Carrimycin ameliorates lipopolysaccharide and cecal ligation and puncture-induced sepsis in mice.

Carrimycin (CA), sanctioned by China's National Medical Products Administration (NMPA) in 2019 for treating acute bronchitis and sinusitis, has recently been observed to exhibit multifaceted biological activities, encompassing anti-inflammatory, antiviral, and anti-tumor properties. Despite these applications, its efficacy in sepsis treatment remains unexplored. This study introduces a novel function of CA, demonstrating its capacity to mitigate sepsis induced by lipopolysaccharide (LPS) and cecal ligation and puncture (CLP) in mice models. Our research employed in vitro assays, real-time quantitative polymerase chain reaction (RT-qPCR), and RNA-seq analysis to establish that CA significantly reduces the levels of pro-inflammatory cytokines, namely tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1ß), and interleukin 6 (IL-6), in response to LPS stimulation. Additionally, Western blotting and immunofluorescence assays revealed that CA impedes Nuclear Factor Kappa B (NF-κB) activation in LPS-stimulated RAW264.7 cells. Complementing these findings, in vivo experiments demonstrated that CA effectively alleviates LPS- and CLP-triggered organ inflammation in C57BL/6 mice. Further insights were gained through 16S sequencing, highlighting CA's pivotal role in enhancing gut microbiota diversity and modulating metabolic pathways, particularly by augmenting the production of short-chain fatty acids in mice subjected to CLP. Notably, a comparative analysis revealed that CA's anti-inflammatory efficacy surpasses that of equivalent doses of aspirin (ASP) and TIENAM. Collectively, these findings suggest that CA exhibits significant therapeutic potential in sepsis treatment. This discovery provides a foundational theoretical basis for the clinical application of CA in sepsis management.

A multimodality therapeutic application on Toxoplasma gondii encephalitis utilizing Spiramycin and 'de novo' Ferula asafetida in immunodeficient mice.

This study investigated a 'de Novo' medicinal herb, Ferula asafetida (FA), against toxoplasma encephalitis either alone or combined with spiramycin (SP). Female Swiss-Webster mice (n = 72) were divided into three batches. Batch-I received no DMS to serve as an immunocompetent control, batch-II was immune-suppressed with the DMS (0.25 mg/g/day) for 14 days pre-infection, whilst batch-III was immune-suppressed with the DMS on the same day of infection. All experimental mice were inoculated with Toxoplasma gondii ME49 cysts (n = 75). Each batch was split into four subgroups: Mono-SP, mono-FA, combined drug (SP + FA), or neither. Therapies were administered on day zero of infection in batches (I and II) and 35 days post-infection in batch (III). Treatments lasted for 14 days, and mice were sacrificed 60 days post-infection. Histopathological changes, cysts load, and CD4 and CD8 T-cells were counted in brain tissues. The cyst-load count in mice receiving SP + FA was significantly (p < .0001) the least compared to the mono treatments in all protocols. Interestingly, the combined therapy demolished the T-cell subsets to zero in immunocompetent and immunocompromised infected mice. In conclusion, F. asafetida might be a powerfully natural, safe vehicle of SP in the digestive system and/or across the brain-blood barrier to control toxoplasmosis even through immunodeficient conditions.

Anti-Toxoplasma gondii agent isolated from Orostachys malacophylla (Pallas) Fischer.

Botanical medicinal plants have aroused our interest to deal with Toxoplasmosis which can causes serious public health problems. Nipagic acid, gallic acid, ethyl gallate, phloretic acid, protocatechuic acid, methyl p-coumarate, arbutin, and homoprotocatechuic acid are first isolated from Orostachys malacophylla (Pallas) Fischer, their inhibition rate, survival rate, biochemical and viscera index are evaluated using gastric epithelia strain-1(GES-1). Among them, arbutin can effectively prolong the survival time of mice acutely infected with T. gondii, and exhibit the same curative effect as Spiramycin (Spi) group in terms of the glutathione (GSH) and malondialdehyde (MDA) content, alleviate hepatomegaly and splenomegaly. Structure-activity relationship (SAR) and molecular docking implies that phenolic hydroxyl group would be preferred for improvement of activity. In a summary, arbutin is a potential anti-T. gondii candidate for clinical application.

Curcumin@metal organic frameworks nano-composite for treatment of chronic toxoplasmosis.

Toxoplasmosis is a zoonotic protozoal disease caused by Toxoplasma gondii, an intracellular opportunistic protozoan parasite that can infect any warm-blooded vertebrate cell. In this study, zirconium, and iron-based metal-organic framework was prepared according to the solvothermal method. New nanocomposite (Curcumin@MOFs) was prepared by reacting curcumin with amino-functionalized metal-organic frameworks (Fe-MOF and UiO-66-NH2). Besides characterizations of the composite by powder X-ray diffraction and scanning electron microscope, nano-Curcumin@MOFs was used as a new novel structure as atrial for treatment of chronic toxoplasmosis. Results showed a reduced number of brain cysts, high levels of serum Toxo IgG, and normal histo-morphology with preserved parenchymal, and stromal tissues in rats groups treated with curcumin and Curcumin@MOFs nanocomposite.

Adjunctive bradyzoite-directed therapy for reducing complications of congenital toxoplasmosis.

Congenital toxoplasmosis is caused by in utero infection of the fetus with the intracellular parasite Toxoplasma gondii. Upon infection, the parasite forms life-long cysts in fetal brain and eyes which are resistant to the currently accepted therapy of pyrimethamine and sulfadiazine. These cysts commonly reactivate later in life causing chorioretinitis and visual impairment, and rarely cause neurological complications. I hypothesize that adjunctive, bradyzoite-directed therapies have the potential to alleviate a significant burden of disease by reducing cyst burden in neonatal brain and eyes. Atovaquone is perhaps the most promising drug for further evaluation given its low side-effect profile, established safety, and efficacy in animal models reducing cyst burden. Very limited observational data in humans suggests atovaquone may prevent Toxoplasma-associated chorioretinitis recurrence. Clinical trials are needed to evaluate it and other potential drugs as adjunctive treatment in congenital toxoplasmosis.

Antiparasitic effects of oxymatrine and matrine against Toxoplasma gondii in vitro and in vivo.

Toxoplasma gondii (T. gondii) is an important pathogen which can causes serious public health problems. Since the current therapeutic drugs for toxoplasmosis present serious host toxicity, research on effective and new substances of relatively low toxicity is urgently needed. This study was carried out to evaluate the anti-parasitic effect of oxymatrine (OM) and matrine (ME) against T. gondii in vitro and in vivo. In our study, the anti-T. gondii activities of ME and OM were evaluated in vitro using cell counting kit-8 assay, morphological observation and trypan blue exclusion assay. In vivo, mice were sacrificed four days post-infection and ascites were drawn out to determine the extent of tachyzoite proliferation. Viscera indexes and liver biochemical parameters, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutathione (GSH) and malondialdehyde (MDA), were examined to evaluate the toxicity of compounds to mice. As a result, OM and ME showed anti-T. gondii activity but low selectivity toxicity to HeLa cells. Both compounds also significantly decreased the number of tachyzoites in peritoneal cavity and recovered the levels of ALT, AST, GSH and MDA in liver. Moreover, the mice treated with OM or ME achieved better results in viscera index and survival rate than that of spiramycin. These results suggest that OM and ME are likely the sources of new drugs for toxoplasmosis, and further studies will be necessary to compare the efficacy of drug combination, as well as identify its action of mechanism.

A Systematic Review and Meta-Analysis of the Efficacy of Anti-Toxoplasma gondii Medicines in Humans.

No effective drug and definitive "gold standard" treatment for Toxoplasma gondii (T. gondii) infection has been available so far, though some medicines have been commonly used in the treatment of T. gondii infection, such as spiramycin, azithromycin, traditional Chinese medicine (TCM), pyrimethamine- sulfadiazine (P-S), trimethoprim-sulfamethoxazole (TMP-SMX), and pyrimethamine-clindamycin (P-C). A systematic review and meta-analysis were performed to compare the efficacies of these conventional medicines in the treatment. Cohort studies for the treatment of acute T. gondii infection were searched from PubMed, Google Scholar, ect. All the cases number for different group extracted from each included literature were input to meta-analysis 3.13 software to calculate the pooled negative conversion rate (NCR), cure rate (CR) or vertical transmission rate based on their sample size and weight. The pooled NCR with 95% confidence intervals (CI) was used to evaluate the overall rate of a diagnosis positive result conversion to a negative result after treatment, which of spiramycin, azithromycin and TCM were 83.4% (95%CI, 72.1%-90.8%), 82.5% (95%CI, 75.9%-87.6%), and 85.5% (95%CI, 71.3%-93.3%) respectively, with no statistical difference between them. The pooled CR with 95% CI was used to evaluate the overall rate of complete disappearance of clinical symptoms for toxoplasmic encephalitis after therapy, which of P-S, TMP-SMX, and P-C were 49.8% (95%CI, 38. 8% -60.8%), 59.9% (95%CI, 48.9%-70.0%), and 47.6% (95%CI, 24.8%-71.4%) respectively, with no statistical difference between them. Primary T. gondii infection in pregnancy was treated mainly with spiramycin alone or combined with other drugs, and the pooled rate of vertical transmission was about 9.9% (95%CI, 5.9%-16.2%) after therapy. Toxoplasmic encephalitis in AIDS patients was usually treated with sulfonamides combined with other drugs and the pooled CR was 49.4% (95%CI, 37.9%-60.9%).

Abundance and distribution of Macrolide-Lincosamide-Streptogramin resistance genes in an anaerobic-aerobic system treating spiramycin production wastewater.

The behaviors of the Macrolide-Lincosamide-Streptogramin (MLS) resistance genes were investigated in an anaerobic-aerobic pilot-scale system treating spiramycin (SPM) production wastewater. After screening fifteen typical MLS resistance genes with different mechanisms using conventional PCR, eight detected genes were determined by quantitative PCR, together with three mobile elements. Aerobic sludge in the pilot system exhibited a total relative abundance of MLS resistance genes (per 16S rRNA gene) 2.5 logs higher than those in control samples collected from sewage and inosine wastewater treatment systems (P < 0.05), implying the presence of SPM could induce the production of MLS resistance genes. However, the total relative gene abundance in anaerobic sludge (4.3 × 10(-1)) was lower than that in aerobic sludge (3.7 × 10(0)) despite of the higher SPM level in anaerobic reactor, showing the advantage of anaerobic treatment in reducing the production of MLS resistance genes. The rRNA methylase genes (erm(B), erm(F), erm(X)) were the most abundant in the aerobic sludge (5.3 × 10(-1)-1.7 × 10(0)), followed by esterase gene ere(A) (1.3 × 10(-1)) and phosphorylase gene mph(B) (5.7 × 10(-2)). In anaerobic sludge, erm(B), erm(F), ere(A), and msr(D) were the major ones (1.2 × 10(-2)-3.2 × 10(-1)). These MLS resistance genes (except for msr(D)) were positively correlated with Class 1 integron (r(2) = 0.74-0.93, P < 0.05), implying the significance of horizontal transfer in their proliferation.

Azithromycin inhibits vertical transmission of Toxoplasma gondii in Calomys callosus (Rodentia: Cricetidae).

Toxoplasma gondii infection during pregnancy may cause severe consequences to the embryo. Current toxoplasmosis treatment for pregnant women is based on the administration of spiramycin or a drug combination as sulphadiazine-pyrimethamine-folinic acid (SPFA) in cases of confirmed fetal infection. However, these drugs are few tolerated and present many disadvantages due to their toxic effects to the host. The aim of this study was to evaluate the effectiveness of different treatments on the vertical transmission of T. gondii, including azithromycin, Artemisia annua infusion, spiramycin and SPFA in Calomys callosus as model of congenital toxoplasmosis. C. callosus females were perorally infected with 20 cysts of T. gondii ME49 strain at the day that a vaginal plug was observed (1st day of pregnancy - dop). Treatment with azithromycin, A. annua infusion, and spiramycin started at the 4th dop, while the treatment with SPFA started at the 14th dop. Placenta and embryonic tissues were collected for morphological and immunohistochemical analyses, mouse bioassay and PCR from the 15th to 20th dop. No morphological changes were seen in the placenta and embryonic tissues from females treated with azithromycin, spiramycin and SPFA, but embryonic atrophy was observed in animals treated with A. annua infusion. Parasites were found in the placenta and fetal (brain and liver) tissues of animals treated with SPFA, A. annua infusion and spiramycin, although the number of parasites was lower than in non-treated animals. Parasites were also observed in the placenta of animals treated with azithromycin, but not in their embryos. Bioassay and PCR results confirmed the immunohistochemical data. Also, bradyzoite immunostaining was observed only in placental and fetal tissues of animals treated with SPFA. In conclusion, the treatment with azithromycin showed to be more effective, since it was capable to inhibit the vertical transmission of T. gondii in this model of congenital toxoplasmosis.

Toxoplasma gondii: a simple high-throughput assay for drug screening in vitro.

Toxoplasma gondii is the etiologic agent of toxoplasmosis. Although the combination of sulfadiazine and pyrimethamine is used as therapy for this disease, these drugs can have serious side effects and its use is limited in pregnancy. Therefore there is a need for new anti-T. gondii drugs in the clinic. Some systems for T. gondii drug screening have been described, but these have limitations and can be difficult. In order to solve these problems, we established a system to screen drugs in vitro that involved using cell viability methods to calculate drug selectivities, which are Trypan blue, [3-(4,5-dimethylthiazol-zyl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazoliuzolium, inner salt] (MTS) method and lactate dehydrogenase (LDH) assay. These assays were simple to establish and perform. The IC(50) values calculated from the morphological assay were not significantly different from the EC(50) values calculated using the other three methods. In particular, the results of the morphological assay showed a distinct association with the MTS assay (R=0.9841). These assays could be used for a wide range of applications in the screening of new drugs and may provide an alternative to the techniques currently used to screen for candidate anti-T. gondii compounds in vitro. In this study, we also tested many compounds and identified some that had a good anti-T. gondii effect in vitro based on the MTS assay. This simple and fast system allowed us to determine which compounds to investigate further using in vivo experiments.

Toxoplasmosis congénita: revisión / Congenital toxoplasmosis: a review

La forma congénita de infección por Toxoplasma gondii se produce a partir de una primo infección gestacional con consecuencias en distintos órganos del feto, especialmente oculares (coriorretinitis), SNC (hidrocefalia, convulsiones) y sistémicos(hepatoesplenomegalia), aunque entre el 80 y 90% son formas subclínicas. El diagnóstico se realiza mediante estudio serológico materno, dependiendo el riesgo de infección fetal del trimestre en que se produzca la seroconversión. Debido a la ausencia de estudios sobre la eficacia del tratamiento prenatal, se administrará a la madre con primoinfección tratamiento con espiramicina hasta conocer los resultados delos estudios complementarios. Ante infección en el recién nacido, se instaurará tratamiento con pirimetamina, sulfadiazina y ácido fólico, siendo el objetivo la disminución del riesgo de secuelas a largo plazo. El cribado gestacional es uno de los puntos de controversia, ya que tanto el gasto sanitario como el nivel de falsos + es elevado. Los programas de educación sanitaria han logrado disminuir en algunos países la tasa de infección al 50%

The congenital form of Toxoplasmga ondii infection is caused by primary maternal infection, with consequences in different fetal systems, especially the ocular system (chorioretinitis) and central nervous system (hydrocephalu, seizures), as well as systemic involvement(hepatosplenomegaly), although between 80% and 90% of the resulting disorders are subclinical. The diagnosis involves maternal serology, as the risk of fetal infection depends on the trimester in which seroconversion occurs. Given the lack of studies on the efficacy of prenatal treatment, spiramycin should be administered to pregnant women with primary infection until the results of complementary studies are known. Should the new born be infected, treatment with pyrimethamine, sulfadiazine and folic acid should be begunin the attempt to reduce the risk of long-term sequelae. Prenatal screening is a controversial issue since both the health care costs and rate of false positives are high. In some countries, health education programs have resulted in a decrease in the rate of infection of 50%

[Efficacy variation of erythromycin and spiramycin on periopathogens in aggressive periodontitis. An in vitro comparative study]. / Variabilité de l'efficacité de l'érythromycine et de la spiramycine sur les pathogènes parodontaux dans les parodontites agressives. Etude in vitro comparative.

AIMS: Erythromycin (ERY) and spiramycin (SPI) are the most frequently prescribed macrolides by dentists. However, the emergence of resistant anaerobic subgingival bacteria imposes an increased vigilance. This study aims to compare these macrolides efficacy on principal periopathogens. MATERIALS AND METHODS: Twenty adult patients with aggressive periodontitis were selected and a total of 60 samples were taken from subgingival flora. Bacterial strains of Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum, Peptostreptococcus micros and Actinobacillus actinomycetemcomitans were isolated according to J. Slots's rapid identification method. The susceptibilities to ERY and SPI were studied using disk diffusion susceptibility test and minimum inhibitory concentration test (MIC test). RESULTS: The efficiency variability of ERY and SPI on the 50 isolated anaerobic periopathogens was present either interindividually (between different patients) and intra-individually (within the same patient). While 68% of the tested anaerobic bacteria were sensitive to SPI (22% resistant), only 54% were sensitive to ERY (34% resistant). Although moderate, the efficacy of SPI seemed more regular in general than ERY: it's variation coefficient (40%) is lower than the ERY one (53%). The 7 A. actinomycetemcomitans tested showed all a high resistance. CONCLUSION: In a general way, the spectre of activity of SPI is stacked in that of ERY. However, this study shows a better and regular activity of SPI on the main tested periopathogens. These results are in favour of the use of SPI in periodontology when penicillins and doxycycline are not useful because specific problems are identified (allergy, pregnancy...).

[Influence of Mn2+ on the biotechmycin fermentation].

The effect of Mn2+ on the biotechmycin fermentation by Bioengineered strain WSJ-l-195 was studied. In the fermentation process, Mn2+ could improve the biological potency significantly, especially when Mn2+ concentration was 5 mmol/L added at 24 h. The pH profile of fermentation broth decreased gradually after 5 mmol/L Mn2+ supplemented at 24 h, and PMV was lower than that of the control sample. Further research about the influence of Mn2+ on the biosynthesis of biotechmycin was carried out in the aspect of organic acids. The results showed that concentrations of organic acids in a fermentation with 5 mmol/L Mn2+ supplemented at 24 h had been changed greatly, especially the concentration of propionic acid, of which the highest value was about 6 times as that in the control sample at 84 h. In addition, it was found that the yield of biotechmycin could be improved significantly with tiny amount of propionic acid added. Therefore, it can be concluded that Mn2+ has profound influence on the biosynthesis of biotechmycin: it enriches the biotechmycin precursor pool such as propionic acid and thus improves the yield of biotechmycin.

Improved production of spiramycin by mutant Streptomyces ambofaciens.

Strain improvement and medium optimization to increase the productivity of spiramycin were carried out. Of oil tolerant mutant strains screened, one mutant, Streptomyces ambofaciens XC 2-37, produced 9% more spiramycin than the parent strain S. ambofaciens XC 1-29. The effects of soybean oil and propyl alcohol on spiramycin production with S. ambofaciens XC 2-37 were studied. The potency of S. ambofaciens XC 2-37 was improved by 61.8% with addition of 2% soybean oil in the fermentation medium and 0.4% propyl alcohol at 24 hours after incubation. The suitable time for feeding propyl alcohol is at 24 hours after incubation in flask fermentation and at 20 hours after incubation in fermentor fermentation. The new process with S. ambofaciens XC 2-37 was scaled up for industrial scale production of spiramycin in a 60 m(3) fermentor in Xinchang Pharmaceutical Factory, Zhejiang Medicine Company, Ltd., China, and the potency and productivity of fermentation were improved by 42.9%.

A blind parallel comparative study of the efficacy and safety of rovamycin versus augmentin in the treatment of acute otitis media.

A single blind randontised controlled parallel clinical trial of Rovamycin was conducted in which (Rovamycin Rhone-Poulenc Rorer) was compared with Augmentin in patients with acute otitis media. Forty patients were randomised to treatment with either Rovamycin or Augmentin and the drugs were evaluated for efficacy and safety. The efficacy parameters used were fever clearance, symptom clearance and cure rate after 8 days of treatment Our study showed that fever regressed in 19 (95%) of the 20 patients in both groups; otalgia in 19 (95) patients for the Augmentin and 18 (90%) for Rovamycin after 8 days of application of the trial drugs in these parameters. There was also no significant difference between them in their safety and tolerability profiles. These results showed that Rovamycin is a useful addition to our armamentarium in the fight against bacterial otitis media. Operationally, Rovamycin has an advantage over Augmentin for the reason that is given only twice a day as against thrice-daily dosage f orAugmentin. Compliance and consequently effectiveness in practices should therefore be better for Rovamycin.

Resistance profile survey of 50 periodontal strains of Actinobacillus actinomyectomcomitans.

BACKGROUND: Antibiotic resistance has been increasingly described among bacterial species colonizing periodontal pockets, particularly in Prevotella and Porphyromonas spp. strains producing beta-lactamases, and frequently associated with resistance to tetracycline and erythromycin. These resistance genes may be carried on motile genetic elements, or transposons, capable of interspecies and intergeneric transmission among bacterial strains colonizing a same ecological niche. The aim of this prospective study was to determine the resistance profile of Actinobacillus actinomycetemcomitans and the prevalence of A. actinomycetemcomitans strains producing beta-lactamases in periodontal pockets. METHODS: Fifty strains of A. actinomycetemcomitans were isolated from 42 patients with adult periodontitis. No patient had periodontal or antibiotic therapy in the previous 6 months. Bacterial samples were collected from periodontal pockets > or =5 mm, appropriately diluted, inoculated onto selective medium (chocolate blood agar with bacitracin 75 microg/ml and vancomycin 5 microm/ml) and incubated for 5 days at 37 degrees C in air with 5% CO2. After conventional identification, susceptibility testing to 11 antibiotics was performed by the broth dilution method, in trypticase soy broth supplemented with yeast extract, hemin, and 0.1% NaHCO3 to maintain microaerophilic conditions in the microtitration plate wells by CO2 formation. RESULTS: No strain demonstrated resistance to amoxicillin, amoxicillin-clavulanic acid combination, pristinamycin, or ciprofloxacin at the breakpoint, but 40% of the strains were slightly resistant to penicillin G, and 4% were resistant to erythromycin, 90% to spiramycin, 18% to clarythromycin, 4% to tetracycline, 72% to metronidazole, and 12% to ornidazole. Amoxicillin, followed by tetracycline and erythromycin, was the most effective antibiotic on A. actinomycetemcomitans. The phenotypic research of a beta-lactamase was negative for all the strains tested. CONCLUSIONS: In this work, most A. actinomycetemcomitans strains were resistant to metronidazole, but the amoxicillin-metronidazole association may be of interest against subgingival anaerobic and capnophilic mixed flora. Pristinamycin and ciprofloxacin appeared as effective alternative monotherapies against A. actinomycetemcomitans. The threat of beta-lactam antibiotic resistance related to beta-lactamase production is currently not a problem with A. actinomycetemcomitans as it has been reported in oral anaerobes.

Spiramycin is comparable to oxytetracycline in eradicating H. pylori when given with ranitidine bismuth citrate and metronidazole.

BACKGROUND: We have consistently achieved about 90% eradication of H. pylori with liquid bismuth, metronidazole and oxytetracycline. AIM: To test eradication and adverse events of ranitidine bismuth citrate (RBC) when given with metronidazole and either oxytetracycline or spiramycin. METHODS: One hundred and eighty-three patients were randomized to one of four 10-day regimens: RBC400OM: RBC 400 mg b.d., oxytetracycline 500 mg q.d.s.; RBC400SM: RBC 400 mg b.d., spiramycin 1 g q.d.s.; RBC200OM: RBC 200 mg q.d.s., oxytetracycline 500 mg q.d.s.; RBC200SM: RBC 200 mg q.d.s., spiramycin 1 g q.d.s. Additionally, all patients received metronidazole 400 mg q.d.s. A 14C-urea breath test was performed at 8 weeks. RESULTS: Intention-to-treat eradication rates were 94%, 91%, 94% and 89% with RBC400OM, RBC400SM, RBC200OM and RBC200SM, respectively (P = 0.81). Eradication was significantly higher in ulcer patients (97%) than in those with diagnoses other than ulcer (86%) (P = 0.009). There was a strong tendency to better eradication among those who had never smoked (100%) compared with ex-smokers (93%) and smokers (89%) (P = 0.06). Fifty-three per cent experienced at least one moderate or severe adverse event, and women had more adverse events than men (P = 0.0002). CONCLUSIONS: All four regimens had comparable efficacy and adverse events. Eradication was significantly better in ulcer patients but there was a trend to better eradication in those who smoked less, used less alcohol and exercised more. Adverse events were frequent, perhaps because of the large dose of metronidazole used, but few patients stopped treatment.

[Recurrent parotitis in children and HIV infection. Apropos of 4 cases]. / Parotidites récidivantes de l'enfant et infection HIV. A propos de 4 observations.

We report four cases of recurrent infectious parotiditis in children and recall the clinical radiographic and pathogenic features. Particular attention was paid to the possible relationship between sialadenitis and HIV infection in two cases. This would open a large etiological field when HIV contamination is suspected. Treatment if all four cases (spiramycine, diclofenac, soframycin washing, lipiodol instillation and local bucco-dental treatment) was successful leading to longer intervals between relapses.