g per day for 7 to 11 days. Clinical and laboratory examinations were performed before, during, at the end of treatment, and 4 weeks later in cases of urinary infection. All 5 patients with pneumonia and bronchopneumonia were cured. Clinical and bacteriological cures were obtained in 28 (70%) of the 40 cases of urinary tract infections. Identification and typing of microorganisms, disk sensitivity tests, minimal inhibitory concentrations and cefaclor blood levels also were determined.
Adult↗
Clinical evaluation of netilmicin therapy in serious infections.
Netilmicin, a new semisynthetic aminoglycoside, was evaluated in the therapy of 33 episodes of infection in 30 patients. Eighteen patients had documented bacteremia. Infection sites included pulmonary, urinary tract and soft tissue areas. A complete bacteriologic and clinical cure rate of 85 per cent was achieved. No treatment failures occurred in the bacteremic group. Although netilmicin is less effective than gentamicin in vitro against Pseudomonas, it was clinically and bacteriologically effective. Netilmicin bacteriologic cures occurred in patients whose organisms were inhibited by 6.2 microgram/ml or less of netilmicin. Despite a uniform dosing protocol, a wide range of netilmicin serum levels was obtained. Adverse effects were limited to one case of transient nephrotoxicity and one Candida urinary suprainfection. Netilmicin appears to be an effective, safe agent for the therapy of serious infections.
Adult↗
Vulvovaginal candidiasis in pregnancy treated with clotrimazole.
An open trial of local clotrimazole therapy in 56 pregnant women with vulvovaginal candidiasis is reported. The diagnosis was confirmed by mycotic culture. The patients were given one vaginal tablet daily and cream was applied to the vulva 2 or 3 times daily. Their male partners were treated with cream only. The duration of therapy was 6 days. Fifty of the patients (89.3%) were clinically cured after 6 days of therapy. Six patients (10.7%) had slight complaints and 10 (17.9%) without symptoms or signs of infection harboured Candida albicans or other yeast species in the genital tract. Six of the patients were given a second treatment with clotrimazole and their remaining symptoms subsided. Candidiasis recurred later in pregnancy in 4 of the 56 patients studied. The implications of the presence of Candida in the genital tract are discussed. It is concluded that clotrimazole is an effective antimycotic agent which can be used for vulvovaginal candidasis during pregnancy without causing side effects. Two of the patients had trichomoniasis concurrently. One of these was cured with clotrimazole.
Administration, Topical↗
The comparative efficacy of minocycline and penicillin-V in Staphylococcus aureus skin and soft tissue infections.
The antistaphylococcal properties of orally administered minocycline and penicillin-V were compared for one hundred and fifteen patients receiving minocycline and one hundred and twenty-eight receiving penicillin-V for various types of cutaneous infections. The majority of bacterial isolates were staphylococcal organisms. Of these 82 percent showed initial in vitro sensitivity to minocycline while only 20 percent did to penicillin-V. The percentage of clinical cures was higher with minocycline (74 percent) than with penicillin-V (54 percent), however, most patients, in both groups, showed clinical improvement. The rate of clinical improvement appeared to be significantly faster with minocycline. There was a higher percentage of adverse, chiefly vestibular, effects in the minocycline group (16 percent vs 7 percent). The study clearly demonstrates the superior antistaphylococcal properties of minocycline as compared with penicillin-V.
Adolescent↗
Treatment of acute bronchitis and pneumonia with cefaclor.
An open, non-comparative clinical trial of cefaclor in adults with acute exacerbations of chronic bronchitis (54 patients) or pneumonia (24 patients) is reported. The dosage of cefaclor used was either 250 mg or 500 mg taken orally three times daily. Clinical cure was obtained in 39 of 42 (93%) of patients on the lower dose and 32 of 33 (97%) on the higher dose. Side effects were minimal and the antibiotic was very well tolerated. Microbiological evaluation was possible in 32 of 75 (43%) of patients in whom potential pathogens were identified before treatment. Microbiological 'cure' was achieved in 17 of 32 (53%), the majority of whom had received the higher dose. The lack of correlation between the clinical and microbiological results cast further doubts on the value of the standard sputum culture methods in the diagnosis and management of lower respiratory tract infection. Cefaclor is useful in the management of acute lower respiratory tract infections by virtue of its excellent clinical efficacy and safety.
Acute Disease↗