We compared growth characteristics of 46 Legionella strains grown on buffered charcoal yeast extract alpha (BCYE alpha) agar and buffered starch yeast extract (BSYE) agar and MICs of macrolides, azalides, and fluoroquinolones for these organisms. Growth was poor and not reproducible on BSYE agar. Growth was excellent on BCYE alpha, and MICs were easy to interpret. BCYE alpha is superior to BSYE for testing susceptibilities of Legionella species by agar dilution.
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A 48-year-old woman with human immunodeficiency virus was admitted for the work up of abdominal pain, fevers, and weight loss. She was noncompliant with antiretroviral therapy with a CD4 count of 30 × 10/L. She reported bilateral reduction in vision with corrected acuities of 6/18 in the right eye and 6/36 in the left eye. Bilateral granulomatous panuveitis with multifocal choroiditis was present. A vitreous biopsy of the left eye confirmed Mycobacterium avium complex, also identified on mycobacterium blood cultures. She was started on oral azithromycin and ethambutol, and after 6 months, her corrected acuities were 6/9 in the right eye bilaterally with an improvement in uveitis and choroiditis.
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We developed a clinical vignette describing a man with typical gonococcal urethritis symptoms to elicit questions about antibiotic treatment. We mailed the electronic questionnaire to a random sample of 1000 French GPs belonging to the Sentinelles Network.
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Both strategies appeared to be effective in reducing the prevalence of clinically active trachoma and infection six months after the treatment. Antibiotic treatment reduced the prevalence of chlamydial infection more than it did the level of clinically active trachoma.
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In this paper we describe how utilization of low molecular weight alginate-derived oligosaccharide (ADO) and chito-oligosaccharide (COS) in conjunction with antibiotics, could more effectively inhibit the growth of wild-type and resistant Pseudomonas aeruginosa. Inhibition is effected by modulating the bacteria's quorum sensing (QS) system, thus regulating biofilm formation and reducing resistance to antibiotic treatment. This can be demonstrated by using conventional MIC screening. COS showed synergistic effects with azithromycin, whereas ADO indicated additive effects against wild-type P. aeruginosa. Using electrospray-ionization mass spectroscopy (ESI-MS), matrix-assisted laser desorption/ionization-time of flightmass spectroscopy (MALDI-TOF-MS) and nuclear magnetic resonance (NMR), the chemical structure of ADO and of COS was characterized. The wild-type and resistant strains were identified by 16S rRNA sequence analysis. This report demonstrates the feasibility of attenuating the tolerance of P. aeruginosa to azithromycin by using specific marine oligosaccharides.
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Random-effects estimates of pooled absolute rate differences of outcomes were derived, and heterogeneity of both the rates and rate differences was assessed. Children with AOM not treated with antibiotics experienced a 1- to 7-day clinical failure rate of 19% (95% confidence interval: 0.10-0.28) and few suppurative complications. When patients were treated with amoxicillin, the 2- to 7-day clinical failure rate was reduced to 7%, a 12% (95% confidence interval: 0.04-0.20) reduction. Adverse effects, primarily gastrointestinal, were more common among children on cefixime than among those on ampicillin or amoxicillin. They were also more common among children on amoxicillin-clavulanate than among those on azithromycin.
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We assessed risk estimates of liver injury associated with antibiotic use in children and adolescent outpatients.
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Shigellosis is more prevalent in children below 15 years in the Buea District. There is a high level of resistance to most of the antibiotics used for the treatment of shigellosis including extended-spectrum beta-lactamases (ESBLs) as well as evidence of resistance to quinolones. Azithromycin was found to be the drug of choice for shigellosis in this setting.
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An in vitro infection model was created using a suspension of macrophages, polymorphonuclear leukocytes, lymphocytes, fibroblasts, and human serum to which pathogen and antibiotic were added. Separate intracellular and extracellular antibiotic concentrations and activity against Staphylococcus aureus and Legionella pneumophila were assessed for three antimicrobial agents: amoxicillin, azithromycin and clarithromycin. Amoxicillin was found almost exclusively in extracellular fluid, where it was active; intracellularly, it was ineffective. Azithromycin, in contrast, was primarily concentrated and active intracellularly, with little activity in extracellular fluid. Clarithromycin was present in both compartments and possessed significant activity both intracellularly and extracellularly.