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Biomedical subjects

M W Garrison

Publications and source records attributed to M W Garrison.

22 records · Page 2Linked to original sources

Protease inhibitors: a therapeutic breakthrough for the treatment of patients with human immunodeficiency virus.

As one of the largest growing classes of antiretroviral drugs, protease inhibitors are promising agents for the management of patients infected with the human immunodeficiency virus (HIV). We reviewed the literature and compared efficacy, dosing, side effects, and drug-interaction profiles of the protease inhibitors saquinavir, ritonavir, indinavir, and nelfinavir. We addressed the use of these antiprotease agents as monotherapy versus use in combination therapy with other antiretroviral medications, and the potential for HIV to develop resistance to this drug class. We also discussed therapy with dual protease inhibitors and the use of protease inhibitors in pregnant or lactating women and in pediatric patients. Finally, we examined case reports of the addition of protease inhibitors to an antiretroviral regimen that ultimately decreases or reverses opportunistic infections.

AIDS-Related Opportunistic Infections↗

Levofloxacin: a therapeutic review.

This therapeutic review discusses the pharmacology, pharmacokinetics, in vitro activity, drug interactions, and adverse effects of levofloxacin, a fluoroquinolone antibiotic. Particular emphasis is placed on the clinical efficacy of levofloxacin and its place in therapy. Compared with ciprofloxacin and the earlier quinolone agents, levofloxacin has an improved pharmacokinetic profile that allows convenient once-daily dosing in either an oral or parenteral formulation. Levofloxacin has enhanced activity against gram-positive aerobic organisms, including penicillin-resistant pneumococci. In published comparative trials involving commonly used treatment regimens, levofloxacin had equivalent if not greater activity in the treatment of community-acquired pneumonia, acute bacterial exacerbations of chronic bronchitis, acute bacterial sinusitis, acute pyelonephritis, and complicated urinary tract infection. Levofloxacin is well tolerated and induces minimal adverse drug reactions. Based on the above attributes, it may be reasonable to include levofloxacin on the hospital formulary in place of older quinolones. More recently released quinolones such as trovafloxacin exhibit similar advantages; however, until direct comparative trials between levofloxacin and these newer agents are conducted, it is difficult to advocate one agent over another. Regardless of which quinolone is the primary agent on the formulary, it is imperative that this class of antimicrobial drugs be used with discretion to minimize the development of resistance.

Animals↗

Identifying and treating common and uncommon infections in the patient with diabetes.

Patients with diabetes represent a unique group of individuals who appear more prone than others to developing infections. Several mechanisms have been proposed to explain the association between diabetes and infections. However, few conclusive studies exist and considerable debate continues regarding evidence for this predisposition. Despite this lack of documented proof, many health care practitioners acknowledge that a number of infections are overrepresented in patients with diabetes. Some of these infections appear to occur exclusively in patients with diabetes, especially patients who are poorly controlled. The presenting clinical features, causative organisms, and preferred treatment approaches will be discussed in this article for a variety of common and uncommon infections observed in patients with diabetes. In addition, the proposed predisposing factors will be addressed briefly.

Cellulitis↗