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UTAH DOCTORS TRY NEW DRUG AGAINST HARD-TO-KILL GERMS

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Physicians have a new weapon to fight a number of bacteria that over the past 10 to 15 years have developed resistance to such common antibiotics as penicillin and Amoxicillin.

Ceftin (cefuroxime axetil), a new antibiotic researched by specialists at Primary Children's Medical Center, has been approved by the federal Food and Drug Administration.The new drug is manufactured by Glaxo Inc., in Research Triangle Park, N.C., and has proven effective in treating everything from persistent strep throats to recurrent ear infections among children.

Dr. W. Manford Gooch's involvement in the research that helped gain FDA approval for Ceftin began three years ago.

Gooch, head of the division of clinical pharmacology in the department of pediatrics at the University of Utah and director of clinical pharmacology at Primary Children's, and his colleagues investigated Ceftin in strep throat among 120 patients.

"Our interest in Ceftin in treating sore throats was the possibility of breaking the chain of patients who have persistent or recurrent strep throats," he said.

In the blind study, two-thirds of the patients were given Ceftin; one-third received penicillin.

"The result was that while both groups had equal clinical response (their fevers subsided and sore throats cleared), the frequency of bacteriological cure among the teenagers was much higher with the Ceftin than the penicillin," Gooch said.

This doesn't mean that the specialists are recommending Ceftin replace penicillin in the treatment of strep.

"Although we are very enthusiastic about Ceftin, we are not suggesting that physicians use it primarily to treat strep throat," Gooch said. "What we are concerned about are those instances in which people have reccurring strep throats.

"We wanted to find a drug that would completely eradicate the strep."

Ceftin appears to be that drug. "It is a big improvement over its forerunner and has several advantages," Gooch said.

"It is more predictably effective against bacteria that have learned in a sense to be resistant to the older drug," he explained.

Particularly advantageous for people who have to work or children who must attend school, the drug can be taken without scheduling around meals. "We commonly admonish patients to take their medicine either an hour before or two hours after their meal because the presence of food in the stomach often impairs the absorption of the antibiotic," Gooch said. "This antibiotic is fairly unique in that food not only doesn't interfere with it, but it enhances its absorption into the blood stream."

Patients, he said, are therefore more likely to remember doses and less likely to skip them due to the discomfort often experienced when antibiotics are taken on an empty stomach.

Gooch said Ceftin is successful in combating a variety of mild and moderate tissue and urinary tract infections, and such respiratory infections as tonsillitis, ear and sinus infections.

Another new drug, Augmentin, can also treat these problems, and Gooch said it can be difficult for physicians to decide which to prescribe.

He recommends that doctors choose between Augmentin and Ceftin based on cost, which varies from community to community, and on toxicity.

Gooch said that Augmentin has a disadvantage in that if a patient uses the dose the manufacturer recommends, he commonly develops diarrhea.

The adverse side effects of Ceftin are those common to the family of penicillin-like drugs.

"There is nothing peculiar about this drug that makes it particularly toxic," Gooch said. "The drug may cause mild diarrhea and some patients may be allergic to Ceftin, but it is remarkably free of toxic effects."

Gooch said Ceftin also enables hospitalized patients to continue antibiotic therapy at home, thereby shortening hospital stays and resulting in more cost-effective treatment.

"If a patient is receiving the drug by injection, then we don't have to administer another drug several times in order to achieve an adequate blood level," he said.