AST was performed using standardized methods and Clinical and Laboratory Standards Institute recommended quality control organisms. Eight drugs were common to all testing methods including amikacin, amoxicillin/clavulanic acid, ampicillin, chloramphenicol, ciprofloxacin, gentamicin, tetracycline and trimethoprim/sulfamethoxazole.
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The pharmacodynamic (PD) efficacy target of amoxicillin is 40% time above the minimal inhibition concentration (40%T > MIC). Recent studies of other antibiotics have shown that PD-efficacy targets are not always reached. The aim of this study was to evaluate the percentage of hospitalised patients, using amoxicillin/clavulanic acid intravenously (iv), that reach the pharmacodynamic efficacy target 40%T > MIC. Additionally, the association of demographic anthropomorphic and clinical parameters with the pharmacokinetics and pharmacodynamics of amoxicillin were determined.
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In all tissues of trauma patients, the rate of distribution was lower, but the steady-state level was higher than those in healthy participants. Blood volume was reduced by 25% and blood flow in organs other than lung, brain, and heart were reduced by 18%. Compared with healthy subjects, the time that free amoxicillin concentration remained above 8 mg/L in the interstitial fluid of trauma patients was higher in blood and muscles, and lower in the tendon compartment.
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Embryo transfer (ET) involves the placement of one or more embryos into the uterine cavity, usually by passing a catheter through the cervical os. ET is the final step in an assisted reproductive technology (ART) cycle, where a woman has undergone controlled ovarian stimulation, egg retrieval and in vitro fertilisation of her eggs. Despite the transfer of high quality embryos, many ETs do not result in a pregnancy. There are many factors which may affect the success of ET, including the presence of upper genital tract microbial colonisation. The administration of antibiotics prior to ET has been suggested as an intervention to reduce levels of microbial colonisation and hence improve pregnancy rates.
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Of 889 patients who survived and underwent follow-up, 86 patients (9.7%) presented with relapse, and 30 patients (3.4%) became reinfected. There was no difference in acute outcome between the relapse and reinfection groups. No risk factors for reinfection were identified. Multivariate analyses identified choice and duration of oral antimicrobial therapy as the most important determinants of relapse, followed by positive blood culture result (hazard ratio [HR], 1.86; 95% confidence interval [CI], 1.18-2.92) and multifocal distribution (HR, 1.95; 95% CI, 1.03-3.67). Patients treated with an appropriate oral antibiotic regimen for 12-16 weeks had a 90% decreased risk of relapse (HR, 0.10; 95% CI, 0.02-0.44), compared with patients who were treated for < or = 8 weeks. Trimethoprim-sulfamethoxazole plus doxycycline was an effective oral therapy.
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Considering syrups with high cariogenic and erosive potential should always follow with proper oral hygiene practices or search for an alternative drugs void of such detrimental effects.
This study shows that the non-enzymatic mechanism of resistance to β-lactams is widespread among H. influenzae isolates in Portugal. Clonal dissemination of BLPACR strains showing high resistance to ampicillin and reduced susceptibility to amoxicillin/clavulanic acid was documented.
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Rhodococcus equi is an emerging opportunistic pathogen of HIV-I infected patients. It is an aerobic, Gram-positive coryneform bacterium which acts as a facultative intracellular micro-organism, multiplying in the phagosome of macrophages. Eighteen cases of R. equi infection in HIV-I positive patients have now been reported. Sixteen of these had pneumonia, of which 12 had cavitating lung lesions. A history of contact with farm animals, which are the primary hosts of R. equi, was found in only three patients. There was a delay in establishing a definite diagnosis in most cases as this depended upon the isolation of R. equi from sputum, bronchoalveolar lavage fluid, or blood. Treatment included surgical resection in five patients and erythromycin with a second antibiotic in 13 cases, but II of the 18 patients died from the infection. In this report we describe our experience of R. equi pneumonia in two AIDS patients and review the published cases of the disease in man.