Clinical toleration and safety of azithromycin
Article Abstract:
This report presents results from several medical centers in the US and Europe concerning the safety and patient tolerance of azithromycin, a newly developed azalide antibiotic. Azithromycin is effective over shorter periods of time (five days) compared with other agents; this attribute generally enhances patient compliance. The data cover approximately 7,000 patients with bacterial infections of the upper respiratory tract (29 percent), lower respiratory tract (27 percent), skin or skin structure (22 percent), and urethra and/or cervix (18 percent). Results of treatment with azithromycin (3,995 patients) are compared with those using other standard antibiotics such as penicillin, cephalosporins, or macrolides (erythromycin) for effectiveness and side effects. Twelve percent of the patients who received azithromycin (480 of 3,995 people) had side effects, 22 percent of which were directly drug-related. Slightly more than 14 percent of the patients treated with other agents (3,108 people) experienced adverse effects. The most common side effects were associated with the gastrointestinal tract (diarrhea, nausea, and abdominal pain), with others occurring in the nervous system, skin, and other organs. Fifty-nine percent of the adverse effects associated with azithromycin were classified as mild; 34 percent as moderate; and 7 percent as severe. Treatment was discontinued because of side effects in 0.7 percent of these patients. Patients taking other agents had a discontinuation rate of 2.6 percent. Overall, azithromycin was tolerated better than other drugs, particularly erythromycin. The few abnormal results on laboratory tests of physiological function in patients taking the drug were neither major nor consistent. None of the patient deaths that occurred during the studies were attributable to the drug therapy. Patients 65 years old or older did not respond differently to azithromycin than the group as a whole. Azithromycin should not be administered to people who are hypersensitive to it or to macrolide antibiotics, or to people currently taking ergot alkaloids. Patients with impaired liver function should be given azithromycin with caution. The drug has not been tested in pregnant or lactating women, nor has azithromycin been evaluated in children younger than 16. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Clinical presentation of hemochromatosis: a changing scene
Article Abstract:
Hemochromatosis is an inherited disease that causes an increased absorption of iron in the intestines. This can then lead to a number of severe diseases, including cirrhosis and cancer of the liver, heart disease, and diabetes. The complications are sometimes fatal. These problems can be avoided if the disease is diagnosed and treated early. The signs and symptoms that led to early diagnosis were studied in 93 patients and the results were compared with the findings from other studies going as far back as 1935. Initially, the disease was detected in 56 patients, which led to examination of other members of their families (probands). The original 56 patients were found to have the disease either because they were suspected of having hemochromatosis or because they had a liver disease of unknown cause. Screenings of their families produced 37 more patients. Tests and interviews were performed to learn which symptoms brought a patient to the doctor, what led to the final diagnosis, and what clinical features of disease were evident. In 40 percent of the probands, the initial reason for a visit to the physician was a routine exam or for another illness. Abdominal pain brought 16 percent to the doctor, while the rest went for a variety of other symptoms. The diagnosis was on the basis of liver enlargement or abnormal results from liver function tests in 69 percent of the probands and related to arthritis in 11 percent. Twelve percent of the probands and 46 percent of the patients found by family screening had no clinical symptoms. The main clinical symptoms in the probands were enlarged livers, arthritis, and weakness. In the screened patients, joint pain and stiffness were the most common clinical symptoms. Body iron stores were less than 5 g in 53 patients and greater than 5 g in the other 40, with symptoms occurring in 13 of the 53 and in 37 of the 40. Fewer symptoms upon diagnosis were found than in earlier studies. This is a consequence of screening for patients in the families of those diagnosed with the disease and of the high number of patients who were diagnosed while being examined for other reasons. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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