Rimantadine offers some desirable features for the treatment and prophylaxis of influenza A infection. It appears to be an attractive choice in elderly patients with a history of CNS adverse effects from amantadine and in patients with mild or moderate renal impairment. Although approved for twice-daily dosing, rimantadine has a pharmacokinetic profile that would allow once-daily dosing. It is effective for prophylaxis (not postexposure prophylaxis) and treatment of influenza A virus. It also has a low incidence of adverse effects.
The use of topical ciprofloxacin in pediatric patients was curative in nearly 70% of patients with otorrhea associated with P. aeruginosa who were previously unresponsive to other antimicrobials. No adverse reactions were reported in the study population.
OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of topical ciprofloxacin in patients with recurrent otorrhea that was unresponsive to other antibiotics.
METHODS: Pediatric patients with otorrhea and confirmed Pseudomonas aeruginosa in the ear fluid were enrolled. Topical ciprofloxacin, three drops three times daily for 14 days, was prescribed with aural care. Efficacy and safety were evaluated on days 7 and 14. A phone follow-up was conducted monthly thereafter for 8.6 months.
RESULTS: Twenty-nine pediatric patients were enrolled. On day 14, 18 were cured, 8 were improved, 2 were changed to an alternate therapy and cured, and 1 showed no improvement, perhaps due to a small external ear canal. Two additional patients were cured at day 21. None of the patients reported any adverse effects. Twelve patients had no recurrence at 3 to 15 months after the study.
CONCLUSION: The use of topical ciprofloxacin in pediatric patients was curative in nearly 70% of patients with otorrhea associated with P. aeruginosa who were previously unresponsive to other antimicrobials. No adverse reactions were reported in the study population.
Acellular (chemically detoxified or recombinant) pertussis vaccine formulation appears to cause fewer adverse reactions than whole-cell vaccine in most studies. Clinical efficacy and safety in the very young has not been well established. Thus, acellular pertussis vaccine is reserved for the 4th and 5th doses in the US. Oral or intranasal formulations of the pertussis vaccine are being evaluated.
Dirithromycin offers some attractive pharmacokinetic properties. The long elimination half-life of dirithromycin allows once-daily dosing and higher and more prolonged tissue concentrations than are achievable with erythromycin. The spectrum of activity, adverse effect profile, clinical efficacy, and bacteriologic eradication rate of dirithromycin may be similar to those of erythromycin. No significant drug interactions with dirithromycin have been reported. Based on available data, dirithromycin may not offer any unique clinical advantage over clarithromycin or azithromycin. Future clinical trials may reveal a special role for dirithromycin in patient care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.