Khalvat A, Rostamian A, Najafizadeh S.r, Meisami A.p,
Volume 64, Issue 11 (10-2006)
Abstract
Background: Rheumatoid arthritis (RA) is a chronic inflammatory condition.
The condition can affected many tissues throught out the body, but the joints
are usually most severely affected. The high incidence of RA, the conventional
treatments and the experimental observation have shown by combination
therapy, the disease symptoms of the patients reduce. To compare the efficacy
and tolerability of single-agent Hydroxychloroquin (HCQ) with combination
therapies composed of (HCQ) and Methotrexate (MTX) and (HCQ), (MTX) and
Sulfasalazin (SSZ) in active rheumatoid arthritis patients with additive arthritis.
Methods: One hundred and twenty RA patients with active arthritis
(male/female: 30/90) who were treated in rheumatology clinic between 2003
and 2005 were enrolled in this trial. Patients treated with (HCQ) alone(200
mg/day)were include in group (I), patients treated with combination of (HCQ)
(200 mg/day)and (MTX) (7.5mg/week)in group (II),and patents treated with
combination of (HCQ) (200mg/day),(MTX) (7.5mg/week)and (SSZ)(1 gr/day)in
group (III), Forty patients (male/female:10/30) in group (I),(II) and (III)were
eligible for statistical analysis at the end of study. Changes in variable were
compared by the T-test.
Results: The combination of (MTX), (HCQ)and (SSZ) and the combination of
(MTX) and (HCQ) were more effective regarding the clinical and laboratory
parameters than (HCQ) alone (P<0.05). Moreover the combination of (MTX),
(HCQ) and (SSZ) was more effective than the combination of (MTX) and (HCQ)
(P<0.05). Combination therapies seem to be more effective and no more toxic
than monotherapy in RA patients with additive arthritis.
Conclusion: Combination therapy with methotrexate, hydroxychloroquin and
sulfasalazin is more effective than hydroxychloroquin alone or a combination
of methotrexate and hydroxychloroquin in RA. We suggest starting
combination therapy for the patients with early RA, when the diagnosis has
been established.
Masoomeh Sofian , Saeed Fooladvand , Farshideh Didgar , Alireza Japoni-Nejad , Alireza Amouzandeh-Nobaveh , Ehsanollah Ghaznavi-Rad ,
Volume 77, Issue 12 (3-2020)
Abstract
Background: It is difficult to treat infections caused by Acinetobacter baumannii due to multiple drug resistance. The aim of this study was to determine the efficacy of combination therapy with two broad-spectrum antibiotics colistin and rifampin on clinical and para clinical indexes of the patients with ventilator-dependent pneumonia due to imipenem-resistant to A. baumannii in intensive care units of a tertiary hospital.
Methods: In a descriptive cross-sectional study, fifty patients admitted to the intensive care units in Vali-Asr Hospital, Arak, Iran, from October 2014 to May 2015, with established ventilator-associated pneumonia were subjected to this study and were treated with standard dosage of colistin and rifampin daily. Once the minimum inhibitory concentration (MIC) of the A. baumannii isolates were susceptible to colistin (MIC˂2 µg/ml) and rifampin (MIC˂2 µg/ml) they were treated with three million international units of colistin in 100 ml of normal saline three times a day and 600 mg of rifampin daily. Side effects of combination therapy and variables of patients like fever, blood pressure, white blood cell count, differential count and, mortality were documented and statistically analyzed.
Results: 31(62%) patients were improved after combined treatment with colistin and rifampin, 4(8%) patients were died due to bloodstream infection with A. baumannii and 15(30%) passed away in effect of other reasons. The mean of BUN (P=0.07) and creatinine significantly increased (P=0.02). Clinical variables such as fever, white blood cell count, white blood cell percentage and red blood cell sedimentation rate significantly decreased (P≤0.05).
Conclusion: Colistin and rifampicin appear to be an effective and safe combination therapy for treatment of ventilator-dependent pneumonia due to imipenem-resistant to A. baumannii
