RESUMEN
Acute otitis externa, cellulitis of the external auditory canal, is most frequently due to bacteria. Patients may present with otalgia, aural fullness, hearing loss, and otorrhea. Its diagnosis is a clinical one. Treatment is focused on analgesia, treating the underlying infection and preventing recurrence.
Asunto(s)
Sordera , Pérdida Auditiva , Otitis Externa , Humanos , Otitis Externa/terapia , Otitis Externa/tratamiento farmacológico , Conducto Auditivo Externo , Enfermedad AgudaRESUMEN
OBJECTIVES: To identify the common bacteria in recent peritonsillar abscesses and the prevalence of antibiotic resistance and compare both between adults and children. METHODS: This is a retrospective chart review at a single academic institution of patients who underwent either incision and drainage or tonsillectomy for a peritonsillar abscess between 2002 and 2012 (n=69). Medical records were reviewed for cultures, comorbidities, and drainage procedures. RESULTS: Cultures obtained from 62.32% of peritonsillar abscesses were polymicrobial, and 34.78% were monomicrobial. The most common pathogens were ß-hemolytic Streptococcus (31.88%), α-hemolytic Streptococcus (21.74%), Neisseria (14.49%), and Streptococcus milleri (13.04%). Group A ß-hemolytic streptococcus was more common in children and Streptococcus milleri was more common in adults. Alpha-hemolytic streptococcus was resistant to clindamycin (6.67%) and erythromycin (6.67%). Streptococcus milleri was resistant to clindamycin (11.11%) and erythromycin (11.11%). Staphylococcus was resistant to penicillin (37.5%), oxacillin (25%), erythromycin (25%), and clindamycin (12.5%). CONCLUSIONS: ß- and α-hemolytic Streptococci, Neisseria, and Streptococcus milleri are the most common pathogens. Streptococcus milleri is more common in adults, and ß-hemolytic streptococcus is more common in children. Resistance to clindamycin and erythromycin is common in Streptococci and Staphylococci, and penicillin resistance is common in Staphylococci.
Asunto(s)
Antibacterianos/farmacología , Drenaje/métodos , Farmacorresistencia Bacteriana , Neisseria/efectos de los fármacos , Absceso Peritonsilar , Streptococcus/efectos de los fármacos , Tonsilectomía/métodos , Adolescente , Adulto , Distribución por Edad , Disección/métodos , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana/métodos , Pruebas de Sensibilidad Microbiana/estadística & datos numéricos , Neisseria/aislamiento & purificación , New York/epidemiología , Evaluación de Resultado en la Atención de Salud , Absceso Peritonsilar/tratamiento farmacológico , Absceso Peritonsilar/epidemiología , Absceso Peritonsilar/microbiología , Absceso Peritonsilar/cirugía , Estudios Retrospectivos , Factores Sexuales , Streptococcus/clasificación , Streptococcus/aislamiento & purificaciónRESUMEN
Symptoms of neuropathic spinal cord injury (SCI) pain include evoked cutaneous hypersensitivity and spontaneous pain, which can be present below the level of the injury. Adverse side-effects obtained with currently available analgesics complicate effective pain management in SCI patients. Voltage-gated Na(+) channels expressed in primary afferent nociceptors have been identified to mediate persistent hyperexcitability in dorsal root ganglia (DRG) neurons, which in part underlies the symptoms of nerve injury-induced pain. Ambroxol has previously demonstrated antinociceptive effects in rat chronic pain models and has also shown to potently block Na(+) channel current in DRG neurons. Ambroxol was tested in rats that underwent a mid-thoracic spinal cord compression injury. Injured rats demonstrated robust hind paw (below-level) heat and mechanical hypersensitivity. Orally administered ambroxol significantly attenuated below-level hypersensitivity at doses that did not affect performance on the rotarod test. Intrathecal injection of ambroxol did not ameliorate below-level hypersensitivity. The current data suggest that ambroxol could be effective for clinical neuropathic SCI pain. Furthermore, the data suggest that peripherally expressed Na(+) channels could lend themselves as targets for the development of pharmacotherapies for SCI pain.