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Emingil G, Han B, Özdemir G, Tervahartiala T, Vural C, Atilla G, Baylas H, Sorsa T. The effect of azithromycin, as an adjunct to nonsurgical periodontal treatment, on microbiological parameters and gingival crevicular fluid biomarkers in generalized aggressive periodontitis. J Periodont Res 2012; 47: 729-739. © 2012 John Wiley & Sons A/S Background and Objective: To study the effectiveness of azithromycin in combination with nonsurgical periodontal therapy on clinical and microbiological parameters, and on the MMP-8 and TIMP-1 levels in gingival crevicular fluid, over a 6-mo time-period in patients with generalized aggressive periodontitis.
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We report a 19-year-old patient with a Cat-scratch disease presenting three months continuous alteration of the general condition, including prolonged-fever, anorexia, asthenia, weight loss associated with adenitis and multiple thoracic-abdominal adenopathies, leukocytosis with neutrophil polynuclear predominance, and increased of C-reactive protein. The serologies of toxoplasmosis, infectious mononucleosis, human immunodeficiency virus, Brucellosis, Bartonellosis and the tuberculosis research by tuberculin reaction test and Ziehl acid-alcohol resistant bacilli direct examination were negatives. The cytomegalovirus and Epstein-Barr virus serologies were positives only for immunoglobulin-G. The Bartonella henselae diagnosis was made with the analysis of histopathological specimens. The clinical and biological symptoms regressed following eight weeks of azithromycin's treatment. According to this observation, the cat-scratch disease should be considered in differential diagnosis of patients presenting prolonged-fever associated with multiple lymphadenopathies and weight loss. The azithromycin would be an alternative therapeutic issue for this pathology in case of confirmed efficacy by studies in a large patient population.
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The effect of sub-MICs of azithromycin, clarithromycin and roxithromycin, as compared to erythromycin, on the production of coagulase, beta-hemolysin, lecithinase and deoxyribonuclease by Staphylococcus aureus was studied. All new macrolides completely inhibited coagulase and beta-hemolysin production and partially inhibited lecithinase and deoxyribonuclease. Such inhibition is not related either to growth inhibition or to inhibition of enzyme activity. Erythromycin, on the other hand, had no effect on coagulase or beta-hemolysin production but slightly suppressed the production of lecithinase and deoxyribonuclease. This inhibitory effect might have clinical significance if it was found to occur in vivo.
Macrolide antimicrobial agents may impair hepatic clearance of drugs metabolized by cytochrome P4503A isoforms. Potential interactions of triazolam, a substrate metabolized almost entirely by cytochrome P4503A in humans, with 3 commonly prescribed macrolides were identified using an in vitro metabolic model. The actual interactions, and their pharmacodynamic consequences, were verified in a controlled clinical study.
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Thymic stromal lymphopoietin (TSLP) is elevated in asthma and triggers dendritic cell-mediated activation of TH2 inflammatory responses. Viral stimuli, a major cause of asthma exacerbations, have been shown to induce overexpression of TSLP in asthmatic epithelium. Azithromycin has various anti-microbial and antiinflammatory effects. However, the effect of azithromycin on the production of TSLP has not been studied. Here we explored the effects of azithromycin on viral surrogate (dsRNA)-induced TSLP in normal human bronchial epithelial (NHBE) cells. NHBE were stimulated with poly (I:C) in the presence azithromycin. The effects of azithromycin on dsRNA-induced inflammatory responses in NHBE cells were analyzed. We demonstrated that azithromycin inhibited the production and mRNA expression of TSLP in NHBE cells. Azithromycin also inhibited the nuclear factor-KB luciferase activity induced by poly (I:C), and it prevented dsRNA-induced loss of the NF-kappaB repressor protein IkappaBalpha. These results suggest that azithromycin can be useful to treat asthma exacerbations due to the inhibition of TSLP.
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Extended spectrum β-lactamases (ESBLs) are produced by Gram negative bacteria showing resistance to new generations of antimicrobial agents. This study was undertaken to characterize ESBL producing bacteria from 222 urinary isolates. Antimicrobial resistance was screened by disc diffusion test. The ESBL status was confirmed by double disc diffusion test (DDDT) and minimum inhibitory concentration (MIC) by agar dilution method by standard procedure. The study revealed the following distribution of ESBL producing isolates: Klebsiella spp (81.6%), Proteus spp (78.1%) E. coli (72.3%) and Pseudomonas spp (66.7%). All the isolates were sensitive to imipenem and nitrofurantoin followed by amikacin 92.9%. A relatively higher rate of resistance to gentamicin, co-trimoxazole, azithromycin and quinolones were also observed for ESBL producers. The study suggested routine detection of ESBL and avoidance of irrational use of third generation cephalosporins to reduce the emergence of multidrug resistance bacteria following an antibiotic policy.
Antimicrobial resistance in Neisseria gonorrhoeae is a major public health concern globally. We report the first verified treatment failure of gonorrhoea with 2 g of azithromycin (extended-release formulation) in Japan and characteristics of the corresponding N. gonorrhoeae isolates.
Three-day topical therapy with azithromycin 1.5% eye drops is an effective and well tolerated therapy for purulent bacterial conjunctivitis.