Audit of the Physico-Chemical Quality of Amoxicillin Based Drugs Marketed in Senegal

Non-compliant antibiotics pose problems of therapeutic efficacy at the level of the individual, but also a serious public health problem. The objective of our study was to evaluate the quality of generic amoxicillin (42 samples) by analytical methods in Dakar/Senegal. At 100% visual inspection of compliance;100% compliance uniformity test;at the dissolution test all > 80% (86.8% to 108.8%). The presence of amoxicillin with the following contents: Tablets (95.2% to 104.1%);Capsules (91.5% to 113.9%) and Suspensions drinkable (96.9% - 118.7%). All the samples in our study are 100% compliant according to the European and American pharmacopoeias (90% - 120%). Other studies should therefore be oriented in the direction of stability as well as the dosage of degradation products.

Clinical Effect of Omeprazole Combined with Amoxicillin in the Treatment of Gastric Ulcer

Objective:To investigate the therapeutic effect of omeprazole+amoxicillin in patients with gastric ulcers.Methods:62 cases of patients with gastric ulcers who were treated from January 2022 to December 2022 were recruited and randomly divided into groups.Omeprazole+amoxicillin treatment was included in the study group,and amoxicillin treatment was included in the control group.The score of gastric ulcer symptoms,time of symptom resolution,gastrointestinal hormone index,and adverse reactions were compared.Results:The gastric ulcer symptom scores in the study group were lower than those in the control group(P<0.05);the gastric ulcer symptoms and Helicobacter pylori-negative time in the study group were shorter than those in the control group(P<0.05);the gastrointestinal hormone indexes in the study group were better than those in the control group(P<0.05);the adverse reaction rate of gastric ulcer in the study group was lower than that in the control group(P<0.05).Conclusion:Omeprazole+amoxicillin in the treatment of gastric ulcers can regulate gastrointestinal hormones,relieve gastric ulcer symptoms,and shorten the duration of ulcers,which is highly effective and feasible.

Meta-analysis:Is combination of tetracycline and amoxicillin suitable for Helicobacter pylori infection?

AIM:To access the efficacy of combination with amoxicillin and tetracycline for eradication of Helicobacter pylori(H.pylori),thus providing clinical practice guidelines.METHODS:Pub Med,EMBASE,Cochrane Central Register of Controlled Trials,Science Citation Index,China National Knowledge Infrastructure,Wanfang,and Chinese Biomedical Literature databases and abstract books of major European,American,and Asian gastroenterological meetings were searched.All clinical trials that examined the efficacy of H.pylori eradication therapies and included both tetracycline and amoxicillin in one study arm were selected for this systematic review and meta-analysis.Statistical analysis was performed with Comprehensive Meta-Analysis Software(Version 2).Subgroup,meta-regression,and sensitivity analyses were also carried out.RESULTS:Thirty-three studies met the inclusion criteria.The pooled odds ratio(OR)was 0.90(95%CI:0.42-1.78)for quadruple therapy with amoxicillin and tetracycline vs other quadruple regimens,and total eradication rates were 78.1%by intention-to-treat(ITT)and 84.5%by per-protocol(PP)analyses in the experimental groups.The pooled eradication rates of 14-d quadruple regimens with a combination of amoxicillin and tetracycline were 82.3%by ITT and89.0%by PP,and those of 10-d regimens were 84.6%by ITT and 93.7%by PP.The OR by ITT were 1.21(95%CI:0.64-2.28)for triple regimens with amoxicillin and tetracycline vs other regimens and 1.81(95%CI:1.37-2.41)for sequential treatment with amoxicillin and tetracycline vs other regimens,respectively.CONCLUSION:The effectiveness of regimens employing amoxicillin and tetracycline for H.pylori eradication may be not inferior to other regimens,but further study should be necessary.

Synergistic anti - Staphylococcus aureus activity of amoxicillin in combination with Emblica officinalis and Nymphae odorata extracts

Objective:To evaluate the antibacterial activity of Emblica officinalis Gaertn(E.officinalis: Family:Euphorbiaceae) seed and Nymphae odorala Aiton(N.odorala:Family:Nymphaeaceae) stamen extracts,alone and in combination,and in combination with amoxicillin(Ax) against Staphylococcus aureus(S.aureus).Methods:Antibacterial activity of ethanolic extracts of amla,E.officinalis,seed(AMS:500μg) and sapla,N.odorala,stamen(SAP:500 p g) for 12 methicillin-resistant S.aureus(MRSA) isolates was determined following agar diffusion:in order to assess the combined antibacterial activity,AMS(250μg) plus SAP(250μg) were considered.The Ax(10μg) activity alone and in combination with AMS(250μg),and SAP(250μg) was determined by disk diffusion.The zone diameters of inhibition(ZDIs) for the agents were recorded,and growth inhibitory indices(GIIs) were calculated.Results:The MRSA isolates (n=12) had AMS(500μg) and SAP(500μg) ZDIs of 12-19 mm and 21-24 mm,respectively.The ZDIs(range 24-27 mm) increased by 3-4 mm due to combined action of AMS(250μg) and SAP(250μg) indicating synergy between extracts for MRSA(GII 0.634-0.742).The MRSA isolates were resistant to Ax(ZDI:8-11 mm),which in combination with AMS and SAP had synergistic effect,both due to increased ZDI[mean±SD=(3.5±0.577) mm]and GII(0.631-0.894).Conclusions:The data suggest that the plants,E.officinalis and N.odorala alone or in combination,are promising in the development of phytomedicines,which may be used,alone or in combination with the antibiotic. Ax,against MRSA infection.

Acute cholestatic hepatitis caused by amoxicillin/ clavulanate

Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used,especially for the treatment of respiratory and cutaneous infections.In general,it is a well-tolerated oral antibiotic.However,amoxicillin/clavulanate can cause adverse effects,mainly cutaneous,gastrointestinal,hepatic and hematologic,in some cases.Presented here is a case report of a 63-yearold male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate.After 6 wk of prolonged use of the drug,he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia(total bilirubin>300 mg/L).Diagnostic investigation was conducted by ultrasonography of the upper abdomen,serum tests for infection history,laboratory screening of autoimmune diseases,nuclear magnetic resonance(NMR)of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound.The duration of disease was approximately 4 mo,with complete resolution of symptoms and laboratory changes at the end of that time period.Specific treatment was not instituted,only a combination of anti-emetic(metoclopramide)and cholestyramine for pruritus.

Development and Validation of Stability Indicating HPLC Method for Simultaneous Estimation of Amoxicillin and Clavulanic Acid in Injection

A simple, fast, precise, accurate and rugged stability indicating high performance liquid chromatography (HPLC) method has been developed for simultaneous estimation of Amoxicillin and Clavulanic acid from injectable dosage form. The stability indicating capability of the method was proven by subjecting the drugs to stress conditions as per ICH recommended test conditions such as alkaline and acid hydrolysis, oxidation, photolysis, thermal degradation and resolution of the degradation products formed therein. The separation was obtained using a mobile phase composition at a ratio of 95:5 (v/v) of pH 5.0 buffer and methanol on Inertsil C18 column (250 × 4.0 mm, 4 μm) with UV detection at 220 nm at a flow rate of 1 ml/minute. The photodiode array detector was used for stress studies. The order of elution of peaks was Clavulanic acid followed by Amoxicillin. The linear calibration range was found to be 79.51 to 315.32 μg/ml for Amoxicillin and 17.82 to 67.90 μg/ml for Clavulanic acid. The Amoxicillin and Clavulanic acid were found to be stable in solution up to 24 hours. The method validation data showed excellent results for precision, linearity, specificity, limit of detection, limit of quantification and robustness. The present method can be successfully used for routine quality control and stability studies.

Kinetic degradation of amoxicillin by using the electro-Fenton process in the presence of a graphite rods from used batteries

This study reports the removal of amoxicillin(AMX)in aqueous media using the electroFenton process in the presence of a graphite cathode recovered from used batteries.The impact of the relevant parameters on the electroFenton process,namely the applied current intensity,the temperature,the initial concentration of AMX and the initial concentration of ferrous ions were investigated.The results showed that the optimal values were:I=600 mA,T=25℃,[AMX]_(0)=0.082 mmol·L^( 1) and[Fe^(2+)]=1 mmol·L^(1),leading to 95%degradation and 74%mineralization.The model parameters of AMX mineralization were determined using nonlinear methods,showing that it follows a pseudosecondorder kinetic.The Energy consumption(EC)calculated under the optimal values was found to be 0.79 kWhg 1,which was of the same order of magnitude of those reported in other findings;while it is noteworthy that the electrodes used in our study are of a lower cost.

Investigation of the Quality of Antibiotics-Based Amoxicillin for Monitoring of Some Different Medicine Markets of Democratic Republic of Congo

In order to combat the counterfeiting of drugs, adapted HPLC analytical USP methods were applied to evaluate the quality of the amoxicillin (with or without potassium clavulanate) powder for suspension sold in some Congolese markets. The adaptation has been done by modifying the column dimensions and adjusting the flow rate. According to the intended deployment of these methods in Democratic Republic of Congo (DRC), 3 factors (analyst, day and equipment) were involved in the validation step while applying the classic total error measurement approach with an accuracy profile as decision tool. Since adequate results were obtained in terms of selectivity, precision, trueness and accuracy (tolerance limits of life expectancy: ?6.0% and 3.8%) for levels of interest concentration, the methods have been considered for routine use on several samples from different provenances and collected in 4 major DRC cities. Out of 278 samples collected, 200 were eligible for analysis from which 28% were found under standards with several figures: pH failure, out of specification for amoxicillin content, absence of potassium clavulanate, physical modifications of the powders. As evidenced by these findings, medicines of low-quality continue to be a major public health problem requiring appropriate action to effectively address this problem.

Amoxicillin–clavulanic acid induced sperm abnormalities and histopathological changes in mice

Objective: To explore the genotoxic potential and histopathological changes induced in liver, kidney, testis, brain and heart after using the antibiotic drug amoxicillin/clavulanic acid(4:1).Methods: The study included chromosomal aberration analysis in bone-marrow and mouse spermatocytes, induction of sperm morphological abnormalities and histopathological changes in different body organs. The drug was administrated orally at a dose of81 mg/kg body weight twice daily(Total = 162 mg/kg/day) for various periods of time equivalent to 625 mg/men(twice daily).Results: The results revealed non-significant chromosomal aberrations induced after treatment with amoxicillin/clavulanic acid(AC) in both bone marrow and mouse spermatocytes after 7 and 10 days treatment. On the other hand, statistically significant percentages of sperm morphological abnormalities were recorded. Such percentage reached 8.10 ± 0.55, 9.86 ± 0.63 and 12.12 ± 0.58 at the three time intervals tested(7, 14 and 35 days after the 1 st treatment respectively)(treatment performed for 5 successive days) compared with 2.78 ± 0.48 for the control. The results also revealed histopathological changes in different body organs after AC treatment which increased with the prolongation of the period of therapy. Congestion of central vain, liver hemorrhage and hydropic changes in hepatocytes were noticed in the liver. Degenerative changes were found in kidney glomerulus and tubules while testis showed atrophy of seminiferous tubules, and reduction of spermatogenesis. AC also induced neurotoxicity and altered brain neurotransmitter levels. Hemorrhage in the myocardium, disruption of cardiac muscle fibers and pyknotic nuclei in cardiomyocytes were recorded as side effects of AC in heart tissue.Conclusions: The results concluded that AC treatment induced sperm morphological abnormalities and histopathological changes in different body organs. Clinicians must be aware of such results while describing the drug.

Cefprozil versus Amoxicillin/Clavulanate for the Treatment of Acute Otitis Media in Children: Meta-Analysis of Efficacy and Safety

Introduction: The efficacy of amoxicillin combined with clavulanic acid in Acute Otitis Media (AOM) is not debatable, but studies report a high frequency of gastrointestinal adverse effects related to this intervention. In this scenario, several studies about the antibiotic cefprozil report that it has the same efficacy as amoxicillin/clavulanate for the treatment of AOM with significantly fewer side effects. The aim of our study was to compare the efficacy and safety of both treatments in AOM. Methodology: We searched for clinical trials and systematic reviews with or without meta-analyses in the Cochrane Group Register and the MEDLINE database up to November 2013, comparing the two interventions mentioned. Results were expressed as a rate of treatment failures or favorable response rates (clinical and microbiological in both cases), and as the rate of adverse events. The analysis was carried out considering the fixed and random effects models. The significance level used in the test for heterogeneity was 0.05. Funnel plot was used to search for publication bias. Results: 7 clinical trials were included in the analysis and no significant difference was found for both interventions regarding clinical and bacteriological response (RR = 1.02, 95% CI, 0.97-1.06, p = 0.780 and RR = 1.02, 95% CI, 0.99-1.07, p = 0.228, respectively). However, a significant difference was found in the comparison of adverse effects, showing that amoxicillin/clavulanate has a significantly higher risk of developing side effects than cefprozil (RR = 0.52, 95% CI, 0.45-0.59, p = 0.000). Conclusion: Both treatments demonstrated equal clinical and microbiological efficacy. However, the use of cefprozil is significantly associated with a lower risk of adverse effects.

Improvement of synergistic effect photocatalytic/peroxymonosulfate activation for degradation of amoxicillin using carbon dots anchored on rod-like CoFe_(2)O_(4)

β-lactam antibiotics in aquatic environment have severely damaged ecological stability and caused a series of environmental pollution problems to be solved urgently.Herein,a novel composite photocatalyst prepared by loading carbon dots(CDs)onto rod-like CoFe_(2)O_(4)(CFO),which can effectively degrade amoxicillin(AMX)by photocata lytic/peroxy mono sulfate(PMS)activation under visible light irradiation.The degradation results exhibits that the optimal degradation efficiency with 97.5%within 80 min is achievd by the CDs-CFO-5 composite.Such enhanced activity is ascribed to the introduction of CDs that effectively improves the separation efficiency of photogenerated electron pairs and creates new active sites as electron bridges that improve the photocata lytic performance.More importantly,a strong synergistic between CDs and photo-induced electrons generated from CFO can further activiate PMS to provide more SO4-·and·OH radicals for boosting the degradation ability towards AMX.The present study aims to elucidate positive role of CDs in photocata lytic/peroxy monosulfate activation during the degradation reaction.

Incompatibility of Paracetamol with Pediatric Suspensions Containing Amoxicillin, Azithromycin and Cefuroxime Axetil

The main objective of this work was to use the Differential Scanning Calorimetry (DSC) and FTIR spectroscopy to study the possible drug-drug or drug-excipient (s) interaction in case of concomitant oral administration of paracetamol with the most common used antibiotics for children. Amoxicillin, azithromycin, cefuroxime axetil and their commercially available suspensions, Amoxil?, Azithromax? and Zinnat? were used. DSC curves for paracetamol, pure antibiotics, commercially available antibiotics and all binary mixtures used in this study showed drug-drug or drug-excipient (s) physical interaction and indicated a possible chemical interaction. To confirm chemical drug-drug or drug-excipient (s) interaction additional ATR-IR spectra for all samples used in this study were obtained. Results obtained from ATR-IR spectra showed drug-excipient (s) interaction in Zinnat?, Azithromax? and binary mixture Azithromax?-paracetamol, while chemical drug-drug interaction was not observed. From this study it can be concluded that the concomitant oral administration of paracetamol with commercially available antibiotics used in this study is not recommended and duration of two hours between the oral administrations of these drugs is strongly recommended to avoid drug-drug or drug-excipient (s) interaction.

The Quality and <i>in Vitro</i>Efficacy of Amoxicillin/Clavulanic Acid Formulations in the Central Region of Ghana

Aim: To assess the quality and in vitro efficacy of five brands of amoxicillin/clavulanic acid tablet, suspension and injectable preparations selected from pharmacies in the Central Region of Ghana. Method: Using a Stratified Representation Sampling method, forty preparations (tablets, suspensions and injectable powders) containing amoxicillin and clavulanic acid were sampled from nine different locations within the Central Region of Ghana. To determine drug quality, several procedures, namely, content assay, disintegration and dissolution testing were employed. In vitro drug efficacy was determined by comparing the Minimum Inhibitory Concentrations (MIC’s) obtained with published values. Results: All tablets passed the disintegration test, with disintegration time ranging between six (6) and fifteen (15) minutes. Analyses of all the tablets for drug content showed 100% failure (14 out of 14) for amoxicillin and 14% failure (2 out of 14) for clavulanic acid. Injectable formulations showed similar results. All four (4) samples analyzed for content failed the amoxicillin content assay (0 out of 4) but all passed clavulanic acid assay (4 out of 4). For tablet dissolution tests, there was a 93% (13 out of 14) pass rate for both amoxicillin and clavulanic acid. Content analysis of all suspension formulations involved twenty-two (22) samples from five (5) brands. Only 41% (9 out of 22) passed for both amoxicillin and clavulanic acid. All the other samples failed for either amoxicillin, clavulanic acid or both. Results obtained from drug quality tests were confirmed by in vitro efficacy tests against selected microorganisms. Conclusion: The samples were therefore not of good quality, since content assay is the most crucial test. It is hypothesized that this is due to poor storage conditions, and recommendations, such as air conditioning and more structured procedures along the supply chain, are put forward to counteract this.

TNF-α、IL-6、IL-1β Effect of omeprazole combined with amoxicillin on cytokines in gingival crevicular fluid of patients with periodontal disease

Objective:To investigate the TNF-α、IL-6、IL-1βeffect of omeprazole combined with amoxicillin on cytokines in gingival crevicular fluid of patients with periodontal disease.Methods:102 patients with periodontal disease who were treated in our hospital from June 2016 to March 2018 were selected.Randomly divided into two groups,the control group was treated with omeprazole alone,and the research group was treated with omeprazole combined with amoxicillin.The levels of inflammatory cytokines(TNF-α、IL-6、IL-1β),therapeutic effects and adverse reactions to drugs were compared between the two groups.Results:the levels of inflammatory factors(TNF-α、IL-6、IL-1β)in the study group were lower than those in the control group(P<0.05).The therapeutic effect(82.4%)of the control group was lower than that of the study group(96.1%)(P<0.05).The incidence of adverse reactions to drugs in the study group(3.8%)was lower than that in the control group(21.5%)(P<0.05).Conclusion:joint take omeprazole amoxicillin treatment of periodontal disease patients achieved ideal therapeutic efficacy.

Efficacy and Safety of Omeprazole and Amoxicillin in the Treatment of Gastric Ulcer

Objective:To study the effect of omeprazole and amoxicillin in the treatment of patients with gastric ulcer.Methods:88 patients with gastric ulcer in our hospital from March 2018 to March 2020 were selected as research subjects and divided into experimental group(44 cases were treated with omeprazole+amoxicillin)and control group(44 cases were treated with omeprazole).The therapeutic effect,13C positive rate of breath test before and after treatment,recurrence rate within half a year and adverse reactions were compared between the two groups.Results:The total effective rate of the experimental group(97.73%,43/44)was higher than that of the control group(84.09%,37/44),P<0.05;After treatment,the 13C positive rate of breath test in the experimental group(22.73%,10/44)was lower than that in the control group(47.73%,21/44),P<0.05;The recurrence rate in the experimental group was 4.55%(2/44),which was significantly higher than that in the control group(20.45%,9/44),P<0.05;The incidence of adverse reactions in the experimental group(9.09%,4/44)was significantly lower than that in the control group(15.91%,7/44),P<0.05.Conclusion:In the process of clinical treatment of gastric ulcer,omeprazole combined with amoxicillin has significant effect,not only the recurrence rate is low,but also the incidence of adverse events should be less,and the treatment is safer.

He/icobacter py/ori infection in hemodialysis patients: Susceptibility to amoxicillin and clarithromycin

AIM: To evaluate susceptibility of Helicobacter pylori to amoxicillin and clarithromycin in end-stage renal disease (ESRD) patients and non-uremic controls.METHODS: The subjects with dyspeptic complaints were 33 ESRD patients and 46 age- and sex-matched nonuremic controls who exhibited H pylori on antral biopsy specimens. The two groups were age and sex matched.The H pylori strains' pattern of susceptibility to amoxicillin and clarithromycin was investigated with the agar dilution technique.RESULTS: None of the H pylori strains from either group showed resistance to amoxicillin with the agar dilution method. Twelve (36.4%) of the ESRD group strains and 7 (15.2%) of the control group strains showed resistance to clarithromycin, and this difference was statistically significant (P＜0.05).CONCLUSION: Resistance to amoxicillin does not appear to be an important problem in H pylori-infected ESRD and non-uremic patients in our region. In contrast, the rates of resistance to clarithromycin are high, particularly in the ESRD population.

Efficacy of omeprazole and amoxicillin with either clarithromycin or metronidazole on eradication of Helicobacter pylori in Chinese peptic ulcer patients

AIM: One-week triple therapy with proton pump inhibitors, clarithromycin and amoxicillin has recently been proposed as the first-line treatment for Helicobacter pylori(H pylori) infection; however, data regarding the effects of this regimen in China are scarce. The aim of this prospective and randomized study was to compare the efficacy of clarithromycin and metronidazole when they were combined with omeprazole and amoxicillin on eradication of H pylori and ulcer healing in Chinese peptic ulcer patients.METHODS: A total of 103 subjects with H pylori-positive peptic ulcer were randomly divided into two groups, and accepted triple therapy with omeprazole 20 mg, amoxicillin 1 000 mg and either clarithromycin 500 mg (OAC group,n = 58) or metronidazole 400 mg (OAM group, n = 45).All drugs were given twice daily for 7 d. Patients with active peptic ulcer were treated with omeprazole 20 mg daily for 2-4 wk after anti-H pylori therapy. Six to eight weeks after omeprazole therapy, all patients underwent endoscopies and four biopsies (two from the antrum and two others from the corpus of stomach) were taken for rapid urease test and histological analysis (with modified Giemsa staining) to examine H pylori. Successful eradication was defined as negative results from both examination methods.RESULTS: One hundred patients completed the entire course of therapy and returned for follow-up. The eradication rate of H pylori for the per-protocol analysis was 89.3% (50/56) in OAC group and 84.1% (37/44) in OAM group. Based on the intention-to-treat analysis, the eradication rate of H pylori was 86.2% (50/58) in OAC group and 82.2% (37/45) in OAM group. There were no significant differences in eradication rates between the two groups on either analysis. The active ulcer-healing rate was 96.7% (29/30) in OAC group and 100% (21/21)in OAM group (per-protocol analysis, P＞0.05). Six patients in OAC group (10.3%) and five in OAM group (11.1%)reported adverse events (P＞0.05).CONCLUSION: One-week triple therapy with omeprazole and amoxicillin in combination with either clarithromycin or metronidazole is effective for the eradication of H pylori. The therapeutic regimen comprising metronidazole with low cost, good compliance and mild adverse events may offer a good choice for the treatment of peptic ulcers associated with H pylori infection in China.

Rabeprazole, clarithromycin, and amoxicillin Helicobacter pylori eradication therapy: Report of an efficacy study

AIM:To investigate the efficacy of a standard triple therapy(comprising rabeprazole,clarithromycin,and amoxicillin)for Helicobacter pylori(H.pylori)eradication,noting factors that influence the outcome and documenting any adverse events.METHODS:Following institutional ethical approval,fifty consecutive and consenting symptomatic patients with evidence of H.pylori infection by either a positive urea breath test(UBT)and/or a campylobacter-like organism test who presented to the Gastroenterology clinic of Lagos State University Teaching Hospital between 2012 and 2013 were recruited into the study.Patients were openly randomized to either a 7-d or a 10-d regimen of amoxicillin 1 g,clarithromycin 500mg and rabeprazole 20 mg twice daily.The extent of symptom resolution was noted following the treatment,and at the end of one month after the completion oftreatment,a repeat UBT was performed in each patient to document the eradication of the infection.All data(demographics,symptoms,and eradication rates)were collated and analyzed with SPSS version 18.RESULTS:Forty-seven patients completed the study(three were excluded from the analysis for breaching the study protocol).The patients included 18 males and 29 females within the age range of 13-80 years(mean 43.7,SD 16.8).The clinical features of the study subjects were dyspepsia,reflux symptoms and features of gastrointestinal bleeding.The average eradication rate was 87.2%.Eighteen subjects were enrolled in the 7-d arm,while 29 were in the 10-d arm.There was no statistically significant difference in the age or sex distributions of the two arms.There was no significant advantage of the 10-d treatment duration over the 7-d duration(P=0.78),and the eradication outcomes were not influenced by the gender or age of the subjects.No adverse effects were reported in either arm.CONCLUSION:The triple therapy regime,employing a combination of amoxicillin,clarithromycin and rabeprazole,showed great efficacy and safety in the eradication of H.pylori,and this outcome was not influenced by gender or age.No difference was observed between the 7-d and 10-d regimens.

Omeprazole-based triple therapy with low-versus high-dose of clarithromycin plus amoxicillin for H pylori eradication in Iranian population

AIM: To investigate the efficacy and tolerability of H pylori eradication in an omeprazole-based triple therapy with high-and low-dose of clarithromycin and amoxicillin. METHODS: One hundred and sixty H pylori positive patients were randomly assigned to two groups based on the following 2 wk investigation; (1) group A or low-dose regimen received omeprazole 20 mg b.i.d, clarithromycin 250 mg b.i.d and amoxicillin 500 mg b.i.d; and (2) group B or high-dose regimen received omeprazole 20 mg b.i.d, clarithromycin 500 mg b.i.d and amoxicillin 1000 mg b.i.d. During the study H pylori status was assessed by histology and rapid urease test prior and by 13C-urea breath test 6 wk after the therapy. Standard questionnaires were administered to determine the compliance to treatment and possible adverse events of therapy. Data were subject to χ2 to compare the eradication rates in the two groups. The significant level of 95% (P ≤ 0.05) was considered statistically different. RESULTS: We found that the per-protocol eradication rate was 88% (68/77) in group A, and 89% (67/75) in group B. The intension-to-treat eradication rate was 85% (68/80) in group A and 83.75% (67/80) in group B. Overall adverse events were 26% in group A and 31% in group B. The adverse events were generally mild in nature and tolerated well in both groups with a compliance of 98% in group A vs 96% in group B. CONCLUSION: The omeprazole-based low dose regimen of clarithromycin and amoxicillin for two weeks in H pylori eradication is as effective as high dose regimen in Iranian population.

β-Cyclodextrin Enhanced Fluorimetric Method for Determination of Amoxicillin in Dosage

A simple sensitive spectrofluorimetric method was developed for the determination of amoxicillin. Amoxicillin in the presence of formaldehyde produces a fluorescent pyrazine derivative, whose fluorescence intensity can be enhanced by forming an inclusion complex with β-cyclodextrin. Optimum conditions for the determination of amoxicillin were also investigated. Fluorimetric detection was carried out at λex=365 nm and λem=445 nm. The linear range of this method for the determination of amoxicillin is 0.1―10 mg/L and the limit of detection is 0.03 mg/L (IF=102.16ρ-9.6, r=0.9994). The developed method is practical and can be successfully applied to determine the content of amoxicillin in capsules and tablets with satisfactory results.