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We compared cefonicid (2 g every 12 h) and ceftriaxone (2 g every 24 h) for their efficacy and safety in treating spontaneous bacterial peritonitis in cirrhotic patients in an open randomized clinical trial (30 patients in each group). Clinical, laboratory, and bacteriologic characteristics were similar in both groups. Ceftriaxone-susceptible strains were isolated on 44 occasions (94%), and cefonicid-susceptible strains were isolated on 43 occasions (91.5%). The antibiotic concentration in ascitic fluid/MIC ratio for ceftriaxone was > 100 throughout the dose interval (24 h), while it was lower for cefonicid (between 1 and 18). A total of 100% of patients treated with ceftriaxone, and 94% of those treated with cefonicid were cured of their infections (P was not significant). Hospitalization mortality was 37% in the cefonicid group and 30% in the ceftriaxone group (P was not significant). The time that elapsed between the initiation of treatment and the patient's death was shorter in the cefonicid group patients (5.3 +/- 3.90 days) than in the ceftriaxone group patients (11.8 +/- 9.15 days) (P < 0.05). None of the patients presented with superinfections, and only two patients treated with cefonicid and three patients treated with ceftriaxone developed colonizations with Enterococcus faecalis or Candida albicans. Ceftriaxone and cefonicid are safe and useful agents for treating cirrhotic spontaneous bacterial peritonitis, although the pharmacokinetic characteristics of ceftriaxone seem to be more advantageous than those of cefonicid.

This study aimed at investigating the changes occurring in the plasma lipid profile of patients with non-insulin-dependent diabetes mellitus (NIDDM) hospitalized for treatment of intercurrent diseases. Twenty-nine non-insulin requiring NIDDM patients (13 men, 16 women; mean age: 67 +/- 2 yrs) and 26 adequately matched patients (12 men, 14 women; mean age: 71 +/- 2 yrs) have been prospectively studied. They were all hospitalized for treatment of various diseases. Diabetic and non-diabetic patients received similar treatment except for intensive insulin therapy in the former group. On admission, diabetic subjects had significantly higher plasma levels of triglycerides and lower levels of HDL cholesterol; during hospitalization, LDL, HDL cholesterol and apo A1 levels increased significantly. In the non-diabetic group, hospitalization and treatment induced significant increases in triglycerides, LDL cholesterol and apo B levels. In conclusion, although insulin treatment during hospitalization of non-insulin requiring NIDDM patients does not fully reverse the abnormal lipid profile, it may help to prevent its further deterioration, particularly by increasing HDL cholesterol levels and hence by decreasing the LDL/HDL cholesterol ratio.

1 Dipyrone 1.0 g, paracetamol 1.0 g and placebo were compared in a double-blind parallel group study in patients with episiotomy pain. 2 Patients were stratified according to severity of initial pain (severe or moderate) and the three treatments were randomized for each of these two groups. 3 Two-hundred and sixty-four patients entered the study: five patients were excluded from analysis; 127 patients had 'severe' pain, 132 'moderate' pain. 4 Both drugs were more effective than placebo, and dipyrone was significantly more effective than paracetamol, particularly where initial pain was severe. 5 The efficacy of dipyrone 1.0 g was compared with paracetamol 1.0 g in relieving pain after tooth extraction. 6 Ninety patients entered the study and 87 were analyzed without stratification according to initial pain severity. 7 Dipyrone was consistently and significantly more effective than paracetamol at every assessment.