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Among community-acquired infections, pneumonia is still a large health problem which is of great interest mainly due its high mortality and morbidity. From 1991 to 1997, 409 patients who had been diagnosed with community-acquired pneumonia and had been admitted to the internal medicine service of a university hospital were prospectively studied. The patients were classified into three groups according to the random antibiotic treatment they had received (ceftriaxone, cefuroxime or amoxicillin-clavulanic acid). The initial characteristics of the patients with regard to epidemiology, clinical description and critical situation were similar in all the groups studied. A total of 36.9% of the cases were documented microbiologically, with the most frequently isolated pathogens being Streptococcus pneumoniae and Haemophilus influenzae. The recovery rate was 92.2% and three patients had a recurrence of pneumonia. Global mortality was 5.8%. No statistically significant differences were found in the evolution of patients treated with cefuroxime, ceftriaxone or amoxicillin-clavulanic acid, with the latter representing an empirical treatment of choice for community-acquired pneumonia.
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Increasing age was a risk factor for amoxycillin-clavulanic acid associated jaundice; patients over 55 years had an odds ratio of 16.1 (95% confidence interval [CI], 2.9-88.9) compared with patients less than 30 years. Men had an odds ratio of 2.5 (95% CI, 1.1-5.4) compared with women, although the proportion of men in the study group was larger than in the reported cases overall. History of serious medical illness, drug dose, route and duration of therapy, other medications, smoking and previous drug allergies or use of amoxycillin-clavulanic acid were not significantly associated with jaundice.
A total of 1650 children were randomized and 1305 were clinically evaluable at visit 3 (630 levofloxacin, 675 comparator). Clinical cure rates were 72.4% (456 of 630) in levofloxacin-treated and 69.9% (472 of 675) in amoxicillin/clavulanate-treated children. Cure rates were also similar for levofloxacin and comparator for each age group (< or =24 months: 68.9% versus 66.2%; >24 months: 76.9% versus 75.1%; respectively). Cure rates at visit 4 were 74.9% and 73.8% in levofloxacin and amoxicillin/clavulanate groups, respectively. The upper limits of the confidence intervals were less than the noninferiority margin of 10% indicating that levofloxacin treatment is noninferior to comparator treatment overall and in both infants (6 months to 2 years) and children 2-5 years. No differences between treatment groups regarding the frequency or type of adverse events were apparent.
To study the pharmacokinetics of amoxicillin sodium clavulanate potassium (10:1) injection with different single doses intravenous infusion and one dose repeated intravenous injection in healthy volunteers for guiding the rational clinical regimen.
In malaria endemic areas, fever has been used as an entry point for presumptive treatment of malaria. At present, the decrease in malaria transmission in Africa implies an increase in febrile illnesses related to other causes among underfives. Moreover, it is estimated that more than half of the children presenting with fever to public clinics in Africa do not have a malaria infection. Thus, for a better management of all febrile illnesses among under-fives, it becomes relevant to understand the underlying aetiology of the illness. The present study was conducted to determine the relative prevalence and predictors of P. falciparum malaria, urinary tract infections and bacteremia among under-fives presenting with a febrile illness at the Makongoro Primary Health Centre, North-Western Tanzania.
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No immediate procedure complications; Infection was the most common postoperative complication; Antibiotics, either prophylaxis or concurrent, reduce the incidence of peristomal wound infection after PEG placement; Early PEG placement facilitates their transfer to a non-acute care environment.
Among young children with non-refractory AOM, cefdinir was as efficacious as high-dose amoxicillin/clavulanate in the ITT group, but somewhat less effective in per-protocol analysis. From the parental perspective, cefdinir was easier to administer, had a better taste, caused less diarrhea, and resulted in higher treatment adherence than high-dose amoxicillin clavulanate.
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The paper describes features of myiasis in a cohort of 163 dogs in an animal shelter, monitored over 3.5 years (4 fly activity seasons). Seven dogs (4 males, 3 females) were presented with myiasis; two dogs were presented twice with infestation in different areas of their body. The overall incidence rate (IR) of myiasis was 5.8 cases per 10(3) animal-months at risk, or else 0.0058 case per animal-month at risk. Six cases occurred from May to July and three from August to October, giving IRs of 7.7 per 10(3) animal-months and 3.9 per 10(3) animal-months, respectively, and an IR ratio of 1.97 (P=0.35). Five cases occurred in males and four in females, giving IRs of 7.8 per 10(3) animal months and 4.3 per 10(3) animal-months, respectively, and an incidence rate ratio of 1.78 (P=0.41). Three cases were diagnosed as cutaneous myiasis of the thigh, 2 cases as myiasis of the ear canal, 2 as myiasis of the prepuce, 1 as myiasis of the toes and 1 case as myiasis of the vagina. Median time from entrance into the shelter to infestation was 5 months; it was 1m in three dogs which were injured at entrance of animal into the shelter, but longer (5-15m) in the other four dogs. Larvae were identified as 2nd or 3rd stage instars of Wohlfahrtia magnifica. Signs characteristic of local inflammation, in the affected area of the body, were recorded. Treatment included mechanical removal of larvae, cleansing of the area, administration of injectable moxidectin and a broad-spectrum antimicrobial agent. Complete recovery was achieved within 1.5 months, bar that of preputial infestations which required 2.5 months.
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190 isolates from clinical specimens were tested in vitro to determine their susceptibility pattern against augmentin. Of the 132 strains of Enterobacteriaceae tested, 109 (82.6%) were susceptible. 41 (93.2%) of the 44 gram-positive bacteria tested were also susceptible to augmentin. Strains of Pseudomonas aeruginosa and Serratia marcescens were resistant to augmentin. However, augmentin showed increased activity against Escherichia coli, and Staphylococcus aureus when compared with ampicillin.
A new, pharmacokinetically enhanced, oral formulation of amoxicillin/clavulanic acid has been developed to overcome resistance in the major bacterial respiratory pathogen Streptococcus pneumoniae, while maintaining excellent activity against Haemophilus influenzae and Moraxella catarrhalis, including beta-lactamase producing strains. This study was conducted to provide in vitro susceptibility data for amoxicillin/clavulanic acid and 16 comparator agents against the key respiratory tract pathogens.