hazu.hr

AIM. To provide information on regional sensitivity of H. pylori to antibiotic treatment by investigating the rate of H. pylori eradication in Croatia. METHODS. The study included 217 outpatients (107 women and 110 men), with gastrointestinal symptoms and H. pylori positive finding. They received the first-line and second-line treatments. The first-line treatment included triple therapies with either omeprazole (omeprazole, amoxicillin, and metronidazole - OAM), or pantoprazole (pantoprazole, amoxicillin, and metronidazole - PAM), or a combination of ranitidine bismuth citrate, amoxicillin, and azithromycin (RBAAz). If this therapy failed, clarithromycin was used in the second-line treatment. RESULTS. H. pylori was eradicated in 93% of the patients, whereas in 7% it was resistant to all administered therapies. The efficacy of OAM or PAM first-line treatments in H. pylori eradication, including resistant patients, was 70%, and of RBAAz treatment 95%. The RBAAz treatment had the highest eradication rate. In the second-line treatment, clarithromycin eradicated 45% of the remaining H. pylori strains that had not reacted to metronidazole and azithromycin administered either alone or in combination with ranitidine bismuth citrate. CONCLUSION. Optimal therapy for the eradication of H. pylori infection is the RBAAz treatment, whereas metronidazole cannot be recommended because of the high rate of resistance of H. pylori to that antibiotic.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11172654&dopt=Abstract antibiotic amoxicillin




J Chemother. 2001 Apr;13(2):154-60.
Prevalence of penicillin-resistant Streptococcus pneumoniae in Kuwait.

Mokaddas EM, Wilson S, Sanyal SC.

Department of Microbiology, Faculty of Medicine & Ibn Sina Hospital, Kuwait.

The worldwide incidence of penicillin-resistant Streptococcus pneumoniae has increased at an alarming rate during the past decade. However, there has been little published data about the extent of this problem in Kuwait. The present study was undertaken to ascertain the preponderance of S. pneumoniae, either resistant or intermediate-resistant to penicillin, other beta-lactams and non-beta-lactam antimicrobials in Kuwait. Two hundred and fifty fresh isolates from as many patients suffering from different clinical conditions were collected from all clinics and hospitals in Kuwait. Optochin sensitivity and bile solubility tests reconfirmed these. Susceptibility testing to penicillin, ampicillin, cefuroxime, ceftriaxone, cefotaxime, imipenem, erythromycin, chloramphenicol, ciprofloxacin and vancomycin was done using E-test strips and to oxacillin, tetracycline, trimethoprim and amoxicillin-clavulanate by disc diffusion technique. Full and intermediate resistance to penicillin was observed in 1.6% and 52.8% of the isolates respectively. Full resistance to third-generation cephalosporins ranged from 0.4% to 3.2%, however, intermediate resistance to these antibiotics varied between 18.8% and 21.2%. Ampicillin resistance was noted in 0.8%, but 40.4% of isolates were intermediately resistant. However, only 0.4% of the isolates showed either intermediate or full resistance to amoxicillin-clavulanate. Resistance to imipenem was observed in 0.4% and intermediate to 13.6% of the organisms. The rates of S. pneumoniae resistant to chloramphenicol, erythromycin, tetracycline and trimethoprim were between 8.4% and 37.6% and intermediate resistance between 1.2% and 17.6% while only 0.4% showed resistance to ciprofloxacin and none to vancomycin. Multiresistance to both beta-lactam and non-beta-lactam antibiotics was observed in 52% of the penicillin-resistant isolates.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11330362&dopt=Abstract antibiotic amoxicillin




Braz J Infect Dis. 2000 Aug;4(4):197-203.
Tissue pharmacokinetics of amoxicillin. An experimental design in rats.

Baglie S, Groppo FC, Filho TR.

Departament of Pharmaceutics Sciences, State University of Ponta Grossa (UNICAMP), Brazil.

Amoxicillin is used as the drug of first choice in many situations in medicine and dentistry, in spite of several reports regarding bacterial resistance. There is little data about the tissue concentration of this antimicrobial agent. Serum levels of amoxicillin have been evaluated in detail, but tissue levels have not. This study was carried out to determine the tissue concentration of amoxicillin during the first 10 h after administration. Four polyurethane sponges were implanted in the backs of 54 male rats. After 14 days, they received 40 mg/kg of po amoxicillin suspension. The animals were killed in groups of 6 at 15, 30, 60, 90, 120, 240, 360, 480 and 600 min after the administration. Serum, placed on paper discs, and granulomatous tissue were assayed by a microbiological method using Mueller Hinton agar inoculated with 108 cfu of Staphylococcus aureus (ATCC 25923). After 18 h of incubation, the inhibition zones were measured. It was observed that the drug in the serum and the tissue reached higher concentrations than MIC and MBC within a period of 30 min and 8 h following administration. We conclude that this method can allow determination of antibiotic tissue concentration without the need for infecting the animal and, therefore, without the associated animal pain and suffering in presently used models.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11008224&dopt=Abstract antibiotic amoxicillin




J Clin Pathol. 2001 May;54(5):408-11.
Role of screening agar plates for in vitro susceptibility testing of Helicobacter pylori in a routine laboratory setting.

Warburton-Timms VJ, McNulty CA.

Public Health Laboratory, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK.

BACKGROUND: Resistance of Helicobacter pylori to the more frequently used antibiotics (metronidazole and clarithromycin) reduces eradication rates even with triple treatment. Determining the antibiogram profile of H pylori can take up to 14 days and delays appropriate treatment. AIMS: To determine the role of screening agar plates for more rapid in vitro susceptibility of H pylori to metronidazole, amoxicillin, and clarithromycin. METHODS: Routine gastric biopsy specimens from 507 dyspeptic patients were inoculated on to 10% lysed blood agar plates containing metronidazole (8 microg/ml), clarithromycin (2 microg/ml), or amoxicillin (0.5 microg/ml). The minimum inhibitory concentration (MIC) of the 90 isolates was determined using the E test. RESULTS: Metronidazole resistance was detected in 28 of 90 isolates by E test and nine of 98 by screening agar. The screening agar detected none of the four clarithromycin resistant isolates detected by the E test. CONCLUSIONS: The screening agar method is not sufficiently sensitive to be used alone.

Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11328845&dopt=Abstract antibiotic amoxicillin