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In an open study 55 patients presenting with acute gonorrhoea were given 4.8 mega units procaine penicillin G, intramuscularly, and oral probenecid (1 g) plus one 375-mg tablet clavulanate-potentiated amoxycillin orally. Before this treatment, 53 patients (96.4%) had presented with a purulent discharge, and dysuria was present in 47 patients (85.5%). The presence of Neisseria gonorrhoeae was confirmed by bacterial culture in 54 patients (98.2%). The majority of pathogens (92.5%) were penicillin resistant. On day 3 after treatment, dysuria was absent in 53 patients (96.4%) and there was no discharge in 40 cases (72.7%). N. gonorrhoeae was eradicated in 53 patients (96.4%). Two further patients were bacteriologically cured, but were suffering from post-gonococcal urethritis. The patients in whom discharge was still apparent were further assessed on day 7; discharge was resolved or resolving in all but one patient. There was one treatment failure. No adverse reactions were reported.
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Multiple characteristics of pretherapy Escherichia coli urine isolates from 39 children with acute, uncomplicated cystitis (including specific virulence genes and phylogenetic groups) identified an increased risk for recurrent bacteriuria after 3-day (but not 10-day) therapy with amoxicillin-clavulanate. Rapid testing conceivably could facilitate rational selection of treatment duration for pediatric cystitis. Certain traits might represent good targets for preventive interventions.
Of the 150 bacteria identified, 51 were P. gingivalis, 45 were black-pigmented Prevotella spp., 36 were F. nucleatum and 18 were A. actinomycetemcomitans. All the isolates were sensitive to amoxicillin/clavulanic acid and to moxifloxacin, but exhibited variable susceptibility patterns to the other antimicrobial agents tested.
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Periodontal therapy improved glycemic control in patients with type 2 DM in both groups; however, the reduction in HbA1c values reached statistical significance only in the group receiving scaling and root planing alone [correction].
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Nine cases of nocardiosis were diagnosed among 1,255 renal transplant recipients given cyclosporine (CsA)-prednisone for immunosuppression between August 1980 and March 1992 (incidence, 0.7%). Of these nine patients presenting with nocardiosis 32-1,806 days after transplantation, eight had pulmonary involvement, two had skin manifestations (one with localized disease), and one had a cerebral abscess and a pleural effusion. All cases required aggressive diagnostic procedures. Nocardia asteroides was isolated in seven cases and Nocardia brasiliensis in two. All but one case was cured. Included among the cures were all of four cases treated with amoxicillin/clavulanic acid. Therapy with CsA-prednisone was continued throughout the infection in eight cases. Analysis of a group of 154 historical controls who received azathioprine (AZA)-prednisone for immunosuppression after renal transplantation (performed before 1980 at the same center) revealed four cases of nocardiosis (incidence, 2.6%). Thus nocardiosis is apparently less common among renal transplant recipients given CsA-prednisone than among those given AZA-prednisone. The clinical presentation of nocardiosis in renal transplant recipients is variable, with pulmonary involvement predominating. Diagnosis requires an aggressive approach. Chemotherapy is successful in most cases, including those treated with amoxicillin/clavulanic acid when the isolate is susceptible.
Infant mice infected with Candida albicans by the oral-intragastric route became colonized in the gut and were persistently colonized into adulthood. Faecal levels of Candida were correlated with total gastrointestinal Candida and provided a useful means of detecting yeast overgrowth or elimination. Antibacterial agents promoting Candida overgrowth when given by the oral or parenteral route included ceftriaxone, augmentin and cefoperazone. Ceftizoxime had less effect. Ceftazidime and latamoxef produced raised levels only by the oral route. Gentamicin, vancomycin and metronidazole did not affect the Candida levels. Dosing with some antibacterials promoted an increase in gastrointestinal Candida and invasion to a greater extent than immunosuppression. Antifungal therapy to reduce gastrointestinal colonization was investigated using amphotericin B, nystatin, ketoconazole, intraconazole and fluconazole. Fluconazole was most effective at reducing faecal Candida.
We studied 192 men with acute gonococcal urethritis, 97 of whom received two oral doses of Augmentin (amoxycillin 3 g and clavulanic acid 250 mg) separated by a four hour interval; the remaining 95 received 2 g kanamycin in a single intramuscular injection. Of the patients treated with Augmentin, 93 (95.9%) were cured, which was significantly more than the 83 (87.4%) patients treated with kanamycin. Augmentin was equally effective in the treatment of penicillinase producing Neisseria gonorrhoeae (PPNG) and non-PPNG infections, the cure rates for which were 96.6% and 95.6% respectively.
From 1985 to 2000, acute suppurative thyroiditis was diagnosed in 11 previously healthy children (6 boys, 5 girls) at the Department of Pediatrics. Their mean age at diagnosis was 6.4 +/- 4.4 years. Leukocyte count, acute-phase reactants, thyroid function, and thyroid autoantibodies were assessed. Samples were taken by thyroid needle aspiration for cytology study and pus culture. Underlying pyriform sinus fistula (PSF) was demonstrated by barium esophagogram.
Both group showed more or less similar results regarding response, as well as the failure rate however, the Augmentin and ceftriaxone groups showed a little bit better survival than the control group.
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The objective of this study was to investigate the effect of polypharmacy and high doses of amoxicillin/clavulanate on warfarin response in hospitalized patients. This was a prospective cross-sectional observational study on 120 patients from July 2013 to January 2014. Potentially interacting drugs were classified according to their tendency of increasing international normalized ratio (INR) or bleeding risk. The 87.5% of patients prescribed high-dose amoxicillin/clavulanate (10-12 g daily) compared with 28.9% of patients prescribed a normal dose (up to 3.6 g daily) had INR values ≥ 4 during the hospital stay (P ≤ .001). Increased number of potentially interacting drugs that are known to increase INR was a significant predictor of having INR values ≥ 4 (OR, 2.5; 95%CI, 1.3-4.7), and increased number of potentially interacting drugs that are known to increase bleeding risk was a significant predictor of experiencing bleeding episodes (OR, 3.1; 95%CI, 1.3-7.3). High doses of amoxicillin/clavulanate were associated with a higher risk of over-anticoagulation when combined with warfarin than were normal doses. Increased risk of having INR ≥ 4 and bleeding events was associated with increased numbers of potentially interacting drugs prescribed, indicating that polypharmacy is a problem of concern. Frequent monitoring of warfarin therapy along with patients' medications is necessary to avoid complications.