Strains of Escherichia coli (N = 124) and Proteus mirabilis (N = 29) harboring known beta-lactamases were analyzed as to their susceptibility to ampicillin, amoxicillin, and piperacillin alone and in combination with sulbactam, clavulanate, and tazobactam. With TEM 1-producing E. coli, a correlation between specific beta-lactamase activity and the MIC of piperacillin and ampicillin-sulbactam was observed. These strains also showed significant differences in susceptibilities to the various combinations, suggesting that, at least in strains resistant to one combination, several beta-lactam/beta-lactamase inhibitor combinations should be tested in the laboratory. All combinations tested enhanced the activity of the beta-lactam towards TEM 1-producing E. coli, piperacillin-tazobactam being the most active. The drugs were less active to OXA 1 enzymes; solely with piperacillin-tazobactam 90% of strains were within the therapeutic range of the drug. Sulbactam acted synergistically to chromosomally encoded beta-lactamases, whereas amoxicillin-clavulanate was inactive. Piperacillin and piperacillin-tazobactam inhibited all strains producing chromosomally encoded beta-lactamases at concentrations within the therapeutic range of the drugs. In contrast, TEM 2 of P. mirabilis was not sensitive to ampicillin-sulbactam, but to the other combinations; here again piperacillin-tazobactam was the most active.
Despite guideline recommendations, there are no published randomised controlled trial data on the efficacy of antibiotics for chronic wet cough in children. The majority of children with chronic wet cough have protracted bacterial bronchitis (PBB), a recognised condition in multiple national guidelines. The authors conducted a parallel 1:1 placebo randomised controlled trial to test the hypothesis that a 2-week course of amoxycillin clavulanate is efficacious in the treatment of children with chronic wet cough.
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These results indicate that a combined mechanical and antimicrobial treatment approach can lead to consistent resolution of GAgP. Further studies including a larger number of cases are warranted to validate these findings.
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Lower respiratory tract infections are clinically important, because of their high incidence, as well as the significant morbidity they cause. Hence the great importance to diagnose the etiology of these infections and treat the patient with selective therapy. In this study 367 bacteria isolated from lower respiratory tract were identified (253 Gram negative and 114 Gram positive) and tested towards augmentin, ceftriaxone, lomefloxacin, ciprofloxacin, ofloxacin and erythromycin. The in vitro activity of such antibiotics against the clinical isolates was compared.
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The way we managed this extreme peri-implantitis case has allowed to give clinical success even if, to comply to the patient's will, the best clinical, evidence-based treatment, was not performed. The implant that was otherwise lost was successfully recovered. As an hypothesis, a new osseointegration process could have occurred between the implant and the newly formed bone.
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Seven hundred and thirty-eight children were enrolled and 539 (405 levofloxacin-treated, 134 comparator-treated) were clinically evaluable at test-of-cure visit. Clinical cure rates were 94.3% (382 of 405) in levofloxacin-treated and 94.0% (126 of 134) in comparator-treated children. Cure rates were also similar for levofloxacin and comparator for each age group (<5 years, 92.2% versus 90.8%; > or =5 years, 96.5% versus 97.1%; respectively) and for children categorized as being at higher risk for severe disease. Mycoplasma pneumoniae was the most frequently identified cause of pneumonia (230 children). Levofloxacin was as well tolerated as comparators, with similar type and incidence of adverse events.
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A male patient was transferred to our hospital from the University Eye Clinic of Guadeloupe 5 days after ocular injury caused by a flying fish. Visual function was light perception. The anterior part of the eye and retina were unremarkable. A computer tomography disclosed a fracture of the sphenoid sinus, with a little bone fragment (DD: foreign body) located close to the optic nerve.
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During the 6-month period July 1987-January 1988, 934 isolates of Haemophilus influenzae were collected from 6 laboratories in Johannesburg. On the basis of counter-immuno-electrophoresis, 30 of the isolates were serotype b, with 9 of 36 (25%) cerebrospinal fluid isolates being type b. Overall, 11.7% of the isolates produced beta-lactamase. The prevalence of resistance based on a disc diffusion test was ampicillin 14%, chloramphenicol 2.3%, cefaclor 4.4%, erythromycin 84.9%, tetracycline 4.7% and co-trimoxazole 9.7%. Problems were encountered with the disc diffusion testing of augmentin- and minimum inhibitory concentrations (MICs) were determined. The MICs of 40 isolates were compared with their zone diameters. Good correlation between these two methods of antimicrobial susceptibility testing was found with all the antimicrobials tested excluding augmentin (correlation coefficient 0.1234) and cefaclor (correlation coefficient -0.2473).
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We surveyed a cohort of 100 osteoporotic patients with 111 alendronate-related ONJ lesions treated during a 4-year period. Prognostic values of clinical variables and serum markers of bone turnover were assessed by univariate and multivariate analyses.
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The main aim of treatment for acute necrotizing periodontal disease is fast and effective reduction of anaerobic destructive microorganisms to avoid periodontal damage. The effect of adjunctive local oxygen therapy in the treatment of necrotizing periodontal disease was examined in this study.