Lansoprazole pharmacokinetics differ in patients with oesophagitis compared to healthy volunteers.

AIM: To compare the pharmacokinetics of lansoprazole in patients with reflux oesophagitis and in healthy volunteers, after a single dose and at steady-state. PATIENTS AND METHODS: A 30 mg dose of lansoprazole was administered orally daily for 7 days in eight healthy male volunteers aged 21-24 years, and in 16 patients aged 29-65 years with grade 2 or 3 reflux oesophagitis. The pharmacokinetics were assessed over the 24 h dose interval following the first dose and again after the 7th dose. RESULTS: Within both the patient and volunteers groups, there were no significant differences between day 1 and day 7 in any of the pharmacokinetic parameters including maximum concentration (Cmax), area under the concentration-time curve (AUC), and terminal half-life of elimination (t(1/2)). However, on both days 1 and 7, values were significantly higher in the patients than in the healthy volunteers. On day 7, Cmax was 1343 ng/mL in patients compared with 765 ng/mL in healthy volunteers, AUC was 3458 ng.h/mL vs. 1350 ng.h/mL and t(1/2) was 1.62 h vs. 0.90 h. CONCLUSION: The differences in results for the pharmacokinetics reflect reduced lansoprazole clearance in the patient group. Other research has not found a difference in pharmacokinetics when comparing healthy volunteers with patients with acid-related disorders. The difference in lansoprazole clearance in this study may be related to a variety of factors that are different in patients compared with young normal volunteers, such as age, gender, other drugs, and reduced general well-being.

The prevalence of Chlamydia trachomatis in a young, sexually-active population.

A prospective study was carried out to determine the prevalence of Chlamydia trachomatis among 1000 sexually-active women at the Family Planning Association Clinic in Melbourne. This organism was isolated from the cervices of 5.1% of screened women. The women were surveyed about their sexual and gynaecological history, and symptoms of discharge or pain. It was found that women who gave positive results for the presence of Chlamydia were younger, and had commenced intercourse at an earlier age. Risk factors of multiple sexual partners, cervical ectopy and symptoms of urethritis were identified. We recommend that women who have more than one sexual partner should ask their partners to use condoms or, failing this, undergo annual screening for Chlamydia by immunofluorescent staining.

PIP: A prospective study was conducted over the December 11, 1985-May 29, 1986, period to determine the prevalence of "Chlamydia trachomatis" among 1000 sexually-active women at Melbourne's (Australia) Family Planning Association Clinic. An epidemiological and clinical history was recorded on a code sheet for study participants. Patients' ages, weights, coitarches, numbers of sexual partners during the last 12 months, and lengths of association with their present partners were recorded along with current contraceptive usage and the results of the last Papanicolaou smear-test. Patients also were asked about the presence of any symptoms of sexually-transmitted disease (STD). The appearance of the cervix was ascertained on speculum examination. Cervical specimens were taken from all women for microbiological assessment. 995 patients completed the patient record form. In 994 of these women, satisfactory swabs were taken for microbiological examination. The patients ranged in age from 15-50 years with a mean age of 25.4. The age at 1st intercourse (coitarche) ranged from 12-30 years and the number of sexual partners during the last 12 months from none to more than 10 partners. 573 (57.6%) women were using oral contraceptives (OCs), 141 (14.2%) no contraception, 101 (10.2%) an IUD, 118 (11.9%) a barrier method, and the remainder a progestagen-only pill, an injectable contraceptive agent, sterilization, or natural contraceptive methods. The previous cervical cytology was available for 775 (77.9%) women; 625 (80.6%) of these showed no abnormal cells. Of the 150 smear-tests that showed some abnormality, only 10 tests demonstrated dysplastic lesions. The rest were indicative of infection or a benign abnormality. Of the 994 cervical swabs, 51 (5.1%) swabs grew Chlamydia trachomatis. 42 swabs gave positive results of both immunofluorescence staining and culture; 9 swabs gave positive results of culture alone. An association between other factors and the presence or absence of Chlamydia was determined. When the ages of patients were compared, patients whose swabs gave positive results for Chlamydia were significantly younger than those whose swabs gave negative results. The women whose swabs gave positive results for Chlamydia began intercourse at a significantly younger age. The prevalence of Chlamydia trachomatis in a young sexually-active population was 5.1%; the group with multiple partner was identified as being at high risk (9.3% positive results). In trying to identify women with an increased risk of carrying Chlamydia, 5 factors appeared relevant: younger age at coitarche; a younger age; more than 1 sexual partner during the previous 12 months; symptoms of urethritis; and the presence of cervical ectopy.