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Introduction

To accomplish the goal of both clinical and microbiological cure in the treatment of lower respiratory tract infections, microbiological data along with pharmacokinetic and pharmacodynamic data should be used. Recent studies have determined 2important antibacterial pharmacokinetic/ pharmacodynamic parameters that differ among classes of antimicrobial agents. The 2major groups include the antibiotics that exhibit concentration-dependent killing with a postantibiotic effect and time-dependent killing with minimal to moderate postantibiotic effects. For drugs that are concentration dependent (aminoglycosides, fluoroquinolones), the area under the concentration-time curve (AUC/MIC) is the most important predictor of bacteriological eradication. Alternatively, for antibiotics that exhibit time-dependent killing (-lactams, macrolides), time above the MIC (T>MIC) is probably the major parameter that determines efficacy. Using these parameters provides the tools needed for appropriate antibiotic dosing.

Eleven morphine naive patients with cancer-related pain were given a single dose of either intravenous morphine (n = 5) or oral morphine (n = 6). Blood sampling was performed over a 24-hr period and serial pain assessments were made using a categorical scale. Plasma samples were analyzed for morphine, morphine-6-glucuronide (M-6-G), morphine-3-glucuronide (M-3-G), and normorphine using high-performance liquid chromatography. In neither the intravenous nor oral group was there a correlation between analgesia duration and the half-lives of morphine and M-6-G. There was no correlation between the time to peak analgesia and time to peak concentration for morphine or M-6-G. There was no significant difference in absolute concentrations of M-6-G or M-3-6 nor in the ratio ofM-3-G to M-6-G at peak analgesia versus relapse.

The efficacy and tolerability of ampicillin/sulbactam versus cefuroxime axetil administered intravenously in the treatment of community-acquired lower respiratory tract infections in patients requiring hospitalization were assessed in a randomized study. A total of 103 adult patients were enrolled, with 49 receiving ampicillin/sulbactam and 54 receiving cefuroxime. Twenty-five of the 49 patients in the ampicillin/sulbactam group and 22 of the 54 patients in the cefuroxime axetil group were included in the statistical analyses. No statistically significant differences were observed between the two groups with regard to demographics or clinical, radiologic, and bacteriologic response rates. There was no apparent difference in the incidence of adverse effects.

Objective.To determine if the addition of weekly quizzes or reducing the number of faculty members teaching improved third-year (P3) pharmacy students’ final grades in a clinical pharmacokinetics course.

The role of complement receptors in bactericidal activity for types III and Ia group B streptococci (GBS) by adult or neonatal polymorphonuclear leukocytes (PMNL) was explored using polyclonal and monoclonal antibodies to complement receptors one (CRt) and three (CR3). In an opsonophagocytic assay, selective blockade of the CR3 sugar or lectin-like binding site on adult or neonatal PMNL effected a significant reduction in killing of both GBS serotypes that was more pronounced for type III. In contrast, blockade of the iC3b binding site effected greater inhibition of bactericidal activity for type Ia than for type III GBS. When both the CR3 sugar or lectin-like binding site and CRt were blocked, inhibition was enhanced for type Ia GBS by adult PMNL and for both serotypes by neonatal PMNL. These results demonstrate a role for both CRt and CR3 in the opsonophagocytosis ofGBS. Possibly, differences in CR3 epitope utilization contribute to the differential virulence among GBS serotypes in neonates.