- A breath-taking DRESS due to amoxicillin-clavulanate presenting as polymorphic eruption of the pregnancy. [Journal Article]
- JEJ Eur Acad Dermatol Venereol 2018 Mar 23
- Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed-type drug hypersensitivity reaction with potential life-threatening complications. To our knowledge, DRESS has never been de...
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed-type drug hypersensitivity reaction with potential life-threatening complications. To our knowledge, DRESS has never been described in pregnancy. Here, we report on a pregnant woman presenting with erythematous plaques on the abdomen, developing cardiac tamponade due to eosinophilic perimyocarditis and an interstitial pneumonitis five weeks after exposure to amoxicillin-clavulanate. This article is protected by copyright. All rights reserved.
- Prevalence and antibiotic resistance of bacteria isolated from the cerebrospinal fluid of neurosurgical patients at Peking Union Medical College Hospital. [Journal Article]
- ARAntimicrob Resist Infect Control 2018; 7:41
- CONCLUSIONS: PCNSIs could lead to high mortality. Although the MRCoNS were the predominant organism, the management ofAcinetobacter baumanniiwas a major clinical challenge with few effective antimicrobials in PCNSIs.
- In Reply: Synergy between amoxicillin and meropenem/clavulanate in drug-resistant tuberculosis. [Journal Article]
- IJInt J Tuberc Lung Dis 2018 Apr 01; 22(4):465-466
- Low-dose amoxicillin-clavulanate in drug-resistant tuberculosis. [Journal Article]
- IJInt J Tuberc Lung Dis 2018 Apr 01; 22(4):465
- Gonococcal cellulitis: an (un)friendly bite. [Journal Article]
- IInfection 2018 Mar 16
- CONCLUSIONS: The manifestations of gonococcal infection have changed significantly over the last few years, with more involvement of extra genital sites attributed to changes in sexual practices. Our patient was treated for cellulitis and abscess caused by N. gonorrhoeae in the absence of systemic or urethral disease. Recommendations regarding treatment of gonococcal infection have been widely published. However, there is a paucity of evidence-based guidelines regarding the therapy of primary cutaneous gonococcal infection. Pooled data from similar cases may help determine the optimum therapy.
- Effects of pH on the Antibiotic Resistance of Bacteria Recovered from Diabetic Foot Ulcer FluidAn In Vitro Study. [Journal Article]
- JAJ Am Podiatr Med Assoc 2018; 108(1):6-11
- CONCLUSIONS: These findings highlight the importance of a more comprehensive understanding of the conditions in DFUs to inform clinical decision making in the selection and application of antibiotics in treating these difficult-to-heal wounds. The scale of the differences in the efficacies of antibiotics at the different pH values examined is likely to be sufficient to suggest reconsideration of the antibiotics of choice in the treatment of DFU infection.
- Effect of Therapy on Periodontal Infections. [Journal Article]
- JPJ Periodontol 1993; 64 Suppl 8S:754-759
- Periodontal disease progression requires the simultaneous presence of high numbers of pathogens, low numbers of compatible or beneficial species, a conducive local environment, and a susceptible host...
Periodontal disease progression requires the simultaneous presence of high numbers of pathogens, low numbers of compatible or beneficial species, a conducive local environment, and a susceptible host. Effective therapy acts by altering one or more of these factors. Data from an ongoing study were used to examine the biological basis of treatment success or failure. Seventeen subjects showing disease progression were treated by Widman flap surgery at deep sites, scaling at shallow sites, and 1 of 4 randomlyassigned, systemically-administered adjunctive agents including amoxicillin/clavulanate potassium (Au) (n = 3), ibuprofen (n = 3), tetracycline (n = 9), or a placebo (n = 2). Clinical measurements and microbiological samples (enumerated using DNA probes) taken from the mesial aspect of each tooth pre-treatment and 12 months post-treatment were compared and 418 pre- and 418 post-therapy plaque samples were enumerated. Overall, the 4 treatments resulted in pocket depth reduction and "gain" in attachment. After therapy, the percentage of sites colonized by Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, and Bacteroides forsythus was decreased and counts > 106were less frequent. Large attachment level gains were accompanied by major decreases in these species and were more frequent in subjects receiving antibiotics. A small number of sites in each treatment group became deeper and/or lost attachment. More than half of these sites were detected in 2 subjects who were older (65 vs. 44), had higher serum antibody to Actinobacillus actinomycetemcomitans serotype a (506 vs. 125 ELISA units), A. actinomycetemcomitans serotype b (518 vs. 130), and Campylobacter rectus (39 vs. 18). They also had the lowest mean total viable subgingival counts (1.1 vs. 12.3 × 106) and the lowest counts of each species pre-therapy. In the total subject group, increased mean counts of P. gingivalis and B. forsythus were seen at sites showing attachment loss > 1 mm after therapy, while counts decreased at sites showing no attachment change or "gain" > 1 mm. J Periodontol 1993; 64:754-759.
- A Role for Antibiotics in the Treatment of Refractory Periodontitis. [Journal Article]
- JPJ Periodontol 1993; 64 Suppl 8S:772-781
- Refractory periodontitis is considered by many investigators to be a separate disease entity that is descriptive of a particular patient who has multiple sites, rather than a few individual sites, th...
Refractory periodontitis is considered by many investigators to be a separate disease entity that is descriptive of a particular patient who has multiple sites, rather than a few individual sites, that do not respond to conventional periodontal treatment modalities. Such patients continue to demonstrate loss of attachment and alveolar bone despite frequent periodontal treatment which includes surgical intervention, scaling and root planing, and often systemically-administered tetracycline. Controlled clinical studies have demonstrated that both clindamycin-hydrochloride and amoxicillin/clavulanate potassium (Au) are beneficial when used in conjunction with periodontal scaling. Gordon et al. found improvements in attachment levels, inflammation, suppuration, and a decrease in pocket depths for up to 2 years following a 7-day course of Clindamycin given in conjunction with a full-mouth scaling. The incidence of disease activity decreased from an annual rate of 8% of all sites prior to antibiotic treatment to 0.5% after treatment. Magnusson, reporting on a similar group treated with a 14-day course of Au, found an average loss of attachment of 2.2 mm and an increase in pocket depth of 1.5 mm in sites demonstrating disease progression prior to antibiotic treatment. At 3 months post-antibiotic therapy, these sites had regained an average of 2 mm of attachment and pocket depths had decreased an equivalent amount. Both attachment levels and pocket depths remained relatively stable for up to 12 months post-therapy. In an ongoing study, 30 subjects with refractory Periodontitis were treated with either Clindamycin or Au in conjunction with scaling or scaling plus a placebo. Prior to antibiotic treatment, but while being scaled at 3-month intervals, sites with disease activity lost an average 2.4 mm of attachment. At 3 months post-treatment, the clindamycin-treated group showed an average gain of 2.1 mm, the Au-treated group gained 1.9 mm, and the scaling group gained 1.4 mm in attachment. The clindamycin group remained relatively stable for up to 21 months and the Au group remained stable for about 15 months without additional treatment. Five of the 6 subjects treated with scaling alone required additional treatment within 9 months. Preliminary analyses have indicated that at least two patterns or rates of attachment loss may be associated with refractory periodontitis and that each pattern may be indicative of a different microflora. The pattern associated with a relatively rapid loss of attachment was characterized by a Gram-negative flora which contained spirochetes, P. intermedia, and Fusobacterium species. A slow, continuous rate was associated with a predominantly Gram-positive flora containing a high proportion of S. intermedius and/or a S. intermedius-like organism. J Periodontol 1993; 64:772-781.
- Current Status of Systemic Antibiotic Usage in Destructive Periodontal Disease. [Journal Article]
- JPJ Periodontol 1993; 64 Suppl 8S:760-771
- The recognition that periodontal diseases are primarily caused by specific microorganisms has led researchers to explore the possibility that antibiotics may enhance the effect of mechanical debridem...
The recognition that periodontal diseases are primarily caused by specific microorganisms has led researchers to explore the possibility that antibiotics may enhance the effect of mechanical debridement procedures such as scaling and surgery. For some selected periodontal diseases, this has proven to be true. This paper will review systemically-administered antibiotics and the clinical studies and case reports supporting their use. In periodontal therapy, the tetracyclines are the most commonly-used antibiotics in the United States. Tetracycline hydrochloride, minocycline, and doxycycline have been shown to inhibit in vitro most putative periodontal pathogens. Several studies support the use of tetracyclines in the treatment of localized juvenile periodontitis. Penicillins such as amoxicillin are effective in vitro against most periodontal pathogens but have limited efficacy due to the presence of beta-lactamases in gingival fluid. Amoxicillin/ clavulanate potassium (Au) has proven effective in treating adult refractory periodontitis characterized by a Gram-positive flora. Metronidazole is an effective adjunct in adult periodontitis associated with high numbers of "black-pigmented Bacteroides" and spirochetes. A combination of metronidazole and amoxicillin produces a synergistic effect against A. actinomycetemcomitans and has been shown to be effective at eliminating this organism. Clindamycin is an effective adjunct in the treatment of adult refractory periodontitis associated with a predominantly Gram-negative flora. The use of macrolides, quinolones, and combinations of antibiotics is discussed. Clinical studies do not support the use of systemically-administered antibiotics in routine adult periodontitis. Clinical studies do, however, support the use of antibiotics in the treatment of specific periodontal diseases. J Periodontol 1993; 64:760-771.
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- Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015). [Journal Article]
- RERev Esp Quimioter 2018 Mar 12
- CONCLUSIONS: SMART-Spain results support current guidelines which include ertapenem as empiric treatment in mild-moderate community-acquired IAI, particularly with ESBL producers. These recommendations will need to be updated with the recently introduction of new antimicrobials.