RESUMEN
The efficacy of pivampicillin and metronidazole were compared in the treatment of Gardnerella vaginalis associated bacterial vaginosis. In a multicenter trial 86 women were given pivampicillin (P) 700 mg twice daily for 6 days and 86 women received metronidazole (M) 400 mg three times daily for 7 days. At control, 2 weeks from the start of treatment, patients in group P showed the best clinical results, 77.9% in group P vs. 64.0% in group M (p = 0.066). P showed a higher clinical efficacy than M, both in women using intra-uterine device and in patients using other forms of contraception. Negative post-treatment cultures were seen in 43% of women in group P and 64% in group M (p less than 0.002). Bacteriological cure was unrelated to disappearance of discharge, odour and itching, although it correlated significantly with a negative amine test (p less than 0.00005). Pivampicillin in the dosages used in the present investigation is a useful alternative to metronidazole therapy.
Asunto(s)
Ampicilina/análogos & derivados , Infecciones por Haemophilus/tratamiento farmacológico , Metronidazol/uso terapéutico , Pivampicilina/uso terapéutico , Vaginitis/tratamiento farmacológico , Adulto , Ensayos Clínicos como Asunto , Femenino , Gardnerella vaginalis/aislamiento & purificación , Humanos , Metronidazol/efectos adversos , Pivampicilina/efectos adversos , Distribución AleatoriaRESUMEN
During recent years, it has been reported that antacids have a beneficial prophylactic effect in critically ill patients regarding upper gastrointestinal bleeding. In these trials rather complicated treatment schedules and high doses of antacids were used. The present study was designed to investigate the therapeutic efficacy of a more practical antacid treatment regimen in patients with haematemesis and/or melaena. Ninety patients, hospitalized for haematemesis and/or melaena within the past 24 hours, were included to double-blind treatment with antacids or placebo for 7 days. The dose, 20 ml liquid antacid (Balancid) with a neutralizing capacity of 105 mmol, was administered each second hour during waking hours. The groups were comparable regarding incidence of ulcer disease, age, sex, acid secretion, and usage of aspirin. Continuous bleeding or rebleeding was recorded in 15 of the 43 patients in the antacid group (34.9%), compared to 19 of the 47 patients in the placebo group (40.4%), the difference not being statistically significant. Furthermore, the requirement of blood transfusions was not significantly different in the two groups. In conclusion, the haemostatic effect of the antacid treatment regimen used in the present study was not significantly superior to placebo in patients with endoscopically verified acute upper gastrointestinal haemorrhage.