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MACGILLIVRAY, Ross T SITAR, Daniel S AARON, Shawn D ACOTT, Philip D ALFIERI, Caroline ARMSTRONG, Paul W BACHELARD, Hlne BEFUS, A. D BELCH, Andrew R BELL, David A BIRCH, Stephen BOUDREAU, Ghislain BRASH, John L CAMERON, Bill E CHAMBERS, Ann F CHAN, Kwan-Leung CHOW, Donna A FIELD, Christopher A FRASER, Paul E GEIGER, Jonathan D HANLEY, David A HEELEY, David HERZBERG, Gene R HOFFMAN, Paul S HOSKIN, David W HUMPHRIES, Richard K KARLIK, Stephen J LAMARRE, Daniel LAUTT, Wilfred W LOPASCHUK, Gary D University of British Columbia University of Manitoba Ottawa Health Research Institute Dalhousie University Hpital Sainte-Justine University of Alberta Universit Laval University of Alberta University of Alberta University of Western Ontario McMaster University Pfizer Canada Inc. McMaster University Ottawa Health Research Institute University of Western Ontario University of Ottawa Heart Institute University of Manitoba Dalhousie University University of Toronto St. Boniface Gen. Hospital Research Fdn. Inc. University of Calgary Memorial University of Newfoundland Memorial University of Newfoundland Dalhousie University Dalhousie University University of British Columbia University of Western Ontario Universit de Montral University of Manitoba University of Alberta MAN, Shu-Fan P MCKELVIE, Robert S MEDLEY, John B MOWAT, Michael R ORGAN, Michael G PARKINSON, Fiona E PETRELLA, Robert J PILARSKI, Linda M RADOMSKI, Marek W RADZIUK, Jerry M REMINGTON, Gary ROY, Sophie RUTKA, James T SASYNIUK, Betty I SCHRYVERS, Anthony B SELLERS, Edward M STEINHART, Allan H TEO, Koon K TIJSSEN, Peter VELDHUYZEN VAN ZANTEN, Sander J WARD, Brian J WEAVER, Donald F WEISS, Margaret D WU, Jiangping ZAKY, Safwat G ZOWALL, Hanna University of Alberta McMaster University University of Waterloo University of Manitoba York University University of Manitoba University of Western Ontario University of Alberta University of Texas Houston ; Ottawa Hospital-Civic Site University of Toronto Merck Frosst Canada Inc. Hospital for Sick Children McGill University University of Calgary University of Toronto Mount Sinai Hospital McMaster University INRS-Institut Armand-Frappier Dalhousie University The Res. Inst. of the McGill University Health Ctr Dalhousie University University of British Columbia Hpital Notre-Dame University of Toronto The Res. Inst. of the McGill University Health Ctr.
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The occurrence of resistant Gram negative E.coli, Pseudomonas spp ; from surveillance cultures and bacteremias has been reported. Kern 1994, Cometta 1994, Carratala 1995 ; E.coli and Pseudomonas quinolone resistant strains and crossresistant to other antibiotics cotrimoxazole, doxyciclin, CAF, betalactams ; have been reported. Sanders 1984, Piddock 1987, Lagakis 1989, Banerfeind 1994 ; Emergence of methicillin resistant staphylococci during prophylaxis with quinolones. Oppenheim 1989, Cometta 1994.
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149; approved expansion of the ama’ s private sector advocacy programs, including initiating litigation, stopping egregious health plan practices, and helping physicians level the playing field with payors and triphasil.
Linear interpolation between consecutive CD4 cell counts to estimate time spent in each CD4 stratum until occurrence of the opportunistic infection person-years of observation PY ; for each CD4 stratum ; Follow-up time was censored at the time of co-trimoxazole initiation for co-trimoxazole-preventable opportunistic infections. Poisson regression was used to examine whether OI incidence rates differed by CD4 stratum. Those excluded from the cohort were not significantly different from those included by age, sex, race, HIV risk factors, or WHO stage, although they had a significantly shorter mean follow-up time p 0.0001 ; . Incidence rates are shown graphically in Figure 1, and the number of cases and incidence rates with standard deviation ; for each opportunistic infection by CD4 cell count stratum are shown in Table 2. Rates of opportunistic infections increased in lower CD4 cell count strata.
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Invasive bacterial pathogens such as Campylobacter, Shigella and Salmonella species can cause severe and prolonged illness in PLHA. They are, however, not a frequent cause of chronic diarrhoea. Salmonellosis is much more frequent in PLHA and is a frequent cause of bacteraemia. The only symptoms may be fever and general malaise, sometimes without GI symptoms. Treatment consists of: cotrimoxazole 960 mg 2 x daily or chloramphenicol 250 mg 4 x daily for 3 weeks. In case of signs of sepsis, IV therapy is necessary. Shorter regimens or suitable alternatives in case of high resistance rates are: ciprofloxacin 500 mg 2 x daily or ofloxacin 400 mg 2 x daily or ceftriaxone 2 g IV for 7-10 days. However, a lot of patients relapse after treatment and chronic maintenance therapy cotrimoxazole 1DD daily ; is sometimes necessary. Shigella infection usually presents with high fever, abdominal pain and bloody diarrhoea. Treatment consists of cotrimoxazole 960 mg 2 x daily for 5 days or amoxycillin 500 mg 3 x daily for 5 days. In many developing countries, however, resistance of Shigella and Salmonella ; to cotrimoxazole and amoxycillin has increased. The antibiotic of choice has become ciprofloxacin 500 mg 2 x daily, ofloxacin 400 mg 2 x daily, norfloxacin 400 mg 2 x daily for 5 days, or nalidixic acid 1 g 4 daily for 10 days. Campylobacter enteritis is more frequent in PLHA and is characterised by fever, bloody diarrhoea, abdominal pain and weight loss. After the diagnosis has been confirmed by stool culture, erythromycin 500 mg 2 x daily for 5 days ; is the first choice treatment. Fluoroquinolones are also effective but resistance rates of 30%-50% have been reported in Spain, Greece and some developing countries. It is clinically impossible to distinguish the different agents without stool culture. Moreover, an organism may be found on microscopy or culture, but not be the cause of the diarrhoea. Cotrimoxazole is the recommended first line treatment in many guidelines but in countries with high resistance rates for Salmonella and Shigella, initial treatment with fluoroquinolones * should be considered. An adapted WHO guideline using norfloxacin and or metronidazole was shown to induce remission of chronic diarrhoea in 85% of patients in Kenya, but cure was less.
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The CLL4 study suggests that outcome for patients with 17p treated with fludarabine or FC is not optimal and, therefore, alternative treatments are required. Alemtuzumab may be a suitable treatment option for this subset of patients, as evidenced by results of the CLL2H study. Preliminary analysis of the first 50 patients revealed that alemtuzumab is effective regardless of 17p status. In summary there is preliminary evidence to suggest: The discordance of IgVH and ZAP70 expression in CLL may be due to the presence of other high-risk genetic factors such as 11q, 17p and VH3-21 usage and verapamil.
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Continue critical incident debriefing as necessary Evaluate impact of first wave and subsequent waves ; on Laboratory Services. Initiate recovery measures to demobilize the emergency response and resume full service delivery, as possible in the circumstance. Review and act on: Staffing requirements in preparation for possible subsequent wave s ; Lessons learned specific to Laboratory Services response during the current wave Contribute to emergency response debriefings internal and external to Northern Health for lessons learned: Recommending areas for improvement and related actions Submitting initial report and subsequent follow-up reports to HSDA Management Review and update Laboratory Services emergency response plans and resources and vicoprofen.
Son, W. J. van, Wit, F., Balen, O. L. van, Tegzess, A. M., Ploeg, R. J., Bakker, W. W. Decreased expression of glomerular ectoATPase in kidney grafts with delayed graft function. Transplantation Proceedings 29: 352-354, 1997. Son, W. J. van, Brijker, F., Elema, J. D., Tegzess, A. M., Meer, J. van der. Elevated factor VIII as a marker for vascular type of rejection after renal transplantation. Transplantation Proceedings 29: 161-163, 1997. Stegeman, C. A., Cohen Tervaert, J. W., Kallenberg, C. G. M. Cotrimoxazole and Wegener's granulomatosis: more than a coincidence? Nephrology Dialysis Transplantation 12: 652-655, 1997. Stegeman, C. A., Cohen Tervaert, J. W. Contemporary diagnosis and management of Wegener's granulomatosis. Current Opinion in Otolaryngol Head 5: 181-186, 1997. Stegeman, C. A., Cohen Tervaert, J. W., Kallenberg, C. G. M. Sulphonamides in vasculitides: which mechanism? Nephrology Dialysis Transplantation 12: 2463-2464, 1997. Welling, G. W., Elfferich, P., Raangs, G. C., Wildeboer-Veloo, A. C. M., Jansen, G. J., Degener, J. E. 16S Ribosomal RNAtargeted oligonucleotide probes for monitoring of intestinal tract bacteria. Scandinavian Journal of Gastroenterology 32: 17-19, 1997. Westra, D., Glazenburg, K. L., Harmsen, H. J. M., Tiran, A., Scheffer, A. J., Welling, G. W., The, T. H., Welling-Wester, S. Glycoprotein H of herpes simplex virus type 1 requires glycoprotein L for transport to the surface of insect cells. Journal of Virology 71: 2285-2291, 1997. Al, M. J., Koopmanschap, M. A., Enckevort, P. J. van, Geertsma, A., Bij, W. van der, Boer, W. J. de, Vergert, E. M. ten. Costeffectiveness of lung transplantation in the Netherlands; A scenario analysis. Chest 113: 124-130, 1998. Basadonna, G. P., Auersvald, L., Khuong, C. Q., Zheng, X. X., Kashio, N., Zekzer, D., Minozzo, M., Qian, H. Y., Visser, L., Diepstra, A., Lazarovits, A. I., Poppema, S., Strom, T. B., Rothstein, D. M. Antibody-mediated targeting of CD45 isoforms: A novel immunotherapeutic strategy. Proceedings of the National Academy of Sciences of the United States of America 95: 3821-3826, 1998. Berg, A. P. van den, Twilhaar, W. N., Corver, K., Geerts, A. B., Mesander, G., Klompmaker, I. J., Slooff, M. J. H., The, T. H., Leij, L. H. F. M. de. Cyclosporine A is associated with a shift of the Th1 Th2 balance in liver transplant patients. Transplant. P. 30: 2378-2379, 1998. Berg, A. P. van den, Haan, A. de, Hepkema, B. G., Dijk, E. van, Twuyver, E. van, Klompmaker, I. J., Leij, L. H. F. M. de, Waal, L. P., Slooff, M. J. H., The, T. H. Donor-specific immunological non-responsiveness after liver transplantation. Transplant. Int. 11: S239-S241, 1998. Berg, A. P. van den, Twilhaar, W. N., Son, W. J. van, Bij, W., Klompmaker, I. J., Slooff, M. J. H., The, T. H., Leij, L. H. F. M. de. Quantification of immunosuppression by flow cytometric measurement of intracellular cytokine synthesis. Transplant. Int. 11: S318-S321, 1998. Berg, A. P. van den, Twilhaar, W. N., Mesander, G., Son, W. J. van, Bij, W. van der, Klompmaker, I. J., Slooff, M. J. H., The, T. H., Leij, L. H. F. M. de. Quantification of immunosuppression by.
Table 3. Baseline values and changes from baseline for blood glucose, body weight, and hypoglycemia in patients receiving Mix25 before the meal or after the meal for 16 weeks. Treatment group Post meal Mix 25MeanSEM, 18 ; Fasting BG * Baseline Change from baseline Morning 2-hour postprandial BG Baseline Change from baseline Morning 2-hour postprandial BG excursion Baseline Endpoint Change from baseline Pre-dinner BG Baseline Change from baseline Evening 2-hour postprandial BG Baseline Endpoint Change from baseline Morning 2-hour postprandial BG excursion Baseline Endpoint Change from baseline Body weight kg ; Baseline Change from baseline Hypoglycemia rate episodes patient 30 days ; Baseline Change from baseline 12.883.20 4.722.95 16.894.98 None None Pre meal Mix 25 MeanSEM, 19 ; 10.883.17 2.562.94 13.814.28 None 0.110.49 p-value * 0.064 0.023 0.051 and vioxx.
In communities where cultural rules about discusing sexual matters are particularly strong, sexual history taking may have to be delegated to someone of the same sex or ethnic background as the patient. Whatever method is used to obtain a sexual history, the patient must feel assured that details given to health care providers are held in strict confidence see Chapter 2 ; . With practice, you will easily integrate sexual history taking into your clinical skills. It is encouraging when patients spontaneously tell you that no clinician has ever been as thorough before.
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Patents are the life-blood of the pharmaceutical industry, the means by which a company attempts to protect its products. To this end, many Specialty Pharma companies are alert to obtaining patent coverage that not only covers the precise formulation that they are attempting to commercialize, but to also attempt through patents ; to block competitors from gleaning important aspects of their technology and then developing "me-too" 505 b ; 2 ; or ANDA products. Patent claims define the metes and bounds of the property right awarded to the patentee. Patent attorneys put great care into drafting claims that encompass the invention eg, the product to be commercialized ; , and often the patent claims do a good job of covering the actual product that is intended for commercialization. Sometimes, however, that mark is missed as a lack of continued communication between scientists and patent attorneys lead to a patent that nicely covers a predecessor to the commercialized product, but does not actually cover the commercialized product as well. An example of how this can happen is when changes are made to ingredients or proportions of ingredients during scale-up. Another significant problem in obtaining patent protection concerns anticipating and obtaining patent protection for potential design-around strategies that may be utilized by competitors. In order to accomplish this goal, patent claims are often written with broad scope and are supported by a detailed patent specification that provides detailed information concerning not only the preferred embodiment of the invention, but alternative embodiments as well. These alternatives are, indeed, the very manner that the patentee believes competitors would turn to for easy design-around strategies.
Both previous T. hominis cases originated from Australia, were detected in individuals in the late stages of HIV infection and mainly involved infection of skeletal muscle Yee et al., 1991; Field et al., 1996; A. Curry, unpublished data ; .The first case involved infection of skeletal muscle and corneal epithelium, but spores were also detected in sputum Field et al., 1996 ; . In the second case, infection was detected in skeletal muscle and myocardium A. Curry, unpublished data ; . The stromal involvement seen here case 2 ; , rather than the epithelial infection seen previously, was also suggestive that T. hominis was not restricted to specific cells and should be considered as a possible multiorgan pathogen Field et al., 1996 ; . Sources of infection of these two parasites for humans are uncertain but may involve animals Curry, 1999 ; . V. corneae spores have been identified in water supplies Dowd et al., 1998 ; and spore-contaminated water may be a source of human infection, particularly in the immunocompromised. In case 1 described here, the patient had negative HIV serology, but had received topical immunosuppression with steroid and antiviral treatment for clinically diagnosed herpes simplex infection not laboratory proven ; . It is possible that this immunosuppressive steroid treatment may have exacerbated pre-existing microsporidial infection or facilitated de novo infection Dowd et al., 1998 ; . Routes of microsporidial infection in the eye are unclear. Abrasions into which microsporidial spores are inoculated would seem to be an obvious route, particularly in immunocompetent individuals. M. ceylonensis may have been introduced into the eye this way, as the boy had been gored in the right eye by a goat approximately 6 years previously Ashton & Wirasinha, 1973 ; . However, in patients with AIDS with disseminated microsporidial infection, ocular infection may be acquired by reverse passage from a respiratory source through the lachrymal canaliculi and nasolachrymal ducts that drain secretions from the eyes into the nasal sinuses Curry & Canning, 1993 ; . Equally, infection may spread from the eyes into the respiratory tract in these patients. It is possible that several factors are required to establish microsporidial infection in the eye. Some form of immunosuppression [either by primary hereditary ; HIV infection, or by use of topical corticosteroids or other forms of systemic immunosuppression] is certainly one factor. The other may be a slightly lower temperature Cali et al., 1998 ; . If some of the microsporidian parasites found in humans are from poikilothermic cold-blooded ; animals, then the slightly lower temperature of the eye because of its exposed position ; may allow opportunistic parasite development to become established, causing symptoms, whereas, development in deeper and warmer ; tissues could curtail parasite development Trammer et al., 1997 ; . Laboratory diagnosis may be difficult because of the small size of these parasites, their intracellular location and poor staining properties particularly of the proliferative stages ; with histological stains. Diagnosis can be made by identifying microsporidian spores from faeces, urine, secretions or and wellbutrin and trimox, for example, drug interactions.
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Figure 6. Non-urinary Escherichia coli: co-trimoxazole, fluoroquinolone and gentamicin resistance among hospital isolates, 1997-2001.
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Corresponding Author: David Rampe, Ph.D. Aventis Pharmaceuticals Route 202-206 P.O. Box 6800 Room JR2-2236 Bridgewater, NJ 08807-0800 Tel: 908 ; 231-3078 Fax: 908 ; 231-2520 e-mail: david.rampe aventis.
Other choices would best require that two different ones should be carried, a cephalosporin cefaclor, cefuroxime, and cefadroxil are choices in the united states ; and co-trimoxazole.
191 subsidiary to a parent company is whether, as a matter of fact, the undertakings concerned act as one economic unit. 883 ; A similar argument has already been rejected by the Commission in the analysis of the second abuse see notably recitals 811 ; - 816 ; . Indeed, it appears from the evidence that the second abuse was highly centralised by Astra AB at the level of the CEO and senior management, aided by Astra AB's wholly owned subsidiaries mainly Astra Hssle AB ; . 884 ; Considering that Astra AB, following the merger between Astra AB and Zeneca Plc on 6 April 1999, has not been simply and purely absorbed by the new merged entity but continues to exist in Swedish law and in fact exists and operates in Sdertlje under the name of AstraZeneca AB, the liability for the infringements relating to the period prior to the said merger must be imputed to AstraZeneca AB only648. 3. LIABILITY FOR THE INFRINGEMENTS FOLLOWING THE MERGER ON 6 APRIL 1999 885 ; For the reasons explained and considering the single and continuous nature of the abuses, AstraZeneca AB should also be held liable for the infringements for the period after 6 April 1999. 886 ; AZ argues that no liability for the alleged infringements in respect of the period following the merger on 6 April 1999 can be imputed to AstraZeneca Plc. In AZ's opinion, the Commission has advanced no evidence that the "SPC Strategy" as alleged by the Commission was disclosed to the AstraZeneca Group CEO. According to AZ the Commission in particular misconstrues the purpose of the action team set up to address the public policy elements of the German SPC litigation. There is, in AZ's view, nothing in the handwritten notes from the in-house counsel of AstraZeneca Plc which shows that he was put on notice of the alleged SPC abuse. Similarly, there is, according to AZ, no evidence to support the Commission's allegations that AstraZeneca Plc was made aware of the circumstances said to constitute the alleged second abuse. 887 ; There is, according to AZ, virtually no allegation of infringements or potentially abusive conduct taking place after 6 April 1999 on the part of Astra AB which could be subject to the instructions or control of AstraZeneca Plc and therefore attributed to it. The evidence cited by the Commission see recitals 230 ; and 291 does not amount to instructions given by AstraZeneca Plc to Astra AB. In AZ's view, it is not possible to impute liability to AstraZeneca Plc based on what amounts to, at best, fragmentary briefings since those briefings do not convey sufficient information to put AstraZeneca Plc on notice that Astra AB has engaged in the conduct as alleged by the Commission and or conduct that was illegitimate. In summary, AZ therefore considers that there is no basis on which liability can be attributed to AstraZeneca Plc for Astra AB's conduct prior to 6 April 1999, even where such conduct may have continuing effects after 6 April 1999, for example, flagyl.
72, 75 ; BODOR, Janos [NL NL]; Unilever R & D Vlaardingen, Olivier van Noortlaan 120, NL-3133 AT Vlaardingen NL ; . M ATTHIJSSEN, Gerardus, A., F. [NL NL]; Unilever R & D Vlaardingen, Olivier van Noortlaan 120, NL-3133 AT Vlaardingen NL ; . SANTOS DA SILVA, Mario, J. [NL NL]; Unilever R & D Vlaardingen, Olivier van Noortlaan 120, NL-3133 AT Vlaardingen NL ; . SMORENBURG, Herm anus, E. [NL ZA]; Unilever Health Institute Africa, Unilever Ghana Ltd., Publishing Road, Light Industrial Area, NL-Tema NL ; . 74 ; HODGETTS, Catherine, D.; Unilever N.V., Patent Department, Olivier van Noortlaan 120, NL-3133 AT Vlaardingen NL ; . 81 ; ZW. 84 ; AP GH A23L 1 164 11 ; W O 2004 034815 21 ; PCT FI2003 000761 22 ; 14 Oct oct 2003 14.10.2003 ; 25 ; en 30 ; 20021822 26 ; en 14 Oct oct 2002 14.10.2002 ; FI 13 ; A1.
55 sdn1977 senior member join date: jul 2005 3, 099 quote: originally posted by j dub if you are going to compare the two professions, pharmacy and medicine, to two drugs at least make them in the same class of drugs.
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Resistance data for 7, 417 isolates were reported and analyzed. The contributors were the Philippine General Hospital PGH ; -2, 629 35% ; , Research Institute for Tropical Medicine RITM ; -801 11% ; , Rizal Medical Center RMC ; -723 10% ; , National Kidney and Transplant Institute NKTI ; -661 9% ; , Celestino Gallares Memorial Medical Center GMH ; , Tagbilaran City 661 9% ; , Zamboanga Medical Center ZMC ; , Zamboanga City-446 6% ; , Eastern Visayas Regional Medical Center EVR ; , Tacloban City-367 5% ; , Corazon Locsin Montelibano Memorial Regional Hospital MMH ; , Bacolod City-295 4% ; , San Lazaro Hospital SLH ; -289 4% ; , Bureau of Research and Laboratories BRL ; -199 3% ; , Santo Tomas University Hospital STUH ; -192 3% ; , Lung Center of the Philippines LCP ; -96 1% ; , Far Eastern University Hospital FEU ; -60 1% ; . The MMH and EVR started contributing data to the gonococcal resistance surveillance, namely the Sta.Rosa, Laguna, Sucat, Bacolod City and Tacloban City STD clinics. The most common specimen sources were blood-24%, urine-20%, respiratory-20%, wounds -15% and stool-1%. There were 286 genital tract specimens reported out of 5, 572 cervical swabs collected. The distribution of the pathogens reported was as follows: E. coli-14%, Pseudomonas aeruginosa-10%, Klebsiella sp.-11%, Acinetobacter sp.-8%, Staphylococcus aureus-8%, Vibrio cholerae-3%, Salmonella typhi-3%, Proteus sp.- 3%, coagulase-negative staphylococcus-6% and others. There were 91 and 63 Streptococcus pneumoniae and Hemophilus influenzae isolates respectively. As previously observed, most of the bacteria reported are nosocomial pathogens expected from tertiary level hospitals such as most of the participants of the program. 1. Enteric pathogens Resistance rates of all Salmonella typhi isolates to chloramphenicol, cotrimoxazole and ampicillin remained low at 6%, 2% and 15% respectively as compared to 3%, 3%and 5% in 1998. There were 30 ampicillin-resistant S.typhi with 27 coming from San Lazaro Hospital, which were not referred to RITM for confirmation. Out of 226 S.typhi isolates, 139 came from Metro Manila, GMH -17, EVR -35, MMH -0 and ZMC -19. Among the regional sentinel sites, resistance to ampicillin, chloramphenicol and cotrimoxazole ranged from 0-6%, 0-7%, and 0-5% respectively compared to Metro Manila where the rates were 19%, 6% and 3%, respectively. It is important to confirm whether ampicillin-resistant S.typhi are being seen in Metro Manila. Based on the above information, empiric therapy for suspected typhoid fever can consist of either chloramphenicol, cotrimoxazole or amoxycillin in the regional hospitals and chloramphenicol and cotrimoxazole for Metro Manila. As has been previously observed, non-typhoidal salmonellae showed higher resistance rates to chloramphenicol 22% ; , ampicillin 26% ; and cotrimoxazole 24% ; compared to rates for S. typhi. These rates did not differ significantly from 1998. The resistance rate of Shigellae to cotrimoxazole was 59% which was lower than the 68% reported in 1998 whereas that for nalidixic acid, the alternative drug was 0% compared to 9% in 1998. Only GMH reported Shigellae isolates among the regional hospitals where cotrimoxazole resistance was 25% n 4 ; . Resistance rates of Vibrio cholerae 01 to tetracycline, chloramphenicol and cotrimoxazole were.
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