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With the discovery of penicillin and entrance into the antibiotic era, the capability of dentists to treat dental infections have changed dramatically. Many antibacterial agents have developed since, but bacterial resistance using diverse mechanisms, have increased concomitantly. Since antimicrobial agents are frequently needed in dentistry, their judicious use is of prime importance. Dental infections can be divided to two main groups according to the origin of the infection. First, odontogenic infections (acute dento-alveolar abscess) originating from the dental pulp are most commonly caused by gram-positive anaerobic or facultative bacteria. Systemic antibiotic should be given concomitantly with drainage of the dento-alveolar abscess, debridment of the root canal of the infected tooth, and placement of inta-canal antimicrobial medication such as calcium hydroxide. Penicillin G, penicillin V (Rafapen) or amoxycillin (moxypen) are the first line systemic antimicrobial agents. In case of no improvement within 2-3 days, second line regimens such as amoxycillin-clavulanate (augmentin), cefuroxime (zinnat) or penicillin and metronidazole are recommended. In patients allergic to penicillin, clindamycinn (dalacin) is preferred over macrolides. The second group of infections originates from the periodontal apparatus, and is caused usually by gram-negative anaerobes bacilli, sometimes with Actinobacillus actinomycetemcomitance (Aa). Systemic antibiotics are only infrequently indicated in this situation, and always accompanied by scaling, root planning and curettage of the infected root and gingiva. In regenerative or post surgical periodontitis, augmentin, metronidazole or metronidazole in combination with penicillin or amoxycillin augmentin are recommended. In aggressive periodontitis the most common pathogen is Aa and therefore tetracycline, augmentin, or metronidazole and amoxicillin are recommended. In necrotizing ulcerative gingivitis, which is caused usually by fusiform bacilli and spirochetes, metronidazole or augmentin are appropriate. In patients with periodontal disease who are allergic to penicillin can be treated with a macrolides.
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The prescription in the Area of Segovia has presented a contained consumption in relation to other studies, showing differences in the volume of prescription from each the subgroups. The centralization of the consumption emphasizes in the subgroup of penicillins that supposed almost two third parts of the prescribed DDD. A change in the habits of prescription is observed detailing a decrease of the amoxicillin use and an increase of amoxicillin-clavulanic acid.
amoclane eg 500 mg
The authors sampled surfaces with swabs that they then used to inoculate selective and differential media. CHRO-Magar Staph aureus (DRG International, Mountainside, N.J.) was the most effective. They used phenotypic and genotypic tests to identify presumptive S. aureus colonies. They determined the sensitivity of S. aureus isolates to five antibiotics, including oxacillin, according to the Kirby-Bauer method.
amoclane eg 875 mg
For 12 years, a 26-year-old man had acne conglobata and a non-suppurative diffuse sclerosing osteomyelitis of the mandible as part of a chronic recurrent multifocal osteomyelitis of the sternum, the pelvic bones, and the femoral head, and aseptic arthritis of the knee, the fibulotalar, and the sternoclavicular joints. This fulfills the formal criteria of the SAPHO syndrome. Repeated surgical and antibiotic treatment combined with hyperbaric oxygen caused partial improvement. Complete relief and partial disappearance of the scintigraphic lesions was achieved with long-term corticosteroids, non-steroidal anti-inflammatory drugs, minocycline, and isotretinoin.
We report a case of melioidosis in a previously healthy Belgian man. He presented with septicemia and prostatic abscesses 1 week after a trip to Vietnam. Burkholderia pseudomallei was isolated from multiple hemocultures. He was treated successfully with intravenous ceftazidime and trimethoprim-sulfamethoxazole, followed by a per-oral maintenance therapy of amoxicillin-clavulanate with supplementary amoxicillin. There was no need for surgical drainage. This is the second reported case of melioidosis in Belgium.
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A randomized study of a 3-day course of azithromycin therapy (500 mg once daily) vs. a 10-day course of co-amoxiclav therapy (625 mg thrice daily) in patients with acute sinusitis was performed with an account of the GCP criteria. One hundred patients in 2 groups each of 50 persons were enrolled. The estimates of the patient body temperature, headache, pain on palpation in the area of the accessory nasal sinuses, nasal cavity stuffing, nasal discharge nature and the nose mucous membrane appearance were recorded prior to the treatment, in 72 hours and on the 10th-12th and 26th-30th days of the treatment. The microbiological analysis of the punctate from the accessory nasal sinuses was undertaken before the antibiotic therapy and 72 hours after its start. The economic analysis included the cost of the antibiotic therapy course, hospitalization term, medical manipulations and laboratory tests as well as the cost/efficacy index. The frequency of the relapses within 6 months after the cure was estimated in the two groups compared. In 72 hours and on the 10th-12th days after the treatment start the efficacy of azithromycin was significantly higher than that of co-amoxiclav. The cure was stated in 41 (82 per cent) and 26 (52 per cent) patients on the 10th-12th days, in 6 (12 per cent) and 21 (42 per cent) patients the improvement was stated and the fail was stated in 3 (6 per cent) and 2 (4 per cent) patients respectively. The efficacy of the drugs on the 26th-30th days after the treatment start did not differ. The isolates of Staphylococcus aureus and Streptococcus pyogenes were the main pathogens. The bacteriologic eradication was recorded in 29 (90.6 per cent) patients treated with azithromycin and only in 18 (69.2 per cent) patients treated with co-amoxiclav. Adverse reactions and relapses of the disease within 6 months after the cure were more frequent in the patients treated with co-amoxiclav. The cost of the azithromycin therapy was significantly lower. It was shown that the shortened course of the azithromycin therapy provided earlier cure of the patients with acute sinusitis, better tolerance of the drug, less frequent adverse reactions, lower cost as compared to the use of co-amoxiclav and no relapses.
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To report a case of death due to Augmentin-induced cholestatic hepatitis and discuss a possible drug interaction between Augmentin and oestrogenic steroids.
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Augmentin promotes a significantly earlier regress of exacerbation symptoms and persistent remission. Eradication potential of augmentin in CB/COPD patients is higher than that of macrolides. Long-term post-exacerbation monitoring (12-month follow-up) discovered that recurrence-free period of augmentin-treated patients is much longer than in patients on macrolides.
amoclane eg 250 mg
CEF provides a clinically and bacteriologically effective treatment for children with PT caused by GABHS, comparable to AMC but significantly safer in terms of gastrointestinal side effects. AMC shows a greater risk of relapse and recurrence than CEF.