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Infants and young children, especially those in day care, are at risk for recurrent or persistent acute otitis media (AOM). There are no data on oral alternatives to high-dose amoxicillin-clavulanate for treating AOM in these high-risk patients. In this double-blind, double-dummy multicenter clinical trial, we compared a novel, high-dose azithromycin regimen with high-dose amoxicillin-clavulanate for treatment of children with recurrent or persistent AOM. Three hundred four children were randomized; 300 received either high-dose azithromycin (20 mg/kg of body weight once a day for 3 days) or high-dose amoxicillin-clavulanate (90 mg/kg divided twice a day for 10 days). Tympanocentesis was performed at baseline; clinical response was assessed at day 12 to 16 and day 28 to 32. Two-thirds of patients were aged < or =2 years. A history of recurrent, persistent, or recurrent plus persistent AOM was noted in 67, 18, and 14% of patients, respectively. Pathogens were isolated from 163 of 296 intent-to-treat patients (55%). At day 12 to 16, clinical success rates for azithromycin and amoxicillin-clavulanate were comparable for all patients (86 versus 84%, respectively) and for children aged < or =2 years (85 versus 79%, respectively). At day 28 to 32, clinical success rates for azithromycin were superior to those for amoxicillin-clavulanate for all patients (72 versus 61%, respectively; P = 0.047) and for those aged < or =2 years (68 versus 51%, respectively; P = 0.017). Per-pathogen clinical efficacy against Streptococcus pneumoniae and Haemophilus influenzae was comparable between the two regimens. The rates of treatment-related adverse events for azithromycin and amoxicillin-clavulanate were 32 and 42%, respectively (P = 0.095). Corresponding compliance rates were 99 and 93%, respectively (P = 0.018). These data demonstrate the efficacy and safety of high-dose azithromycin for treating recurrent or persistent AOM.
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The symptoms of maxillary sinusitis were improved by curettage through the lateral wall of the maxillary sinus, antibiotics, and sinus irrigation after 2 weeks of the operation.
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Between October, 1993, and March, 1994, we conducted a clinical trial comparing cefpodoxime-proxetil and amoxicillin-clavulanate in acute otitis media. From 364 children, 4 months to 4.5 years old, a nasopharyngeal sample was obtained before and after treatment. Antibiotic susceptibility was established by determining minimal inhibitory concentrations by the agar dilution method. Serotype and randomly amplified polymorphic DNA analysis were used to compare pre- and posttreatment S. pneumoniae strains.
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Pustulosis acuta generalisata is an uncommon condition characterized by scattered symmetrical eruption of sterile pustules associated with elevated inflammatory markers, leukocytosis, fever and arthropathy caused by previous infection by group A streptococci (GAS). We reported here a case of pustulosis acuta generalisata in an HIV-positive patient recently treated with chemotherapy for a seminoma.
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We report the first case of Gordonibacter pamelaeae bacteremia, identified by phenotypic tests and 16S rRNA sequencing in a patient with disseminated rectosigmoid carcinoma and responsive to amoxicillin-clavulanate. The bacterium was a nonsporulating, anaerobic, gram-positive, nonmotile, coccobacillus that was catalase, arginine dihydrolase, and arginine acrylamidase positive. The gastrointestinal tract is probably its reservoir.
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Salmonella spp and Escherichia coli are the two most important food-borne pathogens of public health interest incriminated in poultry meat worldwide. This study is to access their levels in frozen poultry meat obtained in Ibadan, Oyo State and compare those obtained from a commercial Nigerian-registered poultry company having a broiler-processing plant, Sayed Farms Ltd(R), with that obtained from retail stores. These retail stores source their products as illegal imports from neighboring Benin Republic or Togo because of a ban imposed by Government policy in Nigeria since July 2002 (USDA, GAIN report #NI2025:1-6, 2002). Microbiological Standards and Guidelines by USDA (National Agricultural library) (USDA 2011) and NCCLS guidelines (from Global Salm-Surv, 2003) were used during the research work. The study was approved by the Ethical Research Review Board (ERRB, Research Management Office 2011), University of Ibadan, Nigeria. A total of one hundred and fifty-two (152) frozen poultry meat samples comprising ninety-nine retail poultry (53 chicken and 46 turkey) and 53 chicken from the processing plant were accessed. ISO Standards catalogue 07.100.30 (2011) was used in accessing the levels of Salmonella, Escherichia coli, Enterobacteriaceae counts and Aerobic plate count. ISO 6579: 2002 was used for Salmonella isolation and ISO-16654:2001 for Escherichia coli isolation. There was a higher level of Aerobic plate counts and Enterobacteriaceae counts in frozen retail poultry meat than from the processing plant. Salmonella contamination from the ninety-nine poultry samples (53 chicken and 46 turkey) obtained from retail markets was at 33% [chicken 32.1% (17/53) and turkey 34.8% (16/46)] while Escherichia coli at 43.4% [chicken 47.2% (25/53) and turkey 39.1% (18/46)]. From the processing plant, twelve (12) Salmonella isolates were obtained and prevalence rate calculated as 22.6% while three (3) Escherichia coli isolates at 5.7% was obtained. Antibiotic sensitivity for isolates using eight different Gram-negative antibiotics showed different resistance patterns. Nitrofurantion and augmentin showed a decrease in their sensitivity to isolates than they normally should. Salmonella enterica spp. showed 93% resistance to tetracycline and 100% resistance to augmentin and amoxicillin, while Escherichia coli showed 100% resistance to augmentin and amoxicillin.
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RO 23-6240 (fleroxacin), pefloxacin, augmentin, cefaclor, cef-uroxime, ceftazidime, vancomycin, piperacillin and amikacin were tested against a wide variety of gram-positive and gram-negative bacteria. The MICs of fleroxacin were very similar to those of pefloxacin. Against all the bacterial groups tested, the quinolones compared favorably with the other antimicrobials tested, particularly against the more resistant species such as Corynebacterium group JK and D2 and methicillin-resistant staphylococci.