clinwas gel topico
One hundred and seventy patients with intra-abdominal infection with non-sporing anaerobes were prospectively studied in an international multicentre study. Patients were randomly allocated to treatment with clindamycin or metronidazole, for a minimum of 48 h to a maximum of 7 days. Other antimicrobial therapy was permitted if indicated by in vitro susceptibility testing. The commonest infections were peritonitis, intra-abdominal abscesses and appendicitis (72 cases), colorectal carcinoma (23 cases), intestinal perforation (16 cases) and diverticulitis (13 cases). Thirty patients received no other antimicrobial chemotherapy and in a further 94 patients, an aminoglycoside was given in addition to the study drugs. In 38 patients the infection required no surgical intervention. Appendicectomy was commonly performed and surgical drainage of pus was required in 14 patients. These variables were evenly distributed between the treatment groups. Both clindamycin and metronidazole were found to be effective therapy for anaerobic infections and were well tolerated. Of the 9 deaths in the study, 7 were in the clindamycin group, and 2 in the metronidazole group. The study protocol allowed patients who were responding poorly to treatment to be crossed over to the alternative therapy. This procedure was followed in 6 patients, 5 of whom were originally receiving clindamycin. It is concluded that metronidazole is as effective for anaerobic infections as clindamycin.
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Each animal model has provided insights. Particularly important was the considerable resistance of bone to infection without manipulation (no morrhuate, fracture, rod, wax, or prosthesis). Such perturbations allow bone infection with much smaller inocula. Typical inocula decreases are 1000 to 10,000 fold. Staphylococci may have a selective advantage in bone because of specialized or tropic binding, perhaps to cartilage or collagen. Osteoclast-induced resorption of hydroxyapatite might explain the distribution of some osteomyelitis. Increased osteoclast activity could link the susceptible metaphyseal regions, the repetitively traumatized diabetic foot, a history of blunt bone trauma, fracture, and perhaps even nearby soft tissue infection. Diagnosis remains difficult; gallium-67 and indium111 labeled WBC probably deserve additional investigation. Therapeutic failures in the rabbit and rat models mirror clinical experience. Clindamycin, rifampin, and quinolones are promising. Neither systemic nor local antimicrobial prophylaxis is well studied yet.
clinwas gel indicaciones
Randomized controlled clinical trial.
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Women with a clinical diagnosis of chorioamnionitis between 32 and 42 weeks of gestation were randomly assigned in labor to receive either daily gentamicin (5 mg/kg intravenously (IV), then 2 placebo doses IV after 8 and 16 hours) or 8-hour gentamicin (2 mg/kg IV, then 1.5 mg/kg IV after 8 and 16 hours). Both groups received ampicillin (2 grams IV every 6 hours for a total of four doses). Patients who underwent cesarean delivery also received clindamycin (900 mg IV every 8 hours, for a total of three doses). The primary outcome was treatment success, defined by resolution of chorioamnionitis after 16 hours of treatment without development of endometritis. One hundred twenty-six patients were required to have 95% confidence that daily gentamicin is at worst 15% inferior to 8-hour dosing with an alpha of .05 and a beta of 0.2.
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In six experiments, gentamicin, clindamycin, amikacin, minocin, tylosin, and Linco-Spectin were tested for their effect on motility and fertility of frozen bull spermatozoa and all but clindamycin were used in fertility trials. Antibiotics were added to raw (unextended) semen and nonglycerol portions of the three commonly used semen extenders, whole milk, egg yolk-Tris, and egg yolk-citrate. Semen was frozen in .5-ml straws, stored in liquid nitrogen, and thawed at 37 degrees C for 30 s. Postthaw percentage of motile spermatozoa in antibiotic-treated semen was different for individual bulls in each experiment. Percentage of motile sperm was slightly but significantly depressed at the higher concentrations of clindamycin and Linco-Spectin tested in whole milk and with minocin in the two egg yolk extenders. In general, nonspermicidal concentrations of each antibiotic were established. Of five antibiotics tested for fertility, only gentamicin reduced fertility on the basis of 59-d nonreturn rates.
clinwas gel topico opiniones
The results of this study show that there is a high frequency of resistant species in the Bacteroides fragilis group in the intestinal tract of children and adults in Brazil. B. fragilis was not studied. Of the 73 strains examined, B. distasonis was the most resistant species to penicillin, cefoxitin, cefotaxime and clindamycin. High rates of multiresistance were found, most commonly to penicillin and clindamycin (18 of 36 strains). High levels of beta-lactamase production were detected in isolates showing high resistance to penicillin and multiresistance to the cephamycins, suggesting a widespread dissemination of such resistance.
prospecto clinwas gel
We compared maternal and neonatal outcomes in women who received prophylactic antibiotics prior to skin incision to those who received antibiotics at cord clamp. We performed a randomized clinical trial at two sites. Eligible women included those undergoing nonemergency cesarean at 36 weeks' gestation or greater. Subjects were randomized (permuted blocks) into one of two treatments: "preoperative antibiotics" (cefazolin 1 g given <30 minutes prior to skin incision) or "intraoperative antibiotics" (cefazolin 1 g at cord clamping). Patients who reported an allergy to penicillin received clindamycin 900 mg. The trial primary outcome was a composite of maternal infectious morbidities, defined as having any one of the following: (1) postoperative fever (defined as oral temperature >38°C on two separate occasions more than 6 hours apart, after the initial 24-hour postoperative period); (2) wound infection (defined as purulent discharge from the incision); (3) endomyometritis (defined as fundal tenderness and fever malodorous lochia, fever); (4) urinary tract infection (defined as fever, positive urine culture). We enrolled a total of 434 subjects in this study, with 217 in each group. Overall, we found no difference in composite maternal infectious morbidity between those who received antibiotics preoperatively and those who received antibiotics at cord clamp (relative risk = 1.2, 95% confidence interval 0.7 to 1.5). Neonatal outcomes were also similar between the two intervention arms. The rate of suspected sepsis was similar between the two groups. There were no cases of antibiotic resistance in the neonates. Either preoperative antibiotic therapy or antibiotic administration after cord clamp is a reasonable clinical method for reducing the risk of postcesarean infectious morbidity.
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100 erythromycin-resistant and clindamycin-sensitive S. aureus were collected as a convenience sample from February to August 2003. Inducible clindamycin resistance was identified using the D-zone disc method.
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The objective of this study was to determine the prevalence and distribution of methicillin-resistant Staphylococcus aureus (MRSA) genotypes circulating at a tertiary hospital in the Sultanate of Oman. A total of 79 MRSA isolates were obtained from different clinical samples and investigated using antibiogram, pulsed-field gel electrophoresis (PFGE), staphylococcal chromosome cassette mec (SCCmec), Spa typing and multilocus sequence typing (MLST). The isolates were susceptible to linezolid, vancomycin, teicoplanin, tigecycline and mupirocin but were resistant to tetracycline (30.4%), erythromycin (26.6%), clindamycin (24.1%), trimethoprim (19.0%), ciprofloxacin (17.7%), fusidic acid (15.2%) and gentamicin (12.7%). Molecular typing revealed 19 PFGE patterns, 26 Spa types and 21 sequence types. SCCmec-IV (86.0%) was the dominant SCCmec type, followed by SCCmec-V (10.1%). SCCmec-III (2.5%) and SCCmec-II (1.3%) were less common. ST6-IV/t304 (n = 30) and ST1295-IV/t690 (n = 12) were the dominant genotypes followed by ST772-V/t657 (n = 5), ST30-IV/t019/t021 (n = 5), ST22-IV/t852 (n = 4), ST80-IV/t044 (n = 3) and 18 single genotypes that were isolated sporadically. On the basis of SCCmec typing and MLST, 91.2% of the isolates were classified as community-associated MRSA and 8.8% of the isolates (consisting of four ST22-IV/t852, one ST239-III/t632, one ST5-III/t311 and one ST5-II/t003) were classified as healthcare-associated MRSA. The study has revealed the dominance of a Panton-Valentine leucocidin-negative ST6-IV/t304 clone and provided insights into the distribution of antibiotic resistance in MRSA at the tertiary hospital in Oman. It also highlights the importance of surveillance in detecting the emergence of new MRSA clones in a healthcare facility.
clinwas gel topico prospecto
Prospective, randomized, controlled experiment.