Moxi oxacin and clarithromycin are important antibacterial drugs in the treatment of community-acquired respiratory tract infections. In a double-blind, randomized, 2-period cross-over study the pharmacokinetics of moxi oxacin versus clarithromycin were determined after single and multiple doses in 12 healthy male volunteers. The concentrations of the antibiotics in serum, saliva and faeces were measured by validated high-performance liquid chromatographi c methods. In serum, moxi oxacin exhibited a mean peak concentration of 3.1 90.6 mg/ l after a time to peak concentration of 1.67 9 0.96 h on day 1, with a signi cant increase to 3.989 1.10 mg/ l on day 7 (p B0.05). The area under the curve-12 revealed a highly signi cant increase from 28.2 9 4.1 mg*h/ l on day 1 to 39.5 96.6 mg*h/ l on day 7 (p B 0.01). There were also signi cant differences in terminal half-life between day 1 and day 7 [10.6 h (range 9.0 -12.8) vs 14.9 h (range 12.6 -28.1); p B 0.01] and in mean residence time (15.1 9 1.9 vs 18.2 9 2.4 h; p B0.01). The concentrations of moxi oxacin in saliva were well equilibrated with serum at a relatively constant saliva -serum ratio of about 0.8. Pharmacokinetic parameters of clarithromycin and its metabolite, 14-hydroxy-clarithromycin , were similar to previously published data. Accumulation was found. No serious adverse events were observed with either study drug.
A multiple-dose, randomized, double-blind, controlled, cross-over trial was performed in 12 healthy male subjects in order to investigate the effect of a 7-day treatment with moxifloxacin (400 mg orally, once daily) versus clarithromycin (500 mg orally, twice daily) on the normal oropharyngeal microflora. Moxifloxacin caused significant reductions in levels of alpha-streptococci and Neisseria cocci during the treatment period, while the numbers of gram-negative anaerobic bacteria increased markedly during moxifloxacin administration. Clarithromycin administration caused a suppression of micrococci and corynebacteria, while no significant changes were recorded in the anaerobic microflora. No new colonizing moxifloxacin-resistant strains were isolated during the investigation period.
Initial walking impairment is a good predictor of therapeutic responsiveness to PR-fampridine. Valid predictors of patients' responsiveness to PR-fampridine are essential for patient stratification and optimization of multiple slcerosis treatment.
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