High blood pressure. Causes, symptoms, treatments

Clinical presentation of genetically defined patients with hypokalemic salt-losing tubulopathies.

2017-04-18

Children of preschool age most often receive medications in liquid form, and smell and taste are major determinants in achieving compliance. We compared smell, taste and other characteristics of 14 commonly prescribed antimicrobial suspensions in a blind test in 30 adult volunteers to determine whether there was a difference in their acceptability. A significant difference was observed with cephalosporins ranking highest and penicillins ranking lowest. Our findings support anecdotal observations and claims often made by parents that cephalosporin antimicrobial suspensions taste good and are readily accepted by children and that penicillin suspensions have an unpleasant taste and aftertaste and are poorly accepted. Other drugs had intermediate scores. Of the two erythromycin suspensions evaluated, Ilosone tested superior to Erythromycin ES.

Randomized, double-blind, placebo-controlled study.

The effect of acute and chronic endotoxin (LPS) treatment on the erythromycin estolate (EE) induced cholestasis, was studied using the isolated perfused rat liver. Addition of EE markedly reduced bile and perfusate flows in livers from control rats but did not alter these parameters in livers from endotoxin pretreated rats or in vitro treated with LPS. We suggest that changes in membrane organization induced by LPS may alter the diplay of EE toxicity.

Cefadroxil monohydrate, an oral cephalosporin with a long half-life, was compared to erythromycin estolate for efficacy in treating upper respiratory tract infections in children. The study was carried out on forty patients, twenty receiving cefadroxil and twenty receiving erythromycin. Each drug was dosed at 50 mg/kg/day and was given every 12 hours in two equally divided doses. The complete cure rate was 95% for the cefadroxil group and 80% for the erythromycin group. Two patients originally in the erythromycin test group showed no improvement either bacteriologically or clinically after 3 days of treatment. It was found that these patients harboured S. aureus which had become resistant to erythromycin during the course of therapy. Both patients were shifted to cefadroxil treatment and achieved complete cures. Two patients in the erythromycin group and one in the cefadroxil group were diagnosed as having scarlet fever. All three responded clinically, yet cultures from the two treated with erythromycin showed persistence of bacteria while the one treated with cefadroxil proved to be cured both clinically and bacteriologically.

Concentrations of erythromycin were measured in serum and tonsil from children who had received either the estolate or ethyl succinate suspension before surgery. The in vitro assay measured total erythromycin activity against a group A beta hemolytic streptococcus. Levels of erythromycin in serum and tonsil after single and multiple doses of the estolate were significantly higher than those after administration of the ethyl succinate. The therapeutic implications of these findings are unknown.

Hepatocytes isolated from young (1 month) rats were as sensitive to the cytotoxic effects of erythromycin estolate and chlorpromazine as were liver cells obtained from older (3, 10 and 24 months) rats. The hepatocytes from the 24-month-old rats released aspartate transaminase more slowly than did parenchymal cells isolated from the younger rats.

During a 1-yr period an increased incidence of hypertrophic PS was noted in a closed referral population. These patients demonstrated a temporal relationship between the ingestion of EE and the development of PS. A sequence of events from pylorospasm to pyloric tumors was suggested from the data.

In this study, organized and financed by the German Society for Pediatric Infectious Diseases, 42 pediatricians in private practice who were selected to represent the 3 main regions of Germany and residence in large cities or small towns, respectively, enrolled consecutive patients who had bacterial infections that required therapy with oral antibiotics. Choice of agent and duration of treatment were left to the study physicians. Compliance was measured by a standardized telephone interview on the penultimate day and a urine bioassay for antibacterial activity on the last day of the planned treatment period. Parents did not know the true purpose of the study.

A double-blind, randomized trial of four antimicrobial regimens was conducted in 383 infants and children with acute otitis media. The drugs used were penicillin V, amoxicillin trihydrate, erythromycin estolate, and erythromycin estolate with trisulfapyrimidines. Aspiration of middle ear fluid for culture was done before treatment and repeated during treatment if fluid persisted. Etiologic bacteria were most commonly pneumococci (31%) or Haemophilus sp (22%), and an additional 5% of patients had both organisms. Amoxicillin was the most effective in promoting initial response in pneumococcal infection. For Haemophilus infections, the cure rates with amoxicillin and the erythromycin-trisulfapyrimidines mixture were significantly better than with the other two regimens, and serous otitis did not occur during the follow-up period; however, new episodes of otitis were comparable in the four groups. Amoxicillin and the erythromycin estolate-trisulfapyrimidines combination appear to be somewhat more effective than penicillin V or erythromycin estolate.