In vitro susceptibility of 185 penicillin-susceptible and -resistant pneumococci to WY-49605, a new oral penem, was compared with susceptibility to penicillin G, amoxicillin with and without clavulanate, cefixime, cefaclor, cefpodoxime, cefuroxime, and cefdinir. WY-49605 yielded MICs for 50 and 90% of the strains tested (MIC50 and MIC90, respectively) of 0.03 and 0.06, 0.125 and 0.5, and 0.5 and 1.0 micrograms/ml, respectively, against penicillin-susceptible, intermediately resistant, and fully resistant strains, respectively. The MIC50 and MIC90 for both amoxicillin and amoxicillin-clavulanate were identical and approximately 1 doubling dilution higher than those for WY-49605 and were < or = 0.06 and 0.125, 0.25 and 1.0, and 1.0 and 1.0 micrograms/ml, respectively. Cephalosporin MIC90s were all significantly higher than those of the latter three compounds for intermediately resistant and fully resistant strains.
The aims of this investigation were to calculate the pharmacokinetic parameters and to identify parameters, based on individual plasma concentration-time curves of amoxicillin and clavulanic acid in cats, that may govern the observed differences in absorption of both drugs. The evaluation was based on the data from plasma concentration-time curves obtained following a single-dose, open, randomised, two-way crossover phase-I study, each involving 24 female cats treated with two Amoxi-Clav formulations (formulation A was Clavubactin and formulation was B Synulox; 80/20 mg, 24 animals, 48 drug administrations). Plasma amoxicillin and clavulanic acid concentrations were determined using validated bioassay methods. The half-life of elimination of amoxicillin is 1.2 h (t1/2 = 1.24 +/- 0.28 h, Cmax = 12.8 +/- 2.12 microg/ml), and that of clavulanic acid 0.6 h (t1/2 = 0.63 +/- 0.16 h, Cmax = 4.60 +/- 1.68 microg/ml). There is a ninefold variation in the AUCt of clavulanic acid for both formulations, while the AUCt of amoxicillin varies by a factor of two. The highest clavulanic acid AUCt values indicate the best absorption; all other data indicate less absorption. Taking into account that the amoxicillin-to-clavulanic acid dose ratio in the two products tested was 4:1, the blood concentration ratios may actually vary much more, apparently without compromising the products" high efficacy against susceptible microorganisms.
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A cross-sectional study of mid-stream urine collected from 339 symptomatic patients over a three-month period at Gulu regional referral hospital. Qualitative culture and identification of bacteria and antibiotic sensitivity testing using the modified Kirby-Bauer disk diffusion method was done. Participants' demographic and clinical characteristics were collected using a standard form. Results were analyzed by simple proportions among related variables and confidence intervals computed using binomial exact distribution.
The mean maximum increase in INR observed was 0.22 ± 0.3 with amoxiclav vs. 0.24 ± 0.6 with placebo (P=0.94). The day 7-day 1 factor II, R(-) and S(-) warfarin plasma concentrations were similar during the amoxiclav and placebo study periods (P=0.81, P=0.45, P=0.75, respectively).
Human actinomycosis is a rare soft tissue infection caused by Gram-positive, anaerobic bacteria Actinomyces israelii, a commensal of the oral cavity. The major clinical forms of actinomycosis are cervicofacial, thoracic, abdominal and pelvic forms. The cervicofacial region is most commonly affected. Actinomycosis is sometimes difficult to diagnose and it should be borne in mind in the differential diagnosis of numerous infectious and non-infectious diseases. We report a patient who came with tooth pain and extra-oral swelling which later on presented as multiple draining sinuses. Our initial suspicion was dento-alveolar abscess or osteomyelitis. However, a culture of the discharge and subsequent biopsy revealed actinomycetes, confirming cervicofacial actinomycosis, but presenting itself not as the typical 'lumpy jaw'. The patient was successfully treated conservatively with a short but intensive antibiotic course.
UK Medical Research Council.
Department of Surgery, Royal Commission Medical Center, Madinat Yambu Al-Sinayah.
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Two hundred and twenty two (222) bacterial isolates were obtained from the culture with ten (10) potentially pathogenic bacteria in the order of Escherichia coli (18.5%), Proteus species (17.1%), Staphylococcus aureus (14.0%), Klebsiella species (9.0%), Acinetobacter species (9.0%), coagulase negative Staphylococcus species (7.7%), Pseudomonas species (6.8%), Actinobacter species (6.8%), Citrobacter species (5.9%) and Streptococcus species (5.4%). Overall, the Gram negative isolates showed resistance to ciprofloxacin (9.3%), sparfloxacin (16.0%), perfloxacin (17.3%), ofloxacin (21.6%), chloramphenicol (34..6%), gentamycin (36.4%), streptomycin (37.%), septrin (49.4%), amoxillin (59.3%), augmentin (62.3%) while the Gram positive bacteria showed resistance to ciprofloxacin (3.3%), perfloxacin (6.7%), erythromycin (13.3%), streptomycin (21.7%), rocephin (28.3%), septrin (28.3%), gentamycin (36.7%), zinnacef (68.3%), ampiclox (81.7%) and amoxillin (85.0%). Multi-drug resistance (MDR) to three or more antimicrobials was observed in some of the isolates. Seventy - seven resistance patterns were observed, 16 in Gram positive and 61 in Gram negative bacteria.
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We describe a patient who presented with recurrent, contralateral abducens nerve palsy resulting from acute sphenoiditis.
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These two bla(TEM) genes did not derive from each other following a mutant selection process in vivo.
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The current study, being the first reports on the molecular typing of A. otitidis by PFGE method, shows that A. otitidis is a heterogenic organism in Iranian children who have OME.