Clinical evaluation of the imipenem/cilastatin combination in the therapy of severe infections in patients with malignant diseases.

Thirty hospitalized patients (23 men and 7 women), aged 42 to 78 years, with impaired host defences for malignant underlying diseases and affected by life-threatening infections, were treated with the imipenem/cilastatin combination at a dosage ranging between 2 and 4 g daily i.v. at 8 or 12 h intervals. The average length of therapy was 9.6 +/- 2.09 days. The isolated organisms were as follows: Pseudomonas aeruginosa [12], Escherichia coli [10], Klebsiella pneumoniae [5], Proteus mirabilis [3], P. vulgaris [2], Serratia marcescens [1], Staphylococcus aureus [3], Streptococcus faecalis [3], Bacteroides fragilis [5]. In fourteen patients a mixed infection was observed. Twenty-three patients (76.66%) were completely cured of infection and 35 out of 44 isolated organisms (79.54%) were eradicated. No important side-effects were observed.

[Comparative evaluation of norfloxacin and cinoxacin in the therapy of complicated infections of the urinary tract]. / Valutazione comparativa della norfloxacina e della cinoxacina nella terapia delle infezioni complicate delle vie urinarie.

A randomized clinical study was conducted in order to compare the effectiveness of norfloxacin and cinoxacin in complicated urinary tract infections. Norfloxacin proved effective in 80% of the 40 patients treated, cinoxacin in only 60%.

[Anti-hepatitis B vaccination in Campania. Final observations of a 3-year vaccination campaign, with special reference to infants born to HBsAg-positive mothers]. / La vaccinazione anti-epatite B in Campania. Osservazioni consuntive di 3 anni di campagna vaccinale, con particolare riguardo ai nati da madre HBsAg positiva.

The results obtained at the end of the first three years of a hepatitis B vaccination campaign in Campania, are reported. HEVAC-B and H-B-VAX proved innocuous and efficacious in producing anti-HBs. Newborn babies and children produced anti-HBs more often and with higher titres than adults. Titre 10 mUI/ml of anti-HBs persisted, in the responders for at least 36 months on average. AVH by HBV was observed in two adult non responders. Transplacental or delivery infection was observed in 9.3% of the babies born of HBsAg positive mothers and more often among babies born of HBeAg positive mothers. Infection by HBV was observed in 6.0% of the babies, in 4.0% of the children and in 12.0% of the adults, in spite of the production of anti-HBs. HB-antigenemia, was as a rule transitory, but sometimes fluctuating or persistent. Careful observation during a prolonged follow up is necessary for these subjects.

[Experience at a branch center of the National HIV Protease Inhibitor Registry]. / L'esperienza di un centro periferico sul registro nazionale degli inibitori delle proteasi di HIV.

In the present study we show our experience as one of the Centers (center 006) of the Italian Index of Protease Inhibitors (PI). In this multicentric, observational study we studied HIV-positive naive patients for antiretroviral therapy with protease inhibitors. From 8/1/97 to 31/1/98 in our department 64 patients were enrolled and followed up through an electronic medical sheet in order to evaluate efficacy, tolerability, toxicity and compliance of treatment with PI. Our results show a reduction in AIDS-related mortality and a decrease in AIDS defining diseases: in particular data show an increase in CNS pathologies in comparison with other opportunistic events. Moreover, in patients non complaints to therapy, the progression of the disease was more frequent. The side effects more frequently observed during PI treatment were hypertrigliceridaemia and lipodystrophy; gynaecomastia and hyperprolactinaemia were even present, perhaps as expression of direct metabolic action of HAART therapy.

[Acute and chronic viral hepatitis in HIV positive patients]. / Le epatiti virali acute e croniche in pazienti HIV positivi.

In this study we evaluated the spreading of HBV, HCV, HDV and HIV among drug user patients. Spreading of hepatotropic viruses resulted high (HBV 84%, HCV 87%, HDV 7%), while spreading of HIV resulted relatively low (18%). During the period considered we did not observe any favourable effect of hepatotropic viruses on the progression of HIV infection, while the chronic evolution of acute viral hepatitis HBV related was high (90%) in HIV+ patients. HIV infection did not determine different histological findings in respect to HIV- patients with chronic hepatitis, HBV or HCV related

Open study on the antidiarrhoeal effectiveness of the L 105 compound.

The therapeutical effectiveness of L 105, a new drug preparation exhibiting antidiarrhoeal activity and containing Rifaxidin, was tested on 22 patients with acute gastroenteric syndrome of bacterial aetiology. In all patients there was a prompt restoration of intestinal function by the 2nd treatment day. Both local and systemic drug tolerance proved to be good in all cases.

Clinical experience with pefloxacin in the therapy of typhoid fever.

Thirty hospitalized patients (22 men and eight women), aged between 15 and 41 years (mean = 25.4 years), with severe proven typhoid sepsis were treated with pefloxacin at daily dose of 1200 mg, divided in three doses, intravenously for the first five days and orally for the following ten days of treatment. All patients completely recovered from infection and pathogens were eradicated after 30 days of follow-up. In none of the patients was a relapse registered during the follow-up or enteric carrier state after disease. Pefloxacin therapy was well tolerated by all patients: in five patients a mild and transient epigastric pain and in one patient a mild and transient nausea were registered. Pefloxacin is a safe and effective agent for therapy of typhoid fever.

[Saquinavir + Zidovudine + Lamivudine in HIV positive naive or not naive patients] / Saquinavir + Zidovudina + Lamivudina in pazienti HIV positivi naive e non.

The aim of the study was to assess the virological/immunological outcome and safety of Saquinavir (SQV), Zidovudine (AZT) and Lamivudine (3TC) therapy in HIV patients. We retrospectively evaluated the charts of 36 HIV patients (male 87% median age 31 yrs, IVDA 72%) who underwent therapy with 5QV (1800 mg/die), AZT (500 mg/die) and 3TC (300 mg/die). 26 (72%) patients were previously on antiviral therapy for at least 16 weeks. No patient ranked in the CDC group. Patients were treated for at least 48 weeks. Hematological indices, changes in CD4+ cell count and plasma HIV-RNA levels were evaluated every 30, 60, and 90 days respectively. At baseline, CD4 cell count and viral load were 230/mcl and 4.55 log respectively for patients previously on therapy and 382/ l and 4.88 log respectively for naive patients. At week 48 the mean CD4+ cell count increase was 70/ l among previously treated and 98/mcl among untreated patients. In respect to the baseline, lower mean HIV-RNA levels were observed at week 12, 24 and 48. No patient showed AIDS-defining events. No patient discontinued therapy due to suspected toxicity. Patients showed a good immunological and virological response, regardless of their previous antiviral treatment. The terapy regimen was safe and well tolerated