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During the first 6 months following formulary introduction, 1535 patients received cefuroxime. Stepdown to any oral antibiotic occurred in 22% of patients. Cefuroxime axetil was used as the stepdown agent in 64% of these cases. In a comparison of nonstepdown courses with stepdown courses, some differences were apparent. Nonstepdown treatment courses were primarily prophylactic, whereas stepdown courses were typically initiated as primary therapy for the 10-day management of respiratory tract infections (p < 0.001). Conversion to oral therapy typically occurred on day 5 of parenteral therapy and continued for 5 days. Stepdown was considered possible in 46% of treatment courses in which this process did not happen. When stepdown did occur, it was considered timely in 64% of cases, unnecessarily delayed in 32%, and premature in 4% of treatment courses. Stepdown did not appear to be associated with a negative impact on patient outcome. Mean +/- SD cost of drug therapy per day was less for the stepdown group (US $15.78 +/- $5.97) than the nonstepdown group (US $25.47 +/- $7.87; p < 0.001).
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The limit of quantification was 0.1 microg/mL for plasma cefuroxime axetil analysis. The geometric mean and 90% confidence interval CI of test/reference product percent ratios were: 106.1% (100.8%-111.8%) for Cmax, 109.4% (104.8%-114.2%) for AUClast.
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For the empiric therapy of urinary tract infections (UTI) in the extra-hospital setting the susceptibility patterns of potential pathogens, among some other factors, should be considered. Thus, the evolution in susceptibility, mainly influenced by the previous consume of antibiotic, can be observed when comparing with susceptibility patterns in the previous years.
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We report the case of 37-year-old woman who developed pruritic bullous lesions spread all over the body three weeks after her last dose of cefuroxime axetil. Antibiotic therapy was started due to rhino-sinusitis.
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The antibacterials studied were amoxicillin, amoxicillin/clavulanate, azithromycin, cefaclor, cefuroxime axetil and clarithromycin.
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Adsorption, metabolism and excretion (ADME) of cefuroxime axetil (CXM-AX) 500 mg given orally at 30 minutes after meals to male volunteers who had undergone gastrectomy was compared with that of healthy volunteers. 1. The transition of the drug's serum concentrations was observed as follows: Tmax was somewhat shorter and T 1/2 longer in the gastrectomized volunteer group than in the healthy volunteer group. 2. Total urinary recovery rates of cefuroxime (CXM) were not significantly different between the 2 groups, averaging 53.6% for the gastrectomized volunteer group and averaging 54.5% for the healthy volunteer group. 3. Total urinary recovery rates of CXM-delta 2 were not significantly different between the 2 groups either, averaging 1.7% for the gastrectomized volunteer group and 1.3% for the healthy volunteer group. 4. The above results suggest that ADME of CXM-AX in the gastrectomized volunteers is not fundamentally different from that of the healthy volunteers. The absorption, however, may be reduced when peristalsis of the intestinal tract is accelerated as a result of gastrectomy.
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This study compared the use and efficacy of ciprofloxacin to cefuroxime axetil for adult patients with acute bacterial sinusitis.
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Ranitidine bismuth citrate is a novel salt of ranitidine and a bismuth citrate complex. It has intrinsic antisecretory and anti-Helicobacter pylori activity, but monotherapy rarely eradicates H. pylori infection in man.
Infectious causes of Pancoast's syndrome are extremely rare. We describe the case of a patient with Pancoast's syndrome due to chronic pneumonia resulting from Pasteurella multocida. The patient was not immunosuppressed and had had no contact with animals. The diagnosis was made by transthoracic needle aspiration and institution of therapy with cefuroxime-axetil resulted in resolution of his symptoms.
Normal tympanograms were obtained after a median time of 7.5 d (range 1-58 d) among 75 successfully monitored patients. In two-thirds (69%) of them, effusion resolved in 14 d. The median duration of effusion did not differ significantly between the two treatment groups (8 vs 7 days, p=0.7). The children who had unilateral AOM cured more rapidly than those with bilateral AOM (5 vs 19 d, p<0.001). In logistic regression analysis adjusted for age, bilaterality explained treatment failure at 2 wk with an odds ratio of 28.1 (95% CI 4.6-169.5, p<0.001).
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Conditions for separation and determination of diastereoisomers of cefuroxime axetil by HPTLC on cellulose layers with densitometry were developed. A good separation of the constituents was achieved using a mobile phase composed of 1% aqueous beta-cyclodextrin-methanol (15 + 1, v/v). For detecting spots on the chromatograms, densitometric measurements were used at 285 nm. The method is characterized by high sensitivity; the LOD was 0.04 microg/spot and LOQ was 0.11 microg/spot for both forms of the cefuroxime axetil diastereoisomers. For the individual diastereoisomers, high recovery values from 96.63 to 104.16% were obtained. Identification of the diastereoisomers was performed by 1H-NMR spectrometric analysis.
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On the basis of MIC determinations and appropriate MIC breakpoints, 370 pathogens showed complete cross resistance between cefpodoxime and cefuroxime axetil, cefotiam hexetil, cefixime and cefotaxime in 69.7%, 80.3%, 92.2% and 87% of the strains, respectively. Cefpodoxime was superior to cefuroxime axetil in 28.7%, to cefotiam hexetil in 17.6%, to cefixime in 7% of strains and to cefotaxime not at all. On the other hand, we found cefpodoxime to be inferior to the cephalosporins mentioned in 1.6%, 2.1%, 0.8% and 13%, respectively.