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In a 2-year prospective study, a total of 255 unilateral impacted mandibular third molar teeth were surgically removed under local anesthesia by 3 surgeons. Standardized surgical and analgesic protocols were followed. At the review appointment, 1 week after surgery, all patients returned a completed follow-up questionnaire (PoSSe scale) and were evaluated clinically for postoperative pain (number of painkillers taken) and trismus (differences in mouth opening). Sixteen predictive variables were evaluated using stepwise logistic regression analysis to identify the risk factors associated with severe discomfort.
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The frequency of resistance among Shigella isolates has increased substantially between 2000-2002 and 2006-2009 and the spectrum of resistance has widened. At present, the option for antimicrobial therapy in shigellosis in Andaman is limited to a small number of drugs. Continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy.
The purpose of the study was to validate a rapid resistance screening (RRS) method for antimicrobial susceptibility testing of a selected periodontopathic microorganism using the standard broth dilution method as a control. Twenty-five subgingival plaque samples from gingivitis or periodontitis sites were plated on Trypticase soy agar supplemented with 5% rabbit blood with antibiotic discs (RRS method) and without (control). The antibiotics tested were: Augmentin, clindamycin, erythromycin, metronidazole, penicillin G and tetracycline hydrochloride. Bacteroides intermedius isolated from both groups of plates were placed onto antibiotic supplemented Trypticase soy broth. The antibiotic susceptibilities of B. intermedius isolated from the plates with antibiotic discs and the standard broth method were compared. The results showed high sensitivity and predictability for the RRS method compared with the control. The percentage of agreement was: 100% for Augmentin 30 micrograms, clindamycin 2 micrograms and tetracycline 30 micrograms; 96% for erythromycin 15 micrograms, metronidazole 80 micrograms and penicillin 10 IU; 92% for penicillin 2 IU; 88% for erythromycin 2 micrograms and 84% for tetracycline 5 micrograms. The results of this study document the feasibility of the RRS method for testing antimicrobial resistance of whole samples if its efficacy can be demonstrated for other bacteria. This method may be a quick and useful test for the periodontal practitioner in determining the antibiotic susceptibility of periodontal plaque pathogens.
Compared with montelukast-treated patients, patients treated with low-dose fluticasone propionate had a significantly lower risk of experiencing an asthma-related hospitalization, a lower risk of switching or augmenting with another controller, and significantly lower asthma and total health care costs.
Chemical synthesis of the penicillin nucleus in the 1950s made introduction of a broad array of new and important antimicrobials, including ampicillin and amoxicillin, possible. Ampicillin was introduced in 1962 in oral and parenteral forms as the first of the semisynthetic penicillins to provide increased activity against Gram-negative bacteria. Amoxicillin replaced oral ampicillin beginning in 1974 because amoxicillin resulted in higher and more prolonged serum concentrations than did equivalent doses of ampicillin. Amoxicillin/clavulanate (Augmentin) was introduced in the United States in 1984 to enhance the activity of amoxicillin by addition of the beta-lactamase inhibitor, clavulanic acid. During the past 20 years, amoxicillin/clavulanate has proven effective for a variety of pediatric infectious diseases, particularly acute otitis media (AOM). In 2001, a new pediatric formulation, high dose amoxicillin/clavulanate (Augmentin ES-600) was approved for use in the United States. The high dose preparation addressed the needs of pediatricians by providing greater amounts of amoxicillin while maintaining the same daily dose of clavulanic acid as the regular strength formulation. Doubling the dose of amoxicillin for management of recurrent and persistent AOM was recommended in 1999 by the Centers for Disease Control and Prevention because of concern about the increased incidence of nonsusceptible strains of Streptococcus pneumoniae. The original formulation combined amoxicillin/clavulanate in a 4:1 ratio and was followed by a 7:1 ratio formulation. The high dose formulation (600 mg of amoxicillin per 5 ml) provides a 14:1 ratio of amoxicillin to clavulanate. Although management of AOM will likely undergo changes in the coming years, amoxicillin is expected to remain first line therapy for AOM. For children who fail initial therapy with amoxicillin, high dose amoxicillin/clavulanate, an oral cephalosporin or parenteral ceftriaxone is recommended.
Co-amoxiclav reduces catheter contamination, but this is not translated into better clinically relevant outcomes such as clinical pregnancy rates. Our findings do not support the routine use of antibiotics at embryo transfer.
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Data obtained from 78 patients (28 females, 50 males) who had undergone tonsillectomy for recurrent tonsillitis by conventional cold surgery were reviewed with prospective, randomized clinical study. Initially, the patients were assigned into topical and systemic drug groups. These groups were then divided into three sub-groups; (i) clindamycin, dexamethasone, and control (saline) (ii) groups for the topical drug group; (iii) cefprozil, amoxicillin+clavulanate and control (no medications except analgesic) for the systemic drug group. The intensity of pain perceived by the patients at 21 different times was assessed by visual analog scale and facial scale.
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541 patients admitted for lower respiratory tract infection during one year. Patients represented 87% of admissions with the diagnosis and excluded those who were immunocompromised and patients with severe life threatening infection.
A 45-year-old man with dilated cardiomyopathy presented with acute leg pain and erythema suggestive of necrotising fasciitis. Initial surgical exploration revealed no necrosis and treatment for a soft tissue infection was started. Blood and tissue cultures unexpectedly grew a Gram-negative bacillus, subsequently identified by an automated broth microdilution phenotyping system as an extended-spectrum β-lactamase producing Escherichia coli. The patient was treated with a 3-week course of antibiotics (ertapenem followed by ciprofloxacin) and debridement for small areas of necrosis, followed by skin grafting. The presence of E. coli triggered investigation of both host and pathogen. The patient was found to have previously undiagnosed liver disease, a risk factor for E. coli soft tissue infection. Whole genome sequencing of isolates from all specimens confirmed they were clonal, of sequence type ST131 and associated with a likely plasmid-associated AmpC (CMY-2), several other resistance genes and a number of virulence factors.
About 5% of restorative proctocolectomy (RPC) patients develop chronic antibiotic-dependent pouchitis. These require antibiotic maintenance therapy. We report our experience in managing this patient group.
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To study the human teratogenic potential of augmentin (amoxicillin+clavulanic acid) treatment during pregnancy.