RESUMO
BACKGROUND: Antimicrobial activity of green tea against Staphylococcus aureus both in vitro and in vivo has been reported recently. Studies on clinical efficacy and safety of green tea as antibacterial agent against S. aureus in human cases are rare. OBJECTIVES: To evaluate the clinical effectiveness and safety of topical green tea on primary pyoderma caused by S. aureus. We also attempted to determine the minimum inhibitory concentration of green tea against S. aureus and methicillin-resistant S. aureus. METHODS: Open label, prospective, placebo-controlled study included community-acquired primary pyoderma cases caused by S. aureus. Severity grading was done on a scale of 1-5. Green tea ointment 3% and placebo ointment were used. Cure was defined on the basis of negative culture and assessment of clinical improvement. Minimum inhibitory concentration was determined by agar dilution method. Data were analyzed using Statistical Package for Social Sciences (SPSS) software version 16. RESULTS: Of the 372 patients, 250 received green tea and 122 received placebo. Multidrug-resistant S. aureus was isolated in 89.1% in green tea group and 81.1% in placebo group, respectively. Methicillin-resistant S. aureus was isolated in 24 patients. Cure was seen in 86% in green tea group and 6.6% in placebo group which was statistically very significant. The number of days for comprehensive cure in green tea group was 9.2 ± 6.4 days. All patients with methicillin-resistant S. aureus infection in the green tea group were cured. Minimum inhibitory concentration of green tea against S. aureus was 0.0265 ± 0.008 µg/ml and against methicillin-resistant S. aureus was 0.0205 ± 0.003 µg/ml. LIMITATIONS OF THE STUDY: Comparative trial was not conducted in the same patient with different lesions; children less than seven years were not considered as the school authorities did not permit for younger children to be included in the study and true randomization and blinding of investigators were not done. CONCLUSIONS: Green tea has a significant antibacterial effect against multidrug-resistant S. aureus. Minimum inhibitory concentration of green tea is established and is promising in methicillin-resistant S. aureus infections.
Assuntos
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Extratos Vegetais/administração & dosagem , Pioderma/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , Chá , Administração Tópica , Adolescente , Criança , Estudos Transversais , Farmacorresistência Bacteriana Múltipla/fisiologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Pioderma/diagnóstico , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/isolamento & purificação , Staphylococcus aureus/fisiologia , Resultado do TratamentoAssuntos
Blastomicose/tratamento farmacológico , Iodeto de Potássio/uso terapêutico , Pioderma/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Blastomicose/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Soluções Farmacêuticas/uso terapêutico , Pioderma/diagnóstico , Neoplasias Cutâneas/diagnósticoRESUMO
Pyodermas are a common group of infectious dermatological conditions on which few studies have been conducted. This study aimed to characterise the clinical and bacteriological profile of pyodermas, and to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection in primary pyodermas in a dermatology outpatient department in Kashmir. Methods We conducted a hospital based cross-sectional study in the outpatient Department of Dermatology, Sexually Transmitted Diseases and Leprosy of Shri Maharaja Hari Singh Hospital, Srinagar, Jammu and Kashmir, India. Patients presenting with primary pyodermas were included in the study. A detailed history and complete physical and cutaneous examination was carried out along with microbiological testing to find aetiological microorganisms and their respectiveantimicrobial susceptibility patterns. Antimicrobial susceptibility testing, including that for methicillin resistance, was carried out by standard methods as outlined in the current Clinical and Laboratory Standards Institute guidelines. Results In total, 110 patients were included; the age of the study population ranged from 3 to 65 years (mean age 28 years); 62% were male. Poor personal hygiene was noted in 76 (69%). Furunculosis (56; 51%) was the most common clinical presentation. Staphylococcus aureus was isolated in 89 (81%) of cases, and MRSA formed 54/89 (61%) of Staphylococcus aureus isolates. All MRSA strains were sensitive to vancomycin. Conclusion The prevalence of MRSA was high in this sample of communityacquired primary pyodermas. It is therefore important to monitor the changing trends in bacterial infection and their antimicrobial susceptibility patterns and to formulate a definite antibiotic policy which may be helpful in decreasing the incidence of MRSA infection.
Assuntos
Antibacterianos/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pioderma , Infecções Estafilocócicas , Adulto , Estudos Transversais , Feminino , Humanos , Higiene/normas , Índia/epidemiologia , Masculino , Testes de Sensibilidade Microbiana/métodos , Testes de Sensibilidade Microbiana/estatística & dados numéricos , Avaliação das Necessidades , Prevalência , Pioderma/diagnóstico , Pioderma/tratamento farmacológico , Pioderma/epidemiologia , Pioderma/microbiologia , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/fisiopatologiaAssuntos
Furunculose/diagnóstico , Miíase/diagnóstico , Pioderma/diagnóstico , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Furunculose/complicações , Furunculose/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Miíase/complicações , Miíase/tratamento farmacológico , Pioderma/complicações , Pioderma/tratamento farmacológicoRESUMO
In order to help primary health care (PHC) workers in developing countries in the care of common skin diseases, an algorithm for the management of pyoderma, scabies, superficial mycoses, contact dermatitis and referral of early leprosy cases (based on the identification of diseases through the presence of objective key signs, and on treatments by generic drugs) was elaborated. One thousand patients were seen by trained dermatologists, who established diagnoses and treatments; in addition, there was systematic recording of each key sign, according to the successive algorithm steps. We compared the diagnostics and treatments obtained for several combinations of diagnostic signs, with those of the dermatologists. Sensitivity, specificity, positive predictive value and negative predictive value of defined combinations were high for pyoderma, scabies and superficial mycoses. Values were less exact for dermatitis and leprosy, but were considered sufficient for the level of health care targeted. The apportionment of treatments between the algorithm and the dermatological approaches was considered appropriate in more than 80% of cases; mismanagement was possible in 7% of cases, with few predictable harmful consequences. The algorithm was found satisfactory for the management of the dermatological priorities according to the standards required at the PHC level.
Assuntos
Algoritmos , Dermatopatias/tratamento farmacológico , Adolescente , Adulto , África Subsaariana/epidemiologia , Dermatite de Contato/diagnóstico , Dermatite de Contato/tratamento farmacológico , Dermatite de Contato/epidemiologia , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Dermatomicoses/epidemiologia , Feminino , Humanos , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/tratamento farmacológico , Hanseníase Virchowiana/epidemiologia , Masculino , Mali/epidemiologia , Projetos Piloto , Atenção Primária à Saúde/métodos , Pioderma/diagnóstico , Pioderma/tratamento farmacológico , Pioderma/epidemiologia , Escabiose/diagnóstico , Escabiose/tratamento farmacológico , Escabiose/epidemiologia , Senegal/epidemiologia , Sensibilidade e Especificidade , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/epidemiologiaRESUMO
A case of extensive pyoderma grangrenosum (PG) that occurred in a three-year-old girl is reported. No etiologic factors were found. Various medications, including clofazimine, prednisone, and micocycline, were ineffective. Administration of thalidomide was followed by complete recovery.