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The susceptibility patterns of 35 Shigella isolates (16 S. flexneri, 14 S. dysenteriae and 5 S. sonnei) to trimethoprim (Tp) and various antibiotics including amoxycillin, amoxycillin-clavulanic acid, nalidixic acid, ciprofloxacin, ceftazidime and ceftriaxone, were investigated. Twenty-two (62.8%) strains were resistant to Tp with a minimal inhibitory concentration (MIC50) value of 512 mg/L. Only six isolates were amoxycillin resistant, to which clavulanic acid restored sensitivity in all of them. None of the isolates were resistant either to extended spectrum cephalosporins or to quinolones. Resistance to Tp was transferred from 7 of the 22 isolates (31.8%) to the recipient Escherichia coli K12. Tp MIC values of the transconjugants were 512 mg/L. In no strain could amoxycillin resistance be transferred. Our results indicate that as the prevalence of transferable Tp resistance in Shigella isolates in Izmir is substantially high, alternative antimicrobial agents should be considered for empirical antibiotic therapy.
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Gram-negative enteric rods were associated with periodontal diseases in several populations. The association between enteric and putative periodontal pathogens has received little attention in the literature. The present investigation determined the occurrence and in vitro antimicrobial susceptibility of isolates of Gram-negative enteric rods from Colombian patients with chronic periodontitis.
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The interaction between an infectious agent (EBV) and amoxicillin could precipitate the severe skin reaction. Patch test and delayed intradermal reading with amoxicilllin were an useful tool for the diagnosis of the etiological agent in this reaction. The negative response to other beta-lactams, suggests that the aminobenzyl group of the side chain of amoxicillin plays a predominant role in this reaction.
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Amoxicillin/clavulanate and azithromycin therapy resulted in increased isolation of nasopharyngeal non-pneumococcal AHS, many of which were multidrug-resistant, in contrast to a decrease in pneumococcal carriage. This suggests that the competitive balance between these 2 groups of organisms was disturbed as a result of differential antibiotic susceptibility. The importance of drug-resistant AHS as a reservoir for resistance genes for S pneumoniae warrants further investigation.
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The prevalence of antimicrobial resistance among urinary pathogens has been increasing worldwide. Laboratory diagnosed urinary tract infections were retrospectively evaluated for the years 1996 through 1999, to document the common pathogens and their changing antimicrobial profiles. From 14,853 hospital specimens, an isolation rate of 6.1% was found; and from 5330 community specimens, the isolation rate was 27.9%. E. coli was the predominant cause of urinary tract infections in both hospital and community practices. The rate of isolation of the other pathogens was relatively stable except for citrobacter species, which increased from 1.3% in 1996 to 20.1% in 1999 (p < 0.001) among community isolates. Significant changes in the susceptibility patterns of uropathogens also were observed. E. coli strains from hospitals were significantly more resistant to cefuroxime than community strains (p < 0.001), while resistance to ampicillin and nalidixic acid was high in both practices. No substantial changes in susceptibility to gentamicin and tetracycline were noticed during the four-year period compared to the 99% resistance to tetracycline in 1995. In relation to nitrofurantoin, no significant changes were noted in both practices where resistant rates remained low, but susceptibility to augmentin showed much improvement among all isolates, including E. coli. Urinary isolates were more commonly recovered from the paediatric age group (1-10 years) and those older than 50 years of age, and males were the predominant gender in both age groups. The study showed that the antibiotics useful in the treatment of UTI in decreasing order of effectiveness in community practice were gentamicin, norfloxacin, nitrofurantoin and cefuroxime. For nosocomial UTI, the drugs most effective include norfloxacin, nitrofurantoin, gentamicin, co-trimoxazole and amoxicillin-clavulanic acid.
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intra-European spread of plasmid pB1000 among H. influenzae has been shown. The coexistence of plasmid pB1000 and mutations in PBP3 produces an additive resistance phenotype in H. influenzae.
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No significant relation was found between topical or systemic antibiotic use and pain intensity after tonsillectomy.
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Gonococcus typically affects the mucosal surfaces but in rare cases can spread to bloodstream causing disseminated gonococcal infection (DGI). The usual presentation of DGI is rash, polyarthralgia, and tenosynovitis. We present the case of a 23-year-old female who presented to our hospital with pustular rash and tenosynovitis of hand and was sent home on Augmentin. Her symptoms worsened despite treatment and she presented back to the ED. On investigation, she was found to have DGI and was appropriately treated. DGI should be kept in mind in sexually active youngsters who have only one or two features of the classic triad of rash, tenosynovitis, and arthritis. Timely management and appropriate treatment of DGI is very important to avoid complications and morbidity.
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We analyzed the National Ambulatory Medical Care Survey, 2002-2006 (N = 1114), which occurred in US physicians' offices. The patients were children aged 6 months to 12 years who were diagnosed with AOM. The time comparisons were the 30-month periods before and after the guideline. The main outcome was the encounter rate at which no antibiotic-prescribing was reported. Secondary outcomes were the identification of factors associated with encounters at which no antibiotic-prescribing was reported and antibiotic- and analgesic-prescribing rates.