The pharmacokinetics of ciprofloxacin following a single 100 mg oral dose were evaluated in elderly patients (mean age 74 years), laboratory staff (30-40 years) and students (less than 20 years). There were no significant differences in serum Tmax (1.2-1.3 h) or in overall serum elimination half-life (3.7-4.0 h) but Cmax in elderly patients was more than double that in young volunteers (P less than 0.005). The serum AUC value was greater both in fasting students (1.4 mg/h/l) compared with the same subjects after food (1.09: P less than 0.01) and, after food, in elderly patients (1.95) compared with students (0.81: P less than 0.005). Urinary recoveries were greater in fasting subjects and in all categories of volunteers compared with elderly patients. However, in the elderly, urinary ciprofloxacin concentrations (0-6 h mean 66 mg/l: range 17.4-200 mg/l) were more than adequate for the eradication of urinary pathogens.
Two panels of monoclonal antibody reagents were used to serotype all strains of Neisseria gonorrhoeae isolated from four separate geographical areas serving two million of the five million Scottish population. Serotype 1B isolates accounted for 60% of the 869 strains examined and were more prevalent than 1A isolates in each geographical area. A total of 11 1A serovars and 47 1B serovars were recognised. Only two of the 11 1A serovars (Aedgkih/Arost and Aedih/Arst) were found in every centre but these accounted for over 90% of the 1A isolates. Although there was a total of 47 different 1B serovars over 80% of the isolates were accounted for by the ten most commonly encountered serovars. There were, however, marked geographical differences within both major and minor serovars. There was a highly significant difference (P less than 0.001) between protein 1A and 1B serovars with respect to their susceptibility to penicillin. Within each protein 1 type there were also differences in antibiotic susceptibility. Penicillinase-producing N. gonorrhoeae (PPNG) were found in all centres and accounted for 24 (2.8%) of the 869 isolates. The majority of the PPNG (71%) were serotype 1A and with one exception were serovar Aedih/Arst. PPNG strains accounted for 37% (16) of the 43 Aedih/Arst isolates. Epidemiological, diagnostic and therapeutic implications arising from the distinct geographical differences in the pool of circulating gonococci are discussed.
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