Application of Cefaclor in Orthodontics through Micro-Implant Anchorage in Patients with Periodontitis.

AIM: Chronic periodontitis leads to gingival swelling, hyperplasia, and tooth mobility, which affects orthodontic treatment. The aim of this study was to investigate the application of cefaclor in orthodontics through micro-implant anchorage in patients with periodontitis. METHODS: A retrospective study was conducted on patients with periodontitis who received micro-implant anchorage treatment in the department of orthodontics at the First People's Hospital of Yongkang City from July 2019 to January 2022. According to different treatment regimens, these patients were divided into the test group (patients receiving cefaclor and micro-implant anchorage treatment) and the control group (patients receiving micro-implant anchorage treatment only). The plaque index (PLI), gingival index (GI), sulcus bleeding index (SBI), and serum inflammatory factor levels were compared between the two groups after treatment. RESULTS: One hundred and five patients were included in the study, (44 males and 61 females, median age 21 [15-25] years), 51 in the cefaclor group and 54 in the no cefaclor group. After treatment, the PLI, GI, and SBI scores in the two groups were higher than those before treatment, and the levels of serum inflammatory markers significantly increased (p < 0.05). After treatment, the PLI, GI, and SBI scores in the test group were significantly lower than those in the control group (p < 0.001). The levels of serum interleukin-1ß, interleukin-6, interleukin-8, and tumor necrosis factor-α were significantly lower in the test group, and the interleukin-2 level was higher in the test group (p < 0.001). There was no significant difference in the incidence of complications between the two groups (p > 0.05). CONCLUSIONS: Cefaclor and micro-implant anchorage have a good clinical effect on orthodontics in patients with periodontitis, improving periodontal health and reducing inflammatory response.

Cefaclor as a first-line treatment for acute uncomplicated cystitis: a retrospective single-center study.

BACKGROUND: Wide-spectrum antibiotics have been favored to treat acute uncomplicated cystitis (AUC) for a long time, leading to the emergence of multi-drug resistant bacteria. We hypothesize that narrow-spectrum antibiotics might mitigate the issue and aim to investigate the clinical efficacy of cefaclor in patients with AUC. METHODS: We retrospectively reviewed the clinical data of female outpatients with AUC treated with cefaclor and evaluated the safety and clinical efficacy. Clinical cure was defined as the elimination of clinical symptom under 4 white blood cells (WBCs) per high power field on microscopy. RESULTS: Overall, 223 women with AUC were enrolled. Escherichia coli was the dominant pathogen (n = 160; 68.6%), followed by Klebsiella species and E. coli-extended spectrum ß-lactamase (ESBL) (n = 19; 8.1% and n = 18; 7.7%). Overall success rate was 94.0% (n = 219) and susceptibility rate of cefazolin was 84.1%, which was close to that of levofloxacin (82.9%). Ampicillin showed the lowest rate of 63.7% with a significantly greater resistance rate of 35.3% among all antibiotics (P < 0.001). In the subgroup analysis, the success rate in patients with resistance to levofloxacin or cefazolin was 100% (n = 24) or 93.3% (n = 14). The rate in patients with resistance to both antibiotics was 60.0% (n = 9), and the pathogens in the other 40.0% (n = 6) of patients with treatment failure were E. coli-ESBL. CONCLUSION: Cefaclor showed excellent efficacy in AUC patients, even in those with in vitro resistance to cefazolin or levofloxacin. Cefaclor may be considered as a first-line option in patients with AUC and a second-line option for those with levofloxacin treatment failure.

[Management of acute pyelonephritis in patients older than 3 months: survey conducted in 39 paediatric emergency departments of the Ile de France Region in 2004]. / Prise en charge des pyélonéphrites aiguës du nourrisson de plus de 3 mois et de l'enfant: enquête effectuée parmi les services d'urgences pédiatriques d'Ile de France en 2004.

OBJECTIVES: To describe the different modalities of ambulatory management of acute pyelonephritis in patients older than 3 months of age in paediatric emergency units of the Ile de France region in 2004. METHODS: Between October 2003 and April 2004, referents of 39 paediatric emergency units of the Ile de France region were questioned through a written questionnaire concerning the management of acute pyelonephritis: in or outpatient modalities, antibiotic regimen (molecule and route of administration), investigations and follow-up. RESULTS: Thirty-one questionnaires (79.5%) were returned and analysed. A written protocol was available in 60% of the units. Outpatient management was performed in 24/31 centres. Young age, poor clinical tolerance, urological abnormalities and social difficulties were the major contra-indications for such management. Ultrasonic echography at diagnosis (within 24 h) was performed in 50% of the units. Antibiotics were started using IV route in 18/24 units (75%) and ceftriaxone and aminoside were respectively prescribed in 100% and 29.4% of the units for a duration of 1 to 5 days before switching to the oral route. Antibiotherapy was started orally in 6 units and cefixime was chosen by 5 of them. Follow-up consultations were scheduled in 100% of the units but with various delay after initiation of the treatment. The total duration of treatment was mostly 10 days and oral prophylactic antibiotherapy was prescribed by 10/24 centres after completion of the treatment. Cystoureterography was systematically realized by 83.3% of the units. CONCLUSIONS: Despite important differences in the management of acute pyelonephritis in Ile-de-France, a majority of the units follows similar therapeutic modalities. In the absence of consensus, new recommendations are necessary concerning the management of pyelonephritis in infants and children in France.

Efficacy of prophylaxis in women with sex induced cystitis.

UNLABELLED: Sexual intercourse has been established as one of the most important risk factors for both isolated and recurrent uncomplicated infections of the urinary tract. Prophylactic therapy requires only a small dose of an antimicrobial agent, which is generally given at bedtime for 6 to 12 months. An alternative method is to give an antimicrobial agent for six months post-intercourse. It is still unknown which of the two methods is most effective. A total of 123 women with suspected sexually induced recurrent cystitis (mean age 28 years, range 15 to 65) and a history of recurrent urinary tract infection (UTI) (the last one within the last six months) were subjected to prophylactic therapy for six months. Half of them were treated with low-dose trimethoprim-cotrimoxazole (TMP-SMX) and cefaclor given orally post-intercourse (spontaneous usage), while the other half were treated with low-dose TMP-SMX and cefaclor given at bedtime. The response to the prophylactic therapy was classified as continued cure in 106 cases (86.17%), failure in 13 cases (10.56%), and unknown in four cases (3.25%). TMP-SMX administered in continuous nightly prophylaxis showed similar efficacy and tolerability as cefaclor post-intercourse. OBJECTIVE: To determine the efficacy of prophylaxis in women with recurrent sex induced cystitis and compare the post-intercourse versus the conventional bedtime given long-term, low-dose use of prophylactic antimicrobials.

Modelling and analysing exchangeable binary data with random cluster sizes.

Correlated binary data occur very frequently in cluster sample surveys, dependent repeated cancer screening, teratological experiments, ophthalmologic and otolaryngologic studies, and other clinical trials. The standard methods to analyse these data include the use of beta-binomial models and generalized estimating equations with third and fourth moments specified by 'working matrices'. However, in many applications it is reasonable to assume that the data from the same cluster are exchangeable. When all sampled clusters have equal sizes, Bowman and George introduced maximum likelihood estimates (MLEs) of the population parameters such as the marginal means, moments, and correlations of order two and higher. They also extended their approach to sampled clusters with unequal sizes. It seems that their extension has a gap. This paper points out the source of this gap and shows that estimates introduced by Bowman and George are not the MLEs of the parameters which are used to identify the joint distribution of correlated binary data. We show that the MLEs of the population parameters have no closed form in general and should be calculated by numerical methods. We apply our results and a generalized estimating equation procedure to a data set from a double-blind randomized clinical trial comparing two antibiotics, cefaclor and amoxicillin, used for the treatment of acute otitis media. To see the performance of the MLEs with small or moderate sample sizes, several simulation studies are also conducted.

Effect of a short course of clarithromycin therapy on sputum production in patients with chronic airway hypersecretion.

STUDY OBJECTIVE: Long-term administration of macrolide antibiotics reduces sputum production in patients with chronic airway diseases, probably by inhibiting airway inflammation. The objective of the present study was to determine the acute effects of a macrolide on airway chloride secretion and sputum production. METHODS: We first investigated the effect of erythromycin treatment on chloride diffusion potential difference (CPD) across tracheal mucosa in vivo. Next, we conducted a double-blind, parallel-group study examining the effect of 7 days of treatment with clarithromycin (400 mg/d), amoxicillin (1,500 mg/d), or cefaclor (750 mg/d) in patients with chronic bronchitis or bronchiectasis without apparent respiratory infection. RESULTS: IV administration of erythromycin decreased the CPD of rabbit tracheal mucosa in a dose-dependent manner. Treatment of patients with clarithromycin decreased sputum production, whereas amoxicillin and cefaclor treatment had no effect. The percentage of patients whose sputum decreased > 30% from baseline (responders) was 38% in the clarithromycin group, 7% in the amoxicillin group, and 0% in the cefaclor group. During treatment with clarithromycin, the sputum solid composition increased and chloride concentration decreased in responders, but these changes were not observed in nonresponders. CONCLUSION: Short-term administration of 14-membered macrolide reduces chronic airway hypersecretion, presumably by inhibiting chloride secretion and the resultant water secretion across the airway mucosa.

An unusual abdominal mass in a renal transplant recipient.

Renal transplant recipients are at increased risk of malignancy and infection. We present the case of a 72-year-old-man with recurrent bladder carcinoma, abdominal aortic aneurysm repair, and end-stage renal failure due to renovascular disease. He received a cadaveric renal allograft into his left iliac fossa, was given cyclosporin A, azathioprine, and prednisolone triple therapy immunosuppression, and had no rejection episodes. He presented four years post-transplantation with a two-year history of intermittent sweats and fevers. Previous episodes had been investigated with no firm diagnosis made. This time he had right iliac fossa pain of three weeks' duration. Examination revealed a tender mass. Investigations showed unchanged graft function, but elevated inflammatory indices. Ultrasonography and computed tomography detailed an infiltrating mass associated with the sigmoid colon, which colonoscopy failed to visualise. At laparotomy a 6-cm tumor was removed, with adherent sigmoid colon and bladder dome. Macroscopically the mass was an abscess, and microscopy found acute and chronic inflammatory giant cells and fibrillary masses suggestive of actinomycosis, with no malignancy. The patient recovered uneventfully on antibiotics. At six months' follow-up, examination, inflammatory markers, and radiographic imaging showed no evidence of recurrence. Twelve months later the patient died of rupture of his proximal abdominal aorta. There was no evidence of recurrence at postmortem examination. We conclude with a brief review of actinomycosis in transplant recipients.

Evaluation of oral antimicrobial agent levels in tooth extraction sites.

OBJECTIVE: The purpose of this study was to evaluate various oral antimicrobial agent levels in tooth extraction sites. STUDY DESIGN: The concentration of dental alveolar blood in extraction wounds after the oral administration of talampicillin (500 mg), cefaclor (500 mg), cefteram pivoxil (200 mg), cefuroxime axetil (250 mg), cefdinir (200 mg), and ofloxacin (100 mg) was determined in 338 patients and was assessed on the basis of its antimicrobial activity against Streptococcus isolated in odontogenic infections. RESULTS: The percentage of patients whose concentrations exceeded the minimum inhibitory concentration for 90% of Streptococcus was 62.5% to 100% for talampicillin at 30 to 360 minutes, 0% to 12.5% for cefaclor at 30 to 360 minutes, 18.2% to 100% for cefteram pivoxil at 30 to 480 minutes, 50% to 100% for cefuroxime axetil at 30 to 480 minutes, 0% to 50% for cefdinir at 16 to 290 minutes, and 0% to 40% for ofloxacin at 30 to 480 minutes. CONCLUSION: These results indicate that talampicillin, cefteram pivoxil, and cefuroxime axetil have minimum inhibitory concentration levels for 90% of Streptococcus in tooth sockets.

Acute generalized exanthematic pustulosis: a case with a lymphoma-like presentation.

A 28-year-old woman developed an acute generalized exanthematic pustulosis in association with a massive lymphadenopathy. A viral etiology seemed highly probable although a drug reaction could not be excluded.

Effects of prophylactic administration of cefaclor on transient bacteremia after dental extraction.

This study was undertaken to investigate the effects of prophylactic administration of cefaclor on bacteremia after dental extraction. Thirty-nine patients were randomly assigned to receive either 1 g cefaclor (19 patients) or placebo (20 patients) 1 h prior to dental extraction. Blood samples for microbiological investigation were collected before, during, and 10 min after surgery, and were processed by lysis filtration under anaerobic conditions. The incidence of bacteremia with viridans streptococci was 79% in the cefaclor group and 50% in the placebo group during extraction. No difference in the incidence or magnitude of bacteremia was observed when the two patient groups were compared.

[Non-comparative open study of the efficacy and tolerance of cefaclor in the prevention of urinary tract infections in children]. / Studio aperto non comparativo sull'efficacia e tollerabilità del cefaclor nella profilassi delle infezioni delle vie urinarie del bambino.

Cefaclor has been investigated as an additional prophylactic agent in the UTI. It is active against virtually all common urinary pathogens, is well absorbed in the upper gastrointestinal tract, is well tolerated and safe. The Authors have carried out a clinical trial of the prophylactic use of cefaclor in the prevention of recurrent urinary tract infection in children. We studied 52 children (25 females and 27 males, median age 7 +/- 19 months) with UTI, investigated by imaging (sonography, micturating cystourethrography, renal scintigraphy) and by urodynamic studies. We found vesicoureteral reflux in 37 cases, primitive megaureter in 6 cases, in 1 patient duplication of the collecting system in 1 patient and substenosis of ureteropelvic junction in 1 case. In the others 5 cases the UTI were associated with bladder disfunction and finally in 1 case the UTI occurred in absence of urinary malformations. All patients received cefaclor, as prophylaxis, at the dosage of 10-20 mg/kg/die, administrated as a single bedtime dose. The mean time of treatment with cefaclor was 8 +/- 3,48 months. We observed an optimal compliance in all patients, also in the first year of life. In only two out of 52 patients, during the prophylaxis, we found documented bacteriuria. We stopped treatment in two cases because of an adverse effect (in both children has been demonstrated a cutaneous rash). In conclusion our study shows that cefaclor is an effective, well tolerated and safe agent in the UTI prophylaxis, also in the first year of life, when it seems to offer an optime alternative to other agents.

[A randomized control study on the treatment of 123 cases of bacterial infections with cefteram and cefaclor].

To evaluate the efficacy and the safety of cefteram in bacterial infections, a randomized control study of cefteram and cefaclor on the treatment of 123 patients with respiratory and urinary tract infections was carried out. The result showed that the effective and bacterial eradication rates were 92.1% and 91.4% for cefteram. 83.3% and 85.2% for cefalor. Adverse reactions were mainly gastrointestinal reactions, occurring in 4.6% of the cefteram group and 9.4% of the cefaclor group. Study of minimum inhibitory concentration displayed high antibacterial activity of cefteram for enterobacteriaceae and other Gram-negative organisms and its activity was higher than that of gentamyicin and ciprofloxacin for E. coli. It is concluded that cefteram was effective and safe in the treatment of respiratory and urinary tract infections.

Case report: cheilitis granulomatosa with periodontitis.

We report a case of cheilitis granulomatosa with periodontitis in a 39-year-old Japanese man. Biopsy specimens from both areas showed noncaseating epithelioid cell granuloma. Dental examination revealed that the lower left first molar had periodontitis. The lower left first molar was removed, and antibiotics and anti-inflammatory drugs were administered. After 2 months of periodontitis therapy, the lips returned to normal size without recurrence and the swelling of the buccal mucosa regressed.

Tratamento da otite média aguda (OMA) em crianças com Cefetamet Pivoxil / Treatment of acute otitis media in children with cefetamet pivoxil

Cefetamet Pivoxil, uma cefaloscoporina oral de terceira geraçao, foi investigada em um estudo aberto e randomizado, em 130 crianças portadoras de OMA. A eficácia e tolerabilidade de 20 mg/Kg de Cefetamet xarope, em duas doses diárias, em 68 pacientes foi comparada com 40 mg/Kg de Cefaclor, em três doses diárias, em 62 pacientes, ambas administradas por via oral por sete dias. Após este período obteve-se 95,6 por cento de cura com Cefetamet e 85,5 por cento com Cefaclor, insucesso no tratamento ocorreu em 4,4 por cento com Cefetamet 11,3 por cento com Cefaclor. Dois pacientes tratados com Cefaclor foram considerados nao avaliáveis, um por abandono e outro por suspensao do tratamento por efeitos colaterais gastrointestinais.

Ceflacor y cefradroxilo en el tratamirnto de infecciones urinaria pediátricas / Ceflacor and vedadroxil for treatment of pediatric urinary trect infections

Introducción.La elevada incidencia de infección urinaria(I.U)en pediatría,junto al aumento de la resistencia de las cepas de Escherichia coli en nuestro medio,determina la necesidad de buscar nuevas opciones terapeúticas.Para ello se comparado la efectividad y tolerancia de ceflacor(CCL)vs cefradroxilo(CDX)para el tratamiento de la I.U en pacientes pediátricos.Material y Métodos.Se trataron 60 pacientes de ambos sexos,con edades comprendidas entre 7 y 156 meses portadores de I.U.Se realizó un estudio multicéntrico comparativo,al azar,en el que se utilizó CDX a 30 mg/kg/día,ambos cada 12 horas por vía oral.La duración del tratamiento fue de 3 y 10 días para infección urinaria baja(I.U.B) e infección urinaria alta,respectivamente,de acuerdo a los criterios de localización utilizados.Conclusiones.Ambos antimicrobianos demostraron ser efectivos para el tratamiento de la I.U presentando los dos muy buena tolerancia oral.CCL presentó mejor actividad frente a las cepas de E.coli aisladas,por lo que consideramos que es una alternativa efectiva para el tratamiento de la IU en pediatría

Comparison of the efficacy and safety of ceftibuten and cefaclor in the treatment of pneumonia and bronchiectasis.

In a multicentre, international study of 187 adult patients with bacterial pneumonia or bronchiectasis, the safety and efficacy of a regimen of 200 mg ceftibuten administered twice-daily was compared with cefaclor given in a dosage of 500 mg three times a day. Of the 94 evaluable patients, 66 received ceftibuten and 28 received cefaclor. The overall bacteriological response was similar in the two treatment groups with elimination of the original pathogen in 91% and 89% of the patients receiving ceftibuten and cefaclor, respectively. The overall clinical response mirrored the bacteriological results with a successful clinical outcome in 92% of ceftibuten-treated patients compared with 93% in patients receiving cefaclor. Adverse experiences were, in general, few and mild, being reported in 8% and 17% of patients receiving ceftibuten and cefaclor, respectively.

Antibiotic therapy for urinary tract infections.

Loracarbef, a member of the carbacephem class of beta-lactam antibiotics, was tested in randomized, double-blind, parallel studies for the treatment of uncomplicated urinary tract infections (UTIs). In one study conducted in the United States, a 7-day course of once-daily doses of loracarbef (200 mg) was compared with a 7-day course of multiple daily doses of cefaclor (250 mg three times a day). Analysis of data from a small, homogeneous patient population of 108 college-aged women showed that loracarbef produced clinical and bacteriologic responses similar to those produced by cefaclor. At 5-9 days posttherapy, bacteriologic cure was observed in 96% of patients in the loracarbef group and 90% of patients in the cefaclor group (p = 0.614); at 4-6 weeks post-therapy, the same cure rate (81%) was observed in both groups. Analysis of the larger (333 patients) and more heterogeneous study population containing several male and elderly female patients showed that loracarbef again produced responses similar to those produced by cefaclor, with no statistically significant differences seen between the groups at 5-9 days or at 4-6 weeks posttherapy. The adverse events reported by the loracarbef and cefaclor groups were also comparable in both the small and large patient populations analyzed. Similarly favorable results were seen when a 7-day regimen of loracarbef (200 mg once a day) was compared with a 7-day regimen of norfloxacin (400 mg twice a day) in a large European study of approximately 300 patients with uncomplicated cystitis. These studies demonstrate that the safety and efficacy of once-daily loracarbef are comparable to the safety and efficacy of multiple-dose/day therapy with other antimicrobial agents commonly used in the treatment of uncomplicated UTIs.

Safety and efficacy of lomefloxacin versus cefaclor in the treatment of acute exacerbations of chronic bronchitis.

In two multicenter trials, lomefloxacin and cefaclor were compared as treatments for acute bacterial exacerbations of chronic bronchitis. In total, 522 adult outpatients were enrolled at 50 centers in the United States. Patients were randomized to treatment groups receiving either 400 mg lomefloxacin orally once daily (n = 259) or 250 mg cefaclor every 8 hours (n = 263) for 7-10 days. Both groups were comparable in terms of age, severity of exacerbation, smoking history, theophylline use, and baseline pathogens. The most common baseline pathogens were Haemophilus influenzae, found in 32% of patients in the lomefloxacin group and in 29% in the cefaclor group, Pseudomonas aeruginosa (13% and 16%, respectively), Moraxella (Branhamella) catarrhalis (12% and 13%), and Streptococcus pneumoniae (10% in both groups). Bacterial eradication rates 1-4 days after the completion of treatment for all patients with baseline pathogens were 81.8% in the lomefloxacin group and 62.7% in the cefaclor group (p less than 0.001). Clinical success (disappearance or improvement of presenting signs and symptoms) was noted in 80.0% of patients in the lomefloxacin group and 64.7% in the cefaclor group (p = 0.002). Eradication rates for the subgroup of patients who had pathogens susceptible in vitro to both study drugs and who completed treatment were 97.1% for lomefloxacin and 84.6% for cefaclor (p = 0.002). Clinical success rates in this subgroup were 92.4% for lomefloxacin and 90.1 for cefaclor (p = 0.585). Treatment-related adverse events were reported for 7% of patients in the lomefloxacin group and 5% in the cefaclor group. The most common adverse events in both groups were nausea and diarrhea. Six patients were withdrawn from treatment with lomefloxacin and four from the cefaclor group because of adverse events. There was no clinical or laboratory evidence of theophylline interaction with either treatment. Once-daily oral administration of 400 mg lomefloxacin was an effective, well-tolerated alternative to 250 mg of cefaclor three times daily in the treatment of acute exacerbations of chronic bronchitis.

Eficácia clínica e bacteriológica da associaçäo clavulanato de potássio + amoxicilina e do cefaclor em otite média aguda em crianças / Clinical and bacteriological efficacy of the association amoxillin-clavulanate potassium compared with cefaclor for acute otitis media in children

Cinquenta e quatro crianças de ambos os sexos, com até 10 anos de idade e portadores de otite média aguda, foram tratadas, aleatoriamente, pela amoxicilina / clavulanato de potássio (AMC) - 27 pacientes ou pelo cefaclor (CEF) - 27 pacientes sob a forma de suspensäo oral e na posologia de 25 a 50 mg/kg/dia e 40 mg/kg/dia, respectivamente, durante 5 a 10 dias, de acordo com a evoluçäo do quadro clínico. Os pacientes foram avaliados clínica e bacteriologicamente, sendo o S. pneumoniae (23 casos - 46%), o H. influenzae (14 casos - 28%) e o S. aureus (11 casos - 22%) os principais patógenos isolados no pré-tratamento. A resposta clínica eficaz foi de 100% no grupo AMC e de 89% no grupo CEF, embora näo se verificasse significância estatística neste resultado; 11 casos CEF näo apresentaram evoluçäo clínica favorável. Foram relatados dois casos de diarréia de intensidade leve com o AMC, que näo necessitaram tratamento específico, e um caso urticária severa com o CEF, obrigando à interrupçäo do tratamento. Os resultados obtidos permitem concluir que a amoxicilina / clavulanato de potássio é uma alternativa muito válida para o tratamento da otite média aguda e recorrente da criança