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This study was performed to find out the effectiveness of three different treatments of patients having acute tonsillopharyngitis. Three groups of patients were selected (50 patients in each group). Group I received one antibiotic according to the result of culture and sensitivity test, while groups II and III received two antibiotics or one antibiotic respectively without a culture and sensitivity test. Diagnosis was based on the acutely subjective symptoms of sore throat and positive clinical examination findings. The effectiveness of treatment in group I (96 per cent) was statistically significant (p<0.05) and higher than group II (82 per cent) and group III (74 per cent), while the difference between group II and III was not statistically significant (p>0.05). Our findings demonstrate that a culture and sensitivity test of the throat swab is necessary before treating acute tonsillopharyngitis. It was suggested that there should be appropriate selection of antibiotics to preserve normal flora, avoidance antibiotics for viral infections, patient compliance with prescription and educational programmes directed at patients and physicians. All of these measures would assist in reducing the volume of antibiotic use, bacterial resistance and the overall cost of treatment of tonsillopharyngitis.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12487671&dopt=Abstract antibiotic, antibiotics



Clin Orthop. 2002 Aug;(401):239-47.
Experimental osteomyelitis treatment with antibiotic-impregnated hydroxyapatite.

Shirtliff ME, Calhoun JH, Mader JT.

Center for Biofilm Engineering, Montana State University, Bozeman, MT 59717-3980, USA.

A calcium hydroxyapatite antibiotic implant was evaluated to determine its efficacy as an antibiotic delivery system in a localized osteomyelitis rabbit model. Localized rabbit tibial osteomyelitis was developed with an intramedullary injection of methicillin resistant Staphylococcus aureus. Infected rabbits were randomized and divided into eight groups depending on treatment with or without debridement, systemic antibiotics, antibiotic-impregnated polymethylmethacrylate beads, or calcium hydroxyapatite implants with and without antibiotic impregnation. All treatments began 2 weeks after infection. After 4 weeks of therapy, the involved bones were cultured for concentrations of Staphylococcus aureus per gram of bone. Rabbits (n = 11) that had calcium hydroxyapatite (impregnated with vancomycin) implanted into the dead space after the debridement surgery had an 81.8% infection clearance after treatment. Rabbits (n = 10) that had polymethylmethacrylate beads (impregnated with vancomycin) implanted into the dead space after debridement surgery had a 70% clearance rate. All other treatment modalities resulted in less than 50% clearance rates. Calcium hydroxyapatite may be an effective alternative to polymethylmethacrylate for providing local antibiotic therapy in cases of methicillin resistant Staphylococcus aureus osteomyelitis.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12151901&dopt=Abstract antibiotic, antibiotics



Arch Intern Med. 2002 Aug 12-26;162(15):1746-52.
Sixty-three cases of Mycobacterium marinum infection: clinical features, treatment, and antibiotic susceptibility of causative isolates.

Aubry A, Chosidow O, Caumes E, Robert J, Cambau E.

Laboratorie de Bacteriologie, Centre National de Reference pour la Surveillance des Infections a Myocobacteries et de leur Resistance aux Antituerculeux, Paris, France.

BACKGROUND: Mycobacterium marinum is a nontuberculous mycobacterium responsible for skin infections. Although cases have been seldom reported, no series of M marinum infection has been recently reported and the treatment is not standardized. METHODS: A national survey was conducted on culture-confirmed M marinum infections that occurred in France from January 1, 1996, to December 31, 1998. Clinical characteristics and therapeutic data were analyzed, and the minimum inhibitory concentrations of 11 antibiotics were determined against the causative isolates. RESULTS: Sixty-three cases of M marinum infection were studied. In 53 (84%) of the patients, inoculation was related to fish tank exposure. The site of infection was mainly the upper limb (in 60 [95%] of the 63 patients), and infection was spread to deeper structures in 18 (29%) of the patients. All patients were treated with antibiotics (median time, 3(1/2) months), and 30 (48%) underwent surgery. Various antibiotic regimens were prescribed, and the initial regimen was modified in 22 (35%) of the patients. Clarithromycin, cyclines, and rifampin were the most commonly prescribed antibiotics. Cure was observed for 55 (87%) of the patients. Failure was related to deep structure involvement (3 of 45 vs 5 of 18 patients; P =.04) but not to any antibiotic regimen. All strains showed the same susceptibility pattern without acquired resistance. The 90% minimum inhibitory concentrations of rifampin and rifabutin were far lower (0.5 and 0.06 micro g/mL, respectively) than the 90% minimum inhibitory concentrations of clarithromycin (2 micro g/mL) and the cyclines (minocycline, 4 micro g/mL; and doxycycline, 8 micro g/mL). CONCLUSIONS: Mycobacterium marinum infections are emerging infections related to fish tank hobby. Because of the severity of the cases with spread of infection, clinical awareness of M marinum infection and its associated risk factors is important so that the diagnosis can be made and therapy can be initiated promptly.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12153378&dopt=Abstract antibiotic, antibiotics



Scand J Infect Dis. 2002;34(6):442-8.
Antibiotic prescribing in outpatients: a 1-week diagnosis-prescribing study in 5 counties in Sweden.

Lundborg CS, Olsson E, Molstad S; Swedish Study Group on Antibiotic Use.

Department of Public Health Sciences, Karolinska Institutet and Apoteket AB, Stockholm, Sweden. cecilia.stalsby.lundborhs.ki.se

A diagnosis-antibiotic prescribing study initiated by the Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance was performed in 5 counties in Sweden (total 1,290,000 inhabitants) during 1 week in November 2000. The aims of the study were to analyse diagnoses and antibiotics prescribed for outpatients and to appraise the feasibility of the data collection method. Physicians in primary care and departments of ENT, paediatrics and infectious diseases completed a questionnaire for each patient with an infectious disease complaint, including information about age, sex, diagnosis, diagnostic methods used and treatment. When an antibiotic was prescribed, the type and duration of treatment were noted. A total of 7,071 forms were returned, of which 7,029 included information on diagnosis; infections of the respiratory tract, urinary tract and the skin or soft tissues were responsible for 70%, 14% and 10% of the visits, respectively. Antibiotics were prescribed in 59% of all cases and phenoxymethylpenicillin was the most commonly prescribed antibiotic. Of the forms returned, 94% emanated from primary care centres. In conclusion, this study provides information on the treatment pattern associated with various diagnoses and the pattern of use of various antibiotics. Such a study is relatively simple to perform and entails only a small extra workload for the participants.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12160172&dopt=Abstract antibiotic, antibiotics



J Orthop Res. 2002 Jul;20(4):654-61.
In vivo study of hot compressing molded 50:50 poly (DL-lactide-co-glycolide) antibiotic beads in rabbits.

Ueng SW, Yuan LJ, Lee N, Lin SS, Liu SJ, Chan EC, Weng JH.

Department of Orthopaedic Surgery, Chang Gang Memorial Hospital, Keelung, Taiwan. wennengmh.org.tw

The authors investigated poly (DL-lactide-co-glycolide) beads as an antibiotic delivery system in vivo for the treatment of various surgical infections. In this study, the copolymer 50:50 poly (DL-lactide):co-glycolide was mixed with vancomycin powder and hot compressing molded at 55 degrees C to form 8 mm in diameter biodegradable antibiotic beads. The antibiotic beads were implanted in the distal femoral cavities of rabbits for in vivo investigation. The local concentration of vancomycin was well above the breakpoint sensitivity concentration (the antibiotic concentration at the transition point between bacterial killing and resistance to the antibiotic) for 56 days. The release was most marked during the first day. The diameters of the sample inhibition zone ranged from 8 to 18 mm, and the relative activity of vancomycin ranged from 9.1% to 100%. Only low systemic blood levels of vancomycin were measured after beads implantation. There was no increase in the concentration of blood urea nitrogen and serum creatinine after the implantation. Histological observations showed that the bead materials were biodegradable, resorbed slowly, and did not cause a significant host reaction. This study offers a biodegradable delivery system of antibiotics to treat various surgical infections.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12168651&dopt=Abstract antibiotic, antibiotics



Pediatr Nephrol. 2002 Jul;17(7):506-10. Epub 2002 Jun 15.
Prophylactic antibiotics in children at risk for urinary tract infection.

Hellerstein S, Nickell E.

Section of Nephrology, The Children's Mercy Hospital, The University of Missouri School of Medicine at Kansas City, 2401 Gillham Road, MO 64108, USA. shellermh.edu

The outcome of using prophylactic antibiotics in children considered at risk for a urinary tract infection (UTI) was documented in 66 children during the period of suppressive antibiotics and for a follow-up period of 3.7+/-2.2 years (range 0.92-9.83 years). A breakthrough UTI occurred in 13 girls but none of the boys during the initial course of prophylactic antibiotics. During the follow-up period, 33 girls and 5 boys had no recurrence of infection, while 25 girls and 3 boys had UTIs. Statistical analysis of the data using chi-square and risk estimate relating factors for infection to the occurrence of a UTI showed that during the period of initial prophylactic antibiotic there was significant risk of infection among children with voiding dysfunction and abnormal kidneys and during the follow-up there was increased risk of infection among those with voiding dysfunction and vesicoureteric reflux (VUR) of grade 3 or greater severity. Lesser grades of VUR and constipation did not significantly increase the risk of UTI. These observations should be useful in developing a study to define the risks and benefits of prophylactic antibiotic in "at-risk" children.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12172763&dopt=Abstract antibiotic, antibiotics



Infect Control Hosp Epidemiol. 2002 Aug;23(8):436-40.
Recurrence of vancomycin-resistant Enterococcus stool colonization during antibiotic therapy.

Donskey CJ, Hoyen CK, Das SM, Helfand MS, Hecker MT.

Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio 44106, USA.

OBJECTIVE: To test the hypothesis that antibiotic therapy may promote recurrence of vancomycin-resistant Enterococcus (VRE) stool colonization in patients who have previously had three consecutive negative stool cultures obtained at least 1 week apart. DESIGN: One-year prospective cohort study examining the effect of antibiotic therapy on recurrence and density of VRE stool colonization in patients who have cleared colonization. Pulsed-field gel electrophoresis (PFGE) was performed to determine whether recurrent VRE strains were the same clone as the previous colonizing strain. SETTING: A Department of Veterans Affairs medical center including an acute care hospital and nursing home. PATIENTS: All patients with at least one stool culture positive for VRE who subsequently had three consecutive negative stool cultures obtained at least 1 week apart. RESULTS: Of the 16 patients who cleared VRE colonization, 13 received antibiotic therapy during the study period. Eight (62%) of the 13 patients who received antibiotics developed recurrent high-density VRE stool colonization (range, 4.9 to 9.1 log10 colony-forming units per gram) during a course of therapy. Five patients had VRE strains available for PFGE analysis; recurrent strains were unrelated to the prior strain in 3 patients, closely related in 1 patient, and indistinguishable in 1 patient. CONCLUSIONS: Antibiotic therapy may be associated with recurrent high-density VRE stool colonization in many patients who have previously had three consecutive negative stool cultures. These patients should be screened for recurrent stool colonization when antibiotic therapy is administered.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12186208&dopt=Abstract antibiotic, antibiotics