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1 dpavlin 1.1 <div align="Center"><b>PLIVA major contributor at ICMAS-KO 6<br>
2     </b></div>
3     <br>
4     <i>Bologna, 23-26 January 2002</i><br>
5     <br>
6     ICMAS-KO is the International Conference on the Macrolides, Azalides, Streptogramins,
7     Ketolides &amp; Oxazolidinones. It is the biggest international scientific
8     event concerning macrolides and similar compounds. The purpose of the ICMAS
9     conferences is to address current issues and future trends in the development
10     and uses of these agents. The conference has been held every 2 years since
11     1992. <br>
12     PLIVA has been a sponsor of this event since 1996. In year 2002, PLIVA was
13     one of the major contributors of the conference along with Pfizer Inc., Abbott
14     Laboratories and Aventis.<br>
15     <br>
16     <div align="Center"><img src="/comm/stand-fJPG.jpg" alt="" width="300" height="225">
17     <br>
18     <br>
19     PLIVA exibition area at ICMASKO 6<br>
20     <br>
21     </div>
22     <br>
23     ICMAS-KO 6 was held in Bologna, Italy from January 23-26, 2002. It gathered
24     about 800 delegates. The scientific program was organised in parallel sessions
25     with the following content:
26     <ul>
27     <li>Plenary session</li>
28     <ul>
29     <li>New Microbial Targets for the MASKO Compounds</li>
30     </ul>
31     <li>5 workshop seminars:</li>
32     <ul>
33     <li>Evolving patterns of resistance mechanisms and prevalence,</li>
34     </ul>
35     <ul>
36     <li>Issues in pharmacology and metabolism of MASKO compounds,</li>
37     </ul>
38     <ul>
39     <li>In vitro activity of new MASKO compounds,</li>
40     </ul>
41     <ul>
42     <li>Clinical infections: adult and paediatric,</li>
43     </ul>
44     <ul>
45     <li>H.- pylori, other special pathogens and non-antibacterial effects
46     of MASKO compounds)</li>
47     </ul>
48     <li>2 laboratory workshops</li>
49     <ul>
50     <li>Susceptibility testing of challenging microbes including streptococci,
51     staphylococci, haemophillus and intracellular pathogens</li>
52     </ul>
53     <ul>
54     <li>Specific techniques to detect and characterise resistance mechanisms</li>
55     </ul>
56     <li>3 company- sponsored symposia (Pfizer, Abbott and Aventis)</li>
57     <li>Keynote lecture</li>
58     <ul>
59     <li>Countering the emergence of resistance to MASKO agents</li>
60     </ul>
61     </ul>
62     <br>
63     <br>
64     A total of 196 posters were presented including 50 posters supported by PLIVA.<br>
65     <br>
66     <div align="Center"><img src="/comm/poster-f.JPG" alt="" width="300" height="225">
67     <br>
68     <br>
69     PLIVA has sponsored 50 poster presentations at ICMASKO 6<br>
70     <br>
71     </div>
72     <br>
73     The majority of PLIVA sponsored posters were discussed during workshop seminars
74     particularly those once dealing with possible new indications.<br>
75     <br>
76     <div align="Center"><img src="/comm/petricekpredavanja-f.JPG" alt="" width="300" height="225">
77     <br>
78     <br>
79     The majority of PLIVA sopnsored posters were discussed during workshop seminars
80     <br>
81     &nbsp;<br>
82     </div>
83     <br>
84     <i><u>Atherosclerosis</u></i><br>
85     Croatian Azithromycin in Atherosclerosis Study (CROAATS) was one of two papers
86     presented in that field. The role of azithromycin in the secondary prevention
87     of adverse cardiovascular events in C. pneumoniae-positive post-myocardial
88     infarction patients is still to be defined. Some data from Azithromycin Coronary
89     Events Study&nbsp; (ACES) were also presented but the study is to be finished
90     in December 2003 and for the time being the presented results are inconclusive.<br>
91     <br>
92     <i><u>H.pylori infections</u></i><br>
93     Four presented H. pylori studies were considered to be very interesting because
94     up to know limited data was available about azithromycin therapy in the treatment
95     of H.pylori infection. According to the presented results azithromycin, as
96     a part of triple therapy, appears to be of equal clinical and bacteriological
97     efficacy as triple therapies containing clarithromycin .The advantage of
98     azithromycin is in simple and short dosage regimen.<br>
99     <br>
100     <u><i>Other infections</i></u><br>
101     The posters dealing with new possible azithromycin indications as acne and
102     chlamydial conjunctivitis also took part in workshop seminars. Single dose
103     of azithromycin was as effective as standard regimen of doxycycline twice
104     daily for 10 days in the treatment of chlamydial conjunctivitis. The preliminary
105     results of acne study support earlier reports on the safety and efficacy
106     of azithromycin pulse therapy in acne treatment. The final findings of the
107     study will be used as a basis for planning a pivotal comparative trial in
108     acne patients. <br>
109     The case report of azithromycin in the therapy of actinomycosis was particularly
110     attractive because of completely new indication area and new dosage regimen
111     (prolonged azithromycin treatment) as well as gathered safety data.<br>
112     According to the presented papers azithromycin seems to be effective therapy
113     in the treatment of cat scratch disease and shows encouraging results in
114     the treatment of respiratory infections in oncology patients.<br>
115     <br>
116     <br>
117     <b>PLIVA satellite symposium: Sumamed &#8211; today and tomorrow<br>
118     <br>
119     </b>
120     <div align="Center"><img src="/comm/sastanaksledja-f.JPG" alt="" width="300" height="225">
121     <br>
122     <br>
123     Sumamed today and tomorrow <br>
124     </div>
125     <br>
126     <br>
127     On January 26 all PLIVA sponsored participants were invited to the PLIVA
128     meeting with following program:
129     <ol>
130     <li>PLIVA today &amp; tomorrow (Mr. Gerard Cole)</li>
131     <li>Mechanisms of macrolide resistance (Viktorija Tomic, MD)</li>
132     <li>Antimicrobial resistance in Russia (Sergei V. Sidorenko, MD. PhD)</li>
133     <li>The position of macrolides in the treatment of respiratory tract infections
134     (Bruno Barsic, MD. PhD)</li>
135     <li>Azithromycin - Future perspectives (Artur Banaszak, MD)</li>
136     </ol>
137     The main issue of the meeting was the problem of the antibacterial resistance
138     and its impact on clinical practice. As it was mentioned in report of Abbott
139     symposium the general impression is that obvious contradiction in results
140     exist. The results from clinical studies from early and late 90`s show that
141     there is no change in macrolide efficacy in the treatment of RTI in the last
142     decate despite reported dramatic increase of laboratory resistance. It opens
143     lot of questions: is resistance rate overestimated, are MIC breakpoints well
144     established -&nbsp; should they be changed, what about influence on immune
145     system?<br>
146     <br>
147     The final conclusions of the meeting were:
148     <ul>
149     <li>Susceptibility testing is performed by different methods &#8211; broth microdilution,
150     agar dilution, disk diffusion, E test, and resistance gene determination
151     with molecular methods. Published data about resistance are not always based
152     on standardised methods and does not take in account influence of medium,
153     incubation atmosphere, length of incubation, inoculum size and colony age
154     when interpreting results and that is why are sometimes missleading.</li>
155     <li>In-vitro and. in-vivo&nbsp; conditions are dfferent (immune response
156     of the host)</li>
157     <li>Pharmacokinetic/pharmacodynamic parameters of the antimicrobial infuence
158     the clinical outcome</li>
159     <li>Factors associated with individual patients should be also taken into
160     account::</li>
161     <ul>
162     <li>outpatient/inpatient, compliance</li>
163     </ul>
164     <ul>
165     <li>age, comorbidity, clinical status</li>
166     </ul>
167     <ul>
168     <li>site of infection, intensity of infection.</li>
169     </ul>
170     </ul>

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