[Activity of vancomycin and teicoplanin against clinical isolates of Staphylococcus aureus in the period 1994-1999]

Since the emergence of the methicillin-resistant S. aureus (MRSA) in the 1960's, glycopeptides (Vancomycin and Teicoplanin) has been the drugs of choice and commonly the sole antimicrobial agents available for the treatment of serious MRSA and other Gram-positive infections. The emergence of S. aureus with intermediate vancomycin-resistance after 1997 threatens to return us to the era before the development of the antibiotics. Prevention of the further spread of S. aureus strains with intermediate and eventually with full glycopeptide resistance requires enhanced laboratory methods to detect resistance. A total of 361 S. aureus clinical isolates (177 MRSA and 184 MSSA) obtained from 1994 to 1999 in eleven Bulgarian hospitals located in geographically distinct areas of the country were enrolled in the study. Minimal inhibitory concentrations of Vancomycin and Teicoplanin were determined by agar-dilution method according to NCCLS recommendations. MIC50 and MIC90 for Vancomycin were 0.7 and 1 mg/ml, and for Teicoplanin--0.5 and 0.9 microgram/ml. All staphylococcal isolates showed sensitivity to Vancomycin and Teicoplanin. MICs of both glicopeptides against MRSA and MSSA did not differ significantly.

[Intravenous treatment with quamatel in reflux-esophagus and erosive gastritis]

Organism's good tolerance toward Ranitidin and Famotidin makes possible an application of doses higher than the ones put into everyday practice. This is a very favorable circumstance considering the fact that according to some authors the decreasing of acidity in oesophagus apparently depends on the applied dose of the medicine. Thus the treatment with famotidin 2 x 40 mg allows an additional decreasing of acidity in lower oesophagus. We investigate the effect of intravenous application of famotidin (quamatel) in dose 2 x 20 mg and 2 x 40 mg as monotherapy in cases of reflux-oesophagitis and erosive gastritis as well as organism's tolerance toward it. There are 23 patients studied--17 men and 6 women, between 18 and 70 years old. The diagnoses are: reflux-oesophagitis--23, chronic erosive gastritis and reflux-oesophagitis--8. The patients are selected according to clinical criteria--scalding and/or pain in the oesophagus accompanied with acidity in the mouth cavity. The diagnoses are put gastoscopically. The results of the intravenous applying of quamatel are accounted in reference to the clinical complaints (scalding and/or pain in the oesophagus, acidity in mouth cavity) as well as to the endoscopic and histologic changes in the oesophagus and stomach mucosa. In patients with chronic erosive oesophagitis the efficiency of treatment was confirmed with complete epithelization of the erosions in 22 of 23. The short-period use of large doses 2 x 40 mg quickly improves the clinic symptoms and decreases the period of epithelization twice. The clinic experience shows that the intravenous form of quamatel remains the most effective in cases of short-term and intensive therapy of erosive gastritis with accomplicated hard and emergency clinical cases when the aim is to be avoided the peroral application of anti-ulcer means. An important advantage of the intravenous treatment with quamatel is its low price.