[Studies on the pharmacokinetics of Sulfaclomid, Mebacid, Nevigramon and Metindol in patients with reduced kidney function]

In patients with restriction of the renal function the pharmacokinetics of Sulfaclomid, Mebacid, Nevigramon and Metindol was investigated. According to the different elimination mechanisms of the drugs investigated the kinetics was infleunced in different way by the restriction of the renal elimination of these drugs: The half-life periods for the elimination of Metindol, Nevigramon and Mebacid remained unchanged in patients with renal diseases; the half-value period for the elimination of Sulfaclomid was prolonged.

[A comparison of Ultrax, Diazil, Bactrim and Spiramycin in experimental toxoplasmosis in mice (author's transl)]

White mice infected intraperitoneally with the RH-strain of Toxoplasma gondii (inoculum size 50,000 to 100,000 free protozoans per mouse) received treatment between the second and eighth day after infection with sulphamethazine-pyrimethamine, sulphamethoxy-diazine-pyrimethamine, trimethoprim-sulphamethoxazole or spiramycin subcutaneously. All untreated controls and all mice of the trimethoprim-sulphamethoxazole and spiramycin-treated groups died during the acute stage (except two mice in the latter group on the 15th day). The mean survival times were 6.5, 7.5 and 7.6 days, respectively. The best results were obtained in the sulphamethazine-pyrimethamine-treated mice; 18 out of 27 survived the 30-day observation period (5 cured), in contrast to only 9 out of 40 sulphamethoxydiazine-pyrimethamine-treated mice. Considering the high pathogenicity of the RH-strain, the differences in immunological defence mechanisms in mice (absence of antibody-activating "accessory factor") and the late commencement of treatment of the infected mice, one can state that the combination of sulphamethoxydiazine-pyrimethamine should also be capable of overcoming acute human toxoplasmosis in pregnancy. Spiramycin, by contrast, should be given only in cases where sulphonamide intolerance exists and must then be given in high doses until delivery. The combination of sulphamethoxazole-trimethoprim cannot be recommended.

[A new strategy of fight against meningococcal meningitis epidemics in Sahelian Africa]

An acquired sulfamido-resistance to menigococcus having appeared, the authors propose a single injection of a cheap and efficient antibiotic, chloram-phenicol, suspended in oil for cerebrospinal meningitis treatment. This treatment has been successfully applied at the Bobo-Dioulasso hospital (recovery in 82.5% of the cases). Two controlled experiments on the field of the group A polysaccharidic antimeningococcic vaccine in the Koudougou (Haute-Volta) and Koutiala (Mali) areas confirmed its efficiency and innocuity, the conferred immunity persisting two years at least. The appearance of serogroup C meningococcus at the origin of the epidemic attacks in Nigeria 1975 has been confirmed at Niamey (Niger). In consequence of this new experience of the logistic and economic conditions in the countries of the "meningitic belt" the following strategy for meningococcus epidemic control may be proposed:--a strict epidemiologic supervision by nurses in rural dispensaries;--as soon as a few cases are reported in a medical sector, application of the "minute treatment" with chloramphenicol to all meningitic patients, which permits the "lethality prophylaxis"; the national authorities shall be then warned; they will make the diagnostic of the causal serogroup (A or C) thanks to the electroimmunodiffusion technique;--as soon as the serogroup is demonstrated, a specific "circonstance vaccination" campaign for the whole population of the sector shall be carried out, in order to stop the development of the disease.

The effect of chemo-immunotherapy with SDDS, pyrimethamine and anti-toxoplasma serum on toxoplasma gondii cysts in latent infected NMRI mice

A substantial reduction of brain cyst numbers could be obtained through a six week therapy with SDDS-pyrimethamine combination or a high titer anti-Toxoplasma serum. NMRI mice experimentally infected three months earlier with cyst-forming Toxoplasma strains Witting, Alt or Gail were used. The effectiveness of the treatments could be increased considerably by simultaneous administration of anti-Toxoplasma serum and SDDS-pyrimethamine. A highly significant reduction of brain cyst numbers, upto 65%, could be obtained by using this mode of chemoimmunotherapy. The effectiveness of the treatments used varied amongst the three Toxoplasma strains.

Sulphonamides in the treatment of acute Escherichia coli infection of the urinary tract in women. Clinical and ecological effects of sulphasomidine and sulphalene

28 non-pregnant women were treated with conventional doses of sulphasomidine or sulphalene for acute urinary tract infections caused by Escherichia coli. Both preparations were found to be effective in simple cystitis infection with sulphonamide-sensitive organisms. Also, both were found to exert a selective pressure favouring sulphonamide-resistant E. coli in the faecal flora.

[Pharmacokinetics of sulfaclomide in man under therapeutically relevant conditions]

Pharmacokinetic parameters of the long-term sulfanilamide Sulfaclomid (4-[4-aminobenzensulphonamido]2,6-dimethyl-5-chlorpyrimidine) were determined in 25 female subjects. Both the elimination half-life of Sulfaclomid in the serum and the maximum acetylation rate in the urine are genetically determined. They show a polymodal behavior. The half-life is unrelated to the protein binding, which shows considerable individual differences in the therapeutic relevant range of about 200 microgram/ml serum. This confirms the human pharmacological postulate according to pharmacokinetical dosage schedules including genetic factors. An individual therapy service is necessary in certain drugs and in highly endangered groups of patients.

Sequential treatment with quinine and mefloquine or quinine and pyrimethamine-sulfadoxine for falciparum malaria

Patients with falciparum malaria were studied in Thailand, an area of known chloroquine resistance. The patients were unselected and some had severe malaria, and they were randomly assigned to one of two sequential regimes. A short course of quinine (average 4 doses, equivalent to 2 g base) followed by a single dose of pyrimethamine-sulfadoxine (Fansidar) cured 92% of patients (36 out of 39), while a short course of quinine followed by a single 1-5-dose of mefloquine cured all of the 35 patients who could be followed up. Gastrointestinal side effects were minimal if at least 12 hours elapsed between the last dose of quinine and the mefloquine. Sequential quinine and mefloquine is the most effective treatment for patients with chloroquine-resistant falciparum malaria, including those with severe or complicated disease. Mefloquine, however, is not commercially available, and the similar regimen using Fansidar is almost as effective.

Bullous pemphigoid responding to sulfapyridine and the sulfones

Since 1968, a total of 84 patients with bullous pemphigoid have been seen at the Mayo Clinic. Of these, 41 were given a trial of sulfapyridine or dapsone, and six showed a significant response. In five patients, the condition was controlled completely. All responsive patients showed indirect and direct immunofluorescent tests indistinguishable from typical bullous pemphigoid. The patients, however, were somewhat younger (mean 54 years) than others having pemphigoid; and in two patients, biopsy specimens showed a reversal of the usual eosinophilic predominance over neutrophils. Three of the six patients were also diabetic.

[Microcirculation and blood coagulation in patients with diabetes mellitus undergoing antidiabetic therapy of different types]

A comparative study of the peculiarities of the course of diabetes and metabolic disturbances, and also of the indices of capillary permeability, biomicroscopy of the conjunctival vessels, platelet aggregation, coagulorgam and blood clot retraction was carried out in the group of patients treated with insulin and sacharreducing sulfanilamides. Marked derangements in the microcirculatory system concerning both the vascular wall proper and of the rheological properties of the blood were revealed. These derangements were more distinct in the patients over 45 years of age with prolonged affection and the presence of vascular complications but proved to be independent of the therapy carried out.