RESUMO
Background: Diseases produced by Streptoccocus pyogenes are still a problem in Chile, as in the rest of the world. It exhibits in vitro susceptibility to different antimicrobials, but penicillin continues to be the treatment of choice. Alternative drugs have been developed for allergic patients, such as erythromycin, new macrolides and cephalosporins. Nevertheless, resistant strains are appearing due to the indiscriminate use of macrolides. Aim: To assess present antimicrobial susceptibility of S Pyogenes strains isolated from chilean patients. Material and Methods: The susceptibility to penicillin, macrolides, clindamycin, cephalotin and vancomycin of 153 S Pyogenes strains, obtained from different health centers of the Metropolitan Region and isolated between 1996 and 1998, was assessed using the Kirby-Bauer method. Agar dilution minimal inhibitory concentration was then determined to macrolide resistant strains. Results: All strains were susceptible to penicillin. There was a 7.2 percent cross-resistance to macrolides. Conclusions: These results confirm that S Pyogenes resistance to macrolides has increased considerably in the Metropolitan Region of Chile during the last years
Assuntos
Streptococcus pyogenes/efeitos dos fármacos , Antibacterianos/farmacocinética , Técnicas In Vitro , Penicilinas/farmacocinética , Resistência Microbiana a Medicamentos , Clindamicina/farmacocinética , Vancomicina/farmacocinética , Testes de Sensibilidade Microbiana , Cefalosporinas/farmacocinética , Eritromicina/farmacocinética , Roxitromicina/farmacocinéticaRESUMO
The bioequivalence of two different formulations containing roxithromycin (SPE-712-1). Oral suspension 300 mg/15 mL as test formulation and Rotram, tablets 300 mg as reference formulation, both by Schering Plough S.A., Brazil) was evaluated in 24 healthy volunteers of both sexes (12 male and 12 female). The study was conducted open with randomized two-period crossover design and a 14-day washout period. Each subject received 300 mg of each roxithromycin formulation. Plasma samples were obtained over a 72-hour interval and roxithromycin concentrations were analyzed by combined LC-MS/MS with positive ion electrospray ionization using selected ion monitoring method. From the plasma roxithromycin concentration vs time curves the following pharmacokinetic parameters were obtained: AUC(0-72 h), AUC(0-infinity), Cmax, t1/2 ratios and tmax individual differences. The 90% for confidence interval (CI) of geometric mean SPE-712-L/Rotram individual percent ratio were 105.0-128.3% for AUC(0-72 h), and 78.4-96.9 for Cmax. Although this 90% CI were marginally outside the interval proposed by the Food and Drug Administration, the probability assessed by the two-one sided West for ratios was included in the 0.8-1.25 interval, as we concluded that SPE-712-L oral suspension formulation was bioequivalent to Rotram tablet formulation for the extent and rate of absorption.
Assuntos
Antibacterianos/farmacocinética , Roxitromicina/farmacocinética , Adolescente , Adulto , Antibacterianos/sangue , Antibacterianos/química , Química Farmacêutica , Cromatografia Líquida de Alta Pressão , Estudos Cross-Over , Feminino , Humanos , Masculino , Espectrometria de Massas/métodos , Pessoa de Meia-Idade , Roxitromicina/sangue , Roxitromicina/química , Equivalência TerapêuticaRESUMO
The bioequivalence of two different formulations containing roxithromycin (SPE-712-1). Oral suspension 300mg/ 15mL as test formulation and Rotram©, tablets 300mg as reference formulation, both by Schering Plough S.A., Brazil) was evaluated in 24 healthy volunteers of both sexes (12 male and 12 female). The study was conducted open with randomized two-period crossover design and a 14-day washout period. Each subject received 300 mg of each roxithromycin formulation. Plasma samples were obtained over a 72-hour interval and roxithromycin concentrations were analyzed by combined LC-MS/MS with positive ion electrospray ionization using selected ion monitoring method. From the plasma roxithromycin concentration vs time curves the following pharmacokinetic parameters were obtained: AUC(0-72h), AUC(0-oo), Cmax,t1/2 ratios and tmax individual differences. The 90 percent for confidence interval (CI) of geometric mean SPE-712-L/ Rotram© individual percent ratio were 105.0-128,3 percent for AUC(0-72h), and 78.4-96.9 for Cmax. Although this 90 percent Cl were marginally outside the interval proposed by the Food and Drug Administration, the probability assessed by the two-one sided West for ratios was included in the 0.8-1.25 interval, as we concluded that SPE-712-L oral suspension formulation was bioequivalent to Rotram tablet formulation for the extent and rate of absorption.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Antibacterianos/farmacocinética , Roxitromicina/farmacocinética , Antibacterianos/sangue , Antibacterianos/química , Cromatografia Líquida de Alta Pressão , Espectrometria de Massas/métodos , Distribuição Aleatória , Roxitromicina/sangue , Roxitromicina/química , Equivalência TerapêuticaRESUMO
The bioequivalence of two different formulations containing roxithromycin (SPE-712-1). Oral suspension 300mg/ 15mL as test formulation and Rotram , tablets 300mg as reference formulation, both by Schering Plough S.A., Brazil) was evaluated in 24 healthy volunteers of both sexes (12 male and 12 female). The study was conducted open with randomized two-period crossover design and a 14-day washout period. Each subject received 300 mg of each roxithromycin formulation. Plasma samples were obtained over a 72-hour interval and roxithromycin concentrations were analyzed by combined LC-MS/MS with positive ion electrospray ionization using selected ion monitoring method. From the plasma roxithromycin concentration vs time curves the following pharmacokinetic parameters were obtained: AUC(0-72h), AUC(0-oo), Cmax,t1/2 ratios and tmax individual differences. The 90 percent for confidence interval (CI) of geometric mean SPE-712-L/ Rotram individual percent ratio were 105.0-128,3 percent for AUC(0-72h), and 78.4-96.9 for Cmax. Although this 90 percent Cl were marginally outside the interval proposed by the Food and Drug Administration, the probability assessed by the two-one sided West for ratios was included in the 0.8-1.25 interval, as we concluded that SPE-712-L oral suspension formulation was bioequivalent to Rotram tablet formulation for the extent and rate of absorption. (AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Roxitromicina/farmacocinética , Antibacterianos/farmacocinética , Roxitromicina/sangue , Roxitromicina/química , Antibacterianos/sangue , Antibacterianos/química , Equivalência Terapêutica , Cromatografia Líquida de Alta Pressão , Espectrometria de Massas/métodos , Distribuição AleatóriaAssuntos
Humanos , Antibacterianos/farmacocinética , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Antibacterianos/efeitos adversos , Azitromicina/farmacocinética , Calymmatobacterium/efeitos dos fármacos , Chlamydia trachomatis/efeitos dos fármacos , Claritromicina/farmacocinética , Miocamicina/farmacocinética , Mycoplasma/efeitos dos fármacos , Neisseria gonorrhoeae/efeitos dos fármacos , Roxitromicina/farmacocinética , Treponema pallidum/efeitos dos fármacosAssuntos
Humanos , Masculino , Feminino , Pré-Escolar , Eritromicina , Macrolídeos , Antibacterianos/uso terapêutico , Antibacterianos/farmacologia , Antibacterianos/administração & dosagem , Antibacterianos , Antibacterianos/efeitos adversos , Claritromicina , Claritromicina/farmacocinética , Claritromicina/uso terapêutico , Roxitromicina , Roxitromicina/farmacocinética , Roxitromicina/uso terapêutico , Azitromicina , Azitromicina/farmacocinética , Azitromicina/uso terapêutico , Pneumonia/tratamento farmacológico , Sinusite/tratamento farmacológico , Celulite/tratamento farmacológico , Impetigo/tratamento farmacológicoAssuntos
Humanos , Masculino , Feminino , Pré-Escolar , Antibacterianos , Antibacterianos/efeitos adversos , Antibacterianos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Eritromicina , Macrolídeos , Azitromicina , Azitromicina/farmacocinética , Azitromicina/uso terapêutico , Celulite (Flegmão)/tratamento farmacológico , Claritromicina , Claritromicina/farmacocinética , Claritromicina/uso terapêutico , Impetigo/tratamento farmacológico , Pneumonia/tratamento farmacológico , Roxitromicina , Roxitromicina/farmacocinética , Roxitromicina/uso terapêutico , Sinusite/tratamento farmacológicoRESUMO
O autor apresenta as perspectivas de progressos, no campo da terapêutica antimicrobiana, representadas pelo aparecimento de novos antibióticos macrolídicos com propriedades que os diferenciam, e muitas vezes os tornam mais atraentes, relativamente aos membros mais antigos da família. Compara esses novos antibióticos com a eritromicina, destacando as diferenças de propriedades farmacocinéticas e de espectro antimicrobiano. Por fim, apresenta as indicaçöes terapêuticas especiais que esses medicamentos poderäo vir a ter