Reanalysis of cefazolin surrogate susceptibility breakpoints utilized as guidances for oral cephalosporin treatments of uncomplicated urinary tract infections: caution concerning application to cefadroxil.

Based on antimicrobial susceptibility test interpretive breakpoint criteria from Clinical and Laboratory Standards Institute and United States Committee on Antimicrobial Susceptibility Testing, cefazolin uncomplicated urinary tract infection (uUTI) surrogate breakpoints do not accurately predict cefadroxil or cephradine susceptibility when testing indicated Enterobacteriaceae species isolates. Hence, these two orally-administered cephalosporins (OC) are not equivalent spectrum substitutes for cephalexin or six other related OC agents for contemporary uUTI therapy.

Reconstrução mamária imediata com retalho do músculo grande dorsal e implante de silicone / Immediate breast reconstruction with latissimus dorsi flap and silicone implant

Introdução: O primeiro tratamento eficaz para o câncer de mama foi descrito em 1894. A partir das décadas de 60 e 70, cirurgias menos agressivas foram desenvolvidas, sem prejuízos oncológicos. Com evolução histórica semelhante, o retalho do músculo grande dorsal (RMGD) foi introduzido em 1906. Contudo, apenas 70 anos após sua primeira descrição, ele ganhou popularidade como uma opção para as reconstruções mamárias. Método: Estudo clínico retrospectivo realizado por meio da coleta de dados de 22 pacientes submetidas à reconstrução mamária imediata com emprego do RMGD associado a implante de silicone durante o período de fevereiro de 2012 a dezembro de 2013. Resultados: Não houve necrose do retalho de grande dorsal ou perda da reconstrução mamária nos casos estudados. Foram observados 10 casos (45%) de seroma em região dorsal, 3 casos (14%) de necrose parcial da pele da mastectomia e 3 casos (14%) de deiscência parcial da ferida operatória. Não foram evidenciados fatores de risco com significância estatística para as complicações apresentadas. Ocorreram 4 casos (18,18%) de alterações de cobertura do implante, com atrofia muscular e cutânea, e 2 casos (9,09%) de contratura capsular. Apenas um caso não foi associado à radioterapia. Contudo, não houve significância estatística em relação à radioterapia adjuvante e às complicações tardias apresentadas (p = 0,635). Conclusão: O RMGD associado ao implante de silicone é uma opção segura e confiável para a reconstrução mamária imediata após mastectomias.

Introduction: The first effective breast cancer treatment was described in 1894. Less aggressive surgeries were developed in the 1960s and 70s, without increased mortality due to cancer. With similar historical evolution, the latissimus dorsi muscle flap (LDMF) procedure was introduced in 1906. Seventy years after its first description, LDMF gained popularity as an option for breast reconstruction. Method: A retrospective clinical study was conducted using data obtained from 22 patients undergoing immediate breast reconstruction with LDMF and silicone implants between February 2012 and December 2013. Results: No latissimus dorsi flap necrosis or breast reconstruction losses were observed in this study. Ten cases (45%) of seroma were detected in the dorsal region, three cases (14%) of partial necrosis of the mastectomized skin, and three cases (14%) of partial surgical wound dehiscence. Statistical significant risk factors for the complications observed have not been emphasized. There were four cases (18.18%) of muscle and skin atrophy associated with implants, and two cases (9.09%) of capsular contracture. Only one case was not associated with radiotherapy. However, there were no statistically significant differences in adjuvant radiotherapy and late complications (p = 0.635). Conclusion: LDMF associated with silicone implants is a safe and reliable option for immediate breast reconstruction after mastectomies.

Eficacia del cefadroxilo oral como profilaxis antibiótica en heridas de extremidades ocasionadas por arma de fuego de baja energía / Efficacy of the ceffadroxil how antibiotic prophylactics in wounds of extremities caused by low energy of firearms

Se presenta el estudio realizado en 30 pacientes que ingresaron a un hospital del área metropolítana de Caracas por presentar heridas en las extremidades, que fueron ocasionadas por arma de fuego de baja velocidad; en ningún caso se encontró afección articular ni neurovascular. El grupo se constituyó por 25 sujetos masculinos y cinco femeninos, con edad promedio de 23.8 años. Al ingresar al hospital se les realizó cura local y desbridamiento mínimo de las heridas. Dieciseis de los individuos presentaron fracturas incompleta de algún hueso largo, que ameritó inmovilización con férula o vendaje circular de yeso abierto en la zona de la herida. El cefadroxilo (Bidroxyl) se administro por vía oral durante seis días, en dosis de 1g dos veces al día los dos primeros y 500 mg dos veces al día los cuatro restantes. El 93.33 por ciento de los pacientes (28/30) evolucionó favorablemente sin manifestar infección. Los dos sujetos adicionales (6.66 por ciento) presentaron abscesos, los cuales fueron tratados con base al cultivo y antibiograma. Se concluyó que el cefadroxilo oral es una buena alternativa como profilaxis antibiótica para heridas no complicadas de extremidades, que fueron ocasionadas por arma de fuego en pacientes ambulatorios. Sin embargo, se requieren más estudios multicéntricos para fortalecer este concepto

Evaluación de eficacia bacteriológica del uso de cefadróxilo en el tratamiento de la faringoamigdalitis estreptocóccica pediátrica / Evaluation of bacteriological efficacy of cefadroxil used in the treatment of pediatric streptococcal pharyngitis

Se trataron 40 pacientes pediátricos, cuyas edades fluctuaron entre 4 y 15 años, durante el período de marzo a octubre de 1995, con el diagnóstico clínico-bacteriológico de faringoamigdalitis estreptococcica. Recibieron cefadroxilo en una dosis diaria de 30 mg por kilo de peso durante 10 días. En todos los pacientes hubo erradicación de Streptococcus beta hemolítico grupo A que se comprobó con un test rápido para detección de grupo A y un cultivo faringeo negativo 2 a 4 días después de finalizado el tratamiento

Cefdinir (FK482), an orally administered cephalosporin in vitro activity comparison against recent clinical isolates from five medical centers and determination of MIC quality control guidelines.

Cefdinir, a new oral cephalosporin, was compared to cefaclor, cefadroxil, cefixime, and cefuroxime against greater than 5000 recent aerobic clinical isolates. This multicenter study revealed broad-spectrum cefdinir activity against all Enterobacteriaceae (MIC50s, 0.06-2 micrograms/ml) except Enterobacter cloacae, Morganella morganii, Proteus vulgaris, and Serratia marcescens (MIC50s, greater than or equal to 4 micrograms/ml). Oxacillin-susceptible staphylococci (MIC90s, 0.5-2 micrograms/ml), beta-hemolytic Streptococcus group B (MIC90, 0.06 micrograms/ml), and Acinetobacter lwoffii were also susceptible to cefdinir. The activity of cefdinir was similar to that of cefixime and cefuroxime against Gram-negative organisms and superior to all tested oral cephems when tested against Gram-positive cocci. None of the cephalosporins were active against oxacillin-resistant Staphylococcus spp., enterococci, Pseudomonas spp., or Xanthomonas maltophilia. MIC quality control range guidelines were established for the strains recommended by the National Committee for Clinical Laboratory Standards documents.

[Treatment of urinary infection with cephadroxyl (Pharmachem)--microbiological and clinical research]. / Lechenie na uroinfektsiiata s tsefadroksil (Farmakhim)--mikrobiologichni i klinichni prouchvaniia.

The bacteria isolated from the urine of renal patients were tested for sensitivity towards cephadroxyl (Pharmachem) and other beta-lactam antibiotics--altogether 654 examinations were made. It was established that the gram-positive bacteria (excluding the Enterococcus) are sensitive towards cephadroxyl. From the Gram negative bacteria E. Coli, Klebsiella sp., Enterobacter sp., P. mirabilis, Citrobacter sp. showed the greatest sensitivity towards cephadroxyl, while the indole positive Proteus were with low sensitivity and P. aeruginosa, Acinetobacter sp., Serratia were resistant towards cephadroxyl. 30 patients with persistent mainly secondary urinary infection were treated with cephadroxyl. The clinical symptoms disappeared in 63.3% of the patients and another 26.7% of them showed considerable improvement. Bacteriological sterility of the urine was achieved in 61.29% of the patients. The side effects were mild and rare, only in single cases.