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In a routine clinical practice setting, the most adequate second-line treatment consists in a 10-day regimen of levofloxacin- amoxicillin-PPI given twice daily, unless regional or new data show high quinolone resistance. Other good options are the bismuth quadruple regimen and a metronidazole-amoxicillin-PPI therapy.
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A randomized controlled trial conducted in 4 staff-model health centers of a health maintenance organization in Massachusetts.
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In patients determined to be appropriate candidates for PDR, a 30%-35% reduction in mean daily warfarin dose was effective in maintaining therapeutic anticoagulation in patients started on concomitant metronidazole.
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The incidence and impact of community-acquired CDIs may be underestimated and the unjustified use of antibiotics may promote their emergence. FPs are not used to treat CDIs as more than 50% prefer referring patients to hospital or to a specialist.
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To assess whether CARD15 mutations are associated with risk of developing Crohn's perianal fistulas and whether these mutations are predictors of the response of perianal fistulas to antibiotics.
Complicated intra-abdominal infections are defined by the U.S. Food and Drug Administration as those in which an operation would not remove all of the infected tissue. Therefore perforated appendicitis, although usually straightforward to treat, would be considered complicated, whereas gangrenous non-perforated appendicitis would not. Antibiotics play an adjunctive role to the surgical procedure in the management of these infections. Studies of newer antibiotics generally exclude critically ill patients, so it is unclear whether dose or duration of therapy can be addressed by such studies. Typical characteristics of anti-infective studies of intra-abdominal infection are: enrollment of upwards of 50% appendicitis cases, mortality 5%, and a clinical cure rate of 85%. Several antibiotic combinations with metronidazole are acceptable (e.g. third- or fourth-generation cephalosporin, aminoglycoside, aztreonam, or second-generation quinolone), as are several agents as monotherapy (e.g. second-generation cephalosporin, beta-lactamase agent, or third-generation quinolone). In addition to questions of dose and duration, questions have been raised regarding the value of intraoperative cultures, and whether issues of the quality of the surgical procedure can be addressed. The issue of the adequacy of surgical "source control" may be paramount, as an improper, untimely, or incorrect operation would have an overwhelmingly negative effect on outcome compared to the efficacy of the antibiotic.
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Ecabet sodium has an anti-H. pylori effect. We assessed the efficacy of ecabet sodium in the rescue therapy for the eradication of H. pylori.
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From 1118 clinical isolates, 13.4% (n = 150) showed phenotypic resistance to metronidazole, clarithromycin and quinolones and 0.9% (n = 10) to metronidazole, clarithromycin and rifampicin; one isolate exhibited resistance to clarithromycin, quinolones and rifampicin. In eight isolates (0.7%), we detected phenotypic quadruple resistance to metronidazole, clarithromycin, quinolones and rifampicin or tetracycline. Triple- and quadruple-resistant strains harboured resistance-associated mutations in their 23S rRNA, 16S rRNA, gyrA or rpoB genes and were nearly exclusively isolated from patients who had already been unsuccessfully treated on multiple occasions.
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The 10-day sequential regimen was significantly more effective than both 7-day triple regimen and 10-day triple regimen, while had the same eradication rate compared with the 14-day sequential therapy. But 10-day triple regimen to eradicate Hp infection in children had the advantages such as short course of treatment and better compliance.