Antibiotic dosing ­ theory and practice. / Antibiotikadosering ­ teori og praksis.

Antimicrobial resistance constitutes one of the most serious threats to public health. Few new antimicrobial drugs are being developed, and the problems of resistance are increasing. Rational use of existing antimicrobials is therefore of growing importance. Basing the use of antimicrobial drugs on their pharmokinetic and pharmacodynamic properties will most often provide a better therapeutic effect and may also help reduce resistance and adverse effects.

Polyhexanide - safety and efficacy as an antiseptic. / Polyheksanid - sikkerhet og effekt som antiseptikum.

BACKGROUND Polyhexamethylene biguanide hydrochloride/polyhexanide/polyaminopropyl biguanide (PHMB) is used as a disinfectant and antiseptic. This article discusses the use of the substance as an antiseptic. We summarise published data on its antimicrobial effect in vitro and its clinical effect and safety when used on skin, wounds and mucosa.MATERIAL AND METHOD A literature search was conducted in PubMed for articles published in the last five years. Articles available as of June 2014 were considered.RESULTS Of 332 articles identified, 27 were included. In vitro studies have demonstrated an antimicrobial effect on Gram-negative bacteria, Gram-positive bacteria and Candida albicans. The clinical studies are small, not well controlled and frequently sponsored by industry. Few adverse effects from the substance were reported.INTERPRETATION Better designed, larger-scale clinical studies of effect and safety are needed in order to give recommendations on the use of polyhexanide on skin, wounds and mucosa.

[Is combining metronidazole and alcohol really hazardous?]. / Er det virkelig farlig å kombinere metronidazol og alkohol?

BACKGROUND: It is common practice to warn against intake of alcohol (ethanol) when taking metronidazole because of the risk of an effect similar to disulfiram (Antabuse). In this article we investigate whether such a warning has any real basis. KNOWLEDGE BASE: The article is based on a review of relevant literature retrieved through a search in PubMed. A search was also made in the WHO's database on adverse effects. RESULTS: No in-vitro studies, animal models, reports of adverse effects or clinical studies provide any convincing evidence of a disulfiram-like interaction between ethanol and metronidazole. INTERPRETATION: The warning against simultaneous use of alcohol and metronidazole appear to be based on laboratory experiments and individual case histories in which the reported reactions are equally likely to have been caused by ethanol alone or by adverse effects of metronidazole. Recent research does not confirm a clinically relevant interaction between ethanol and metronidazole.