Comparison of GEM with cisplatin-based therapy in symptomatic, advanced NSCLC demonstrates that GEM produces significantly a stronger and longer-lasting clinical benefit, probably due to its equal effectiveness in terms of ORR, time-to-progression or survival, combined with significantly less severe therapy-related toxicity.

No abstract

Pharmacokinetics of ciprofloxacin after single oral administration of 250 mg were studied in patients with and without renal failure. Ciprofloxacin concentrations were measured by HPLC. The elimination half-life was 8.7 +/- 0.9 h (mean +/- S.E.M.) in six renal failure patients not on haemodialysis, as compared to 4.4 +/- 0.2 h in six patients with normal renal function. The urinary recovery of unchanged ciprofloxacin was 5.3 +/- 1.7% of dose over 24 h in the renal failure patients, as compared to 37.0 +/- 3.7% in the patients with normal renal function. In haemodialysis patients, the half-life was 5.8 +/- 0.9 h on an interdialysis day, and 3.2 +/- 0.4 h during haemodialysis.

We studied the penetration of ampicillin-sulbactam in the alveolar lining fluid (ALF) of eight patients after intravenous administration of 2,000 mg of ampicillin and 1,000 mg of sulbactam three times daily over 30 min. Bronchoalveolar lavage was performed on day 3, 30 min after the end of the morning drug administration. The mean penetration ratios (i.e., the ratios of the concentrations in ALF versus those in serum) were 53% (standard error, 12%) and 611% (standard error 31%) for ampicillin and sulbactam, respectively. The concentration ratio of ampicilin versus sulbactam in serum was not significantly different from that in ALF. From a pharmacokinetic point of view, ampicillin-sulbactam is a good choice for treatment of infectious exacerbation of chronic obstructive pulmonary disease and community-acquired bacterial pneumonia, since the concentrations of both drugs in ALF exceed the MICs for the respiratory pathogens responsible.The clinical outcome of bacterial lower respiratory tract infections is a function of two, main factors: the efficacy of the host defense mechanisms and institution of appropriate antimicrobial therapy. The antimicrobial drug concentration at the site of infection is supposed to be a determinative element for effective antimicrobial therapy (2). This concentration should equal or exceed the MIC for the respiratory pathogen responsible (3,17,22). The final bioactive antibiotic concentrations in the bronchial wall and in secretions and in the alveolar lining fluid (ALF), which are the sites of infection in the lower respiratory tract, are the results of a complex and dynamic process (1, 2, 14).We evaluated the pharmacokinetic behavior of parenterally administered ampicillin-sulbactam in serum and studied the disposition of both drugs in ALF by using the bronchoalveolar lavage (BAL) technique. BAL has been used to study the chemical compositions of ALF in both normal and pathologic situations, such as interstitial lung disease and asthma. With this technique, the concentrations of immunoglobulins, complement components, surfactant, a2-macroglobulin, ao-antitrypsin, and several mediators have been determined (8,28). Only a few studies have used BAL for evaluation of the concentrations of drugs such as corticosteroids and antibiotics in ALF (5-7).Sulbactam is a semisynthetic P-lactamase inhibitor (10,20). In combination with ampicillin, it restores and extends the antibacterial activity of ampicillin to include some ,Blactamase-producing strains of bacteria, such as Haemophilus influenzae and Branhamella catarrhalis, that would otherwise be resistant (10,15,24). The penetration and ampicillin/sulbactam ratio in ALF have not been studied previously. MATERIALS AND METHODSPatients. Seven males and one female (average age, 71 years) with bacterial respiratory tract infections were invited to participate in the study after giving informed consent. All patients had chronic obstructive pulmonary disease and were hospitalized because of infectious exacerbation. Five * Corresponding author.patients...

No abstract