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All articles were critically evaluated and all relevant information was included in this review.
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This study aimed to determine rates of resistance to topical and other class agents against S aureus isolates collected from SSSIs.
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Penicillin non-susceptible VGS were more resistant to erythromycin, clindamycin and ceftriaxone than were penicillin-susceptible isolates. A constitutive MLS(B) phenotype associated with erm(B) was the predominant mechanism of macrolide resistance among erythromycin non-susceptible isolates from this Korean hospital.
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The present work continues our series on the use of MARCH-INSIDE molecular descriptors (parts I and II: J Mol Mod 8:237-245,  and 9:395-407, ). These descriptors encode information pertaining to the distribution of electrons in the molecule based on a simple stochastic approach to the idea of electronegativity equalization (Sanderson's principle). Here, 3D-MARCH-INSIDE molecular descriptors for 667 organic compounds are used as input for a linear discriminant analysis. This 2.5D-QSAR model discriminates between antibacterial compounds and non-antibacterial ones with 92.9% accuracy in training sets. On the other hand, the model classifies 94.0% of the compounds in test set correctly. Additionally, the present QSAR performs similar-to-better than other methods reported elsewhere. Finally, the discovery of a novel compound illustrates the use of the method. This compound, 2-bromo-3-(furan-2-yl)-3-oxo-propionamide has MIC50 of 6.25 and 12.50 microg/mL against Pseudomonas aeruginosa ATCC 27853 and Escherichia coli ATCC 27853, respectively while ampicillin, amoxicillin, clindamycin, and metronidazole have, for instance, MIC50 values higher than 250 mug/mL against E. coli. Consequently, the present method may becomes a useful tool for the in silico discovery of antibacterials.
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The study was conducted in order to evaluate effectiveness of the treatment of bacterial vaginosis (BV) with different therapeutic regimes according to recommendations of the World Health Organization (WHO). During a one-year period (February 2000-February 2001) the Sexually Transmitted Diseases (STD) Center was visited by 482 women aged 14-51. The diagnosis of BV was established by standard methods: Amsel's clinical criteria and Gram stain of vaginal discharge. The first-line treatment was oral Metronidazole 2 g single dose. Second line was Metronidazole 500 mg twice daily orally for 7 days or oral Clindamycin 300 mg twice daily for seven days. BV was confirmed in 74 women (15.4%). Most often it was observed in women aged 17-30 years of age. Thirty-three (44.6% of total) were young women 14-21 years of age. Thirty-one (42%) women received a follow-up examination and of those, 11 (38.7%) needed a repeat treatment for BV due to unsatisfactory results of this treatment. It is concluded that treatment of BV with standard methods was not always effective with no significant difference between women under 21 years and older women found in regards to response to treatment. Besides antibiotic treatment, the so-called Probiotics (Lactobacillus acidophilus) can be taken into consideration as an alternative treatment. Additional research about the therapeutic effect of this type of drugs is needed.
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The prevalence of macrolide resistance and the distribution of resistance mechanisms differ among beta-hemolytic streptococci and S. pneumoniae, with GBS, GGS and S. pneumoniae showing the highest resistance rate. Macrolide or lincosamide cannot be empirically used for severe streptococcal infections before strains are proved to be susceptible. Continuous surveillance of erythromycin and clindamycin resistance patterns among streptococci is needed.
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Four cases of necrotizing fasciitis of the head and neck region, which were treated at the ENT-Department of the Martin Luther University Halle-Wittenberg since 1995, were described.
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Imipenem/cilastatin was compared with the combination of gentamicin plus clindamycin in terms of efficacy and safety for the treatment of moderate to severe infections in an open, randomized study. The rates of cure achieved with the two regimens were similar. Gentamicin/clindamycin treatment failed only in two of four instances of severe infection. Patients given imipenem/cilastatin seemed to respond more rapidly to treatment; this observation applied both to the entire group treated and to the subgroup with moderate intraabdominal infections. Susceptible etiologic agents were more frequently eradicated by imipenem/cilastatin (95%) than by gentamicin/clindamycin (79%). The most common adverse reactions were nausea or vomiting in patients given imipenem/cilastatin and urinary abnormalities in those given gentamicin/clindamycin. Self-limited diarrhea was observed with equal frequency in the two groups. No adverse reactions required the discontinuation of treatment. Colonization or superinfection with resistant organisms and Pseudomonas aeruginosa occurred significantly more often among patients given gentamicin/clindamycin. These results suggest that imipenem/cilastatin is a promising alternative to the combination of gentamicin and clindamycin for the treatment of moderate to severe infections in hospitalized patients.
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The important diversity of scores of assessed antibiotics was observed in every category. In most cases clindamycin and macrolides obtained the lowest scores, penicillins and co-trimoxazol--medium ones and cephalosporins--the best scores. Among penicillins, amoxicillins with clavulanic acids were scored lower than pure amoxicillins. In overall score, different preparations of the same substance obtained similar scores, statistically non-different, with one exception for clarithromycin, in which Klacid was characterized by better palatability.
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The questionnaires were analysed and the responses to each question expressed as absolute frequencies.
The microbiologic and therapeutic aspects of sixty-one cases of pyogenic dental infection were studied through the use of modern anaerobic culture methods. Forty-five (74 percent) patients had anaerobic infections. Among them, eighteen (29.5 percent) had Bacteroides fragilis, of which six were resistant to penicillin at 16 microgram/ml. but all were susceptible to clindamycin at less than 2 microgram/ml. Of twenty-five patients treated with 4 to 20 million units of penicillin per day, twenty were cured and did not suffer relapse. The five patients in whom treatment failed had mandibular fractures infected with B. fragilis. Of ten patients treated with clindamycin (600 mg. intravenously every 6 hours), which included five patients with B. fragilis infections, all were cured. The presence of B. fragilis in dental infections has not been recognized. Dental infections associated with mandibular fracture that fail to respond to conventional penicillin therapy should be routinely cultured for B. fragilis.
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The authors report a case of Lemierre's syndrome. This uncommon clinical entity is characterized by a septic internal jugular vein thrombosis with secondary metastatic abscesses and Fusobacterium necrophorum septicemia, following an acute oropharyngeal infection. The diagnosis is primarily clinical and it should be suspected when a severe septicaemic illness, with pulmonary symptoms, occurs after an acute pharyngotonsillar infection. This article reviews the clinical picture, microbiology and treatment of this forgotten complication of acute tonsillitis.