In patients with AIDS and M. avium complex bacteremia, treatment with the three-drug regimen of rifabutin, ethambutol, and clarithromycin leads to resolution of the bacteremia more frequently and more rapidly than treatment with rifampin, ethambutol, clofazimine, and ciprofloxacin, and survival rates are better.
MTX decreases circulating purine and pyrimidine concentrations, and their availability for DNA and RNA synthesis, which may affect immune cell proliferation and protein (cytokine) expression. The absence of adenosine concentration changes and lack of ZTP formation is evidence against an AICAR/adenosine mechanism, although localized adenosine concentration changes cannot be excluded.
Amoxicillin, a new semisynthetic penicillin, was administered in 250-mg doses intravenously and orally to normal men. After intravenous doses, the mean alpha disposition constant was 3.994 hr-1 and the mean beta disposition constant was 0.692 hr-1 with a corresponding beta half-life of 1.05 hr. The serum clearance rate was 0.264 1.kg-1 with a volume of distribution at steady state (Vd,,) of 0.311 1.kg-1 • The mean k. of the oral dose was 1.08 hr-l with a lag time of 0.34 hr. Calculation of areas under individual oral and intravenous serum concentration-time curves indicated an absolute availability of the oral dose of 88.7% (range, 70.9 to 105.5). In comparison with ampiCillin, amoxicillin is absorbed at a faster rate and more completely from the gastro-intestinal tract and has a larger Vd". The beta phase half-life and serum clearance rates of the two antibiotics are similar.
Uveitis occurred in a substantial proportion of AIDS patients receiving rifabutin, 600 mg daily, together with clarithromycin and ethambutol for treatment of Mycobacterium avium complex bacteremia. A case-control study was undertaken to examine potential risk factors for developing uveitis. Of eight parameters examined, only baseline body weight predicted the development of uveitis by both univariate and multivariate analyses (P = .001). The incidence of uveitis was 14% in patients weighing >65 kg, 45% in patients between 55 and 65 kg, and 64% in patients <55 kg. Concomitant therapy with fluconazole, a drug known to raise serum rifabutin concentrations, was not associated with an increased incidence of uveitis. The risk of uveitis was markedly reduced when rifabutin was given at 300 mg daily in combination with clarithromycin and ethambutol.
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