Thirty-five of the 80 women (44%) had achieved amenorrhea. Ten women required further treatment; of these seven had a hysterectomy (9%). None of the non-responders had a hysterectomy. Following rollerball endometrial ablation, many women reported improvement in cyclical pelvic pain (73%), pre-menstrual symptoms (65%), ability to do housework (85%), and an improved sexual life (96%). Seventy-nine (99%) women were able to return to normal work within 4 weeks following surgery. The majority of them remained satisfied with treatment (79%) and they would recommend it to a friend (91%).
In this pooled analysis of data from 7 randomized, single-blind, crossover trials, children between the ages of 4 and 8 years preferred the taste of cefdinir oral suspension to that of other pediatric antibiotic suspensions. Based on smile-face scores, subjects found the smell of cefdinir oral suspension to be at least as good as that of the comparators.
Most, but not all, species of subgingival bacteria are considerably more resistant in biofilms than in planktonic cultures. Resistance appeared to be age-related because biofilms demonstrated progressive antibiotic resistance as they matured with maximum resistance coinciding with the steady-state phase of biofilm growth.
Two models of respiratory tract infection were used to investigate the pharmacodynamics of amoxicillin-clavulanate against Streptococcus pneumoniae. Eight strains of S. pneumoniae were used in a mouse model in which the animals were infected intranasally and were then treated with a range of doses and dose intervals. The time that the plasma amoxicillin concentration remained above the MIC (T>MIC) correlated well with bacterial killing, such that if T>MIC was below 20% there was no effect on bacterial numbers in the lungs. As T>MIC increased, the response, in terms of decreased bacterial load, improved and at T>MICs of greater than 35 to 40% of the dosing interval, bacteriological cure was maximal. On the basis of equivalent T>MICs, these data would suggest that in humans a dosage of 500 mg three times daily (t.i.d.) should have efficacy equal to that of a dosage of 875 mg twice daily (b.i.d.). This hypothesis was evaluated in a rat model in which amoxicillin-clavulanate was given by computer-controlled intravenous infusion to achieve concentrations that approximate the concentrations achieved in the plasma of humans following oral administration of 500/125 mg t.i.d. or 875/125 mg b.i.d. Infusions continued for 3 days and bacterial numbers in the lungs 2 h after the cessation of the infusion were significantly reduced (P < 0.01) by both treatments in strains of S. pneumoniae for which amoxicillin MICs were below 2 microg/ml. When tested against a strain of S. pneumoniae for which the amoxicillin MIC was 4 microg/ml, the simulated 500/125-mg dose was ineffective but the 875/125-mg dose demonstrated a small but significant (P < 0. 01) reduction in bacterial numbers. These data confirm the findings in the mouse and indicate that amoxicillin-clavulanate administered at 875/125 mg b.i.d. would be as effective clinically as amoxicillin-clavulanate administered at 500/125 mg t.i.d.
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Study carried out during the period 1992-1999 in Centro Sociosanitario Albada (Sabadell, Spain). Data were taken from the Pharmacy Department's unidose registry. We determined the most frequently used antibiotics, the hospital units with highest consumption, the variation in these factors over time, and related costs.
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With no difference in demographics between treatment groups, overall the mean age (+/-SD) was 2.8 +/- 1.8 years, 65% had received conjugated pneumococcal vaccination and 48% had bilateral AOM. The satisfactory clinical response rate at end of therapy was comparable for cefdinir versus amoxicillin/clavulanate (88%, 170 of 194 versus 85%, 164 of 192; 95% CI -4.9, 9.3). Although this must be interpreted with caution, cefdinir showed an apparent trend for higher efficacy than amoxicillin/clavulanate (92%, 72 of 78 versus 77%, 55 of 71; P = 0.019) in a subsample of patients 6-24 months old who had received conjugated pneumococcal vaccination. The incidence of drug-related adverse events was less for cefdinir than for amoxicillin/clavulanate (24%, 50 of 211 versus 38%, 82 of 214; P = 0.0018)
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Urinary tract infections (UTIs) are among the most common bacterial infections in adult population. They are prevalent in all age groups both in women and men. Also, UTIs are the most frequent indication for empirical antibiotic treatment in emergency department. The aim of this study was to determine the antibiotic resistance rates in the treatment of uncomplicated UTIs. Adult patients admitted to emergency department with uncomplicated UTIs were included in this cross-sectional study. Mid-stream urine samples were obtained under sterile conditions and cultured quantitatively. After 24 hours, the samples showing 10(5) colony forming unit per milliliter (CFU/mL) were tested for antibiotic susceptibility. Resistance to fosfomycin-trometamol (FT), amoxicillin-clavulanic acid (AC), ciprofloxacin (CIP), trimethoprim-sulfamethoxazole (TMP-SMX) and cefpodoxime (CEF) was tested by Kirby-Bauer disc diffusion system. Escherichia (E.) coli accounted for the vast majority (93.4%) of the organisms isolated in the study. Among the E. coli positive patients, resistance to TMP-SMX was the most common antibiotic resistance. The E. coli species detected in our study group were least resistant to FT (2.4%). The resistance rates, especially to CEF, AC and CIP, were significantly higher in patients over 50 years of age. In conclusion, in the treatment of uncomplicated UTIs, TMP-SMX should be excluded from empirical treatment, while fosfomycin could be a viable option in all age groups.
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We report here a rare case of simultaneous onset of preseptal cellulitis in twins. The absence of any infection in three other siblings during this period would suggest that the twins may not have developed simultaneous lid infection by sheer coincidence. The authors discuss the possible mechanism and emphasize the need for close surveillance of the twin of an index case with ocular infection.
Infection after head and neck oncological surgery is relatively frequent, and is associated with significant morbidity and mortality.
The enzyme glucose-6-phosphate dehydrogenase (G6P-DH, EC.188.8.131.52) catalyzes the oxidation of glucose-6-phosphate in 6-phosphogluconat which is indispensable in the defence of erythrocytes from oxidative insult. The aim of this study was to examine the influence of commonly used drugs in our medical practice, amoxiclav (amoxicillin-clavulanate combination) and lidaprim (trimethoprim-sulfamethrole combination) respectively, upon the erythrocyte G6P-DH activity in experimental rats. In addition, the effect of the toxic drug 1-chloro-2,4-dinitrobenzen (CDNB) on the activity of G6P-DH was examined. The experiment was conducted in fresh blood haemolysates of white laboratory rats, Wistar type, of both genders (n=80). The enzyme activity was determined by "Boehringer-Mannheim" diagnostic assay kits (Kornberg et al., 1955). However, the measured enzyme activity in the control group of rats was found to be a statistically insignificant difference between the genders (140.2 +/- 21.2 mU/10(9)Er in male rats, 144.3 +/- 20.6 mU/10(9) in the female group). Hence, the established enzyme activity does not differ from the activity of the same enzyme in healthy human subjects. The administered dose of lidaprim did not affect the activity of G6P-DH in the treated group of rats, thus attaining levels similar to the control group. By contrast, amoxiclav administration provoked a significant reduction in enzyme activity of 13.6% in male and 19.5% in female rats (p < 0.001), while the treatment with CDNB significantly increased the activity of the latter to 49.7% in male and 30.1% in female rats (p < 0.001) in comparison with the control ones. Testing of haemolitical potential is strongly recommended prior to the use of new drugs, particularly in the Mediterranean region, were this enzymopathy is found to be frequent bearing in mind that there is an established list of drugs which affect the G6P-DH activity in the erythrocytes. The above-mentioned method may be used in experimental animal models allowing for administration of a wider selection of drugs in this type of research.