Patients in
the ‘empirical’ arm received CAV in accordance with established guidelines.
Results: Of 27 episodes in the preemptive arm, two cases of IPA were picked up by monitoring. In six episodes, CAV was started despite persistently negative GM readings. One additional patient received CAV for a false-positive GM. Of 25 episodes in the empirical arm, CAV was started empirically in 10, one of whom had CT features of IPA. By intent-to-treat and evaluable-episode analyses, respectively, the preemptive approach saved 11% and 14% of patients from empirical antifungals. Twelve-week survival was 85.2% in the preemptive arm and 84% in the empirical arm.
Conclusions: A preemptive approach may reduce empirical antifungal use without compromising survival in Z-DEVD-FMK persistently febrile neutropenic patients. (C) 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.”
“Lansoprazole (LSP), a proton-pump inhibitor, belongs to class II drug. It is especially instable to heat, light, and acidic media, indicating that fabrication of a formulation stabilizing the drug is difficult. The addition of alkaline stabilizer is the most powerful method to protect the drug in
solid formulations under DMH1 TGF-beta/Smad inhibitor detrimental environment. The purpose of the study was to characterize the designed multiple coating pellets of LSP containing an alkaline stabilizer (sodium carbonate) and assess the effect of the stabilizer on the physicochemical properties of the drug. The coated pellets were prepared by layer-layer film coating with a fluid-bed coater. In vitro release and acid-resistance studies were carried out in simulated gastric fluid and simulated intestinal fluid, respectively. Furthermore, the moisture-uptake test was performed to evaluate the influence of sodium carbonate on the drug stability. The results indicate
that the drug exists in the amorphous state or small (nanometer size) particles without crystallization even after storage at 40 degrees C/75% for 5 months. The addition of sodium carbonate to the pellet protects the drug from degradation in simulated gastric fluid in a dose-dependent AG-120 in vitro manner. The moisture absorbed into the pellets has a detrimental effect on the drug stability. The extent of drug degradation is directly correlated with the content of moisture absorption. In conclusion, these results suggest that the presence of sodium carbonate influence the physicochemical properties of LSP, and the designed multiple coating pellets enhance the drug stability.”
“Objective: To examine the association between trimethoprim/sulfamethoxazole, other US Food and Drug Administration (FDA) C and D anti-infectives, and non anti-infective FDA C, D, and X drugs used during pregnancy with preterm birth and low birth weight.