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Information on level of drugs into breastmilk
Published in Wendy Jones, Breastfeeding and Medication, 2018
Cefaclor is well absorbed from the gastrointestinal tract, although the presence of food may delay absorption. Takase et al. (1979) studied two breastfeeding mothers given a single dose of 250 mg cefaclor – in one mother the level was undetectable; in the other the maximum achieved was 0.19 mg per litre. He also studied five mothers who took single doses of 500 mg cefaclor and determined an average peak level of 0.21 mg per litre. Relative infant dose is quoted as 0.4–0.8% (Hale 2017 online access).
Answers
Published in John D Firth, Professor Ian Gilmore, MRCP Part 2 Self-Assessment, 2018
John D Firth, Professor Ian Gilmore
Ciprofloxacin has been associated with arthropathy and cartilage erosions in young animals. Gentamicin needs to be given parenterally and is not suitable for outpatient use, and there is also a risk of fetal nephrotoxicity and ototoxicity. Trimethoprim is a folate antagonist and can increase the risk of neural tube defects. Co-amoxiclav is a combination of amoxycillin and clavulanic acid, and although there is no definite risk of teratogenicity it should not be used unless absolutely necessary. Furthermore, this patient has previously had a rash with penicillin. Although there is a small risk of cross-allergy (10%) with cephalosporins, cefaclor would be the best choice given that the penicillin allergy was relatively mild and not a full-blown anaphylactic reaction.
Cefaclor, Cefprozil, and Loracarbef
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Cefaclor is commonly used for the treatment of mild cases of pharyngitis, tonsillitis, and bacterial bronchitis. Cefaclor has been curative for children and adults with acute streptococcal pharyngitis (Stillerman, 1986; Peter, 1992), otitis media, and maxillary sinusitis. In children with acute streptococcal pharyngitis, 5 days of cefaclor is as efficacious as 10 days of amoxicillin (Esposito et al., 2002). In children with acute otitis media, it is about as effective as amoxicillin (Giebink et al., 1984; Mandel et al., 1993). It is effective in otitis media and sinusitis caused by beta-lactamase-producing strains of H. influenzae and M. catarrhalis (Bluestone et al., 1979; McLinn, 1980; Ekedahl, 1983; Wald et al., 1984; Bluestone, 1992). Cefaclor is ineffective for eradicating H. influenzae from pharyngeal carriers (Horner et al., 1980). It is about equally as effective as amoxicillin for the treatment of infective exacerbations of chronic bronchitis (Mattson et al., 1979; Law et al., 1983). In a small group of patients, Maeson et al. (1990) found low-dosage cefaclor unsatisfactory for chronic bronchitis. Oberlin and Hyslop (1990) analyzed data from 18 clinical studies and concluded that cefaclor had been successful as treatment of upper and lower respiratory tract infections caused by M. catarrhalis.
Skin cancer signal associated with phosphodiesterase inhibitors: gaining insight through the FDA pharmacovigilance database
Published in Expert Opinion on Drug Safety, 2023
Jun-Wei Chow, Ming-Ming Yan, Hui Zhao, Zi-Ran Li, Qian Zhang, Ming-Kang Zhong, Xiao-Yan Qiu
Preferred term (PT) from ‘Skin neoplasms, malignant and unspecified (SMQ)’ was the main adverse event (AEs) of interest, enrolled in the Standardized MedDRA Query (SMQ, version 23.0) terminology, which is a rich and highly specific standardized medical terminology database developed by the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) [20]. The case/non-case method was used to evaluate the casual relations between sildenafil, tadalafil, and vardenafil, and cancers. This method was first introduced in a study investigating the serum sickness-like reaction of cefaclor [21]. According to this method, cases are reports of the reaction of interest (i.e. malignancies), non-cases are all reports of reactions other than that being studied.
Could Penile Mondor’s Disease Worsen Symptoms in Patients with Erectile Dysfunction?
Published in Journal of Investigative Surgery, 2022
PMD is clinically divided into the acute, subacute–chronic, and recanalization stages. Conservative treatment is usually sufficient for PMD [12]. Surgical methods, such as thrombectomy and superficial penile vein resection, are applied to patients who are resistant to medical treatment [13]. In most cases, improvement was observed at 2–6 weeks. It has been reported that recanalization takes an average of nine weeks [14]. All patients were treated with 1000 mg of cefaclor twice a day, 300 mg of acetylsalicylic acid once a day, and topical mucopolysaccharide polysulfate gel twice a day for one week. They were also advised to avoid sexual intercourse for three weeks. In the evaluation made after the third month of treatment, all patients had a full recovery. None of our patients developed any complications.
Confidence intervals for assessing equivalence of two treatments with combined unilateral and bilateral data
Published in Journal of Applied Statistics, 2022
For this study, it is important to test whether the cure rates are identical between the Cefaclor and Amoxicillin groups. Under the equal correlation coefficient model, Pei et al.[17] considered the equivalence testing of two successful cure rates and developed several asymptotic test procedures under the independent and the dependent models, respectively. However, CI estimators for comparative studies with combined unilateral and bilateral binary data have not been developed. In this article, we consider the CI construction for proportion difference in comparative medical studies with combined unilateral and bilateral binary outcomes under Rosner's correlated binary data model.