Chemotherapy and immunomodulation in the elderly.

Ageing brings about an impairment of all body functions. Any antimicrobial and oncological treatment must take into account the senescent condition of the patient. Aged people are considered an immunodepressed population and oncotherapy has envisaged the use of components of the immune system. Our hope is to dispose shortly such neuroimmunomodulators as to be able to activate the impaired immune system which is present in the elderly.

Bactericidal effect of ceftriaxone versus imipenem plus cilastatin in bronchial secretion.

The bactericidal quotient (BQ) assessed in the site of infection represents an essential parameter for evaluating the real bactericidal potency of an antibiotic in vivo. The assessment and knowledge of BQ values allow us to set up a more accurate and appropriate antibacterial therapy. The two drugs--ceftriaxone (Rocephin) and imipenem plus cilastatin (Tienam)--that have been taken into consideration in this study, having a similar antibacterial spectrum though with different kinetics, may have the same BQ values in bronchial secretion versus Haemophilus influenzae, Klebsiella pneumoniae and Streptococcus pneumoniae, when administered at different dosages, i.e. ceftriaxone 1 g (i.v.) every 24 h, imipenem 0.5 g (i.v.) every 8 h.

Non-interference of xibornol on the theophylline blood levels.

The authors have proposed the evaluation of the possible pharmacokinetic interactions between xibornol and theophylline. This study has been carried out on eight healthy volunteers of both sexes between 19 and 27 years of age. On the first day each subject was treated with 600 mg oral sustained-release formulation of aminophylline at 08h00 and at 20h00. From the 2nd day an oral administration of 500 mg of xibornol every 8 h was added to the treatment of aminophylline. On the 1st, 2nd and 5th day blood samples were taken after 30, 90, 180 and 300 min following drug administration. After serum separation an analysis was performed on them. The results have shown that theophylline levels at the programmed times during the three days tested are just overlapping. In conclusion the administration of xibornol does not introduce any interference with theophylline clearance or lengthening of its plasma half-life.

Prostatic tissue concentrations and serum levels of Myocamicin in human subjects.

The diffusion of Myocamicin in the prostatic tissue of patients undergoing prostatectomy after a single oral dose of 600 mg has been studied. The maximum concentration of antibiotic in the prostatic tissue and the serum peak are reached at the first hour with mean values respectively of 3.8 micrograms/g and 2.6 micrograms/ml. The concentrations of Myocamicin remain more elevated in the prostatic tissue compared with the serum levels, at the second, fourth and sixth hours. Myocamicin has shown itself to be an antibiotic with optimal capabilities of diffusion in the prostatic tissue, where it rapidly reaches good therapeutic concentrations.

Use of aztreonam in patients suffering from urinary tract infections with contraindications for the use of aminoglycosides.

The clinical efficacy and safety of aztreonam were studied in 30 patients suffering from urinary tract infections caused by gram-negative bacteria. Aztreonam was given in a dose of 1 g i.m. at intervals of 12 or 24 hours. Duration of therapy was 2-8 days. Bacteria isolated in urine cultures were: Escherichia coli (60%); Proteus mirabilis (10%); Pseudomonas aeruginosa and Citrobacter sp. (7%); Proteus vulgaris, Serratia marcescens; Klebsiella pneumoniae and Pseudomonas species (3%). At completion of therapy and at follow-up all patients were bacteriologically and clinically cured. No significant side effects or toxicity were observed in all patients treated. It is concluded from these data that aztreonam is highly effective and well tolerated in patients affected either by upper or lower urinary tract infections.

Ceftriaxone therapy in otolaryngological and pulmonary infections.

The efficacy of ceftriaxone, 1 g given intramuscularly once daily, was evaluated in 38 patients with pneumonia (n = 11), pulmonary empyema (n = 2), bronchitis (n = 4), tonsillitis (n = 9), sinusitis (n = 7), and otitis (n = 5). Causative organisms were Streptococcus pneumoniae (n = 11), viridans type streptococcus (n = 1), Haemophilus influenzae (n = 6), group A streptococcus (n = 10), Staphylococcus aureus (n = 3), Klebsiella pneumoniae (n = 2), Pseudomonas aeruginosa (n = 1), Escherichia coli (n = 2), Proteus mirabilis (n = 1), and Proteus vulgaris (n = 1). Sterilization of infected foci was obtained in 89.4% of those treated, with clinical recovery in 86.8%. The ceftriaxone regimen was well tolerated.

Chemotherapeutic agents and future fertility.

The recent progress in antiblastic therapy has achieved significant successes in the treatment of tumors, obtaining in some cases a complete recovery and very frequently a remission of the disease for a considerable number of years. Therefore the clinician has to deal with the problem of long term toxicity which always accompanies these therapies. This aspect was once considered as a secondary feature in respect to the severity of prognosis quod vitam of the subjects affected with cancer, while now, with a significant increase of survival, it is preeminent that there be the possibility to offer these patients an acceptable quality of life under both physical and social profiles. The reintroduction of patients affected with cancer or treated ones into their social and familiar functions must take into account many factors which are bound to the degree of physical integrity, to psychological conditioning and problems of resumption of working activity. Under a strictly social profile it is fundamental to have knowledge of troubles and disturbances that may involve the reproductive sphere.