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6. Future Aspects

Author

Segev, S., Rubinstein, E., Kuhlmann, J., editor, Dalhoff, A., editor, and Zeiler, H.-J., editor

Published
1998
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8. A 90° bend curved light-guide for TOF scintillating detectors

Author

Olivenboim, M., primary, Cohen, E.O., additional, Burshtein, L., additional, Denniston, A., additional, Hen, O., additional, Kahlbow, J., additional, Beck, S. May-Tal, additional, Piasetzky, E., additional, Segarra, E.P., additional, Shapira, T., additional, and Segev, S., additional

Published
2021
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13. Drug shortages in Israel, revisited: a bitter pill to swallow

Author

Eyal Schwartzberg, Eli Marom, Alla Vishkautzan, Einat Gorelik, and Segev Shani

Subjects
Drug shortages, Regulatory perspectives, Healthcare system, Patient access, Mitigation strategies, Medicine (General), R5-920, Public aspects of medicine, RA1-1270
Abstract

Abstract Background In 2017, we published an article addressing drug shortages (DS) in Israel, exploring regulatory perspectives, challenges, and potential solutions. Since then, DS remain a significant concern for patients, healthcare providers, and policymakers globally. In this updated article, we revisit the topic, providing new insights, data, and analysis on the current DS landscape in Israel, efforts to mitigate them, and propose strategies to combat this escalating issue. Methods We conducted a comprehensive search of the Israeli Ministry of Health (MOH) DS database, spanning from 2014 to the present. We extracted DS numbers and their reasons. Further searches on the Israeli MOH website, pharmaceutical division archives, and the internet yielded official MOH publications and correspondence regarding regulatory responses to DS from 2017 onwards. Additionally, two specific cases of DS were examined to analyze their handling. Recent activities and publications from the Israeli MOH aimed at reducing DS were also reviewed. Results Between 2014 and 2022, DS surged 2.66-fold. Total DS were 3228; 672 due to commercial reasons, and 2556 to operational reasons (20.5% and 79.5% respectively). The average duration of intermittent DS increased 1.56-fold, from 85 to 133 days. Manufacturers informed the MOH 22 days prior to actual shortage on average. Analyzing 2022's DS (640) by ATC groups, prominent categories included nervous system drugs (18%), drugs acting on the alimentary tract and metabolism (14%), and dermatologicals (11%). Operational DS in 2022 (n = 564) were primarily due to stock delivery delays (38%), stock over-utilization (12%), and raw material shortages (9%). Sixteen official MOH publications on DS were identified from 2017 onwards. Moreover, two high-impact DS case studies were examined. Conclusion Despite routine monitoring by the Israeli MOH and updating the DS policy throughout this period, DS persist, intensifying annually and posing serious health risks. This trend mirrors international patterns, affecting countries globally. In Israel's uniquely structured healthcare system, with its swift stakeholder cooperation and implementation capabilities, more effective DS management is conceivable. We propose ten universally applicable rules to address DS challenges.

Published
2024
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28. Sparfloxacin as alternative treatment to standard therapy for community-acquired bacteremic pneumococcal pneumonia

Author

Lode, H. Aubier, M. Portier, H. Ortqvist, A. Garau, J. Grassi, C. Hosie, J. Huchon, G. Legakis, N. Segev, S. Wijnands, G. Regamey, C. Verster, R. May, T. Valtonen, M. Cars, O. Wahl, M. Saikku, P. Jean, C. Richard, M.P.

Abstract

Objective: To assess the effectiveness of a single daily dose of sparfloxacin in comparison with standard antibacterial therapy for the treatment of pneumococcal bacteremic community-acquired pneumonia (CAP). Methods: The results were analyzed of four comparative trials in CAP, in which 107 adult patients with CAP confirmed by blood cultures positive for Streptococcus pneumoniae were included. Sparfloxacin was given at a loading dose of 400 mg followed by 200 mg daily, Comparator drugs included amoxycillin 3 g/day, amoxycillin/clavulanate 1.5/0.375 g/day and erythromycin 2 g/day. Dosing was for 7-14 days (mean 10 days). Success was determined by a combination of clinical and microbiological assessment and radiologic changes, Results: Sparfloxacin was as effective as the comparator drugs, with an overall success rate of 80% at the end of treatment (comparators 78%), and a 79% success rate at follow-up (76% for comparators). There were no pneumococcal isolates resistant to sparfloxacin, but eight of 56 were either resistant (four) or had reduced susceptibility to penicillin G, and two strains were resistant to erythromycin. Tolerance to sparfloxacin was good, with fewer patients reporting drug-related adverse events (15.8%) than with the comparator drugs (33.3%). Conclusions: This analysis suggests that sparfloxacin would be an alternative candidate for empirical therapy in moderately severe CAP.

Published
1998

29. Sparfloxacin for the treatment of community-acquired pneumonia: A pooled data analysis of two studies

Author

Aubier, M. Lode, H. Gialdroni-Grassi, G. Huchon, G. Hosie, J. Legakis, N. Regamey, C. Segev, S. Vester, R. Wijnands, W.J. Tolstuchow, N.

Abstract

A pooled data analysis of two double-blind studies encompassing 1137 episodes of community-acquired pneumonia in hospitalised adults, of which 560 were treated with sparfloxacin and 577 were randomised to comparator antibacterial agents (amoxycillin/clavulanic acid, erythromycin or amoxycillin administered at reference dosages), was performed. The global efficacy rate at the end of treatment in evaluable patients treated with sparfloxacin was 88.3% compared with 84.1% in those who received comparator antibacterial agents. This analysis verified the efficacy of this new aminofluoroquinolone, given orally once daily, in the treatment of community acquired pneumonia. The overall outcome favoured sparfloxacin for use in the empirical treatment of community-acquired pneumonia.

Published
1996

43. Immunosuppressive treatments reduce long-term immunity to smallpox among patients with breast cancer.

Author

Wiser I, Orr N, Kaufman B, Segev S, Smetana Z, Bialik A, Epstein N, Mendelson E, Catane R, and Cohen D

Abstract

BACKGROUND: Mass vaccination is the principal preventive measure against a smallpox outbreak after an act of bioterrorism. Vaccination of subjects who received immunosuppressive therapies is problematic because of smallpox vaccine reactogenicity. Moreover, long-term immunity to vaccinia might be affected. OBJECTIVE: The objective of the study was to examine the effect of cytotoxic chemotherapy on long-term immunity to vaccinia. METHODS: In a case-control study, 67 patients with breast cancer who received cytotoxic chemotherapy and who were disease free for at least 1 year were matched with healthy controls according to age, sex, and the number of smallpox vaccinations received. Markers of immunity to smallpox were examined. Forty-one patients with breast cancer who did not receive chemotherapy were used to assess the affect of cancer and radiotherapy on immunity to smallpox. RESULTS: Patients with breast cancer who received chemotherapy had lower levels of vaccinia total immunoglobulin G and immunoglobulin G1 (expressed as enzyme-linked immunosorbent assay units per milliliter), neutralizing antibodies, vaccinia:memory B cell ratio (expressed as a percentage), and interferon-gamma level (expressed as picograms per milliliter), compared with healthy control individuals. CONCLUSIONS: Immunity to smallpox is reduced after receipt of chemotherapy for breast cancer. This finding should be considered when planning smallpox vaccination campaigns. The effect of immunosuppressive treatments on persistence of immunity should be tested with respect to additional vaccines or natural infections. [ABSTRACT FROM AUTHOR]

Published
2010
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48. Pefloxacin treatment of meningitis caused by gram-negative bacteria

Author

Segev, S., Barzilai, A., Rosen, N., Joseph, G., and Rubinstein, E.

Subjects
Antibiotics -- Health aspects, Meningitis -- Care and treatment, Bacterial infections -- Drug therapy, Health
Abstract

Ten patients with acute meningitis (inflammation of the membranes of the brain and spinal cord) caused by a bacteria were treated with pefloxacin antibiotic for an average of 10 days. Eight patients appeared to improve, and the bacteria was eradicated from the cerebrospinal fluid, which circulates within the ventricles of the brain and the spinal cord, in nine out of the 10 patients. Pefloxacin may offer a new, effective and safe treatment for meningitis caused by such bacteria.

Published
1989

50. Human Exserohilumand Bipolarisinfections: report of Exserohilumnasal infection in a neutropenic patient with acute leukemia and review of the literature

Author

Douer, D., Goldschmied-Reouven, A., Segev, S., and Ben-Bassat, I.

Abstract

A neutropenic patient with acute myeloid leukemia developed nasal and perinasal infection caused by the fungus Exserohilum rostratum. Early amphotericin B treatment along with marrow recovery resulted in resolution of the infection. A review of other previously reported cases of Exserohilumand Bipolarisinfections show a favourable outcome in most patients who receive systemic antifungal treatment with amphotericin B.

Published
1987
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