Zithromax - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

ZITHROMAX A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. ...

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ZITHROMAX A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Zithromax: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84250-7 1. Zithromax-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on Zithromax. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ZITHROMAX .............................................................................................. 3 Overview........................................................................................................................................ 3 Federally Funded Research on Zithromax ..................................................................................... 3 E-Journals: PubMed Central ......................................................................................................... 5 The National Library of Medicine: PubMed ................................................................................ 18 CHAPTER 2. NUTRITION AND ZITHROMAX .................................................................................... 35 Overview...................................................................................................................................... 35 Finding Nutrition Studies on Zithromax .................................................................................... 35 Federal Resources on Nutrition ................................................................................................... 41 Additional Web Resources ........................................................................................................... 41 CHAPTER 3. ALTERNATIVE MEDICINE AND ZITHROMAX .............................................................. 43 Overview...................................................................................................................................... 43 National Center for Complementary and Alternative Medicine.................................................. 43 Additional Web Resources ........................................................................................................... 45 General References ....................................................................................................................... 46 CHAPTER 4. CLINICAL TRIALS AND ZITHROMAX........................................................................... 47 Overview...................................................................................................................................... 47 Recent Trials on Zithromax ......................................................................................................... 47 Keeping Current on Clinical Trials ............................................................................................. 48 CHAPTER 5. PATENTS ON ZITHROMAX ........................................................................................... 51 Overview...................................................................................................................................... 51 Patents on Zithromax .................................................................................................................. 51 Patent Applications on Zithromax .............................................................................................. 57 Keeping Current .......................................................................................................................... 64 CHAPTER 6. BOOKS ON ZITHROMAX .............................................................................................. 67 Overview...................................................................................................................................... 67 The National Library of Medicine Book Index ............................................................................. 67 Chapters on Zithromax ................................................................................................................ 67 CHAPTER 7. PERIODICALS AND NEWS ON ZITHROMAX................................................................. 69 Overview...................................................................................................................................... 69 News Services and Press Releases................................................................................................ 69 Academic Periodicals covering Zithromax................................................................................... 71 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................... 73 Overview...................................................................................................................................... 73 U.S. Pharmacopeia....................................................................................................................... 73 Commercial Databases ................................................................................................................. 74 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 77 Overview...................................................................................................................................... 77 NIH Guidelines............................................................................................................................ 77 NIH Databases............................................................................................................................. 79 Other Commercial Databases....................................................................................................... 81 APPENDIX B. PATIENT RESOURCES ................................................................................................. 83 Overview...................................................................................................................................... 83 Patient Guideline Sources............................................................................................................ 83 Finding Associations.................................................................................................................... 85 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 87 Overview...................................................................................................................................... 87 Preparation................................................................................................................................... 87 Finding a Local Medical Library.................................................................................................. 87 Medical Libraries in the U.S. and Canada ................................................................................... 87

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ONLINE GLOSSARIES.................................................................................................................. 93 Online Dictionary Directories ..................................................................................................... 93 ZITHROMAX DICTIONARY ....................................................................................................... 95 INDEX .............................................................................................................................................. 129

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with Zithromax is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about Zithromax, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to Zithromax, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on Zithromax. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to Zithromax, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on Zithromax. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON ZITHROMAX Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Zithromax.

Federally Funded Research on Zithromax The U.S. Government supports a variety of research studies relating to Zithromax. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to Zithromax. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore Zithromax. The following is typical of the type of information found when searching the CRISP database for Zithromax: •

Project Title: ANTIBIOTIC GENE CLUSTERS Principal Investigator & Institution: Weber, J Mark.; President; Fermalogic, Inc. Chicago Technology Park Chicago, Il 60612 Timing: Fiscal Year 2001; Project Start 16-JUL-2001; Project End 15-JUL-2002 Summary: (provided by applicant): The global health problem of microbial antibiotic resistance continues unabated. One practical aspect of this problem is that when new

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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more effective antibiotics are found they must be produced in large enough quantities and at reasonable prices. Most antibiotics are made through Actinomycete fermentations. Despite the wide use of these organisms, very little is known about the genes that control the level, and therefore the cost, of antibiotic production. One of the best-studied Actinomycetes is the mycelial, grampositive, Saccharopolyspora erythraea, which has been used to make erythromycin since the mid-1950's. Erythromycin is the starting material for two widely prescribed semi-synthetic derivatives, Biaxin and Zithromax. It is little known that over 30 years ago another Actinomycete, Aeromicrobium erythreum, was also discovered to produce erythromycin. A. erythreum, however, is unicellular and faster growing than Sac. erythraea and has other features that make it a favorable fermentation organism. The gene cluster for erythromycin biosynthesis in this organism is uncharacterized. We propose to revisit A. erythreum and begin by cloning and sequencing the ery gene cluster from it as a prelude to further work that will lead to commercial opportunities for strain improvement and new drug discovery. PROPOSED COMMERCIAL APPLICATION: Commercial strains for the production of the bulk pharmaceutical erythromycin are responsible for the production or material with a market value of greater than $600 million per year, world-wide (1995 figure). Any strain that is significantly superior to existing strains would therefore be of great economic value. The development of new generation erythromycin derivatives means the market for erythromycin as a chemical intermediate will continue to grow. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NOVEL ANTIBACTERIALS TARGETING THE 50S RIBOSOMAL SUBUNIT Principal Investigator & Institution: Sutcliffe, Joyce A.; Rib-X Pharmaceuticals, Inc. 300 George St, Ste 301 New Haven, Ct 06053 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 14-JAN-2004 Summary: (provided by applicant): Rib-X Pharmaceuticals, Inc. has proprietary, highresolution structural information on how antibiotics bind to the large ribosomal subunit (50S). Using this information in combination with a computational approach that calculates the energetics of RNA-ligand interactions and drug-like properties of these antibiotics, a series of novel compounds were designed and synthesized. One of the compounds was complexed to Haloarcula marismortui 50S ribosomal subunits and solved to 3.0 Angstroms resolution. The position of the analog within the 50S subunit validated our approach and suggested that solving related structures within the series would provide a solid platform to understand how this series of compounds overcomes target-based resistance. To aid in drug design, this proposal seeks to: 1. Determine two additional high resolution structures of compounds complexed with the 50S subunit of Haloarcula marismortui. 2. Determine the minimally-active chemical core in the compound series. 3. Determine the pharmacokinetics of the most promising compound in mice. The overall goal of this work is to identify new chemical entities for the treatment of antibiotic resistant bacterial infections. This is important because the incidence of antimicrobial resistance has increased in hospital and community settings. Therapeutic failures with current agents, extended hospital stays, and the use of increasingly costly and toxic antimicrobials that contribute to healthcare costs is driving the need for new antimicrobial agents that overcome multidrug resistance. Resistance is likely to become worse when patents for widely used, branded antibiotics like Augmentin, Cipro, and Zithromax expire, resulting in widespread use of generic versions of these drugs. The 50S subunit is a highly validated target in that two of the

Studies

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top four oral antibiotics in the US target it (Zithromax and Biaxen); collectively, these two antibiotics account for >$2 billion in annual sales. Further, the most recently approved class of antibiotics, Zyvox, also binds to the 50S. Zyvox is used to treat serious Gram-positive nosocomial infections. Thus, the 50S presents an opportunity to target medical needs and to find new antimicrobials for both community- and hospitalacquired infections. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “Zithromax” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for Zithromax in the PubMed Central database: •

A Randomized Controlled Comparison of Azithromycin and Ofloxacin for Treatment of Multidrug-Resistant or Nalidixic Acid-Resistant Enteric Fever. by Chinh NT, Parry CM, Ly NT, Ha HD, Thong MX, Diep TS, Wain J, White NJ, Farrar JJ.; 2000 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89974

•

Activities of a New Fluoroketolide, HMR 3787, and Its (Des)-Fluor Derivative RU 64399 Compared to Those of Telithromycin, Erythromycin A, Azithromycin, Clarithromycin, and Clindamycin against Macrolide-Susceptible or -Resistant Streptococcus pneumoniae and S. pyogenes. by Nagai K, Davies TA, Ednie LM, Bryskier A, Palavecino E, Jacobs MR, Appelbaum PC.; 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90817

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Activities of amikacin, roxithromycin, and azithromycin alone or in combination with tumor necrosis factor against Mycobacterium avium complex. by Bermudez LE, Young LS.; 1988 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172367

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Activities of Azithromycin and Amphotericin B against Naegleria fowleri In Vitro and in a Mouse Model of Primary Amebic Meningoencephalitis. by Goswick SM, Brenner GM.; 2003 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=151771

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Activities of azithromycin and clarithromycin against nontuberculous mycobacteria in beige mice. by Klemens SP, Cynamon MH.; 1994 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284575

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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Activities of HMR 3004 (RU 64004) and HMR 3647 (RU 66647) Compared to Those of Erythromycin, Azithromycin, Clarithromycin, Roxithromycin, and Eight Other Antimicrobial Agents against Unusual Aerobic and Anaerobic Human and Animal Bite Pathogens Isolated from Skin and Soft Tissue Infections in Humans. by Goldstein EJ, Citron DM, Gerardo SH, Hudspeth M, Merriam CV.; 1998 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105757

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Activities of sparfloxacin, azithromycin, temafloxacin, and rifapentine compared with that of clarithromycin against multiplication of Mycobacterium avium complex within human macrophages. by Perronne C, Gikas A, Truffot-Pernot C, Grosset J, Vilde JL, Pocidalo JJ.; 1991 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245171

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Activities of Telithromycin (HMR 3647, RU 66647) Compared to Those of Erythromycin, Azithromycin, Clarithromycin, Roxithromycin, and Other Antimicrobial Agents against Unusual Anaerobes. by Goldstein EJ, Citron DM, Merriam CV, Warren Y, Tyrrell K.; 1999 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89565

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Activity and local delivery of azithromycin in a mouse model of Haemophilus influenzae lung infection. by Vallee E, Azoulay-Dupuis E, Pocidalo JJ, BergogneBerezin E.; 1992 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=191595

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Activity of azithromycin against Mycobacterium avium infection in beige mice. by Cynamon MH, Klemens SP.; 1992 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192015

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Activity of Moxifloxacin by Itself and in Combination with Ethambutol, Rifabutin, and Azithromycin In Vitro and In Vivo against Mycobacterium avium. by Bermudez LE, Inderlied CB, Kolonoski P, Petrofsky M, Aralar P, Wu M, Young LS.; 2001 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90264

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Antimicrobial Activities and Postantibiotic Effects of Clarithromycin, 14-HydroxyClarithromycin, and Azithromycin in Epithelial Cell Lining Fluid against Clinical Isolates ofHaemophilus influenzae and Streptococcus pneumoniae. by Bergman KL, Olsen KM, Peddicord TE, Fey PD, Rupp ME.; 1999 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89263

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Antimicrobial interference with bacterial mechanisms of pathogenicity: effect of subMIC azithromycin on gonococcal piliation and attachment to human epithelial cells. by Gorby GL, McGee ZA.; 1990 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172082

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Assessment of Azithromycin in Combination with Other Antimalarial Drugs against Plasmodium falciparum In Vitro. by Ohrt C, Willingmyre GD, Lee P, Knirsch C, Milhous W.; 2002 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127390

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Azithromycin Activities against Orientia tsutsugamushi Strains Isolated in Cases of Scrub Typhus in Northern Thailand. by Watt G, Kantipong P, Jongsakul K, Watcharapichat P, Phulsuksombati D.; 1999 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89570

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Azithromycin as Treatment for Disseminated Mycobacterium avium Complex in AIDS Patients. by Koletar SL, Berry AJ, Cynamon MH, Jacobson J, Currier JS, MacGregor RR, Dunne MW, Williams DJ.; 1999 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89578

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Azithromycin inhibition of intracellular Legionella micdadei. by Donowitz GR, Earnhardt KI.; 1993 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192376

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Azithromycin Inhibits Quorum Sensing in Pseudomonas aeruginosa. by Tateda K, Comte R, Pechere JC, Kohler T, Yamaguchi K, Van Delden C.; 2001 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90577

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Azithromycin pharmacokinetics and intracellular concentrations in Legionella pneumophila-infected and uninfected guinea pigs and their alveolar macrophages. by Stamler DA, Edelstein MA, Edelstein PH.; 1994 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284429

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Azithromycin versus Ciprofloxacin for Treatment of Uncomplicated Typhoid Fever in a Randomized Trial in Egypt That Included Patients with Multidrug Resistance. by Girgis NI, Butler T, Frenck RW, Sultan Y, Brown, Tribble D, Khakhria R.; 1999 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89293

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Azithromycin, a macrolide antibiotic with potent activity against Toxoplasma gondii. by Araujo FG, Guptill DR, Remington JS.; 1988 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172266

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Azithromycin, rifabutin, and rifapentine for treatment and prophylaxis of Mycobacterium avium complex in rats treated with cyclosporine. by Brown ST, Edwards FF, Bernard EM, Tong W, Armstrong D.; 1993 Mar; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=187683

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Azithromycin-induced block of elementary body formation in Chlamydia trachomatis. by Engel JN.; 1992 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245493

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Bacteriologic Efficacies of Oral Azithromycin and Oral Cefaclor in Treatment of Acute Otitis Media in Infants and Young Children. by Dagan R, Leibovitz E, Fliss DM, Leiberman A, Jacobs MR, Craig W, Yagupsky P.; 2000 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89626

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Beneficial Effect of Adjunctive Azithromycin in Treatment of Mucoid Pseudomonas aeruginosa Pneumonia in the Murine Model. by Nicolau DP, Banevicius MA, Nightingale CH, Quintiliani R.; 1999 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89611

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Bronchopulmonary Pharmacokinetics of Clarithromycin and Azithromycin. by Kashuba AD, Amsden GW.; 1998 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105444

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Cellular accumulation of the new ketolide RU 64004 by human neutrophils: comparison with that of azithromycin and roxithromycin. by Vazifeh D, Abdelghaffar H, Labro MT.; 1997 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=164077

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Characteristics of murine model of genital infection with Chlamydia trachomatis and effects of therapy with tetracyclines, amoxicillin-clavulanic acid, or azithromycin. by Beale AS, Upshon PA.; 1994 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284665

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Clinical Efficacy of Intravenous followed by Oral Azithromycin Monotherapy in Hospitalized Patients with Community-Acquired Pneumonia. by Plouffe J, Schwartz DB, Kolokathis A, Sherman BW, Arnow PM, Gezon JA, Suh B, Anzuetto A, Greenberg RN, Niederman M, Paladino JA, Ramirez JA, Inverso J, Knirsch CA.; 2000 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89964

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Comparative activities of azithromycin and clarithromycin against Mycobacterium avium infection in beige mice. by Cynamon MH, Klemens SP, Grossi MA.; 1994 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284574

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Comparative activities of clarithromycin, erythromycin, and azithromycin against penicillin-susceptible and penicillin-resistant pneumococci. by Ednie LM, Visalli MA, Jacobs MR, Appelbaum PC.; 1996 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163449

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Comparative efficacy and safety of 3-day azithromycin and 10-day penicillin V treatment of group A beta-hemolytic streptococcal pharyngitis in children. by Pacifico L, Scopetti F, Ranucci A, Pataracchia M, Savignoni F, Chiesa C.; 1996 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163247

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Comparative in vitro activities of azithromycin, Bay y 3118, levofloxacin, sparfloxacin, and 11 other oral antimicrobial agents against 194 aerobic and anaerobic bite wound isolates. by Goldstein EJ, Nesbit CA, Citron DM.; 1995 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162690

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Comparative in vitro activities of clarithromycin, azithromycin, and erythromycin against Borrelia burgdorferi. by Dever LL, Jorgensen JH, Barbour AG.; 1993 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188047

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Comparative in vitro exoenzyme-suppressing activities of azithromycin and other macrolide antibiotics against Pseudomonas aeruginosa. by Mizukane R, Hirakata Y, Kaku M, Ishii Y, Furuya N, Ishida K, Koga H, Kohno S, Yamaguchi K.; 1994 Mar; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284493

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Comparative Intracellular (THP-1 Macrophage) and Extracellular Activities of [beta]Lactams, Azithromycin, Gentamicin, and Fluoroquinolones against Listeria monocytogenes at Clinically Relevant Concentrations. by Carryn S, Van Bambeke F, Mingeot-Leclercq MP, Tulkens PM.; 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127291

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Comparative Pharmacodynamic Analysis of Q-T Interval Prolongation Induced by the Macrolides Clarithromycin, Roxithromycin, and Azithromycin in Rats. by Ohtani H, Taninaka C, Hanada E, Kotaki H, Sato H, Sawada Y, Iga T.; 2000 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90127

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Comparative study of once-weekly azithromycin and once-daily amoxicillin treatments in prevention of recurrent acute otitis media in children. by Marchisio P, Principi N, Sala E, Lanzoni L, Sorella S, Massimini A.; 1996 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163612

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Comparison of bronchopulmonary pharmacokinetics of clarithromycin and azithromycin. by Patel KB, Xuan D, Tessier PR, Russomanno JH, Quintiliani R, Nightingale CH.; 1996 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163537

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Comparison of mutants of Toxoplasma gondii selected for resistance to azithromycin, spiramycin, or clindamycin. by Pfefferkorn ER, Borotz SE.; 1994 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284392

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Comparison of Pharmacodynamics of Azithromycin and Erythromycin In Vitro and In Vivo. by den Hollander JG, Knudsen JD, Mouton JW, Fuursted K, Frimodt-Moller N, Verbrugh HA, Espersen F.; 1998 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105417

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Comparison of the effects of the new azalide antibiotic, azithromycin, and erythromycin estolate on rat liver cytochrome P-450. by Amacher DE, Schomaker SJ, Retsema JA.; 1991 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284308

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Decreased Azithromycin Susceptibility of Neisseria gonorrhoeae Due to mtrR Mutations. by Zarantonelli L, Borthagaray G, Lee EH, Shafer WM.; 1999 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89502

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Direct evidence for antipseudomonal activity of macrolides: exposure-dependent bactericidal activity and inhibition of protein synthesis by erythromycin, clarithromycin, and azithromycin. by Tateda K, Ishii Y, Matsumoto T, Furuya N, Nagashima M, Matsunaga T, Ohno A, Miyazaki S, Yamaguchi K.; 1996 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163517

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Distribution of Azithromycin in Plasma and Tonsil Tissue after Repeated Oral Administration of 10 or 20 Milligrams per Kilogram in Pediatric Patients. by Blandizzi C, Malizia T, Batoni G, Ghelardi E, Baschiera F, Bruschini P, Senesi S, Campa M, Del Tacca M.; 2002 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127138

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Distribution of azithromycin into brain tissue, cerebrospinal fluid, and aqueous humor of the eye. by Jaruratanasirikul S, Hortiwakul R, Tantisarasart T, Phuenpathom N, Tussanasunthornwong S.; 1996 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163212

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Double-blind randomized study comparing the efficacies and safeties of a short (3day) course of azithromycin and a 5-day course of amoxicillin in patients with acute exacerbations of chronic bronchitis. by Mertens JC, van Barneveld PW, Asin HR, Ligtvoet E, Visser MR, Branger T, Hoepelman AI.; 1992 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=191603

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Dynamics of Clarithromycin and Azithromycin Efficacies against Experimental Haemophilus influenzae Pulmonary Infection. by Alder JD, Ewing PJ, Nilius AM, Mitten M, Tovcimak A, Oleksijew A, Jarvis K, Paige L, Tanaka SK.; 1998 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105838

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Effect of Azithromycin plus Rifampin versus Amoxicillin Alone on Eradication and Inflammation in the Chronic Course of Chlamydia pneumoniae Pneumonitis in Mice. by Bin XX, Wolf K, Schaffner T, Malinverni R.; 2000 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89955

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Effect of Azithromycin plus Rifampin versus That of Azithromycin Alone on the Eradication of Chlamydia pneumoniae from Lung Tissue in Experimental Pneumonitis. by Wolf K, Malinverni R.; 1999 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89304

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Effect of CO2 on susceptibilities of anaerobes to erythromycin, azithromycin, clarithromycin, and roxithromycin. by Spangler SK, Jacobs MR, Appelbaum PC.; 1994 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284428

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Effect of Prolonged Treatment with Azithromycin, Clarithromycin, or Levofloxacin on Chlamydia pneumoniae in a Continuous-Infection Model. by Kutlin A, Roblin PM, Hammerschlag MR.; 2002 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127037

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Effect of single oral dose of azithromycin, clarithromycin, and roxithromycin on polymorphonuclear leukocyte function assessed ex vivo by flow cytometry. by Wenisch C, Parschalk B, Zedtwitz-Liebenstein K, Weihs A, el Menyawi I, Graninger W.; 1996 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163469

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Effects of Azithromycin and Rifampin on Chlamydia trachomatis Infection In Vitro. by Dreses-Werringloer U, Padubrin I, Zeidler H, Kohler L.; 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90774

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Effects of Azithromycin on Shiga Toxin Production by Escherichia coli and Subsequent Host Inflammatory Response. by Ohara T, Kojio S, Taneike I, Nakagawa S, Gondaira F, Tamura Y, Gejyo F, Zhang HM, Yamamoto T.; 2002 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=128727

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Efficacy of azithromycin as a causal prophylactic agent against murine malaria. by Andersen SL, Ager AL, McGreevy P, Schuster BG, Ellis W, Berman J.; 1994 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284651

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Efficacy of azithromycin or clarithromycin for prophylaxis of viridans group streptococcus experimental endocarditis. by Rouse MS, Steckelberg JM, Brandt CM, Patel R, Miro JM, Wilson WR.; 1997 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163983

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Efficacy of Doxycycline, Azithromycin, or Trovafloxacin for Treatment of Experimental Rocky Mountain Spotted Fever in Dogs. by Breitschwerdt EB, Papich MG, Hegarty BC, Gilger B, Hancock SI, Davidson MG.; 1999 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89211

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Erythromycin and azithromycin transport into Haemophilus influenzae ATCC 19418 under conditions of depressed proton motive force (delta mu H). by Capobianco JO, Goldman RC.; 1990 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=171926

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Erythromycin, clarithromycin, and azithromycin: use of frequency distribution curves, scattergrams, and regression analyses to compare in vitro activities and describe cross-resistance. by Fass RJ.; 1993 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192232

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Evaluation of in vitro spectra of activity of azithromycin, clarithromycin, and erythromycin tested against strains of Neisseria gonorrhoeae by reference agar dilution, disk diffusion, and Etest methods. by Mehaffey PC, Putnam SD, Barrett MS, Jones RN.; 1996 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=228828

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Ex vivo effect of azithromycin in human leukocyte bactericidal functions. by Tomazic J, Maticic M, Kotnik V, Simcic S, Wraber B, Zakotnik B.; 1995 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=162854

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Experimental Acute Otitis Media Due to Nontypeable Haemophilus influenzae: Comparison of High and Low Azithromycin Doses with Placebo. by Babl FE, Pelton SI, Li Z.; 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127299

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Failure of Azithromycin in Treatment of Brill-Zinsser Disease. by Turcinov D, Kuzman I, Herendic B.; 2000 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89948

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In vitro activities of azithromycin (CP 62,993), clarithromycin (A-56268; TE-031), erythromycin, roxithromycin, and clindamycin. by Barry AL, Jones RN, Thornsberry C.; 1988 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172265

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In vitro activities of azithromycin and doxycycline against 15 isolates of Chlamydia pneumoniae. by Gnarpe J, Eriksson K, Gnarpe H.; 1996 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163427

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In Vitro Activities of Azithromycin and Ofloxacin against Chlamydia pneumoniae in a Continuous-Infection Model. by Kutlin A, Roblin PM, Hammerschlag MR.; 1999 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89459

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In vitro activities of azithromycin, clarithromycin, and other antibiotics against Chlamydia pneumoniae. by Kuo CC, Jackson LA, Lee A, Grayston JT.; 1996 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163599

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In vitro activities of azithromycin, clarithromycin, erythromycin, and tetracycline against 13 strains of Chlamydia pneumoniae. by Welsh L, Gaydos C, Quinn TC.; 1996 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163084

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In vitro activities of azithromycin, clarithromycin, L-ofloxacin, and other antibiotics against Chlamydia pneumoniae. by Hammerschlag MR, Qumei KK, Roblin PM.; 1992 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=191624

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In Vitro Activities of Clarithromycin and Azithromycin against Clinical Isolates of Mycobacterium avium-M. intracellulare. by Steele-Moore L, Stark K, Holloway WJ.; 1999 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89317

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In vitro activity of azithromycin (CP-62,993) against Chlamydia trachomatis and Chlamydia pneumoniae. by Agacfidan A, Moncada J, Schachter J.; 1993 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188064

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In vitro activity of azithromycin against bacterial enteric pathogens. by Gordillo ME, Singh KV, Murray BE.; 1993 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=187935

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In vitro activity of azithromycin against clinical isolates of Legionella species. by Edelstein PH, Edelstein MA.; 1991 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=244963

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In vitro activity of azithromycin compared with that of erythromycin against Actinobacillus actinomycetemcomitans. by Pajukanta R, Asikainen S, Saarela M, Alaluusua S, Jousimies-Somer H.; 1992 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=190325

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In vitro and in vivo activities of azithromycin, a new azalide antibiotic, against chlamydia. by Niki Y, Kimura M, Miyashita N, Soejima R.; 1994 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284733

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In vitro and in vivo intraleukocytic accumulation of azithromycin (CP-62, 993) and its influence on ex vivo leukocyte chemiluminescence. by Bonnet M, Van der Auwera P.; 1992 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=190336

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In vitro and in vivo uptake of azithromycin (CP-62,993) by phagocytic cells: possible mechanism of delivery and release at sites of infection. by Gladue RP, Bright GM, Isaacson RE, Newborg MF.; 1989 Mar; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=171479

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In vitro effectiveness of azithromycin against doxycycline-resistant and -susceptible strains of Rickettsia tsutsugamushi, etiologic agent of scrub typhus. by Strickman D, Sheer T, Salata K, Hershey J, Dasch G, Kelly D, Kuschner R.; 1995 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162956

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In vitro effects of four macrolides (roxithromycin, spiramycin, azithromycin [CP62,993], and A-56268) on Toxoplasma gondii. by Chang HR, Pechere JC.; 1988 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172214

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In vitro evaluation of activities of azithromycin, erythromycin, and tetracycline against Chlamydia trachomatis and Chlamydia pneumoniae. by Welsh LE, Gaydos CA, Quinn TC.; 1992 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188358

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In vitro evaluation of the activities of azithromycin alone and combined with pyrimethamine against Toxoplasma gondii. by Cantin L, Chamberland S.; 1993 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188107

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In Vitro Selection of Resistance in Haemophilus influenzae by AmoxicillinClavulanate, Cefpodoxime, Cefprozil, Azithromycin, and Clarithromycin. by Clark C, Bozdogan B, Peric M, Dewasse B, Jacobs MR, Appelbaum PC.; 2002 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127454

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In Vitro Selection of Resistance to Four [beta]-Lactams and Azithromycin in Streptococcus pneumoniae. by Pankuch GA, Jueneman SA, Davies TA, Jacobs MR, Appelbaum PC.; 1998 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105965

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In Vitro Susceptibilities of Bordetella pertussis and Bordetella parapertussis to Two Ketolides (HMR 3004 and HMR 3647), Four Macrolides (Azithromycin, Clarithromycin, Erythromycin A, and Roxithromycin), and Two Ansamycins (Rifampin and Rifapentine). by Hoppe JE, Bryskier A.; 1998 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105582

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In vitro susceptibilities of Campylobacter jejuni and Campylobacter coli to azithromycin and erythromycin. by Taylor DE, Chang N.; 1991 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245292

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In vitro susceptibilities of Entamoeba histolytica to azithromycin, CP-63,956, erythromycin, and metronidazole. by Ravdin JI, Skilogiannis J.; 1989 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284263

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In Vitro Susceptibilities of Rhodococcus equi and Other Common Equine Pathogens to Azithromycin, Clarithromycin, and 20 Other Antimicrobials. by Jacks SS, Giguere S, Nguyen A.; 2003 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153307

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In vivo administration of azithromycin affects lymphocyte activity in vitro. by Tomazic J, Kotnik V, Wraber B.; 1993 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188071

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In vivo efficacy of azithromycin in treatment of systemic infection and septic arthritis induced by type IV group B Streptococcus strains in mice: comparative study with erythromycin and penicillin G. by Tissi L, von Hunolstein C, Mosci P, Campanelli C, Bistoni F, Orefici G.; 1995 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162860

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Influence of Macrolide Susceptibility on Efficacies of Clarithromycin and Azithromycin against Streptococcus pneumoniae in a Murine Lung Infection Model. by Hoffman HL, Klepser ME, Ernst EJ, Petzold CR, Sa'adah LM, Doern GV.; 2003 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=151733

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Influence of Variations in Test Methods on Susceptibility of Haemophilus influenzae to Ampicillin, Azithromycin, Clarithromycin, and Telithromycin. by Fuchs PC, Barry AL, Brown SD.; 2001 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=87676

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Inhibition of Toxoplasma gondii protein synthesis by azithromycin. by Blais J, Garneau V, Chamberland S.; 1993 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188046

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Intermittent azithromycin for treatment of Mycobacterium avium infection in beige mice. by Klemens SP, Cynamon MH.; 1994 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284628

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Intracellular accumulation of azithromycin by cultured human fibroblasts. by Gladue RP, Snider ME.; 1990 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=171758

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Intracellular activity of azithromycin against bacterial enteric pathogens. by Rakita RM, Jacques-Palaz K, Murray BE.; 1994 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284662

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Intracellular and extracellular penetration of azithromycin into inflammatory and noninflammatory blister fluid. by Freeman CD, Nightingale CH, Nicolau DP, Belliveau PP, Banevicius MA, Quintiliani R.; 1994 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284759

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Intrapulmonary pharmacokinetics of azithromycin in healthy volunteers given five oral doses. by Olsen KM, San Pedro G, Gann LP, Gubbins PO, Halinski DM, Campbell GD Jr.; 1996 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163580

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Intrapulmonary steady-state concentrations of clarithromycin and azithromycin in healthy adult volunteers. by Rodvold KA, Gotfried MH, Danziger LH, Servi RJ.; 1997 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163925

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Lack of Effect of Zafirlukast on the Pharmacokinetics of Azithromycin, Clarithromycin, and 14-Hydroxyclarithromycin in Healthy Volunteers. by Garey KW, Peloquin CA, Godo PG, Nafziger AN, Amsden GW.; 1999 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89125

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Levels of azithromycin and alpha-1 acid glycoprotein in serum in patients with community-acquired pneumonia. by Bohte R, Mattie H, van den Broek PJ.; 1995 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163034

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Localization of azithromycin in Toxoplasma gondii-infected cells. by Schwab JC, Cao Y, Slowik MR, Joiner KA.; 1994 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284602

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Microbiologic Efficacy of Azithromycin and Susceptibilities to Azithromycin of Isolates of Chlamydia pneumoniae from Adults and Children with CommunityAcquired Pneumonia. by Roblin PM, Hammerschlag MR.; 1998 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105482

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Mononuclear and Polymorphonuclear Leukocyte Dispositions of Clarithromycin and Azithromycin in AIDS Patients Requiring Mycobacterium avium Complex Prophylaxis. by Bui KQ, McNabb J, Li C, Nightingale CH, Nicolau DP.; 1999 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89466

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Mycobacterium avium strains resistant to clarithromycin and azithromycin. by Wolinsky E.; 1994 Mar; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284513

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Mycobacterium avium strains resistant to clarithromycin and azithromycin. by Heifets L, Mor N, Vanderkolk J.; 1993 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192393

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Once-a-week azithromycin in AIDS patients: tolerability, kinetics, and effects on zidovudine disposition. by Chave JP, Munafo A, Chatton JY, Dayer P, Glauser MP, Biollaz J.; 1992 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188827

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Outer membrane permeability barrier to azithromycin, clarithromycin, and roxithromycin in gram-negative enteric bacteria. by Vaara M.; 1993 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=187668

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Pharmacokinetic and in vivo studies with azithromycin (CP-62,993), a new macrolide with an extended half-life and excellent tissue distribution. by Girard AE, Girard D, English AR, Gootz TD, Cimochowski CR, Faiella JA, Haskell SL, Retsema JA.; 1987 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=175833

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Pharmacokinetics in Serum and Leukocyte Exposures of Oral Azithromycin, 1,500 Milligrams, Given over a 3- or 5-Day Period in Healthy Subjects. by Amsden GW, Nafziger AN, Foulds G.; 1999 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89039

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Pharmacokinetics of Azithromycin Administered Alone and with Atovaquone in Human Immunodeficiency Virus-Infected Children. by Ngo LY, Yogev R, Dankner WM, Hughes WT, Burchett S, Xu J, Sadler B, Unadkat JD.; 1999 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89312

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Pharmacokinetics of azithromycin in pediatric patients after oral administration of multiple doses of suspension. by Nahata MC, Koranyi KI, Gadgil SD, Hilligoss DM, Fouda HG, Gardner MJ.; 1993 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=187659

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Pharmacokinetics of azithromycin in pediatric patients with acute otitis media. by Nahata MC, Koranyi KI, Luke DR, Foulds G.; 1995 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162845

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Postantibiotic and Sub-MIC Effects of Azithromycin and Isepamicin against Staphylococcus aureus and Escherichia coli. by Fuentes F, Izquierdo J, Martin MM, Gomez-Lus ML, Prieto J.; 1998 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105424

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Postantibiotic Effect and Postantibiotic Sub-MIC Effect of Levofloxacin Compared to Those of Ofloxacin, Ciprofloxacin, Erythromycin, Azithromycin, and Clarithromycin against 20 Pneumococci. by Spangler SK, Lin G, Jacobs MR, Appelbaum PC.; 1998 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105793

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Postantibiotic effects and postantibiotic sub-MIC effects of roxithromycin, clarithromycin, and azithromycin on respiratory tract pathogens. by OdenholtTornqvist I, Lowdin E, Cars O.; 1995 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162512

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Potentiation of antibacterial activity of azithromycin and other macrolides by normal human serum. by Pruul H, McDonald PJ.; 1992 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=189218

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Prophylactic and therapeutic activities of azithromycin in a mouse model of pneumococcal pneumonia. by Azoulay-Dupuis E, Vallee E, Bedos JP, Muffat-Joly M, Pocidalo JJ.; 1991 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284280

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Prospective open randomized study comparing efficacies and safeties of a 3-day course of azithromycin and a 10-day course of erythromycin in children with

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community-acquired acute lower respiratory tract infections. by Roord JJ, Wolf BH, Gossens MM, Kimpen JL.; 1996 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163618 •

Relationship between antibiotic concentration in bone and efficacy of treatment of staphylococcal osteomyelitis in rats: azithromycin compared with clindamycin and rifampin. by O'Reilly T, Kunz S, Sande E, Zak O, Sande MA, Tauber MG.; 1992 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245530

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Rifabutin and sparfloxacin but not azithromycin inhibit binding of Mycobacterium avium complex to HT-29 intestinal mucosal cells. by Bermudez LE, Young LS, Inderlied CB.; 1994 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188180

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Safety, toleration, and pharmacokinetics of intravenous azithromycin. by Luke DR, Foulds G, Cohen SF, Levy B.; 1996 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163579

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Single-dose intrapulmonary pharmacokinetics of azithromycin, clarithromycin, ciprofloxacin, and cefuroxime in volunteer subjects. by Conte JE Jr, Golden J, Duncan S, McKenna E, Lin E, Zurlinden E.; 1996 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163383

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Single-Oral-Dose Azithromycin Prophylaxis against Experimental Streptococcal or Staphylococcal Aortic Valve Endocarditis. by Tsitsika A, Pefanis A, Perdikaris GS, Donta I, Karayiannakos P, Giamarellou H.; 2000 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89953

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Spectrum and mode of action of azithromycin (CP-62,993), a new 15-membered-ring macrolide with improved potency against gram-negative organisms. by Retsema J, Girard A, Schelkly W, Manousos M, Anderson M, Bright G, Borovoy R, Brennan L, Mason R.; 1987 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=175832

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Stimulation with cytokines enhances penetration of azithromycin into human macrophages. by Bermudez LE, Inderlied C, Young LS.; 1991 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245442

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Studies of the killing kinetics of benzylpenicillin, cefuroxime, azithromycin, and sparfloxacin on bacteria in the postantibiotic phase. by Odenholt I, Lowdin E, Cars O.; 1997 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=164155

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Susceptibilities of 201 anaerobes to erythromycin, azithromycin, clarithromycin, and roxithromycin by oxyrase agar dilution and E test methodologies. by Spangler SK, Jacobs MR, Appelbaum PC.; 1995 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=228167

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Susceptibility of penicillin-susceptible and -resistant pneumococci to dirithromycin compared with susceptibilities to erythromycin, azithromycin, clarithromycin, roxithromycin, and clindamycin. by Visalli MA, Jacobs MR, Appelbaum PC.; 1997 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=164026

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Synergistic activity of azithromycin and gamma interferon in murine toxoplasmosis. by Araujo FG, Remington JS.; 1991 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245240

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Synergistic activity of azithromycin and pyrimethamine or sulfadiazine in acute experimental toxoplasmosis. by Derouin F, Almadany R, Chau F, Rouveix B, Pocidalo JJ.; 1992 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188824

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Tolerance and Pharmacokinetic Interactions of Rifabutin and Azithromycin. by Hafner R, Bethel J, Standiford HC, Follansbee S, Cohn DL, Polk RE, Mole L, Raasch R, Kumar P, Mushatt D, Drusano G.; 2001 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90510

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Triangular test applied to the clinical trial of azithromycin against relapses in Plasmodium vivax infections. by Ranque S, Badiaga S, Delmont J, Brouqui P.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149384

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Uptake of azithromycin by human monocytes and enhanced intracellular antibacterial activity against Staphylococcus aureus. by Meyer AP, Bril-Bazuin C, Mattie H, van den Broek PJ.; 1993 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192385

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Uptake of azithromycin by various cells and its intracellular activity under in vivo conditions. by Wildfeuer A, Laufen H, Zimmermann T.; 1996 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163060

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Variability in susceptibilities of Haemophilus influenzae to clarithromycin and azithromycin due to medium pH. by Nilius AM, Beyer JM, Flamm RK, Tanaka SK.; 1997 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=229740

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web 6

PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with Zithromax, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “Zithromax” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for Zithromax (hyperlinks lead to article summaries): •

A 33-year-old woman with jaundice after azithromycin use. Author(s): Suriawinata A, Min AD. Source: Seminars in Liver Disease. 2002; 22(2): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12016551&dopt=Abstract

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A case of QT-interval prolongation precipitated by azithromycin. Author(s): Matsunaga N, Oki Y, Prigollini A. Source: N Z Med J. 2003 November 7; 116(1185): U666. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14615808&dopt=Abstract

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A comparative clinical trial of combinations of dihydroartemisinin plus azithromycin and dihydroartemisinin plus mefloquine for treatment of multidrug resistant falciparum malaria. Author(s): Krudsood S, Buchachart K, Chalermrut K, Charusabha C, Treeprasertsuk S, Haoharn O, Duangdee C, Looareesuwan S. Source: Southeast Asian J Trop Med Public Health. 2002 September; 33(3): 525-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12693587&dopt=Abstract

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A comparison of 5-day courses of dirithromycin and azithromycin in the treatment of acute exacerbations of chronic obstructive pulmonary disease. Author(s): Castaldo RS, Celli BR, Gomez F, LaVallee N, Souhrada J, Hanrahan JP. Source: Clinical Therapeutics. 2003 February; 25(2): 542-57. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749513&dopt=Abstract

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A multicenter, open-label, randomized comparison of levofloxacin and azithromycin plus ceftriaxone in hospitalized adults with moderate to severe community-acquired pneumonia. Author(s): Frank E, Liu J, Kinasewitz G, Moran GJ, Oross MP, Olson WH, Reichl V, Freitag S, Bahal N, Wiesinger BA, Tennenberg A, Kahn JB. Source: Clinical Therapeutics. 2002 August; 24(8): 1292-308. Erratum In: Clin Ther. 2003 March; 25(3): 1039. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240780&dopt=Abstract

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A prospective, randomized trial of pyrimethamine and azithromycin vs pyrimethamine and sulfadiazine for the treatment of ocular toxoplasmosis. Author(s): Bosch-Driessen LH, Verbraak FD, Suttorp-Schulten MS, van Ruyven RL, Klok AM, Hoyng CB, Rothova A. Source: American Journal of Ophthalmology. 2002 July; 134(1): 34-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12095805&dopt=Abstract

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A randomized controlled trial of azithromycin versus doxycycline/ciprofloxacin for the syndromic management of sexually transmitted infections in a resource-poor setting. Author(s): Rustomjee R, Kharsany AB, Connolly CA, Karim SS. Source: The Journal of Antimicrobial Chemotherapy. 2002 May; 49(5): 875-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12003988&dopt=Abstract

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A randomized, comparative pilot study of azithromycin versus benzathine penicillin G for treatment of early syphilis. Author(s): Hook EW 3rd, Martin DH, Stephens J, Smith BS, Smith K. Source: Sexually Transmitted Diseases. 2002 August; 29(8): 486-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172535&dopt=Abstract

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Activity of beta-lactams (ampicillin, meropenem), gentamicin, azithromycin and moxifloxacin against intracellular Listeria monocytogenes in a 24 h THP-1 human macrophage model. Author(s): Carryn S, Van Bambeke F, Mingeot-Leclercq MP, Tulkens PM. Source: The Journal of Antimicrobial Chemotherapy. 2003 April; 51(4): 1051-2. Epub 2003 March 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654747&dopt=Abstract

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Adverse and beneficial secondary effects of mass treatment with azithromycin to eliminate blindness due to trachoma in Nepal. Author(s): Fry AM, Jha HC, Lietman TM, Chaudhary JS, Bhatta RC, Elliott J, Hyde T, Schuchat A, Gaynor B, Dowell SF. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2002 August 15; 35(4): 395-402. Epub 2002 July 23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12145722&dopt=Abstract

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An outbreak of pneumococcal pneumonia among military personnel at high risk: control by low-dose azithromycin postexposure chemoprophylaxis. Author(s): Sanchez JL, Craig SC, Kolavic S, Hastings D, Alsip BJ, Gray GC, Hudspeth MK, Ryan MA. Source: Military Medicine. 2003 January; 168(1): 1-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546236&dopt=Abstract

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Azithromycin as treatment for cryptosporidiosis in human immunodeficiency virus disease. Author(s): Kadappu KK, Nagaraja MV, Rao PV, Shastry BA. Source: Journal of Postgraduate Medicine. 2002 July-September; 48(3): 179-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12432190&dopt=Abstract

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Azithromycin for acute bronchitis: a randomised, double-blind, controlled trial. Author(s): Evans AT, Husain S, Durairaj L, Sadowski LS, Charles-Damte M, Wang Y. Source: Lancet. 2002 May 11; 359(9318): 1648-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12020525&dopt=Abstract

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Azithromycin for odontogenic infection. Author(s): Cotter CJ, Bierne JC. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2003 October; 61(10): 1238; Author Reply 1238. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14586869&dopt=Abstract

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Azithromycin for the secondary prevention of coronary heart disease events: the WIZARD study: a randomized controlled trial. Author(s): O'Connor CM, Dunne MW, Pfeffer MA, Muhlestein JB, Yao L, Gupta S, Benner RJ, Fisher MR, Cook TD; Investigators in the WIZARD Study. Source: Jama : the Journal of the American Medical Association. 2003 September 17; 290(11): 1459-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13129985&dopt=Abstract

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Azithromycin for the treatment of pertussis. Author(s): Pichichero ME, Hoeger WJ, Casey JR. Source: The Pediatric Infectious Disease Journal. 2003 September; 22(9): 847-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14515842&dopt=Abstract

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Azithromycin found to be comparable to levofloxacin for the treatment of US travelers with acute diarrhea acquired in Mexico. Author(s): Adachi JA, Ericsson CD, Jiang ZD, DuPont MW, Martinez-Sandoval F, Knirsch C, DuPont HL. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 November 1; 37(9): 1165-71. Epub 2003 September 30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14557959&dopt=Abstract

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Azithromycin in a triple therapy for H.pylori eradication in active duodenal ulcer. Author(s): Ivashkin VT, Lapina TL, Bondarenko OY, Sklanskaya OA, Grigoriev PY, Vasiliev YV, Yakovenko EP, Gulyaev PV, Fedchenko VI. Source: World Journal of Gastroenterology : Wjg. 2002 October; 8(5): 879-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378634&dopt=Abstract

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Azithromycin in patients with cystic fibrosis chronically infected with Pseudomonas aeruginosa: a randomized controlled trial. Author(s): Saiman L, Marshall BC, Mayer-Hamblett N, Burns JL, Quittner AL, Cibene DA, Coquillette S, Fieberg AY, Accurso FJ, Campbell PW 3rd; Macrolide Study Group. Source: Jama : the Journal of the American Medical Association. 2003 October 1; 290(13): 1749-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14519709&dopt=Abstract

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Azithromycin in the treatment of cholera in children. Author(s): Bhattacharya MK, Dutta D, Ramamurthy T, Sarkar D, Singharoy A, Bhattacharya SK. Source: Acta Paediatrica (Oslo, Norway : 1992). 2003 June; 92(6): 676-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12856976&dopt=Abstract

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Azithromycin in the treatment of Legionella pneumonia requiring hospitalization. Author(s): Plouffe JF, Breiman RF, Fields BS, Herbert M, Inverso J, Knirsch C, Kolokathis A, Marrie TJ, Nicolle L, Schwartz DB. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 December 1; 37(11): 1475-80. Epub 2003 October 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14614670&dopt=Abstract

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Azithromycin is effective in patients with chronic bronchitis. Author(s): Kopjar B. Source: The Journal of Antimicrobial Chemotherapy. 2002 September; 50(3): 433-4; Author Reply 434. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12205072&dopt=Abstract

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Azithromycin modulates neutrophil function and circulating inflammatory mediators in healthy human subjects. Author(s): Culic O, Erakovic V, Cepelak I, Barisic K, Brajsa K, Ferencic Z, Galovic R, Glojnaric I, Manojlovic Z, Munic V, Novak-Mircetic R, Pavicic-Beljak V, Sucic M, Veljaca M, Zanic-Grubisic T, Parnham MJ. Source: European Journal of Pharmacology. 2002 August 30; 450(3): 277-289. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12208321&dopt=Abstract

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Azithromycin monotherapy for patients hospitalized with community-acquired pneumonia: a 31/2-year experience from a veterans affairs hospital. Author(s): Feldman RB, Rhew DC, Wong JY, Charles RA, Goetz MB; American Thoracic Society. Source: Archives of Internal Medicine. 2003 July 28; 163(14): 1718-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12885688&dopt=Abstract

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Azithromycin treatment coverage in Tanzanian children using community volunteers. Author(s): Lynch M, West S, Munoz B, Frick KD, Mkocha HA. Source: Ophthalmic Epidemiology. 2003 July; 10(3): 167-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12815491&dopt=Abstract

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Azithromycin treatment failure in community-acquired pneumonia caused by Streptococcus pneumoniae resistant to macrolides by a 23S rRNA mutation. Author(s): Kays MB, Wack MF, Smith DW, Denys GA. Source: Diagnostic Microbiology and Infectious Disease. 2002 June; 43(2): 163-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12088625&dopt=Abstract

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Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials. Author(s): Lau CY, Qureshi AK. Source: Sexually Transmitted Diseases. 2002 September; 29(9): 497-502. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12218839&dopt=Abstract

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Azithromycin versus penicillin V for treatment of acute group A streptococcal pharyngitis. Author(s): Schaad UB, Kellerhals P, Altwegg M; Swiss Pharyngitis Study Group. Source: The Pediatric Infectious Disease Journal. 2002 April; 21(4): 304-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12075761&dopt=Abstract

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Azithromycin vs doxycycline in the treatment of inclusion conjunctivitis. Author(s): Katusic D, Petricek I, Mandic Z, Petric I, Salopek-Rabatic J, Kruzic V, Oreskovic K, Sikic J, Petricek G. Source: American Journal of Ophthalmology. 2003 April; 135(4): 447-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654359&dopt=Abstract

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Azithromycin, a lysosomotropic antibiotic, has distinct effects on fluid-phase and receptor-mediated endocytosis, but does not impair phagocytosis in J774 macrophages. Author(s): Tyteca D, Van Der Smissen P, Mettlen M, Van Bambeke F, Tulkens PM, Mingeot-Leclercq MP, Courtoy PJ. Source: Experimental Cell Research. 2002 November 15; 281(1): 86-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441132&dopt=Abstract

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Azithromycin-induced intrahepatic cholestasis. Author(s): Chandrupatla S, Demetris AJ, Rabinovitz M. Source: Digestive Diseases and Sciences. 2002 October; 47(10): 2186-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12395890&dopt=Abstract

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Azithromycin-induced rash in infectious mononucleosis. Author(s): Dakdouki GK, Obeid KH, Kanj SS. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(12): 939-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587634&dopt=Abstract

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Bioequivalence assessment of Azomycin (Julphar, UAE) as compared to Zithromax (Pfizer, USA)--two brands of azithromycin--in healthy human volunteers. Author(s): Najib NM, Idkaidek N, Ghanem IE, Admour I, Mahmood Alam S, Zaman Q, Dham R. Source: Biopharmaceutics & Drug Disposition. 2001 January; 22(1): 15-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11745903&dopt=Abstract

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Community treatment with azithromycin for trachoma is not associated with antibiotic resistance in Streptococcus pneumoniae at 1 year. Author(s): Gaynor BD, Holbrook KA, Whitcher JP, Holm SO, Jha HC, Chaudhary JS, Bhatta RC, Lietman T. Source: The British Journal of Ophthalmology. 2003 February; 87(2): 147-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543738&dopt=Abstract

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Comparative analysis of azithromycin and ciprofloxacin in the treatment of chronic prostatitis caused by Chlamydia trachomatis. Author(s): Skerk V, Schonwald S, Krhen I, Banaszak A, Begovac J, Strugar J, Strapac Z, Vrsalovic R, Vukovic J, Tomas M. Source: International Journal of Antimicrobial Agents. 2003 May; 21(5): 457-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727080&dopt=Abstract

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Comparative analysis of azithromycin and clarithromycin efficacy and tolerability in the treatment of chronic prostatitis caused by Chlamydia trachomatis. Author(s): Skerk V, Schonwald S, Krhen I, Markovinovic L, Barsic B, Marekovic I, Roglic S, Zeljko Z, Vince A, Cajic V. Source: Journal of Chemotherapy (Florence, Italy). 2002 August; 14(4): 384-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420857&dopt=Abstract

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Comparative distribution of azithromycin in lung tissue of patients given oral daily doses of 500 and 1000 mg. Author(s): Danesi R, Lupetti A, Barbara C, Ghelardi E, Chella A, Malizia T, Senesi S, Angeletti CA, Del Tacca M, Campa M. Source: The Journal of Antimicrobial Chemotherapy. 2003 April; 51(4): 939-45. Epub 2003 February 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654753&dopt=Abstract

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Comparative intracellular (THP-1 macrophage) and extracellular activities of betalactams, azithromycin, gentamicin, and fluoroquinolones against Listeria monocytogenes at clinically relevant concentrations. Author(s): Carryn S, Van Bambeke F, Mingeot-Leclercq MP, Tulkens PM. Source: Antimicrobial Agents and Chemotherapy. 2002 July; 46(7): 2095-103. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069960&dopt=Abstract

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Comparative randomized trial of azithromycin versus erythromycin and amoxicillin for treatment of community-acquired pneumonia in children. Author(s): Kogan R, Martinez MA, Rubilar L, Paya E, Quevedo I, Puppo H, Girardi G, Castro-Rodriguez JA. Source: Pediatric Pulmonology. 2003 February; 35(2): 91-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12526069&dopt=Abstract

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Comparison of azithromycin and clarithromycin in triple therapy regimens for the eradication of Helicobacter pylori. Author(s): Sullivan B, Coyle W, Nemec R, Dunteman T. Source: The American Journal of Gastroenterology. 2002 October; 97(10): 2536-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12385435&dopt=Abstract

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Comparison of single-dose azithromycin and 12-dose, 3-day erythromycin for childhood cholera: a randomised, double-blind trial. Author(s): Khan WA, Saha D, Rahman A, Salam MA, Bogaerts J, Bennish ML. Source: Lancet. 2002 November 30; 360(9347): 1722-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480424&dopt=Abstract

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Comparison of two dosages of azithromycin for three days versus penicillin V for ten days in acute group A streptococcal tonsillopharyngitis. Author(s): Cohen R, Reinert P, De La Rocque F, Levy C, Boucherat M, Robert M, Navel M, Brahimi N, Deforche D, Palestro B, Bingen E. Source: The Pediatric Infectious Disease Journal. 2002 April; 21(4): 297-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12075760&dopt=Abstract

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Correct dose of azithromycin for patients scheduled to undergo dental procedures. Author(s): Rocha JL. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 September 15; 37(6): 860. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12955653&dopt=Abstract

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Correlation between erythromycin and azithromycin resistance in Streptococcus pneumoniae. Author(s): Wasas AD, Huebner RE, Hockman M, Klugman KP. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2003 April; 93(4): 283. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12806721&dopt=Abstract

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Cost-effectiveness of IV-to-oral switch therapy: azithromycin vs cefuroxime with or without erythromycin for the treatment of community-acquired pneumonia. Author(s): Paladino JA, Gudgel LD, Forrest A, Niederman MS. Source: Chest. 2002 October; 122(4): 1271-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377852&dopt=Abstract

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Delirium in the elderly resulting from azithromycin therapy. Author(s): Cone LA, Padilla L, Potts BE. Source: Surgical Neurology. 2003 June; 59(6): 509-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826358&dopt=Abstract

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Determination of intracellular efficacies of azithromycin against Leishmania major infection in human neutrophils in vitro. Author(s): Tanyuksel M, Bas AL, Araz E, Aybay C. Source: Cell Biochemistry and Function. 2003 March; 21(1): 93-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12579528&dopt=Abstract

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Disposition and intracellular activity of azithromycin in human THP-1 acute monocytes. Author(s): Hall IH, Schwab UE, Ward ES, Butts JD, Wolford ET, Ives TJ. Source: International Journal of Antimicrobial Agents. 2002 November; 20(5): 348-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12431870&dopt=Abstract

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Double-blind, placebo-controlled study comparing the effect of azithromycin with clarithromycin on oropharyngeal and bowel microflora in volunteers. Author(s): Matute AJ, Schurink CA, Krijnen RM, Florijn A, Rozenberg-Arska M, Hoepelman IM. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2002 June; 21(6): 427-31. Epub 2002 June 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12111597&dopt=Abstract

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Effect of azithromycin in the treartment of cyclosporine-induced gingival hyperplasia in renal transplant recipients. Author(s): Kwun WH, Suh BY, Kwun KB. Source: Transplantation Proceedings. 2003 February; 35(1): 311-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12591416&dopt=Abstract

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Effect of azithromycin on endothelial function of patients with coronary artery disease and evidence of Chlamydia pneumoniae infection. Author(s): Hammerschlag MR. Source: Circulation. 2002 October 8; 106(15): E65-6; Author Reply E65-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370232&dopt=Abstract

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Effect of short-term treatment with azithromycin on recurrent ischaemic events in patients with acute coronary syndrome in the Azithromycin in Acute Coronary Syndrome (AZACS) trial: a randomised controlled trial. Author(s): Cercek B, Shah PK, Noc M, Zahger D, Zeymer U, Matetzky S, Maurer G, Mahrer P; AZACS Investigators. Source: Lancet. 2003 March 8; 361(9360): 809-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12642046&dopt=Abstract

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Effects of azithromycin on shiga toxin production by Escherichia coli and subsequent host inflammatory response. Author(s): Ohara T, Kojio S, Taneike I, Nakagawa S, Gondaira F, Tamura Y, Gejyo F, Zhang HM, Yamamoto T. Source: Antimicrobial Agents and Chemotherapy. 2002 November; 46(11): 3478-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12384353&dopt=Abstract

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Efficacy and safety of azithromycin as monotherapy or combined with metronidazole compared with two standard multidrug regimens for the treatment of acute pelvic inflammatory disease. Author(s): Bevan CD, Ridgway GL, Rothermel CD. Source: J Int Med Res. 2003 January-February; 31(1): 45-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12635534&dopt=Abstract

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Efficacy and safety of azithromycin vs levofloxacin in the outpatient treatment of acute bacterial exacerbations of chronic bronchitis. Author(s): Amsden GW, Baird IM, Simon S, Treadway G. Source: Chest. 2003 March; 123(3): 772-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12628877&dopt=Abstract

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Efficacy of azithromycin in the treatment of cutaneous leishmaniasis. Author(s): Prata A, Silva-Vergara ML, Costa L, Rocha A, Krolewiecki A, Silva JC, de Paula EV, Pimenta Junior FG, Giraldo LE. Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2003 January-February; 36(1): 65-9. Epub 2003 April 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12715065&dopt=Abstract

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Efficacy of azithromycin, praziquantel and mirazid in treatment of cryptosporidiosis in school children. Author(s): Allam AF, Shehab AY. Source: J Egypt Soc Parasitol. 2002 December; 32(3): 969-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12512828&dopt=Abstract

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Efficacy of single-dose azithromycin in treatment of acute otitis media in children after a baseline tympanocentesis. Author(s): Dunne MW, Khurana C, Mohs AA, Rodriguez A, Arrieta A, McLinn S, Krogstad JA, Blatter M, Schwartz R, Vargas SL, Emparanza P, Fernandez P, Gooch WM 3rd, Aspin M, Podgore J, Roine I, Blumer JL, Ehrlich GD, Chow J. Source: Antimicrobial Agents and Chemotherapy. 2003 August; 47(8): 2663-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12878537&dopt=Abstract

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Emergence of gonococcal strains with resistance to azithromycin in Spain. Author(s): Arreaza L, Vazquez F, Alcala B, Otero L, Salcedo C, Vazquez JA. Source: The Journal of Antimicrobial Chemotherapy. 2003 January; 51(1): 190-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12493814&dopt=Abstract

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Height as a proxy for weight in determining azithromycin treatment for paediatric trachoma. Author(s): Basilion EV, Kilima PM, Turner VM, Mecaskey JW. Source: Trans R Soc Trop Med Hyg. 2002 November-December; 96(6): 691-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625152&dopt=Abstract

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High percentages of resistance to tetracycline and penicillin and reduced susceptibility to azithromycin characterize the majority of strain types of Neisseria gonorrhoeae isolates in Cuba, 1995-1998. Author(s): Sosa J, Ramirez-Arcos S, Ruben M, Li H, Llanes R, Llop A, Dillon JA. Source: Sexually Transmitted Diseases. 2003 May; 30(5): 443-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12916137&dopt=Abstract

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Household willingness to pay for azithromycin treatment for trachoma control in the United Republic of Tanzania. Author(s): Frick KD, Lynch M, West S, Munoz B, Mkocha HA. Source: Bulletin of the World Health Organization. 2003; 81(2): 101-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12751418&dopt=Abstract

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Impact of azithromycin administration for trachoma control on the carriage of antibiotic-resistant Streptococcus pneumoniae. Author(s): Batt SL, Charalambous BM, Solomon AW, Knirsch C, Massae PA, Safari S, Sam NE, Everett D, Mabey DC, Gillespie SH. Source: Antimicrobial Agents and Chemotherapy. 2003 September; 47(9): 2765-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12936971&dopt=Abstract

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Impact of single dose azithromycin on group A streptococci in the upper respiratory tract and skin of Aboriginal children. Author(s): Shelby-James TM, Leach AJ, Carapetis JR, Currie BJ, Mathews JD. Source: The Pediatric Infectious Disease Journal. 2002 May; 21(5): 375-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12150171&dopt=Abstract

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Improved tonsillar disposition of azithromycin following a 3-day oral treatment with 20 mg kg(-1) in paediatric patients. Author(s): Baschiera F, Fornai M, Lazzeri G, Blandizzi C, Bruschini P, del Tacca M. Source: Pharmacological Research : the Official Journal of the Italian Pharmacological Society. 2002 July; 46(1): 95-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12208127&dopt=Abstract

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Influence of macrolide susceptibility on efficacies of clarithromycin and azithromycin against Streptococcus pneumoniae in a murine lung infection model. Author(s): Hoffman HL, Klepser ME, Ernst EJ, Petzold CR, Sa'adah LM, Doern GV. Source: Antimicrobial Agents and Chemotherapy. 2003 February; 47(2): 739-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543686&dopt=Abstract

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Is azithromycin the first-choice macrolide for treatment of community-acquired pneumonia? Author(s): Sanchez F, Mensa J, Martinez JA, Garcia E, Marco F, Gonzalez J, Marcos MA, Soriano A, Torres A. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 May 15; 36(10): 1239-45. Epub 2003 May 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12746768&dopt=Abstract

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Is azithromycin treatment associated with prolongation of the Q-Tc interval? Author(s): Strle F, Maraspin V. Source: Wiener Klinische Wochenschrift. 2002 June 14; 114(10-11): 396-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708094&dopt=Abstract

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Long term azithromycin in children with cystic fibrosis: a randomised, placebocontrolled crossover trial. Author(s): Equi A, Balfour-Lynn IM, Bush A, Rosenthal M. Source: Lancet. 2002 September 28; 360(9338): 978-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12383667&dopt=Abstract

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Low efficacy of an ultra-short term, once-daily dose triple therapy with omeprazole, azithromycin, and secnidazole for Helicobacter pylori eradication in peptic ulcer. Author(s): Silva FM, Eisig JN, Chehter EZ, da Silva JJ, Laudanna AA. Source: Revista Do Hospital Das Clinicas. 2002 January-February; 57(1): 9-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12170343&dopt=Abstract

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Maintenance azithromycin therapy for bronchiolitis obliterans syndrome: results of a pilot study. Author(s): Gerhardt SG, McDyer JF, Girgis RE, Conte JV, Yang SC, Orens JB. Source: American Journal of Respiratory and Critical Care Medicine. 2003 July 1; 168(1): 121-5. Epub 2003 April 02. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672648&dopt=Abstract

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Maternal and transplacental pharmacokinetics of azithromycin. Author(s): Ramsey PS, Vaules MB, Vasdev GM, Andrews WW, Ramin KD. Source: American Journal of Obstetrics and Gynecology. 2003 March; 188(3): 714-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634646&dopt=Abstract

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Mutations causing in vitro resistance to azithromycin in Neisseria gonorrhoeae. Author(s): Johnson SR, Sandul AL, Parekh M, Wang SA, Knapp JS, Trees DL. Source: International Journal of Antimicrobial Agents. 2003 May; 21(5): 414-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727073&dopt=Abstract

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No advantage of treating acute respiratory tract infections with azithromycin in a placebo-controlled study. Author(s): Batieha A, Yahia G, Mahafzeh T, Omari M, Momani A, Dabbas M. Source: Scandinavian Journal of Infectious Diseases. 2002; 34(4): 243-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064684&dopt=Abstract

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Norfloxacin and azithromycin for treatment of nontyphoidal salmonella carriers. Author(s): Sirinavin S, Thavornnunth J, Sakchainanont B, Bangtrakulnonth A, Chongthawonsatid S, Junumporn S. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 September 1; 37(5): 685-91. Epub 2003 August 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942401&dopt=Abstract

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Omeprazole plus azithromycin and either amoxicillin or tinidazole for eradication of Helicobacter pylori infection. Author(s): Anagnostopoulos GK, Kostopoulos P, Margantinis G, Tsiakos S, Arvanitidis D. Source: Journal of Clinical Gastroenterology. 2003 April; 36(4): 325-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12642739&dopt=Abstract

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Patient-delivered partner treatment with azithromycin to prevent repeated Chlamydia trachomatis infection among women: a randomized, controlled trial. Author(s): Schillinger JA, Kissinger P, Calvet H, Whittington WL, Ransom RL, Sternberg MR, Berman SM, Kent CK, Martin DH, Oh MK, Handsfield HH, Bolan G, Markowitz LE, Fortenberry JD. Source: Sexually Transmitted Diseases. 2003 January; 30(1): 49-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12514443&dopt=Abstract

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Pattern of antibiotic use in a trachoma-endemic region of Nepal: implications for mass azithromycin distribution. Author(s): Schiedler V, Bhatta RC, Miao Y, Bird M, Jha H, Chaudary JS, Fry AM, Lietman TM. Source: Ophthalmic Epidemiology. 2003 February; 10(1): 31-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12607157&dopt=Abstract

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Pharmacodynamic activity of azithromycin against macrolide-susceptible and resistant Streptococcus pneumoniae simulating clinically achievable free serum, epithelial lining fluid and middle ear fluid concentrations. Author(s): Zhanel GG, DeCorby M, Noreddin A, Mendoza C, Cumming A, Nichol K, Wierzbowski A, Hoban DJ. Source: The Journal of Antimicrobial Chemotherapy. 2003 July; 52(1): 83-8. Epub 2003 May 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775677&dopt=Abstract

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Pharmacokinetics of azithromycin in lung tissue, bronchial washing, and plasma in patients given multiple oral doses of 500 and 1000 mg daily. Author(s): Di Paolo A, Barbara C, Chella A, Angeletti CA, Del Tacca M. Source: Pharmacological Research : the Official Journal of the Italian Pharmacological Society. 2002 December; 46(6): 545-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457629&dopt=Abstract

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Pharmacokinetics of intravenous azithromycin and ceftriaxone when administered alone and concurrently to healthy volunteers. Author(s): Chiu LM, Menhinick AM, Johnson PW, Amsden GW. Source: The Journal of Antimicrobial Chemotherapy. 2002 December; 50(6): 1075-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461037&dopt=Abstract

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Randomized comparison of azithromycin versus cefixime for treatment of shigellosis in children. Author(s): Basualdo W, Arbo A. Source: The Pediatric Infectious Disease Journal. 2003 April; 22(4): 374-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12712971&dopt=Abstract

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Randomized double-blind study comparing 3- and 6-day regimens of azithromycin with a 10-day amoxicillin-clavulanate regimen for treatment of acute bacterial sinusitis. Author(s): Henry DC, Riffer E, Sokol WN, Chaudry NI, Swanson RN. Source: Antimicrobial Agents and Chemotherapy. 2003 September; 47(9): 2770-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12936972&dopt=Abstract

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Randomized trial of azithromycin in the prophylaxis of Mediterranean spotted fever. Author(s): Dzelalija B, Petrovec M, Avsic-Zupanc T, Strugar J, Milic TA. Source: Acta Med Croatica. 2002; 56(2): 45-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12596623&dopt=Abstract

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Reduction of MIC of azithromycin for Salmonella typhi and Staphylococcus aureus in broth exposed to previous growth of Salmonella typhi. Author(s): Butler T. Source: The Journal of Antimicrobial Chemotherapy. 2002 July; 50(1): 143-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12096025&dopt=Abstract

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Reoccurrence of culture-positive pertussis in an infant initially treated with azithromycin and steroids. Author(s): Steinberg JM, Srugo I. Source: Archives of Pediatrics & Adolescent Medicine. 2002 October; 156(10): 1057-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361458&dopt=Abstract

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Solitary erythema migrans in children: comparison of treatment with azithromycin and phenoxymethylpenicillin. Author(s): Arnez M, Pleterski-Rigler D, Luznik-Bufon T, Ruzic-Sabljic E, Strle F. Source: Wiener Klinische Wochenschrift. 2002 July 31; 114(13-14): 498-504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422590&dopt=Abstract

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Steady-state plasma and bronchopulmonary concentrations of intravenous levofloxacin and azithromycin in healthy adults. Author(s): Rodvold KA, Danziger LH, Gotfried MH. Source: Antimicrobial Agents and Chemotherapy. 2003 August; 47(8): 2450-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12878504&dopt=Abstract

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Targeted mass treatment for syphilis with oral azithromycin. Author(s): Rekart ML, Patrick DM, Chakraborty B, Maginley JJ, Jones HD, Bajdik CD, Pourbohloul B, Brunham RC. Source: Lancet. 2003 January 25; 361(9354): 313-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12559870&dopt=Abstract

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Tendon or joint disorders in children after treatment with fluoroquinolones or azithromycin. Author(s): Yee CL, Duffy C, Gerbino PG, Stryker S, Noel GJ. Source: The Pediatric Infectious Disease Journal. 2002 June; 21(6): 525-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12182376&dopt=Abstract

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The cost-effectiveness of single-dose azithromycin for treatment of incubating syphilis. Author(s): Blandford JM, Gift TL. Source: Sexually Transmitted Diseases. 2003 June; 30(6): 502-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782951&dopt=Abstract

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The effect of amoxicillin-clavulanate, cefixime and azithromycin on normal throat flora in children with group A streptococcal pharyngitis. Author(s): Rush C, Simon MW. Source: Clinical Pediatrics. 2003 June; 42(5): 447-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12862350&dopt=Abstract

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The efficacy of azithromycin in the treatment of acute infraorbital space infection. Author(s): Al-Belasy FA, Hairam AR. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2003 March; 61(3): 310-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618970&dopt=Abstract

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The natural history of recurrent acute tonsillitis and a clinical trial of azithromycin for antibiotic prophylaxis. Author(s): Lildholdt T, Doessing H, Lyster M, Outzen KE. Source: Clinical Otolaryngology and Allied Sciences. 2003 August; 28(4): 371-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12871256&dopt=Abstract

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The new macrolactones: clarithromycin (Biaxin) and azithromycin (Zithromax). Author(s): Peltier K. Source: Conn Med. 1992 July; 56(7): 371-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1330429&dopt=Abstract

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Tolerability of azithromycin as malaria prophylaxis in adults in northeast papua, indonesia. Author(s): Taylor WR, Richie TL, Fryauff DJ, Ohrt C, Picarima H, Tang D, Murphy GS, Widjaja H, Braitman D, Tjitra E, Ganjar A, Jones TR, Basri H, Berman J. Source: Antimicrobial Agents and Chemotherapy. 2003 July; 47(7): 2199-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12821468&dopt=Abstract

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Treatment of cast bronchitis with low-dose oral azithromycin. Author(s): Schultz KD, Oermann CM. Source: Pediatric Pulmonology. 2003 February; 35(2): 139-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12526076&dopt=Abstract

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Triangular test applied to the clinical trial of azithromycin against relapses in Plasmodium vivax infections. Author(s): Ranque S, Badiaga S, Delmont J, Brouqui P. Source: Malaria Journal [electronic Resource]. 2002 November 12; 1(1): 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12473182&dopt=Abstract

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Use of directly observed azithromycin treatment for syphilis in a homeless woman. Author(s): Campos-Outcalt D, Hurwitz S, Mickey T. Source: Sexually Transmitted Diseases. 2002 June; 29(6): 372. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12035029&dopt=Abstract

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Visual compatibility of azithromycin with 24 commonly used drugs during simulated Y-site delivery. Author(s): Voytilla KL, Tyler LS, Rusho WJ. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2002 May 1; 59(9): 853-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12004465&dopt=Abstract

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CHAPTER 2. NUTRITION AND ZITHROMAX Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and Zithromax.

Finding Nutrition Studies on Zithromax The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “Zithromax” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

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Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “Zithromax” (or a synonym): •

A randomized clinical trial of combinations of artesunate and azithromycin for treatment of uncomplicated Plasmodium falciparum malaria in Thailand. Author(s): Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. Source: Krudsood, S Silachamroon, U Wilairatana, P Singhasivanon, P Phumratanaprapin, W Chalermrut, K Phophak, N Popa, C Southeast-Asian-J-Trop-MedPublic-Health. 2000 December; 31(4): 801-7 0125-1562

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Ability of azithromycin in combination with quinine for the elimination of babesial infection in humans. Author(s): Department of Parasitology and Tropical Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China. Source: Shih, C M Wang, C C Am-J-Trop-Med-Hyg. 1998 October; 59(4): 509-12 00029637

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Activities of azithromycin and clarithromycin against nontuberculous mycobacteria in beige mice. Author(s): State University of New York Health Science Center, Syracuse. Source: Klemens, S P Cynamon, M H Antimicrob-Agents-Chemother. 1994 July; 38(7): 1455-9 0066-4804

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Activity of artemether-azithromycin versus artemether-doxycycline in the treatment of multiple drug resistant falciparum malaria. Author(s): Clinical Pharmacology Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. Source: Na Bangchang, K Kanda, T Tipawangso, P Thanavibul, A Suprakob, K Ibrahim, M Wattanagoon, Y Karbwang, J Southeast-Asian-J-Trop-Med-Public-Health. 1996 September; 27(3): 522-5 0038-3619

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Activity of azithromycin as a blood schizonticide against rodent and human plasmodia in vivo. Author(s): Division of Experimental Therapeutics, Walter Reed Army Institute of Research, Washington, District of Columbia. Source: Andersen, S L Ager, A McGreevy, P Schuster, B G Wesche, D Kuschner, R Ohrt, C Ellis, W Rossan, R Berman, J Am-J-Trop-Med-Hyg. 1995 February; 52(2): 159-61 00029637

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Atovaquone and azithromycin for the treatment of babesiosis. Author(s): Division of Infectious Diseases, Connecticut Children's Medical Center and the University of Connecticut School of Medicine, Hartford 06106, USA. [email protected] Source: Krause, P J Lepore, T Sikand, V K Gadbaw, J Burke, G Telford, S R Brassard, P Pearl, D Azlanzadeh, J Christianson, D McGrath, D Spielman, A N-Engl-J-Med. 2000 November 16; 343(20): 1454-8 0028-4793

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Azithromycin concentrations at the sites of pulmonary infection. Author(s): Dept of Thoracic Medicine, Dudley Road Hospital, Birmingham, UK. Source: Baldwin, D R Wise, R Andrews, J M Ashby, J P Honeybourne, D Eur-Respir-J. 1990 September; 3(8): 886-90 0903-1936

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Azithromycin drug interactions. Author(s): Clinical and Safety Regulatory Affairs, PFYZER Central Research, Sandwich, UK.

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Source: Felstead, S Pathol-Biol-(Paris). 1995 June; 43(6): 512-4 0369-8114 •

Azithromycin for acute bronchitis: a randomised, double-blind, controlled trial. Author(s): Collaborative Research Unit, Department of Medicine, Cook County Hospital and Rush Medical College, Chicago, IL 60612, USA. [email protected] Source: Evans, Arthur T Husain, Shahid Durairaj, Lakshmi Sadowski, Laura S Charles Damte, Marjorie Wang, Yue Lancet. 2002 May 11; 359(9318): 1648-54 0140-6736

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Azithromycin impact on neutrophil oxidative metabolism depends on exposure time. Author(s): Laboratoire de Pharmacologie et Pharmacie Clinique, Faculte des Sciences Pharmaceutiques et Biologiques, Lille, France. Source: Levert, H Gressier, B Moutard, I Brunet, C Dine, T Luyckx, M Cazin, M Cazin, J C Inflammation. 1998 April; 22(2): 191-201 0360-3997

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Azithromycin modulates neutrophil function and circulating inflammatory mediators in healthy human subjects. Author(s): PLIVA d.d., Research Division, Prilaz Baruna Filipovica 25 HR-10 000, Zagreb, Croatia. Source: Culic, O Erakovic, V Cepelak, I Barisic, K Brajsa, K Ferencic, Z Galovic, R Glojnaric, I Manojlovic, Z Munic, V Novak Mircetic, R Pavicic Beljak, V Sucic, M Veljaca, M Zanic Grubisic, T Parnham, M J Eur-J-Pharmacol. 2002 August 30; 450(3): 277-289 0014-2999

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Azithromycin no more effective than vitamin C for acute bronchitis. Author(s): Dept of Family Medicine, University of Virginia, Stoney Creek Family Practice, Nellysford, VA, USA. [email protected] Source: Tribastone, A D J-Fam-Pract. 2002 September; 51(9): 783 0094-3509

•

Azithromycin triple therapy for Helicobacter pylori infection: azithromycin, tetracycline, and bismuth. Author(s): Department of Medicine, Veterans Affairs Medical Center, Houston, Texas. Source: al Assi, M T Genta, R M Karttunen, T J Cole, R A Graham, D Y Am-JGastroenterol. 1995 March; 90(3): 403-5 0002-9270

•

Bleeding complication during coumarin therapy due to amiodarone and azithromycin. Author(s): Department of Cardiology, Tata Main Hospital, Jamshedpur, Bihar, 831 001. Source: Bharat, V Mohanty, B J-Assoc-Physicians-India. 2000 July; 48(7): 746-7 0004-5772

•

Chlamydia pneumoniae antigens facilitate experimental aortic dilatation: prevention with azithromycin. Author(s): Imperial College at Charing Cross, London, United Kingdom. Source: Tambiah, J Powell, J T J-Vasc-Surg. 2002 November; 36(5): 1011-7 0741-5214

•

Clinical toleration and safety of azithromycin. Author(s): Pfizer Central Research, Groton, Connecticut 06340. Source: Hopkins, S Am-J-Med. 1991 September 12; 91(3A): 40S-45S 0002-9343

•

Comparative activities of azithromycin and clarithromycin against Mycobacterium avium infection in beige mice. Author(s): Veterans Affairs Medical Center, Syracuse, New York 13210. Source: Cynamon, M H Klemens, S P Grossi, M A Antimicrob-Agents-Chemother. 1994 July; 38(7): 1452-4 0066-4804

•

Comparative pharmacodynamics of clarithromycin and azithromycin against respiratory pathogens. Author(s): Max von Pettenkofer Institut, Universitat Munchen, Germany.

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Source: Bauernfeind, A Jungwirth, R Eberlein, E Infection. 1995 Sep-October; 23(5): 31621 0300-8126 •

Comparison of azithromycin and clarithromycin in triple therapy regimens for the eradication of Helicobacter pylori. Author(s): Naval Medical Center Portsmouth, Virginia, USA. Source: Sullivan, B Coyle, W Nemec, R Dunteman, T Am-J-Gastroenterol. 2002 October; 97(10): 2536-9 0002-9270

•

Comparison of bronchopulmonary pharmacokinetics of clarithromycin and azithromycin. Author(s): Department of Pharmacy Practice, Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, New York 11201, USA. Source: Patel, K B Xuan, D Tessier, P R Russomanno, J H Quintiliani, R Nightingale, C H Antimicrob-Agents-Chemother. 1996 October; 40(10): 2375-9 0066-4804

•

Comparison of the palatability of the oral suspension of cefdinir vs. amoxicillin/clavulanate potassium, cefprozil and azithromycin in pediatric patients. Author(s): Hill Top Research, Inc, Scottsdale, AZ, USA. Source: Powers, J L Gooch, W M 3rd Oddo, L P Pediatr-Infect-Dis-J. 2000 December; 19(12 Suppl): S174-80 0891-3668

•

Efficacy of azithromycin for treating Babesia microti infection in the hamster model. Author(s): Dept. of Pathology, Albert Einstein College of Medicine, Bronx, New York 10461. Source: Weiss, L M Wittner, M Wasserman, S Oz, H S Retsema, J Tanowitz, H B J-InfectDis. 1993 November; 168(5): 1289-92 0022-1899

•

Ethanol feeding does not affect the efficacy or pharmacokinetics of azithromycin, trovafloxacin, or ceftriaxone in a rat model of pneumococcal pneumonia. Author(s): Infectious Diseases Section, Veterans Affairs Medical Center, Creighton University School of Medicine, Omaha, Nebraska 68105, USA. [email protected] Source: Preheim, L C Olsen, K M Yue, M Snitily, M U Gentry, M J Alcohol-Clin-Exp-Res. 1999 May; 23(5): 842-9 0145-6008

•

Evaluation of the efficacy of atovaquone alone or in combination with azithromycin against acute murine toxoplasmosis. Author(s): Parasitology Department, Medical Science Faculty, Tarbiat Modarres University, Tehran, IR, Iran. Source: Moshkani, S K Dalimi, A Vet-Res-Commun. 2000 April; 24(3): 169-77 0165-7380

•

Factors affecting the intracellular accumulation and activity of azithromycin. Author(s): Department of Microbiology, School of Medicine, Sevilla, Spain. Source: Pascual, A Conejo, M C Garcia, I Perea, E J J-Antimicrob-Chemother. 1995 January; 35(1): 85-93 0305-7453

•

In vitro and in vivo intraleukocytic accumulation of azithromycin (CP-62, 993) and its influence on ex vivo leukocyte chemiluminescence. Author(s): Service de Medecine, Institut Jules Bordet, Universite Libre de Bruxelles, Belgium. Source: Bonnet, M Van der Auwera, P Antimicrob-Agents-Chemother. 1992 June; 36(6): 1302-9 0066-4804

•

In vitro comparative dynamics of modified-release clarithromycin and of azithromycin. Author(s): Department of Pharmacology, University of Milan, Italy.

Nutrition

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Source: Scaglione, F Demartini, G Dugnani, S Fraschini, F Chemotherapy. 2000 SepOctober; 46(5): 342-52 0009-3157 •

In vitro effects of azithromycin on Salmonella typhi: early inhibition by concentrations less than the MIC and reduction of MIC by alkaline pH and small inocula. Author(s): Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA. [email protected] Source: Butler, T Frenck, R W Johnson, R B Khakhria, R J-Antimicrob-Chemother. 2001 April; 47(4): 455-8 0305-7453

•

In vivo administration of azithromycin affects lymphocyte activity in vitro. Author(s): Department of Infectious Diseases, University Medical Center Ljubljana, Japljeva, Slovenia. Source: Tomazic, J Kotnik, V Wraber, B Antimicrob-Agents-Chemother. 1993 September; 37(9): 1786-9 0066-4804

•

Infection with Chlamydia pneumoniae accelerates the development of atherosclerosis and treatment with azithromycin prevents it in a rabbit model. Author(s): University of Utah, LDS Hospital, Salt Lake City 84143, USA. Source: Muhlestein, J B Anderson, J L Hammond, E H Zhao, L Trehan, S Schwobe, E P Carlquist, J F Circulation. 1998 February 24; 97(7): 633-6 0009-7322

•

Influence of outer membrane mutations on susceptibility of Escherichia coli to the dibasic macrolide azithromycin. Author(s): Department of Microbiology, University of British Columbia, Vancouver, Canada. Source: Farmer, S Li, Z S Hancock, R E J-Antimicrob-Chemother. 1992 January; 29(1): 2733 0305-7453

•

Intermittent azithromycin for treatment of Mycobacterium avium infection in beige mice. Author(s): State University of New York Health Science Center, Syracuse 13210. Source: Klemens, S P Cynamon, M H Antimicrob-Agents-Chemother. 1994 August; 38(8): 1721-5 0066-4804

•

Intracellular accumulation of azithromycin by cultured human fibroblasts. Author(s): Central Research Division, Pfizer, Inc., Groton, Connecticut 06340. Source: Gladue, R P Snider, M E Antimicrob-Agents-Chemother. 1990 June; 34(6): 105660 0066-4804

•

Life-threatening babesiosis in an asplenic patient treated with exchange transfusion, azithromycin, and atovaquone. Author(s): Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501, USA. Source: Bonoan, J T Johnson, D H Cunha, B A Heart-Lung. 1998 Nov-December; 27(6): 424-8 0147-9563

•

Low- versus high-dose azithromycin triple therapy for Helicobacter pylori infection. Author(s): Department of Internal Medicine, University of Michigan, Ann Arbor, USA. [email protected] Source: Chey, W D Fisher, L Barnett, J Delvalle, J Elta, G H Hasler, W L Nostrant, T Palaniappan, J Scheiman, J Aliment-Pharmacol-Ther. 1998 December; 12(12): 1263-7 0269-2813

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Pharmacokinetics of azithromycin administered alone and with atovaquone in human immunodeficiency virus-infected children. The ACTG 254 Team. Author(s): Department of Pharmaceutics, University of Washington, Seattle, Washington 98195, USA. Source: Ngo, L Y Yogev, R Dankner, W M Hughes, W T Burchett, S Xu, J Sadler, B Unadkat, J D Antimicrob-Agents-Chemother. 1999 June; 43(6): 1516-9 0066-4804

•

Potential interaction between azithromycin and warfarin. Author(s): College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, Michigan, USA. Source: Foster, D R Milan, N L Pharmacotherapy. 1999 July; 19(7): 902-8 0277-0008

•

Quantitative determination of the macrolide antibiotics erythromycin, roxithromycin, azithromycin and clarithromycin in human serum by high-performance liquid chromatography using pre-column derivatization with 9-fluorenylmethyloxycarbonyl chloride and fluorescence detection. Author(s): Department of Pharmacy, Academic Medical Center, University of Amsterdam, The Netherlands. Source: Sastre Torano, J Guchelaar, H J J-Chromatogr-B-Biomed-Sci-Appl. 1998 December 11; 720(1-2): 89-97 1387-2273

•

Reduced serum theophylline concentrations after discontinuation of azithromycin: evidence for an unusual interaction. Author(s): Department of Medicine, College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada. Source: Pollak, P T Slayter, K L Pharmacotherapy. 1997 Jul-August; 17(4): 827-9 02770008

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Requirements for intracellular accumulation and release of clarithromycin and azithromycin by human phagocytes. Author(s): Chair of Chemotherapy, University of Pavia, IRCCS Policlinico San Matteo, Italy. Source: Fietta, A Merlini, C Gialdroni Grassi, G J-Chemother. 1997 February; 9(1): 23-31 1120-009X

•

Response of babesiosis to a combined regimen of quinine and azithromycin. Author(s): Department of Parasitology and Tropical Medicine, National Defence Medical Centre, Taipei, Taiwan. Source: Shaio, M F Yang, K D Trans-R-Soc-Trop-Med-Hyg. 1997 Mar-April; 91(2): 214-5 0035-9203

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Retrospective evaluation of a potential interaction between azithromycine and warfarin in patients stabilized on warfarin. Author(s): Department of Veterans Affairs Medical Center, West Palm Beach, Florida 33410, USA. Source: Beckey, N P Parra, D Colon, A Pharmacotherapy. 2000 September; 20(9): 1055-9 0277-0008

•

The absence of an effect of food on the bioavailability of azithromycin administered as tablets, sachet or suspension. Author(s): Central Research Division, Pfizer Inc., Groton, CT 06340, USA. Source: Foulds, G Luke, D R Teng, R Willavize, S A Friedman, H Curatolo, W J JAntimicrob-Chemother. 1996 June; 37 Suppl C37-44 0305-7453

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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

•

Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMD®Health: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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The following is a specific Web list relating to Zithromax; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Vitamin K Source: Healthnotes, Inc.; www.healthnotes.com

•

Minerals Magnesium Source: Healthnotes, Inc.; www.healthnotes.com

43

CHAPTER 3. ALTERNATIVE MEDICINE AND ZITHROMAX Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to Zithromax. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to Zithromax and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “Zithromax” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to Zithromax: •

Chlamydia trachomatis genitourinary infections: laboratory diagnosis and therapeutic aspects. Evaluation of in vitro and in vivo effectiveness of azithromycin. Author(s): Chiarini F, Mansi A, Tomao P, Gentile V, De Marco F, Brunori S, Wongher L, Di Silverio F. Source: Journal of Chemotherapy (Florence, Italy). 1994 August; 6(4): 238-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7830100&dopt=Abstract

•

Comparative analysis of azithromycin and ciprofloxacin in the treatment of chronic prostatitis caused by Chlamydia trachomatis. Author(s): Skerk V, Schonwald S, Krhen I, Banaszak A, Begovac J, Strugar J, Strapac Z, Vrsalovic R, Vukovic J, Tomas M. Source: International Journal of Antimicrobial Agents. 2003 May; 21(5): 457-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727080&dopt=Abstract

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•

Comparative analysis of azithromycin and clarithromycin efficacy and tolerability in the treatment of chronic prostatitis caused by Chlamydia trachomatis. Author(s): Skerk V, Schonwald S, Krhen I, Markovinovic L, Barsic B, Marekovic I, Roglic S, Zeljko Z, Vince A, Cajic V. Source: Journal of Chemotherapy (Florence, Italy). 2002 August; 14(4): 384-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420857&dopt=Abstract

•

Effectiveness and safety of azithromycin on the treatment of cyclosporine-induced gingival overgrowth. Author(s): Palomar R, Belart M, Soy D, Oppenheimer F, Campistol JM. Source: Nephron. 1998; 79(1): 101-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9609470&dopt=Abstract

•

Efficacy of azithromycin, praziquantel and mirazid in treatment of cryptosporidiosis in school children. Author(s): Allam AF, Shehab AY. Source: J Egypt Soc Parasitol. 2002 December; 32(3): 969-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12512828&dopt=Abstract

•

Erythromycin and azithromycin transport into Haemophilus influenzae ATCC 19418 under conditions of depressed proton motive force (delta mu H). Author(s): Capobianco JO, Goldman RC. Source: Antimicrobial Agents and Chemotherapy. 1990 September; 34(9): 1787-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2178338&dopt=Abstract

•

Esberitox N as supportive therapy when providing standard antibiotic treatment in subjects with a severe bacterial infection (acute exacerbation of chronic bronchitis). A multicentric, prospective, double-blind, placebo-controlled study. Author(s): Hauke W, Kohler G, Henneicke-Von Zepelin HH, Freudenstein J. Source: Chemotherapy. 2002 December; 48(5): 259-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476043&dopt=Abstract

•

In vitro demonstration of transport and delivery of antibiotics by polymorphonuclear leukocytes. Author(s): Frank MO, Sullivan GW, Carper HT, Mandell GL. Source: Antimicrobial Agents and Chemotherapy. 1992 December; 36(12): 2584-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1336337&dopt=Abstract

•

Opportunistic infections in Vancouver. Author(s): Marco M. Source: Gmhc Treat Issues. 1996 September; 10(9): 4-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11363841&dopt=Abstract

Alternative Medicine 45

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

•

drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

•

Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMD®Health: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to Zithromax; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Herbs and Supplements Antibiotics Source: Healthnotes, Inc.; www.healthnotes.com Azithromycin Source: Healthnotes, Inc.; www.healthnotes.com Brewer's Yeast Source: Healthnotes, Inc.; www.healthnotes.com Macrolides Source: Healthnotes, Inc.; www.healthnotes.com Macrolides Source: Integrative Medicine Communications; www.drkoop.com Probiotics Source: Healthnotes, Inc.; www.healthnotes.com

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General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. CLINICAL TRIALS AND ZITHROMAX Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning Zithromax.

Recent Trials on Zithromax The following is a list of recent trials dedicated to Zithromax.8 Further information on a trial is available at the Web site indicated. •

Azithromycin/Bicillin for treatment of early syphilis Condition(s): Syphilis Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The purpose of this study is to determine if azithromycin (2.0 grams administered orally as a single dose), a drug approved for treatment of other infections, is as effective for syphilis therapy as the usual penicillin treatment (Benzathine G penicillin- 2.4 million units). This study is considered research because azithromycin is not licensed for the treatment of syphilis. In addition, in a substudy population of subjects allergic to penicillin, the efficacy of azithromycin will be compared with the currently recommended alternative treatment, doxycycline (100 mg twice daily for 14 days). Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00031499

8

These are listed at www.ClinicalTrials.gov.

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Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “Zithromax” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

•

For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

•

For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

•

For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

•

For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

•

For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

•

For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

Clinical Trials 49

•

For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

•

For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

51

CHAPTER 5. PATENTS ON ZITHROMAX Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “Zithromax” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on Zithromax, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Zithromax By performing a patent search focusing on Zithromax, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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Zithromax

example of the type of information that you can expect to obtain from a patent search on Zithromax: •

Azithromycin and derivatives as antiprotozoal agents Inventor(s): Remington; Jack S. (Menlo Park, CA) Assignee(s): Pfizer Inc. (New York, NY) Patent Number: 4,963,531 Date filed: August 16, 1988 Abstract: A method of use of azithromycin or derivatives of azithromycin in the treatment of infection caused by Toxoplasma gondii in mammals is disclosed. Excerpt(s): The present invention is directed to the use of compounds of the formula (I) as defined below, viz., azithromycin, its 4"-epimer, and corresponding 4"-deoxy-4"amino analogs in the treatment of systemic protozoal infections in mammals, particularly in the treatment of toxoplasmosis, a protozoal infection due to strains of Toxoplasma gondii, particularly troublesome in pregnant women and among those such as AIDS patients, who are immune deficient. Azithromycin is the U.S.A.N. (generic name) for 9a-aza-9a-methyl-9-deoxo-9a-homoerythromycin A, a broad spectrum antibacterial compound derived from erythromycin A. Azithromycin was independently discovered by Bright, U.S. Pat. No. 4,474,768 and Kobrehel et al., U.S. Pat. No. 4,517,359. The name "N-methyl-11-aza-10-deoxo-10-dihydroerythromycin A" was employed in these patents. The present more systematic name is based upon the ring expansion and replacement nomenclature of the "IUPAC Nomenclature of Organic Chemistry, 1979 Edition," Pergamon Press, 1979, pp. 68-70, 459, 500-503. 4"-Epiazithromycin (4"-epi-9a-aza-9a-methyl-9-deoxo-9a-homoerythromycin A), 4"-amino-4"deoxy-azithromycin (4"-amino-9a-aza-9a-methyl-9-deoxo-4"-deoxy-9ahomoerythromycin A), and 4"epi-4"-amino-4"-deoxyazithromycin A (4"-epi-4"-amino9a-aza-9a-methyl-9-deoxo-4"-deoxy-9a-homoerythromycin A), also broad spectrum antibacterials derived from erythromycin A, are the subjects of Bright, U.S. Pat. No. 4,526,889, Hauske and Nagel, U.S. Pat. No. 4,512,982, and Hauske and Nagel, loc. cit., respectively. There is a continuing need for drugs which are effective against protozoal infections in mammals, in particular against toxoplasmosis in man. Transmission of the disease may occur transplacentally, by ingestion of raw or undercooked meat containing tissue cysts, or by exposure to oocysts in cat feces. Neonatal congenital toxoplasmosis, which is acquired transplacentally, the mother having acquired a primary infection during or prior to pregnancy, can lead to spontaneous abortion, miscarriage or stillbirth, birth defects, or the birth of a child with the clinical disease. The disease can cause brain damage and even death in those having weakened immune systems, particularly among those suffering from AIDS (acquired immune deficiency syndrome) where toxoplasma encephalitis is a commonly found, life threatening infection. Heretofore, there has been no alternative to the present regimen of pyrimethamine plus a sulfonamide--a relatively toxic regimen with numerous side effects among the latter patient population. Approximately 20% of AIDS patients are seropositive for Toxoplasma antibodies and approximately 30% of these seropositive individuals will suffer toxoplasmic encephalitis, reflecting the critical problem in this patient population. In one recent series, approximately 50% of the patients died, median time to death being 4 months. Furthermore, since the incidence of relapse is also prohibitively high, new drugs are needed which can be given both for initial treatment and as suppressive therapy for the life of the patient.

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Web site: http://www.delphion.com/details?pn=US04963531__ •

Azithromycin dihydrate Inventor(s): Allen; Douglas J. M. (New London, CT), Nepveux; Kevin M. (Old Saybrook, CT) Assignee(s): Pfizer Inc. (New York, NY) Patent Number: 6,268,489 Date filed: December 21, 1992 Abstract: Non-hygroscopic, azithromycin homoerythromycin) dihydrate and a process therefor.

(9-deoxo-9a-aza-9a-methyl-9a-

Excerpt(s): The present invention is directed to a valuable new form of azithromycin (9deoxo-9a-aza-9a-methyl-9a-homoerythromycin A), viz., a non-hygroscopic dihydrate form thereof. Azithromycin is the U.S.A.N. (generic name) for 9-deoxo-9a-aza-9amethyl-9a-homoerythromycin A, a broad spectrum antibacterial compound derived from erythromycin A. Azithromycin was independently discovered by Bright, U.S. Pat. No. 4,474,768 and Kobrehel et al., U.S. Pat. No. 4,517,359. The name "N-methyl-11-aza10-deoxo-10-dihydroerythromycin A" was employed in these patents. The present more systematic name is based upon the ring expansion and replacement nomenclature of the "IUPAC Nomenclature of Organic Chemistry, 1979 Edition," Pergamon Press, 1979, pp. 68-70, 459, 500-503. As previously crystallized from ethanol and water (e.g., Example 3 of U.S. Pat. No. 4,474,768), azithromycin was obtained as a hygroscopic monohydrate (for details, see Preparation 1 below). Because of its hygroscopic nature, it is most difficult to prepare and maintain this prior monohydrate product in a form having a constant, reproducible water-content. It is particularly difficult to handle during formulation, since at higher relative humidity levels which are generally required to avoid electrostatic problems (e.g., flow rates, dusting with potential for explosion), the monohydrate readily picks up varying amounts of water, the amount depending upon exposure time and the precise value of the relative humidity (see Preparation 1 below). Such problems have been overcome by the present invention of a stable dihydrate which is essentially non-hygroscopic under conditions of relative humidity conducive to formulation of azithromycin. Web site: http://www.delphion.com/details?pn=US06268489__ •

Azithromycin monohydrate isopropanol clathrate and methods for the manufacture thereof Inventor(s): Karimian; Khashayar (Mississauga, CA), Motamedi; Mehrnoush (San Diego, CA) Assignee(s): Apotex, Inc. (Weston, CA) Patent Number: 6,245,903 Date filed: August 13, 1999 Abstract: A novel form of azithromycin and processes for preparation of pure azithromycin monohydrate isopropanol clathrate (3 molecules of isopropanol for every 10 molecules of azithromycin monohydrate) has been obtained. Preparation of the novel

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form of azithromycin comprises the steps of dissolving azithromycin in isopropanol, followed by the slow addition of water to the organic solution. Excerpt(s): This invention relates to a new form of azithromycin, namely azithromycin monohydrate isopropanol clathrate, which has improved properties over amorphous azithromycin, azithromycin monohydrate and azithromycin dihydrate. This invention also relates processes for the manufacture of azithromycin monohydrate isopropanol clathrate. The spectrum of azithromycin's antibacterial activity has been reported by Aronoff, et al (J. Antimicrob. Chemother., 1987, 19, 275). Its mode of action has been reviewed by Retsema, et al (Antimicrob. Ag. Chemother., 1987, 31, 1939)n, and its pharmacology has been reviewed by a number of investigators (J. Antimicrob. Chemother., 1993, 31, Suppl. E, 1-198). Three forms of Azithromycin are known. Anhydrous azithromycin is reported as an amorphous crude product (foam) in Canadian Patent 1 191 843 (example 1). It is obtained by evaporating the final solvent (e.g. chloroform) used in the process of preparation of azithromycin. It is not a crystalline product and therefore can not be made in pure form per se in commercial scale. In laboratory scale, it can be obtained in pure form by chromatography of the crude final product or by dissolving pure crystalline azithromycin mono- or dihydrate in an organic solvent and evaporating the said solvent to obtain amorphous anhydrous azithromycin. Web site: http://www.delphion.com/details?pn=US06245903__ •

Controlled-release dosage forms of Azithromycin Inventor(s): Curatolo; William J. (Niantic, CT), Friedman; Hylar L. (Brattleboro, VT), Korsmeyer; Richard W. (Old Lyme, CT), LeMott; Steven R. (East Lyme, CT) Assignee(s): Pfizer Inc. (New York, NY) Patent Number: 6,068,859 Date filed: November 4, 1996 Abstract: A controlled-release dosage form of azithromycin having an improved side effect profile; a process for preparing the dosage form; and a method of treating a microbial infection, comprising administering azithromycin in such a controlled-release dosage form to a mammal, including a human patient, in need of such treatment. Excerpt(s): This invention relates to a controlled-release dosage form of azithromycin having an improved side effect profile, to a process for preparing the dosage form, and to a method of treating a microbial infection, comprising administering azithromycin in such a controlled-release dosage form to a mammal, including a human patient, in need of such treatment. Azithromycin is the U.S.A.N. (generic name) for 9a-aza-9a-methyl-9deoxo-9a-homoerythromycin A, a broad spectrum antimicrobial compound derived from erythromycin A. Azithromycin was independently discovered by Bright, U.S. Pat. No. 4,474,768 and Kobrehel et al., U.S. Pat. No. 4,517,359. These patents disclose that azithromycin and certain derivatives thereof possess antimicrobial properties and are accordingly useful as antibiotics. It is widely known that oral dosing of azithromycin can result in the occurrence, in some patients, of adverse gastrointestinal (GI) side effects, such as cramping, diarrhea, nausea, and vomiting. In combined clinical studies of azithromycin involving 3,995 patients (all dose levels combined), 9.6% of patients reported gastrointestinal side effects. The most frequent of these side effects were diarrhea (3.6%), nausea (2.6%), and abdominal pain (2.5%) (Hopkins, Am. J. Med. 91(suppl 3A) (1991) 40S-45S).

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Web site: http://www.delphion.com/details?pn=US06068859__ •

Intermediate for azithromycin Inventor(s): Yang; Bingwei V. (Waterford, CT) Assignee(s): Pfizer Inc. (New York, NY) Patent Number: 5,686,587 Date filed: November 13, 1995 Abstract: A compound having formula (III). Also, a process of making azithromycin comprising reducing the compound of formula (III) and N-methylating the reduced product. Excerpt(s): This invention relates to antibiotics, and particularly relates (1) to an intermediate per se, useful for making the known antibiotic azithromycin, (2) to a process for making azithromycin with the intermediate, and (3) to processes for making the intermediate. The structure reveals that the antibiotic is comprised of three main portions: a sugar fragment known as cladinose, a second sugar moiety containing a basic amino substituent known as desosamine and a fourteen membered lactone ring referred to as erythronolide A or B or as the macrolide ring. In particular, the procedure for making azithromycin from erythromycin A involves relatively strong reaction conditions as described, for example, in Djokic et al., J. Chem. Soc. Perkin Trans. I, 1881, (1986), wherein the preparation of 10-dihydro-10-deoxo-11-azaerythromycin A from an imino ether precursor was effected by catalytic hydrogenation in acetic acid under 70 atm of H.sub.2. Web site: http://www.delphion.com/details?pn=US05686587__

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Method of administering azithromycin Inventor(s): Curatolo; William J. (Niantic, CT), Foulds; George H. (Waterford, CT), Friedman; Hylar L. (Brattleboro, VT) Assignee(s): Pfizer Inc. (New York, NY) Patent Number: 5,605,889 Date filed: April 29, 1994 Abstract: An oral dosage form of azithromycin which does not exhibit an adverse food effect; Specific azithromycin oral dosage forms including tablets, powders for oral suspensions and unit dose packets; Methods of treating microbial infections with the dosage forms; And therapeutic packages containing the dosage forms. Excerpt(s): This invention relates to a dosage form of azithromycin, and also to a method of treating a microbial infection which involves administering azithromycin in the fed state to a mammal, including a human patient, in need of such treatment. Azithromycin is the U.S.A.N. (generic name) for 9a-aza-9a-methyl-9-deoxo-9ahomoerythromycin A, a broad spectrum antimicrobial compound derived from erythromycin A. Azithromycin was independently discovered by Bright, U.S. Pat. No. 4,474,768 and Kobrehel et al., U.S. Pat. No. 4,517,359. These patents disclose that azithromycin and certain derivatives thereof possess antibacterial properties and are accordingly useful as antibiotics. In general, it is known that the absorption and bioavailability of any particular therapeutic agent can be affected by numerous factors

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when dosed orally. Such factors include the presence of food in the gastrointestinal (GI) tract because, in general, the gastric residence time of a drug is usually significantly longer in the presence of food than in the fasted state. If the bioavailability of a drug is affected beyond a certain point due to the presence of food in the GI tract, the drug is said to exhibit a "food effect". Food effects are important inasmuch as, when a drug exhibits an adverse food effect, there is risk associated with administering it to a patient who has eaten recently. The risk derives from the potential that absorption into the bloodstream may be adversely affected to the point that the patient risks insufficient absorption to remediate the condition for which the drug was administered. Web site: http://www.delphion.com/details?pn=US05605889__ •

Preparation method of azithromycin hydrates Inventor(s): Aronhime; Judith (Rechovot, IL), Pesachovich; Michael (Givat Shmuel, IL), Singer; Claude (Kfar Saba, IL) Assignee(s): Teva Pharmaceutical Industries LTD (Petah Tiqva, IL) Patent Number: 6,586,576 Date filed: January 4, 2001 Abstract: This invention relates to a method for preparing azithromycin dihydrate from crude azithromycin by the gradual crystallization of azithromycin from acetone by the addition of a minimal amount of water to effect crystal formation is disclosed. This invention also relates to a method of making azithromycin from desmethylazithromycin by dissolving desmethyl-azithromycin in acetone, adding activated carbon, adding formaldehyde, adding formic acid; refluxing the desmethylazithromycin acetone solution, adding sodium hydroxide to induce precipitation of azithromycin, and isolating azithromycin. Excerpt(s): This invention relates to methods of preparing antibiotics, and more particularly to a new method for the crystallization of azithromycin dihydrate. and is a semi-synthetic macrolide antibiotic related to erythromycin A. Azithromycin possesses broad-antibacterial activity, and is useful for treating infections caused by susceptible microorganisms. U.S. Pat. Nos. 4,517,359 and 4,474,768 describe methods for the preparation of azithromycin. According to European Patent Application EP 298 650 ("the EP '650 application"), the azithromycin obtained by the methods of U.S. Pat. Nos. 4,517,359 and 4,474,768 is a hygroscopic monohydrate. Because of its hygroscopic nature, the azithromyycin monohydrate is difficult to prepare and maintain in a form having a constant, reproducible water-content, and is particularly difficult to handle during formulation. The EP '650 application describes a dihydrate form of azithromycin that is less hygroscopic than the previously known azithromycin monohydrate. The method described in the EP '650 application for making the dihydrate form from the monohydrate is by crystallization from tetrahydrofuran, hexane and water. It would be advantageous to be able to manyfacture azithromycin dihydrate by a process which uses less potentially toxic solvents. Web site: http://www.delphion.com/details?pn=US06586576__

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Process for the preparation of azithromycin Inventor(s): De Mouro Vaz Azevedo Mendes; Zita Maria (Lisbon, PT), Heggie; William (Palmela, PT) Assignee(s): Hovione Inter Ltd. (CH) Patent Number: 6,013,778 Date filed: May 18, 1998 Abstract: The present invention describes a new process for the preparation of azithromycin from a suitable imino ether as precursor, characterised by the fact that the reduction and the reductive methylation of said imino ether are sequentially carried out with a noble metal catalyst and hydrogen in the presence of formaldehyde, or a source thereof, wherein both reactions can be conducted in the same reaction vessel. Excerpt(s): Azithromycin is a well-known semi-synthethic macrolide antibiotic (U.S. Pat. Nos. 4,474,768 and 4,517,358), which is prepared through the expansion/inclusion of a nitrogen atom in the macrolide ring of erythromycin A, followed by reductive methylation. In this way, an antibiotic more stable and more effective than erythromycin A is obtained, particularly against gram-negative bacteria. The reaction sequence to transform erythromycin A into azithromycin involves extremely strong and aggressive reaction conditions (compare, J. Chem. Soc. Perkin Trans. I, 1881 (1986)), and requires the isolation of intermediates, which, in certain conditions, are even more unstable than the starting material. Reaction conditions and isolation procedures must be at the same time both mild and have their parameters strictly controlled. This can result in additional problems when a laboratory scale process is put into practice at an industrial level. Under these circumstances, additional restrictions on the manufacturing process have to be implemented in order to ensure that azithromycin is obtained in good yield and high purity. The transformation of erythromycin A into azithromycin involves: conversion of erythromycin into its oxime; Beckmann rearrangement of the oxime to produce the imino ether of erythromycin A; reduction of the imino ether to 9-deoxo-9aaza-9a-homoerythromycin, and, finally, reductive N-methylation to obtain the final product. Web site: http://www.delphion.com/details?pn=US06013778__

Patent Applications on Zithromax As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to Zithromax:

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This has been a common practice outside the United States prior to December 2000.

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Azithromycin as a therapeutic agent for infections with leishmania parasites Inventor(s): Abraham, David; (Wynnewood, PA), Kroleweicki, Alejandro Javier; (Buenos Aires, AR) Correspondence: Thomas Jefferson University; Intellectual Property Division; 1020 Walnut Street; Suite 620; Philadelphia; PA; 19107; US Patent Application Number: 20020049167 Date filed: March 21, 2001 Abstract: The present invention generally relates to an in vitro analysis of antiLeishmania activity of the anti-parasitic agent azithromycin, and more particularly the invention uses a novel source of macrophages, which are monocyte-derived bone marrow macrophages, to show the efficacy of azithromycin anti-parasitic therapy. Excerpt(s): This application claims priority under 35 U.S.C.sctn.119 based upon U.S. Provisional Patent Application No. 60/191264 filed Mar. 22, 2000. The present invention relates to an improved method for treating Leishmaniasis, specifically treating patients infected with Leishmania sp. with the therapeutic agent azithromycin. Parasites of the genus Leishmania are protozoans that cause mammalian disease. Leishmania sp. are widely distributed in tropical and subtropical regions and are transmitted by the bites of sandflies. Parasitic infections are manifested in cutaneous, mucosal and/or visceral symptomologies. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Controlled- release dosage forms of azithromycin Inventor(s): Curatolo, William J.; (Niantic, CT), Friedman, Hylar L.; (Brattleboro, VT), Koresmeyer, Richard W.; (Old Lyme, CT), LeMott, Steven R.; (East Lyme, CT) Correspondence: Gregg C. Benson; Pfizer INC.; Patent Department, MS 4159; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20020044965 Date filed: March 9, 2001 Abstract: A controlled-release dosage form of azithromycin having an improved side effect profile; a process for preparing the dosage form; and a method of treating a microbial infection, comprising administering azithromycin in such a controlled-release dosage form to a mammal, including a human patient, in need of such treatment. Excerpt(s): This invention relates to a controlled-release dosage form of azithromycin having an improved side effect profile, to a process for preparing the dosage form, and to a method of treating a microbial infection, comprising administering azithromycin in such a controlled-release dosage form to a mammal, including a human patient, in need of such treatment. Azithromycin is the U.S.A.N. (generic name) for 9a-aza-9a-methyl-9deoxo-9a-homoerythromycin A, a broad spectrum antimicrobial compound derived from erythromycin A. Azithromycin was independently discovered by Bright, U.S. Pat. No.4,474,768 and Kobrehel et al., U.S. Pat. No. 4,517,359. These patents disclose that azithromycin and certain derivatives thereof possess antimicrobial properties and are accordingly useful as antibiotics. It is widely known that oral dosing of azithromycin can result in the occurrence, in some patients, of adverse gastrointestinal (GI) side effects, such as cramping, diarrhea, nausea, and vomiting. In combined clinical studies of azithromycin involving 3,995 patients (all dose levels combined), 9% of patients

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reported gastrointestinal side effects. The most frequent of these side effects were diarrhea (3.6%), nausea (2.6%), and abdominal pain 2.5%) (Hopkins, Am. J. Med.91(suppl 3A) (1991) 40S-45S). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Crystal forms of azithromycin Inventor(s): Li, Zheng J.; (Quaker Hill, CT), Trask, Andrew V.; (Stonington, CT) Correspondence: Paul H. Ginsburg; Pfizer Inc; 20th Floor; 235 East 42nd Street; New York; NY; 10017-5755; US Patent Application Number: 20030162730 Date filed: May 21, 2002 Abstract: The invention relates to novel crystal forms of azithromycin, an antibiotic useful in the treatment of infections. Excerpt(s): This invention relates to crystal forms of azithromycin. Azithromycin is sold commercially and is an effective antibiotic in the treatment of a broad range of bacterial infections. The crystal forms of this invention are likewise useful as antibiotic agents in mammals, including man, as well as in fish and birds. Azithromycin is described and claimed in U.S. Pat. Nos. 4,517,359 and 4,474,768. It is also known as 9-deoxo-9a-aza-9amethyl-9a-homoerytho- mycin A. Other patents or patent applications which directly or indirectly cover azithromycin include: EP 298,650 which claims azithromycin dihydrate; U.S. Pat. No. 4,963,531 which claims a method of treating a strain of Toxoplasma gondii species; U.S. Pat. No. 5,633,006 which claims a chewable tablet or liquid suspension pharmaceutical composition having reduced bitterness; U.S. Pat. No. 5,686,587 which claims an intermediate useful in the preparation of azithromycin; U.S. Pat. No. 5,605,889 which claims an oral dosage form that reduces the "food effect" associated with the administration of azithromycin; U.S. Pat. No. 6,068,859 which claims a controlled dosage form containing azithromycin; U.S. Pat. No. 5,498,699 which claims a composition containing azithromycin in combination with bivalent or trivalent metals; EP 925,789 which claims a method of treating eye infections; Chinese patent application CN 1123279A which relates to water soluble salts of azithromycin; Chinese patent application CN 1046945C which relates to azithromycin sodium dihydrogenphosphate double salts; Chinese patent application CN 1114960A which relates to azithromycin crystals, Chinese patent application CN 1161971A which relates to azithromycin crystals; Chinese patent application CN 1205338A which relates to a method of preparing water soluble salts of azithromycin; International Publication WO 00/32203 which relates to an ethanolate of azithromycin; and European patent application EP 984,020 which relates to an azithromycin monohydrate isopropanol clathrate. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Derivatives of erythromycin, clarithromycin, roxithromycin or azithromycin with antibiotic and mucolytic activity Inventor(s): Hermann, Gesine; (Cork, IE), Nikolopoulos, Aggelos; (Cork, IE), Schickaneder, Helmut; (Cork, IE) Correspondence: Jacobson Holman Pllc; 400 Seventh Street N.W.; Suite 600; Washington; DC; 20004; US Patent Application Number: 20010031736 Date filed: April 19, 2001 Abstract: A pharmaceutical with an enhanced pharmaceutical profile comprises a mucolytic and an antibiotic in which the mucolytic is present in an amount of greater than one molar equivalent of the antibiotic. The antibiotic may be selected from Erythromycin, Roxithromycin, Clarithromycin, Azithromycin, Dirithromycin; and pharmaceutically acceptable salts or esters thereof. The mucolytic is a mucolytically active thiol, especially N-acetylcysteine, mercaptoethanesulfonic acid, tiopronin or methylcysteine. The adducts can be isolated via a simple and efficient process. Excerpt(s): The invention relates to a pharmaceutical including a macrolide antibiotic. The invention also relates to a process for manufacturing the pharmaceutical. It is known that the stability and the pharmacological and immunomicrobiological profile of these compounds can be improved by derivatisation and by conversion into various salts. EP-A-0005789 describes salts of Erythromycin and Erythromycin propionate with N-acetylcysteine, carboxymethylcysteine, thiazolidin-carboxylic acid and mercaptosuccinic acid. However these salts are sensitive to sunlight, humidity and heat. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Dry granulated formulations of azithromycin Inventor(s): Johnson, Barbara A.; (Niantic, CT), Quan, Ernest S.; (East Lyme, CT) Correspondence: Pfizer INC.; Patent Department, Ms8260-1611; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20030228357 Date filed: January 31, 2003 Abstract: This invention relates to a pharmaceutical formulation, in the form of a tablet, sachet or powder for suspension dosage form, which comprises dry granulated particles of a non-dihydrate form of azithromycin and, optionally, one or more pharmaceutically acceptable excipients. Preferably, the pharmaceutical formulation is a tablet containing between about 40%, by weight, to about 90%, by weight, non-dihydrate azithromycin.More preferably, the pharmaceutical formulation contains non-dihydrate azithromycin selected from the forms B, D, E, F, G, H, J, M, N, O, P, Q, R, or mixtures thereof.Even more preferably, the invention relates to a pharmaceutical formulation wherein the dosage of azithromycin is 250 mgA, 500 mgA, 600 mgA or 1000 mgA.The present invention further relates to a dry granulated azithromycin particle, comprising a form of azithromycin, selected from forms D, E, F, G, H, J, M, N, O, P, Q, R and mixtures of non-dihydrate forms, and at least one pharmaceutically acceptable excipient. Excerpt(s): Dry granulation is a process in which granulates are formed by a compaction step that is followed by sizing the compacts into particles that can be processed easily. It

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is often used to improve flow properties and/or densify the formulation which can facilitate further manufacturing processes such as tableting, encapsulation and powder filling. The compacts are made directly from powder blends that usually contain an active ingredient and other excipients including a lubricant. Pharmaceutical manufacturers prefer the use of dry granulation techniques to wet granulation methods because of shorter processing times and cost advantages. However, dry granulation is generally limited to those situations in which the drug or active ingredient has physical characteristics suitable for forming pharmaceutically acceptable granulations and dosage forms such as tablets. The addition of at least one excipient to the formulation is generally required and will contribute to increasing the tablet size of the final product. As tablet size must be within certain parameters to function as a suitable dosage form, there is a limit beyond which increasing tablet size to accommodate increasing amounts of excipients to enhance compactability is not practical. As a result, manufacturers are often limited to using the dry granulation method for formulations containing a low dose of the active ingredient per compressed tablet such that the formulation may accommodate sufficient levels of excipient to make dry granulation practical. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

ETHANOLATE OF AZITHROMYCIN, PROCESS FOR MANUFACTURE, AND PHARMACEUTICAL COMPOSITIONS THEREOF Inventor(s): ARONHEIM, JUDITH; (Rehovot, IL), SINGER, CLAUDE; (Kfar Sava, IL) Correspondence: Kenyon & Kenyon; One Broadway; New York; NY; 10004; US Patent Application Number: 20020007049 Date filed: November 30, 1999 Abstract: A novel, non-hygroscopic form of azithromycin is disclosed, as well as a method for preparing it by the gradual crystallization of azithromycin from ethanol by the addition of a minimal amount of water to effect crystal formation. Pharmaceutical compositions containing this novel form of azithromycin are also disclosed. Excerpt(s): This invention relates to a new ethanolate of azithromycin, processes for its manufacture, and pharmaceutical compositions containing the new ethanolate. is a semi-synthetic macrolide antibiotic related to erythromycin A, useful for treating infections caused by susceptible microorganisms. This invention provides a new nonhygroscopic form of azithromycin, processes for its manufacture, and pharmaceutical compositions containing it. Azithromycin may be made by methods described in U.S. Pat. Nos. 4,517,359 and 4,474,768. According to European Patent Application EP 298,650, the azithromycin obtained by these methods is a hygroscopic monohydrate. Because of its hygroscopic nature, this monohydrate is difficult to prepare and maintain in a form having a constant, reproducible water-content, and is particularly difficult to handle during formulation. EP 298,650 describes a dehydrate form of azithromycin that is less hygroscopic than the previously known monohydrate. The method described in EP 298,650 for making the dehydrate form is by crystallization from tetrahydrofuran, hexane and water. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method of increasing the bioavailability and tissue penetration of azithromycin Inventor(s): Curatolo, William J.; (Niantic, CT), Foulds, George; (Chester, CT) Correspondence: Gregg C. Benson; Pfizer INC.; Patent Department, MS 4159; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20020009433 Date filed: February 20, 2001 Abstract: The bioavailability of azithromycin can be increased by co-administering azithromycin with a p-glycoprotein (p-gp) inhibitor. The azithromycin and p-gp inhibitor can be administered together in a composition or as separate components. If administered separately, they can be embodied as a kit. Excerpt(s): This invention relates to a method for increasing the bioavailability of azithromycin, comprising co-administering azithromycin with a p-glycoprotein (p-gp) inhibitor. The invention further relates to compositions and kits comprising azithromycin and a p-gp inhibitor. Azithromycin is the U.S.A.N. (generic) name for 9aaza-9a-methyl-9-deoxo-9a-homoerythromycin A. It is a semisynthetic, acid-stable, azalide broad spectrum antimicrobial agent produced by inserting a methyl-substituted nitrogen in place of the 9A carbonyl group in the aglycone ring of erythromycin A. It is a well known antibiotic which is readily commercially available as a therapeutic agent of choice for remediating bacterial infections. It is disclosed, inter alia, in U.S. Pat. Nos. 4,474,768 and 4,517,359. Azithromycin has an oral bioavailability in humans of 37%. The elimination half-life of azithromycin in blood, and more importantly in tissues, is long enough to permit single-dose therapy by dosing the entire course of therapy (usually 1.5 gm) at once. However, azithromycin exhibits gastrointestinal side effects which can prevent dosing such a high dose to certain individuals who are sensitive to azithromycin. It is known that the gastrointestinal side effects of azithromycin are locally mediated; that is, that they are due to direct contact of the drug with the gastrointestinal tract, rather than via the circulatory system. It is also known that the incidence of gastrointestinal side effects of azithromycin is dose dependent. It is not possible to predetermine which patients will be sensitive to high doses of azithromycin. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Preparation method of azithromycin dihydrate Inventor(s): Aronhime, Judith; (Rechovot, IL), Pesachovich, Michael; (Givat Shmuel, IL), Singer, Claude; (Kfar Saba, IL) Correspondence: Kenyon & Kenyon; One Broadway; New York; NY; 10004; US Patent Application Number: 20010047089 Date filed: January 4, 2001 Abstract: This invention relates to a method for preparing azithromycin dihydrate from crude azithromycin by the gradual crystallization of azithromycin from acetone by the addition of a minimal amount of water to effect crystal formation is disclosed. This invention also relates to a method of making azithromycin from desmethylazithromycin by dissolving desmethyl-azithromycin in acetone, adding activated carbon, adding formaldehyde, adding formic acid; refluxing the desmethylazithromycin acetone solution, adding sodium hydroxide to induce precipitation of azithromycin, and isolating azithromycin.

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Excerpt(s): This application claims the benefit of provisional applications serial Nos. 60/174,330, filed Jan. 4, 2000; and 60/220,681, filed Jul. 25, 2000. This invention relates to methods of preparing antibiotics, and more particularly to a new method for the crystallization of azithromycin dihydrate. and is a semi-synthetic macrolide antibiotic related to erythromycin A. Azithromycin possesses broad-antibacterial activity, and is useful for treating infections caused by susceptible microorganisms. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Process for preparation of anhydrous azithromycin Inventor(s): Khan, Anjum R.; (Aurangabad, IN), Mukarram, Siddiqui M. Jaweed; (Maharashtra, IN), Purohit, Manish; (Mahatashtra, IN), Singh, Shiva P.; (Gujarat, IN) Correspondence: Schwegman, Lundberg, Woessner & Kluth, P.A.; P.O. Box 2938; Minneapolis; MN; 55402; US Patent Application Number: 20030139583 Date filed: February 24, 2003 Abstract: The present invention provides a stable form of azithromycin derivatives that act as antibiotics. These compounds are in anhydrous form and have increased stability over the hydrated forms. Excerpt(s): This application is a continuation Under 35 U.S.C. 111(a) of International Application No. PCT/IB01/01523 filed Aug. 23, 2001 and published as WO 02/15842 A2 on Feb. 28, 2002, which claims priority from U.S. Provisional Application No. 60/227,341, filed Aug. 23, 2000, which applications and publication are incorporated herein by reference. Azithromycin is a well-known semi-synthetic macrolide antibiotic. It is prepared through the ring expansion to incorporate a nitrogen atom in the macrolide ring of erythromycin A, followed by reductive methylation. This provides an antibiotic having more stability and greater effectiveness than erythromycin-A. The ring expansion and subsequent conversion of erythromycin-A to provide azithromycin is described in U.S. Pat. No. 4,474,768, (e.g., Example 3). Generally, the synthesis requires several steps. The product obtained is one of the hydrated versions, either monohydrate or dihydrate. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Process for the preparation of non-hygroscopic azithromycin dihydrate Inventor(s): Rengaraju, Srinivasan; (Vadodara, IN) Correspondence: Staas & Halsey Llp; 700 11th Street, NW; Suite 500; Washington; DC; 20001; US Patent Application Number: 20020111318 Date filed: January 18, 2002 Abstract: An improved process for preparing non-hygroscopic Azithromycin dihydrate wherein Azithromycin monhydrate can be converted to Azithromycin dihydrate with continous stirring/agitation in presence of a mixture of at least one solvent and water until non-hygroscopic crystals of Azithromycin dihydrate are obtained. The solvent used in the process can be selected from the group comprising dimethylformamide, dimethylacetamide, acetonitrile and iso-propanol.

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Excerpt(s): This application is based upon and claims priority of Indian Patent Application No. 95/Mum/2001 filed Jan. 29, 2001, the entire contents of same being incorporated herein by reference. The invention relates to an improved process for the production of non-hygroscopic Azithromycin dihydrate. Azithromycin was first discovered by G. Kobrehel and S. Djokic (Belgium Patent No. 892357 and its related U.S. Pat. No. 4,517,359). S. Djokic et al (J CHEMRESEARCH(S). 1988, 132 and idem miniprint 1988, 1239), have demonstrated the existence of the dihydrate form of Azithromycin. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Stabilized azithromycin compositions Inventor(s): Hrakovsky, Julia; (Rosh-H-Ayin, IL), Khondo, Lev; (Toronto, CA), Lessen, Tania; (Toronto, CA), Mathivanan, Mathi; (Markham, CA), Pesachovich, Michael; (Ramat Gan, IL), Schwarz, Joseph; (Toronto, CA), Singer, Claude; (Kfar Saba, IL), Tenengauzer, Ruth; (Hod Hasharon, IL) Correspondence: Kenyon & Kenyon; One Broadway; New York; NY; 10004; US Patent Application Number: 20030176369 Date filed: October 18, 2002 Abstract: Compositions and methods of stabilizing azithromycin compositions are described. Stabilized azithromycin compositions comprise an intimate admixture of azithromycin and a stabilizing-effective amount of an antioxidant to improve the resistance of the azithromycin to degradation. Coprecipitation or co-milling of azithromycin and an antioxidant are particularly preferred means of achieving an intimate admixture. Pharmaceutical formulations comprising a stabilized azithromycin composition and methods of making such formulations are also described. Excerpt(s): This application claims priority under 35 U.S.C.sctn.119(e) to U.S. provisional application serial No. 60/336,346, filed Oct. 18, 2001; No. 60/331,931, filed Nov. 21, 2001; and, No. 60/341,295, filed Dec. 17, 2001. The entire content of each of these applications is incorporated herein by reference. This invention relates to stabilized azithromycin compositions, methods of preparing stabilized azithromycin compositions, pharmaceutical formulations containing the stabilized azithromycin compositions and methods of making such formulations. The first of the macrolide antibiotics, erythromycin, was discovered in 1952 among the metabolic products of Streptomyces erythreus. Erythromycin is most effective against Gram-positive bacteria. Erythromycin has low acid stability which reduces its oral bioavailability and necessitates enteric coating of the drug. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with Zithromax, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “Zithromax” (or synonyms) into

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the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on Zithromax. You can also use this procedure to view pending patent applications concerning Zithromax. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON ZITHROMAX Overview This chapter provides bibliographic book references relating to Zithromax. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Zithromax include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “Zithromax” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •

Measuring patient-centered outcomes in the Pfizer-CCTG trial of azithromycin vs. rifabutin vs. both for the prevention of HIV-associated mycobacterium avium: instruments, methods, application, and results Author: Bozzette, Samuel A.; Year: 1996; San Diego: RAND, Medicine Education and Research Foundation, [1996]

Chapters on Zithromax In order to find chapters that specifically relate to Zithromax, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book 11

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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chapters and Zithromax using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “Zithromax” (or synonyms) into the “For these words:” box.

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CHAPTER 7. PERIODICALS AND NEWS ON ZITHROMAX Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Zithromax.

News Services and Press Releases One of the simplest ways of tracking press releases on Zithromax is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “Zithromax” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to Zithromax. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “Zithromax” (or synonyms). The following was recently listed in this archive for Zithromax: •

Azithromycin does not prevent CHD events in Chlamydia-exposed MI patients Source: Reuters Industry Breifing Date: September 16, 2003

•

Pfizer to pay $6 million to settle Zithromax ad suit Source: Reuters Industry Breifing Date: January 06, 2003

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•

FDA okays Pfizer's Zithromax as one-dose treatment for pediatric otitis media Source: Reuters Industry Breifing Date: December 17, 2001

•

Zithromax endorsed as single-dose treatment of acute otitis Source: Reuters Medical News Date: November 07, 2001 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “Zithromax” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “Zithromax” (or synonyms). If you know the name of a company that is relevant to Zithromax, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/.

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BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “Zithromax” (or synonyms).

Academic Periodicals covering Zithromax Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to Zithromax. In addition to these sources, you can search for articles covering Zithromax that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for Zithromax. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with Zithromax. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to Zithromax: Azithromycin •

Systemic - U.S. Brands: Zithromax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202642.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

12

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:14 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

13

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 14 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Zithromax” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 1577 2 1012 201 0 2792

HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.19 Simply search by “Zithromax” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

15

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

16

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists20 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.21 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

20 Adapted 21

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on Zithromax can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to Zithromax. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to Zithromax. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “Zithromax”:

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•

Other guides AIDS and Infections http://www.nlm.nih.gov/medlineplus/aidsandinfections.html Angina http://www.nlm.nih.gov/medlineplus/angina.html Chlamydia Infections http://www.nlm.nih.gov/medlineplus/chlamydiainfections.html Cystic Fibrosis http://www.nlm.nih.gov/medlineplus/cysticfibrosis.html Gonorrhea http://www.nlm.nih.gov/medlineplus/gonorrhea.html Sexually Transmitted Diseases http://www.nlm.nih.gov/medlineplus/sexuallytransmitteddiseases.html Syphilis http://www.nlm.nih.gov/medlineplus/syphilis.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to Zithromax. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

Patient Resources

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

85

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to Zithromax. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Zithromax. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about Zithromax. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “Zithromax” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “Zithromax”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For

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publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “Zithromax” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “Zithromax” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

23

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)24: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

24

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

95

ZITHROMAX DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acetone: A colorless liquid used as a solvent and an antiseptic. It is one of the ketone bodies produced during ketoacidosis. [NIH] Acetylcysteine: The N-acetyl derivative of cysteine. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, oxidative metabolism, or cell respiration. [NIH] Aerobic Respiration: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as oxidative metabolism, cell respiration, or aerobic metabolism. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

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Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Amikacin: A broad-spectrum antibiotic derived from kanamycin. It is reno- and ototoxic like the other aminoglycoside antibiotics. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amiodarone: An antianginal and antiarrhythmic drug. It increases the duration of ventricular and atrial muscle action by inhibiting Na,K-activated myocardial adenosine triphosphatase. There is a resulting decrease in heart rate and in vascular resistance. [NIH] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Angina: Chest pain that originates in the heart. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another

Dictionary 97

living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anthelmintic: An agent that is destructive to worms. [EU] Antianginal: Counteracting angina or anginal conditions. [EU] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]

Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiprotozoal Agents: Substances that are destructive to protozoans. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Aqueous: Having to do with water. [NIH] Aqueous humor: Clear, watery fluid that flows between and nourishes the lens and the cornea; secreted by the ciliary processes. [NIH]

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Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [NIH] Babesiosis: A group of tick-borne diseases of mammals including zoonoses in humans. They are caused by protozoans of the genus babesia, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick ixodes scapularis. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin,

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biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Bivalent: Pertaining to a group of 2 homologous or partly homologous chromosomes during the zygotene stage of prophase to the first metaphase in meiosis. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures.

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[NIH]

Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] Bronchiolitis: Inflammation of the bronchioles. [NIH] Bronchiolitis Obliterans: Inflammation of the bronchioles with obstruction by fibrous granulation tissue or bronchial exudate. It may follow inhalation of irritating gases or foreign bodies and it complicates pneumonia. [NIH] Bronchiseptica: A small, gram-negative, motile bacillus. A normal inhabitant of the respiratory tract in man, dogs, and pigs, but is also associated with canine infectious tracheobronchitis and atrophic rhinitis in pigs. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchopulmonary: Pertaining to the lungs and their air passages; both bronchial and pulmonary. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Cardiac: Having to do with the heart. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cefixime: A third-generation cephalosporin antibiotic that is stable to hydrolysis by betalactamases. [NIH] Ceftriaxone: Broad-spectrum cephalosporin antibiotic with a very long half-life and high penetrability to usually inaccessible infections, including those involving the meninges, eyes, inner ears, and urinary tract. [NIH] Cefuroxime: Broad-spectrum cephalosporin antibiotic resistant to beta-lactamase. It has been proposed for infections with gram-negative and gram-positive organisms, gonorrhea, and haemophilus. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cestode: A flatworm that is an endoparasite and belongs to the class Cestoda. [NIH]

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Chlamydia: A genus of the family Chlamydiaceae whose species cause a variety of diseases in vertebrates including humans, mice, and swine. Chlamydia species are gram-negative and produce glycogen. The type species is Chlamydia trachomatis. [NIH] Chloroform: A commonly used laboratory solvent. It was previously used as an anesthetic, but was banned from use in the U.S. due to its suspected carcinogenecity. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholera: An acute diarrheal disease endemic in India and Southeast Asia whose causative agent is vibrio cholerae. This condition can lead to severe dehydration in a matter of hours unless quickly treated. [NIH] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla. [NIH]

Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic prostatitis: Inflammation of the prostate gland, developing slowly and lasting a long time. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary processes: The extensions or projections of the ciliary body that secrete aqueous humor. [NIH] Cinchona: A genus of rubiaceous South American trees that yields the toxic cinchona alkaloids from their bark; quinine, quinidine, chinconine, cinchonidine and others are used to treat malaria and cardiac arrhythmias. [NIH] Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Clavulanic Acid: Clavulanic acid (C8H9O5N) and its salts and esters. The acid is a suicide inhibitor of bacterial beta-lactamase enzymes from Streptomyces clavuligerus. Administered alone, it has only weak antibacterial activity against most organisms, but given in combination with beta-lactam antibiotics prevents antibiotic inactivation by microbial lactamase. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clindamycin: An antibacterial agent that is a semisynthetic analog of lincomycin. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

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Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colloidal: Of the nature of a colloid. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]

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Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Coumarin: A fluorescent dye. [NIH] Cryptosporidiosis: Parasitic intestinal infection with severe diarrhea caused by a protozoan, Cryptosporidium. It occurs in both animals and humans. [NIH] Crystallization: The formation of crystals; conversion to a crystalline form. [EU] Culture Media: Any liquid or solid preparation made specifically for the growth, storage, or transport of microorganisms or other types of cells. The variety of media that exist allow for the culturing of specific microorganisms and cell types, such as differential media, selective

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media, test media, and defined media. Solid media consist of liquid media that have been solidified with an agent such as agar or gelatin. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some nonleukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Dehydration: The condition that results from excessive loss of body water. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel

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movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disposition: A tendency either physical or mental toward certain diseases. [EU] Diuresis: Increased excretion of urine. [EU] Domesticated: Species in which the evolutionary process has been influenced by humans to meet their needs. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Doxycycline: A synthetic tetracycline derivative with a range of antimicrobial activity and mode of action similar to that of tetracycline, but more effective against many species. Animal studies suggest that it may cause less tooth staining than other tetracyclines. [NIH] Drug Design: The molecular designing of drugs for specific purposes (such as DNAbinding, enzyme inhibition, anti-cancer efficacy, etc.) based on knowledge of molecular properties such as activity of functional groups, molecular geometry, and electronic structure, and also on information cataloged on analogous molecules. Drug design is generally computer-assisted molecular modeling and does not include pharmacokinetics, dosage analysis, or drug administration analysis. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until

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it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Emulsions: Colloids of two immiscible liquids where either phase may be either fatty or aqueous; lipid-in-water emulsions are usually liquid, like milk or lotion and water-in-lipid emulsions tend to be creams. [NIH] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocytosis: Cellular uptake of extracellular materials within membrane-limited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enteric bacteria: Single-celled microorganisms that lack chlorophyll. Some bacteria are capable of causing human, animal, or plant diseases; others are essential in pollution control because they break down organic matter in the air and in the water. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH]

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Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Erythromycin Estolate: A macrolide antibiotic, produced by Streptomyces erythreus. It is the lauryl sulfate salt of the propionic ester of erythromycin. This erythromycin salt acts primarily as a bacteriostatic agent. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Excipient: Any more or less inert substance added to a prescription in order to confer a suitable consistency or form to the drug; a vehicle. [EU] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH]

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Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating

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food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gingival Hyperplasia: A pathological increase in the depth of the gingival crevice surrounding a tooth at the gum margin. [NIH] Glottis: The vocal apparatus of the larynx, consisting of the true vocal cords (plica vocalis) and the opening between them (rima glottidis). [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granulation Tissue: A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guinea Pigs: A common name used for the family Caviidae. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research.

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[NIH]

Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Haemophilus: A genus of Pasteurellaceae that consists of several species occurring in animals and humans. Its organisms are described as gram-negative, facultatively anaerobic, coccobacillus or rod-shaped, and nonmotile. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocyte: A liver cell. [NIH] Hepatomegaly: Enlargement of the liver. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperaemia: An excess of blood in a part; engorgement. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH]

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Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunodiffusion: Technique involving the diffusion of antigen or antibody through a semisolid medium, usually agar or agarose gel, with the result being a precipitin reaction. [NIH]

Immunoelectrophoresis: A technique that combines protein electrophoresis and double immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incubation: The development of an infectious disease from the entrance of the pathogen to the appearance of clinical symptoms. [EU] Incubation period: The period of time likely to elapse between exposure to the agent of the disease and the onset of clinical symptoms. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infectious Mononucleosis: A common, acute infection usually caused by the Epstein-Barr virus (Human herpesvirus 4). There is an increase in mononuclear white blood cells and other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally hepatomegaly with hepatitis. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow

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tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intrahepatic: Within the liver. [NIH] Intravenous: IV. Into a vein. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ixodes: A large, widely distributed genus of ticks consisting of approximately 245 species. Many infest man and other mammals and several are vectors of diseases such as Lyme disease, tick-borne encephalitis (encephalitis, tick-borne), and Kyasanur forest disease. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kanamycin: Antibiotic complex produced by Streptomyces kanamyceticus from Japanese soil. Comprises 3 components: kanamycin A, the major component, and kanamycins B and C, the minor components. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Kinetic: Pertaining to or producing motion. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Leishmania: A genus of flagellate protozoa comprising several species that are pathogenic for humans. Organisms of this genus have an amastigote and a promastigote stage in their life cycles. As a result of enzymatic studies this single genus has been divided into two subgenera: Leishmania leishmania and Leishmania viannia. Species within the Leishmania

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leishmania subgenus include: L. aethiopica, L. arabica, L. donovani, L. enrietti, L. gerbilli, L. hertigi, L. infantum, L. major, L. mexicana, and L. tropica. The following species are those that compose the Leishmania viannia subgenus: L. braziliensis, L. guyanensis, L. lainsoni, L. naiffi, and L. shawi. [NIH] Leishmaniasis: A disease caused by any of a number of species of protozoa in the genus Leishmania. There are four major clinical types of this infection: cutaneous (Old and New World), diffuse cutaneous, mucocutaneous, and visceral leishmaniasis. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Levofloxacin: A substance used to treat bacterial infections. It belongs to the family of drugs called quinolone antibiotics. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Lincomycin: (2S-trans)-Methyl 6,8-dideoxy-6-(((1-methyl-4-propyl-2pyrrolidinyl)carbonyl)amino)-1-thio-D-erythro-alpha-D-galacto-octopyranoside. An antibiotic produced by Streptomyces lincolnensis var. lincolnensis. It has been used in the treatment of staphylococcal, streptococcal, and Bacteroides fragilis infections. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Loc: A brain region associated with object recognition. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH]

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Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Macrolides: A group of organic compounds that contain a macrocyclic lactone ring linked glycosidically to one or more sugar moieties. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Maculopapular: Both macular and papular, as an eruption consisting of both macules and papules; sometimes erroneously used to designate a papule that is only slightly elevated. [EU]

Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Mefloquine: A phospholipid-interacting antimalarial drug (antimalarials). It is very effective against Plasmodium falciparum with very few side effects. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be

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absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metaphase: The second phase of cell division, in which the chromosomes line up across the equatorial plane of the spindle prior to separation. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Migrans: Infestation of the dermis by various larvae, characterized by bizarre red irregular lines which are broad at one end and fade at the other, produced by burrowing larvae. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monocyte: A type of white blood cell. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucocutaneous: Pertaining to or affecting the mucous membrane and the skin. [EU] Mucolytic: Destroying or dissolving mucin; an agent that so acts : a mucopolysaccharide or glycoprotein, the chief constituent of mucus. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multidrug resistance: Adaptation of tumor cells to anticancer drugs in ways that make the

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drugs less effective. [NIH] Mycobacterium: A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. [NIH]

Mycobacterium avium: A bacterium causing tuberculosis in domestic fowl and other birds. In pigs, it may cause localized and sometimes disseminated disease. The organism occurs occasionally in sheep and cattle. It should be distinguished from the M. avium complex, which infects primarily humans. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia is a characteristic feature of myotonic disorders. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neutrophil: A type of white blood cell. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ofloxacin: An orally administered broad-spectrum quinolone antibacterial drug active against most gram-negative and gram-positive bacteria. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH]

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Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Ototoxic: Having a deleterious effect upon the eighth nerve, or upon the organs of hearing and balance. [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]

Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pelvic: Pertaining to the pelvis. [EU] Pelvic inflammatory disease: A bacteriological disease sometimes associated with intrauterine device (IUD) usage. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves

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peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Peptide Elongation Factors: Protein factors uniquely required during the elongation phase of protein synthesis. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pertussis: An acute, highly contagious infection of the respiratory tract, most frequently affecting young children, usually caused by Bordetella pertussis; a similar illness has been associated with infection by B. parapertussis and B. bronchiseptica. It is characterized by a catarrhal stage, beginning after an incubation period of about two weeks, with slight fever, sneezing, running at the nose, and a dry cough. In a week or two the paroxysmal stage begins, with the characteristic paroxysmal cough, consisting of a deep inspiration, followed by a series of quick, short coughs, continuing until the air is expelled from the lungs; the close of the paroxysm is marked by a long-drawn, shrill, whooping inspiration, due to spasmodic closure of the glottis. This stage lasts three to four weeks, after which the convalescent stage begins, in which paroxysms grow less frequent and less violent, and finally cease. Called also whooping cough. [EU] P-Glycoprotein: A 170 kD transmembrane glycoprotein from the superfamily of ABC transporters. It serves as an ATP-dependent efflux pump for a variety of chemicals, including many antineoplastic agents. Overexpression of this glycoprotein is associated with multidrug resistance. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharyngitis: Inflammation of the throat. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pilot study: The initial study examining a new method or treatment. [NIH]

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Plant Diseases: Diseases of plants. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Praziquantel: An anthelmintic used in most schistosome and many cestode infestations. [NIH]

Precipitation: The act or process of precipitating. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostatitis: Inflammation of the prostate. [EU] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with

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formation of smaller polypeptides). [EU] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Protozoal: Having to do with the simplest organisms in the animal kingdom. Protozoa are single-cell organisms, such as ameba, and are different from bacteria, which are not members of the animal kingdom. Some protozoa can be seen without a microscope. [NIH] Proxy: A person authorized to decide or act for another person, for example, a person having durable power of attorney. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Embolism: Embolism in the pulmonary artery or one of its branches. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH]

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Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Rifabutin: A broad-spectrum antibiotic that is being used as prophylaxis against disseminated Mycobacterium avium complex infection in HIV-positive patients. [NIH] Rod: A reception for vision, located in the retina. [NIH] Roxithromycin: Semisynthetic derivative of erythromycin. It is concentrated by human phagocytes and is bioactive intracellularly. While the drug is active against a wide spectrum of pathogens, it is particularly effective in the treatment of respiratory and genital tract infections. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salmonella: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria that utilizes citrate as a sole carbon source. It is pathogenic for humans, causing enteric fevers, gastroenteritis, and bacteremia. Food poisoning is the most common clinical manifestation. Organisms within this genus are separated on the basis of antigenic characteristics, sugar fermentation patterns, and bacteriophage susceptibility. [NIH] Schistosome: Dermatitis caused by the snail parasite, Schistosoma cercariae. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrub Typhus: An acute infectious disease caused by Orientia tsutsugamushi. It is limited to eastern and southeastern Asia, India, northern Australia, and the adjacent islands. Characteristics include the formation of a primary cutaneous lesion at the site of the bite of an infected mite, fever lasting about two weeks, and a maculopapular rash. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Shiga Toxin: A toxin produced by Shigella dysenteriae. It is the protype of class of toxins that inhibit protein synthesis by blocking the interaction of ribosomal RNA with peptide elongation factors. [NIH] Shigellosis: Infection with the bacterium Shigella. Usually causes a high fever, acute diarrhea, and dehydration. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition

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causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Spasmodic: Of the nature of a spasm. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spiramycin: A macrolide antibiotic produced by Streptomyces ambofaciens. The drug is effective against gram-positive aerobic pathogens, N. gonorrhoeae, and staphylococci. It is used to treat infections caused by bacteria and Toxoplasma gondii. [NIH] Spirochete: Lyme disease. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Steroids: Drugs used to relieve swelling and inflammation. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH]

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Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sulfadiazine: A short-acting sulfonamide used in combination with pyrimethamine to treat toxoplasmosis in patients with acquired immunodeficiency syndrome and in newborns with congenital infections. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]

Systemic: Affecting the entire body. [NIH] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases,

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palliative or curative. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tick-Borne Diseases: Bacterial, viral, or parasitic diseases transmitted to humans and animals by the bite of infected ticks. The families Ixodidae and Argasidae contain many bloodsucking species that are important pests of man and domestic birds and mammals and probably exceed all other arthropods in the number and variety of disease agents they transmit. Many of the tick-borne diseases are zoonotic. [NIH] Tinidazole: A nitroimidazole antitrichomonal agent effective against Trichomonas vaginalis, Entamoeba histolytica, and Giardia lamblia infections. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tonsillitis: Inflammation of the tonsils, especially the palatine tonsils. It is often caused by a bacterium. Tonsillitis may be acute, chronic, or recurrent. [NIH] Tonsils: Small masses of lymphoid tissue on either side of the throat. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Toxoplasma: A genus of protozoa parasitic to birds and mammals. T. gondii is one of the most common infectious pathogenic animal parasites of man. [NIH] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Trachoma: A chronic infection of the conjunctiva and cornea caused by Chlamydia trachomatis. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is

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analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Trivalent: Having a valence of three. [EU] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] TYPHI: The bacterium that gives rise to typhoid fever. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Typhoid fever: The most important member of the enteric group of fevers which also includes the paratyphoids. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH]

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Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricles: Fluid-filled cavities in the heart or brain. [NIH] Ventricular: Pertaining to a ventricle. [EU] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vibrio: A genus of Vibrionaceae, made up of short, slightly curved, motile, gram-negative rods. Various species produce cholera and other gastrointestinal disorders as well as abortion in sheep and cattle. [NIH] Vibrio cholerae: The etiologic agent of cholera. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Whooping Cough: A respiratory infection caused by Bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath. [NIH] Whooping Cough: A respiratory infection caused by Bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath. [NIH] Zidovudine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA during reverse transcription. It improves immunologic function, partially reverses the HIVinduced neurological dysfunction, and improves certain other clinical abnormalities associated with AIDS. Its principal toxic effect is dose-dependent suppression of bone

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marrow, resulting in anemia and leukopenia. [NIH] Zoonoses: Diseases of non-human animals that may be transmitted to man or may be transmitted from man to non-human animals. [NIH]

129

INDEX A Abdominal, 54, 59, 95, 108, 117 Abdominal Pain, 54, 59, 95, 108 Acetone, 56, 62, 95, 112 Acetylcysteine, 60, 95 Acute renal, 95, 110 Adenosine, 95, 96, 123 Adverse Effect, 95, 121 Aerobic, 6, 8, 95, 116, 117, 122 Aerobic Metabolism, 95, 117 Aerobic Respiration, 95, 117 Aerosol, 95, 123 Affinity, 95, 122 Agar, 11, 17, 95, 104, 111 Algorithms, 96, 99 Alimentary, 96, 118 Alkaline, 39, 96 Alkaloid, 96, 120, 123 Alpha-1, 15, 96 Alternative medicine, 70, 96 Amebiasis, 96, 115 Amikacin, 5, 96 Amino Acid Sequence, 96, 97 Amino Acids, 96, 107, 118, 119, 125 Amiodarone, 37, 96 Amoxicillin, 8, 9, 10, 13, 25, 31, 32, 33, 38, 96 Ampicillin, 14, 20, 96 Ampulla, 96, 101 Anaerobic, 6, 8, 96, 110, 121 Analgesic, 96, 120 Analog, 4, 96, 101 Analogous, 96, 105, 125 Anemia, 96, 114, 127 Angina, 84, 96, 97 Antagonism, 96, 123 Anthelmintic, 97, 119 Antianginal, 96, 97 Antiarrhythmic, 96, 97 Antibacterial, 16, 18, 52, 53, 54, 55, 56, 63, 97, 101, 116, 122 Antibiotic Prophylaxis, 34, 97 Antibodies, 52, 97, 110, 111, 114, 119 Antibody, 95, 97, 102, 104, 110, 111, 122 Anticoagulant, 97, 126 Antigen, 95, 97, 102, 110, 111

Antimicrobial, 4, 6, 8, 20, 22, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 43, 44, 54, 55, 58, 62, 97, 101, 105 Antineoplastic, 97, 118 Antineoplastic Agents, 97, 118 Antioxidant, 64, 97 Antiprotozoal Agents, 52, 97 Antipyretic, 97, 120 Antiseptic, 95, 97 Antiviral, 95, 97, 112 Aqueous, 9, 97, 98, 101, 106, 113 Aqueous humor, 9, 97, 101 Arterial, 98, 119 Arteries, 98, 99, 103, 115, 116 Atrial, 96, 98, 126 Atrial Fibrillation, 98, 126 Attenuated, 98, 105, 125 Atypical, 98, 111 B Babesiosis, 36, 39, 40, 98, 120 Bacteremia, 98, 121 Bacteria, 17, 64, 97, 98, 101, 106, 107, 108, 109, 110, 115, 116, 120, 121, 122, 123, 125 Bacterial Infections, 4, 59, 62, 98, 113 Bactericidal, 9, 11, 98, 107 Bacteriophage, 98, 121 Bacteriostatic, 98, 107 Bacterium, 98, 110, 116, 121, 124, 125 Base, 98, 104, 112 Basophils, 98, 113 Beta-Lactamases, 98, 100 Bile, 98, 99, 108, 112, 113 Bile Pigments, 98, 112 Biliary, 99, 101 Bioavailability, 40, 55, 62, 64, 99 Biochemical, 99, 108, 118 Biological response modifier, 99, 111 Biological Transport, 99, 104 Biosynthesis, 4, 99 Biotechnology, 5, 18, 67, 70, 79, 99 Biotransformation, 99 Bismuth, 37, 99 Bivalent, 59, 99 Blister, 14, 99 Blood pressure, 99, 122 Blood vessel, 99, 101, 106, 107, 110, 118, 122, 123, 124, 125 Body Fluids, 99, 122

130 Zithromax

Bone Marrow, 58, 99, 104, 114, 127 Bowel, 27, 99, 104, 112 Bowel Movement, 99, 105 Branch, 91, 99, 117, 122, 123 Broad-spectrum, 96, 100, 116, 121 Bronchi, 100, 123 Bronchial, 32, 100, 123 Bronchioles, 100 Bronchiolitis, 30, 100 Bronchiolitis Obliterans, 30, 100 Bronchiseptica, 100, 118 Bronchitis, 10, 21, 22, 28, 34, 37, 44, 100, 101 Bronchopulmonary, 7, 9, 33, 38, 100 C Capsules, 100, 105 Carbohydrates, 95, 100, 117 Carcinogen, 100, 115 Cardiac, 97, 98, 100, 101, 106, 108, 116 Causal, 10, 100, 110 Cefixime, 32, 33, 100 Ceftriaxone, 19, 32, 38, 100 Cefuroxime, 17, 26, 100 Cell Division, 98, 100, 114, 115, 119 Cell Respiration, 95, 100, 117 Cell Size, 100, 108 Central Nervous System, 100, 123 Cerebrospinal, 9, 100 Cerebrospinal fluid, 9, 100 Cestode, 100, 119 Chlamydia, 7, 8, 10, 11, 12, 13, 15, 24, 27, 31, 37, 39, 43, 44, 69, 84, 101, 124 Chloroform, 54, 101 Chlorophyll, 101, 106 Cholera, 22, 25, 101, 126 Cholestasis, 24, 101 Cholesterol, 98, 101, 103, 113 Chronic, 10, 19, 22, 24, 28, 43, 44, 96, 101, 111, 121, 123, 124 Chronic Obstructive Pulmonary Disease, 19, 101 Chronic prostatitis, 24, 43, 44, 101 Ciliary, 97, 101, 115 Ciliary processes, 97, 101 Cinchona, 101, 120 Ciprofloxacin, 7, 16, 17, 20, 24, 43, 101 Circulatory system, 62, 101 Clavulanic Acid, 8, 101 Clear cell carcinoma, 101, 104 Clindamycin, 5, 9, 11, 17, 18, 101 Clinical Medicine, 101, 119

Clinical trial, 3, 18, 19, 34, 47, 48, 79, 102, 103, 104, 120 Cloning, 4, 99, 102 Coagulation, 102, 126 Cofactor, 102, 119 Collagen, 102, 108 Colloidal, 102, 123 Complement, 102, 103, 109 Complementary and alternative medicine, 43, 46, 102 Complementary medicine, 43, 103 Computational Biology, 79, 103 Congenita, 103, 120 Congestion, 103, 107 Conjugated, 103, 104 Conjunctiva, 103, 124 Conjunctivitis, 23, 103 Connective Tissue, 99, 102, 103, 108, 109 Contraindications, ii, 103 Controlled study, 27, 31, 44, 103 Cornea, 97, 103, 124 Coronary, 21, 27, 103, 115, 116 Coronary heart disease, 21, 103 Coronary Thrombosis, 103, 115, 116 Cortex, 103, 117 Coumarin, 37, 103 Cryptosporidiosis, 21, 28, 44, 98, 103 Crystallization, 56, 61, 62, 63, 103 Culture Media, 95, 103 Curative, 104, 124 Cutaneous, 28, 58, 104, 113, 121 Cyclic, 104, 123 Cyclosporine, 7, 27, 44, 104 Cysteine, 95, 104 Cytochrome, 9, 104 Cytokines, 17, 104 D Databases, Bibliographic, 79, 104 Dehydration, 101, 104, 121 Density, 104, 108, 113 DES, 37, 104 Deuterium, 104, 110 Diagnostic procedure, 51, 70, 104 Diarrhea, 21, 54, 58, 96, 103, 104, 121 Diffusion, 11, 99, 104, 105, 111 Digestion, 96, 98, 99, 104, 112, 113, 118, 122, 125 Digestive system, 48, 104 Dilatation, 37, 105 Dilution, 11, 17, 105 Direct, iii, 9, 62, 73, 101, 105, 109, 120, 121 Disinfectant, 105, 107

Index 131

Disposition, 15, 24, 26, 29, 105 Diuresis, 105, 123 Domesticated, 105, 109 Dosage Forms, 54, 55, 58, 61, 105 Dose-dependent, 105, 126 Doxycycline, 11, 13, 20, 23, 36, 47, 105 Drug Design, 4, 105 Drug Interactions, 36, 74, 105 Duodenal Ulcer, 22, 105 Duodenum, 98, 105, 122 E Efficacy, 8, 10, 11, 14, 15, 17, 24, 27, 28, 30, 33, 38, 44, 47, 58, 105 Electrolyte, 105, 119, 122 Electrons, 97, 98, 105, 112, 117, 120 Emboli, 105, 106, 126 Embolism, 106, 120, 126 Embolization, 106, 126 Embryo, 106, 122 Emphysema, 101, 106 Emulsions, 95, 106 Encephalitis, 52, 106, 112 Encephalitis, Viral, 106 Endemic, 31, 101, 106, 114 Endocarditis, 11, 17, 106 Endocardium, 106 Endocytosis, 23, 106 Endotoxin, 106, 125 Enteric bacteria, 15, 106 Environmental Health, 78, 80, 106 Enzymatic, 102, 106, 112 Enzyme, 105, 106, 108, 117, 119, 126 Eosinophils, 106, 113 Epidermis, 99, 106 Epithelial, 6, 31, 99, 107 Epithelial Cells, 6, 107 Erythema, 33, 107 Erythrocytes, 96, 98, 99, 107, 110, 121 Erythromycin Estolate, 9, 107 Esophagus, 105, 107, 122 Ethanol, 38, 53, 61, 107, 108 Ether, 55, 57, 107 Excipient, 60, 61, 107 Excitation, 107, 108 Exhaustion, 97, 107, 114 Exogenous, 99, 107, 119 Extracellular, 8, 14, 25, 103, 106, 107, 108, 122 Extracellular Matrix, 103, 107, 108 Exudate, 100, 107 Eye Infections, 59, 107

F Family Planning, 79, 107 Fat, 99, 103, 106, 107, 112, 122 Feces, 52, 108 Fermentation, 4, 108, 121 Fetus, 108, 122 Fibroblasts, 14, 39, 108 Fibrosis, 22, 30, 84, 108 Flow Cytometry, 10, 108 Fluorescence, 40, 108 Fluorescent Dyes, 108 Fungi, 107, 108, 115, 125 G Gallbladder, 95, 99, 105, 108 Gas, 104, 108, 110, 116, 123, 125 Gastric, 56, 96, 105, 108, 118 Gastric Acid, 96, 108 Gastric Juices, 108, 118 Gastric Mucosa, 108, 118 Gastroenteritis, 108, 121 Gastrointestinal, 54, 56, 58, 62, 101, 107, 109, 114, 123, 126 Gastrointestinal tract, 62, 107, 109 Gene, 4, 67, 99, 109 Genetic Engineering, 99, 102, 109 Genital, 8, 23, 101, 109, 121, 125 Genitourinary, 43, 109, 125 Gestation, 109, 122 Giardiasis, 109, 115 Gingival Hyperplasia, 27, 109 Glottis, 109, 118 Glycogen, 101, 109 Glycoprotein, 15, 109, 115, 118, 125 Gonorrhea, 84, 100, 109 Governing Board, 109, 119 Graft, 109, 110 Gram-negative, 15, 17, 57, 100, 101, 109, 110, 116, 121, 126 Gram-Negative Bacteria, 57, 109 Gram-positive, 5, 64, 100, 109, 116, 122, 123 Granulation Tissue, 100, 109 Growth, 32, 96, 97, 98, 103, 109, 112 Guinea Pigs, 7, 109 H Habitat, 110, 116 Haemophilus, 6, 10, 11, 13, 14, 18, 44, 100, 110 Half-Life, 16, 62, 100, 110 Heme, 104, 110 Hemolysis, 98, 110 Hemolytic, 8, 110

132 Zithromax

Hemorrhage, 110, 123 Hepatitis, 110, 111 Hepatocyte, 101, 110 Hepatomegaly, 110, 111 Heredity, 109, 110 Homologous, 99, 110 Hormone, 104, 110 Host, 10, 27, 98, 110 Hydrogen, 57, 98, 100, 104, 110, 115, 117, 120 Hydrolysis, 98, 99, 100, 110, 119 Hyperaemia, 103, 110 Hyperbilirubinemia, 110, 112 I Id, 41, 45, 84, 90, 92, 110 Immune response, 97, 110, 111, 123, 126 Immune system, 52, 110, 114, 126 Immunodeficiency, 16, 21, 40, 111, 123 Immunodeficiency syndrome, 111, 123 Immunodiffusion, 95, 111 Immunoelectrophoresis, 95, 111 Immunologic, 111, 126 Impairment, 101, 107, 111, 114 In vitro, 8, 11, 12, 13, 14, 26, 30, 38, 39, 43, 44, 58, 111 In vivo, 12, 13, 14, 16, 18, 36, 38, 39, 43, 111 Incubation, 111, 118 Incubation period, 111, 118 Infarction, 111 Infection, 6, 8, 10, 12, 13, 14, 21, 26, 27, 29, 31, 33, 36, 37, 38, 39, 44, 52, 54, 55, 58, 96, 99, 101, 103, 106, 107, 108, 109, 111, 113, 114, 116, 117, 118, 121, 122, 123, 124, 125, 126 Infectious Mononucleosis, 24, 111 Inflammation, 10, 37, 100, 101, 103, 106, 107, 108, 110, 111, 117, 118, 119, 120, 122, 124 Infusion, 111, 125 Ingestion, 52, 111, 119 Inhalation, 95, 100, 111, 119 Inner ear, 100, 111 Interferon, 18, 111, 112 Interferon-alpha, 112 Intestinal, 17, 103, 112 Intestine, 99, 112, 123 Intracellular, 7, 8, 14, 18, 20, 25, 26, 38, 39, 40, 111, 112, 119 Intrahepatic, 24, 112 Intravenous, 8, 17, 32, 33, 111, 112 Ions, 98, 105, 110, 112 Ixodes, 98, 112

J Jaundice, 19, 110, 112 Joint, 33, 101, 112 K Kanamycin, 96, 112 Kb, 78, 112 Ketone Bodies, 95, 112 Kinetic, 112 L Large Intestine, 105, 112, 120, 122 Laxative, 95, 112 Leishmania, 26, 58, 112, 113 Leishmaniasis, 28, 58, 113 Lens, 97, 103, 113 Lesion, 113, 121, 125 Lethal, 98, 113 Leucocyte, 96, 113 Leukocytes, 44, 98, 99, 104, 106, 112, 113, 125 Leukopenia, 113, 127 Levofloxacin, 8, 10, 16, 19, 21, 28, 33, 113 Library Services, 90, 113 Life cycle, 108, 112, 113 Ligaments, 103, 113 Lincomycin, 101, 113 Linkages, 113, 118, 126 Lipopolysaccharide, 109, 113 Lipoprotein, 109, 113 Liver, 9, 19, 95, 98, 99, 105, 108, 109, 110, 112, 113 Loc, 52, 113 Localized, 111, 113, 116, 117, 125 Lymph, 101, 111, 113, 114 Lymphadenopathy, 111, 113 Lymphatic, 111, 113, 114 Lymphocyte, 14, 39, 97, 114 Lymphoid, 97, 109, 113, 114, 124 M Macrolides, 9, 13, 16, 23, 45, 114 Macrophage, 8, 20, 25, 114 Maculopapular, 114, 121 Malaria, 10, 19, 34, 36, 101, 114 Malaria, Falciparum, 114 Malaria, Vivax, 114 Meat, 52, 114 MEDLINE, 79, 114 Mefloquine, 19, 114 Meiosis, 99, 114 Membrane, 15, 39, 102, 103, 106, 107, 109, 114, 115, 120 Meninges, 100, 114 Mental Disorders, 49, 114

Index 133

Mercury, 108, 114 Meta-Analysis, 23, 115 Metaphase, 99, 115 Metronidazole, 13, 27, 115 MI, 69, 93, 115 Microorganism, 102, 115, 126 Migrans, 33, 115 Miscarriage, 52, 115 Modeling, 105, 115 Modification, 109, 115, 126 Molecular, 79, 81, 96, 99, 103, 105, 115, 125 Molecule, 97, 98, 102, 107, 110, 115, 117, 120 Monocyte, 58, 115 Mononuclear, 15, 111, 115, 125 Monotherapy, 8, 23, 27, 115 Motion Sickness, 115, 116 Mucociliary, 115, 122 Mucocutaneous, 113, 115 Mucolytic, 60, 95, 115 Mucus, 115 Multidrug resistance, 4, 115, 118 Mycobacterium, 5, 6, 7, 8, 12, 14, 15, 17, 37, 39, 67, 98, 116, 121, 125 Mycobacterium avium, 5, 6, 7, 8, 12, 14, 15, 17, 37, 39, 67, 98, 116, 121 Myocardial infarction, 103, 115, 116, 126 Myocardium, 115, 116 Myotonia, 116, 120 N Nausea, 54, 58, 105, 108, 116 NCI, 1, 48, 77, 116 Necrosis, 111, 115, 116 Need, 4, 52, 54, 55, 58, 67, 85, 95, 109, 116 Neutrophil, 22, 37, 116 Nitrogen, 57, 62, 63, 96, 116 Nosocomial, 5, 116 Nucleic acid, 116, 126 O Ocular, 20, 116 Ofloxacin, 5, 12, 16, 116 Ointments, 105, 116 Osteomyelitis, 17, 117 Otitis, 7, 9, 11, 16, 28, 70, 117 Otitis Media, 7, 9, 11, 16, 28, 70, 117 Ototoxic, 96, 117 Outpatient, 28, 117 Oxidation, 97, 99, 104, 117 Oxidative metabolism, 37, 95, 117 P Paediatric, 28, 29, 117 Palliative, 117, 124

Pancreas, 95, 105, 117 Paranasal Sinuses, 117, 121 Parasite, 117, 121, 125 Parasitic, 58, 103, 117, 124 Paroxysmal, 117, 118, 126 Particle, 60, 117 Pathologic, 103, 110, 117 Pelvic, 27, 117, 119 Pelvic inflammatory disease, 27, 117 Penicillin, 8, 14, 18, 20, 23, 25, 29, 47, 96, 97, 117 Pepsin, 117, 118 Pepsin A, 117, 118 Peptic, 30, 118 Peptic Ulcer, 30, 118 Peptide, 101, 117, 118, 119, 121 Peptide Chain Elongation, 101, 118 Peptide Elongation Factors, 118, 121 Perfusion, 118, 124 Pertussis, 13, 21, 32, 118, 126 P-Glycoprotein, 62, 118 Phagocytosis, 23, 118 Pharmaceutical Solutions, 105, 118 Pharmacodynamics, 9, 37, 118 Pharmacokinetic, 16, 18, 118 Pharmacologic, 110, 118, 124 Pharyngitis, 8, 23, 33, 118 Physiologic, 99, 110, 118, 120 Pilot study, 20, 30, 118 Plant Diseases, 106, 119 Plasma, 9, 32, 33, 97, 109, 119, 124 Plasma cells, 97, 109, 119 Poisoning, 108, 115, 116, 119, 121 Potassium, 38, 119 Practice Guidelines, 80, 119 Praziquantel, 28, 44, 119 Precipitation, 56, 62, 119 Precursor, 55, 57, 106, 119 Progressive, 109, 116, 119 Prophase, 99, 119 Prophylaxis, 7, 11, 15, 17, 32, 34, 119, 121, 126 Prostate, 101, 119 Prostate gland, 101, 119 Prostatitis, 119 Protein Binding, 119, 124 Protein S, 9, 14, 67, 99, 101, 107, 118, 119, 121, 123 Proteins, 96, 97, 102, 104, 107, 111, 115, 116, 117, 118, 119, 121, 124, 125 Proteolytic, 96, 102, 119 Protons, 110, 120

134 Zithromax

Protozoa, 112, 113, 115, 120, 124, 125 Protozoal, 52, 120 Proxy, 28, 120 Public Policy, 79, 120 Publishing, 5, 120 Pulmonary, 10, 36, 99, 100, 120, 126 Pulmonary Embolism, 120, 126 Pyogenic, 117, 120 Q Quinine, 36, 40, 101, 120 R Radiation, 108, 115, 120 Radioactive, 110, 120 Randomized, 5, 7, 10, 16, 19, 20, 21, 22, 23, 25, 31, 32, 36, 105, 120 Randomized clinical trial, 23, 36, 120 Receptor, 23, 97, 120 Rectum, 99, 105, 108, 112, 119, 120 Red blood cells, 107, 110, 121 Refer, 1, 102, 108, 116, 121 Refraction, 121, 122 Regimen, 32, 40, 52, 105, 121 Relapse, 52, 121 Rifabutin, 6, 7, 17, 18, 67, 121 Rod, 98, 110, 121 Roxithromycin, 5, 6, 8, 9, 10, 11, 13, 15, 16, 17, 18, 40, 60, 121 S Salivary, 105, 121 Salivary glands, 105, 121 Salmonella, 31, 32, 39, 108, 121 Schistosome, 119, 121 Screening, 102, 121 Scrub Typhus, 6, 13, 121 Semisynthetic, 62, 96, 101, 121 Septic, 14, 121 Sequencing, 4, 121 Serum, 15, 16, 31, 40, 96, 102, 121, 125 Shiga Toxin, 10, 27, 121 Shigellosis, 32, 121 Side effect, 52, 54, 58, 62, 73, 95, 114, 121, 124 Signs and Symptoms, 121 Sinusitis, 32, 121 Skeleton, 112, 122 Small intestine, 105, 109, 110, 112, 122 Sneezing, 118, 122 Sodium, 56, 59, 62, 120, 122 Soft tissue, 99, 122 Solvent, 54, 63, 95, 101, 107, 118, 122 Spasmodic, 118, 122 Specialist, 85, 122

Species, 12, 59, 101, 105, 108, 109, 110, 112, 113, 114, 116, 117, 122, 123, 124, 125, 126 Specificity, 95, 122, 124 Spectrum, 17, 52, 53, 54, 55, 58, 62, 121, 122 Spinal cord, 100, 101, 114, 122 Spiramycin, 9, 13, 122 Spirochete, 122, 123 Splenomegaly, 111, 122 Spontaneous Abortion, 52, 122 Steroids, 32, 122 Stomach, 95, 105, 107, 108, 109, 110, 116, 117, 122 Streptococcal, 8, 17, 23, 25, 33, 113, 122 Streptococci, 29, 123 Streptococcus, 5, 6, 11, 13, 14, 23, 24, 26, 29, 31, 122, 123 Stress, 109, 116, 123 Stroke, 49, 78, 123 Subacute, 111, 121, 123 Subclinical, 111, 123 Subspecies, 122, 123 Substance P, 107, 123 Sulfadiazine, 18, 20, 123 Suppression, 123, 126 Suppressive, 52, 123 Suspensions, 55, 123, 125 Syphilis, 20, 33, 34, 47, 84, 123 Systemic, 14, 52, 74, 99, 111, 123, 125, 126 T Terminator, 123, 126 Tetracycline, 12, 13, 29, 37, 105, 123 Theophylline, 40, 123 Therapeutics, 19, 36, 74, 123 Thrombosis, 119, 123, 124 Tick-Borne Diseases, 98, 124 Tinidazole, 31, 124 Tinnitus, 117, 124 Tissue, 6, 9, 10, 16, 25, 32, 52, 62, 97, 99, 102, 103, 104, 106, 107, 108, 109, 113, 114, 116, 117, 118, 121, 122, 124 Tissue Distribution, 16, 124 Tonsillitis, 34, 124 Tonsils, 124 Topical, 107, 124 Toxic, iv, 4, 52, 56, 101, 124, 126 Toxicity, 105, 115, 124 Toxicokinetics, 124 Toxicology, 80, 124 Toxins, 97, 106, 111, 121, 124 Toxoplasma, 7, 9, 13, 14, 15, 52, 59, 122, 124

Index 135

Toxoplasmosis, 18, 20, 38, 52, 98, 123, 124 Trachoma, 20, 24, 28, 29, 31, 124 Transfection, 99, 124 Transfusion, 39, 125 Translation, 107, 125 Translocation, 101, 107, 125 Treatment Failure, 23, 125 Trichomoniasis, 115, 125 Trivalent, 59, 125 Tuberculosis, 116, 125 Tumor Necrosis Factor, 5, 125 TYPHI, 32, 39, 125 Typhoid fever, 125 U Ulcer, 105, 109, 118, 125 Unconscious, 110, 125 Urinary, 100, 101, 109, 125 Urinary tract, 100, 125 Urogenital, 109, 125 V Vaccines, 125, 126 Vacuoles, 106, 125 Vagina, 104, 125 Vascular, 96, 109, 111, 125 Vascular Resistance, 96, 125

VE, 23, 125 Vein, 112, 126 Venereal, 123, 126 Venous, 119, 126 Venous Thrombosis, 126 Ventricles, 100, 126 Ventricular, 96, 126 Vertigo, 117, 126 Veterinary Medicine, 79, 126 Vibrio, 101, 126 Vibrio cholerae, 101, 126 Viral, 95, 106, 124, 126 Virus, 16, 21, 40, 98, 109, 111, 112, 126 Visceral, 58, 113, 126 Viscosity, 95, 126 Vitro, 5, 6, 9, 10, 12, 13, 14, 126 Vivo, 6, 9, 10, 11, 12, 38, 126 W Warfarin, 40, 126 White blood cell, 97, 111, 113, 114, 115, 116, 119, 126 Whooping Cough, 118, 126 Z Zidovudine, 15, 126 Zoonoses, 98, 127

136 Zithromax

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