ABSTRACT
5-flucytosine (5-FC) is an antifungal drug used for the treatment of serious infections caused by Candida or Cryptococcus spp. In the UK, the recommended pre- and post-dose serum therapeutic ranges are 30-40 mg/L and 70-80 mg/L, respectively. A 12-year retrospective review of serum concentrations of 5-FC in three groups of children aged 1-30 days (n=167), 31-60 days (n=102) and 91 days to 12 years (n=122) was conducted. In these three age groups, 65.1%, 44.4% and 21.3% of pre-dose samples and 39.3%, 29.2% and 19.7% of post-dose samples were above the recommended ranges. Both the mean concentration and the percentage of concentrations above the recommended ranges were significantly higher in the youngest age group (1-30 days old), suggesting that the standard dose of 100 mg/kg daily may not be an appropriate dose in this age group.
Subject(s)
Antifungal Agents/administration & dosage , Antifungal Agents/pharmacokinetics , Drug Monitoring , Flucytosine/administration & dosage , Flucytosine/pharmacokinetics , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Laboratories , Mycoses/drug therapy , Reference Standards , United KingdomABSTRACT
Ertapenem is a new carbapenem with a broad spectrum of activity and an extended half-life, permitting once daily administration. Although high-performance liquid chromatography (HPLC) methods have been described for ertapenem, these are complex and involve column switching and thus this type of assay may not suitable for use in routine clinical microbiology laboratories. In this study we report a rapid, straightforward HPLC method for the detection of ertapenem in human serum.
Subject(s)
Anti-Bacterial Agents/blood , Blood Chemical Analysis/methods , Chromatography, High Pressure Liquid/methods , beta-Lactams/blood , Blood Chemical Analysis/statistics & numerical data , Chromatography, High Pressure Liquid/statistics & numerical data , Ertapenem , Humans , Reproducibility of ResultsABSTRACT
The Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) monitors trends in antimicrobial resistance in consecutive gonococcal isolates from 26 genitourinary medicine clinics in England and Wales. In 2002, 2204 gonococcal isolates were tested, and the overall prevalence of ciprofloxacin resistance (minimum inhibitory concentration > or =1 mg/L) was 9.8%, compared with 3.1% in 2001 and 2.1% in 2000. Between 2001 and 2002, prevalence of ciprofloxacin resistance increased two to three-fold, irrespective of recent sexual contact overseas, sex, or residence within or outside of London. These findings suggest that national and local treatment guidelines need to be reviewed urgently.
