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Bacterial vaginosis (BV) is very prevalent and is the most common cause of vaginal discharge worldwide. It is a dysbiosis resulting from the replacement of hydrogen peroxide and lactic acid-producing lactobacilli by anaerobic bacteria in high concentrations, including Gardnerella vaginalis, Prevotella, Mobiluncus, Atopobium and other anaerobes. BV can be self-diagnosed when the patient presents the classic symptoms, or clinically and laboratory-based, following the Amsel criteria or by determining the Nugent score. The recommended treatments for BV are oral metronidazole, secnidazole and tinidazole, as well as vaginal metronidazole gel, clindamycin cream and Schinus terebinthifolia Raddi gel. The present study aimed to determine the ability of vaginal clindamycin cream, vaginal metronidazole gel and S. terebinthifolia Raddi vaginal gel to inhibit the growth or preserve the population of Lactobacillus gasseri ATCC 19992 microorganisms in vitro. The methodology used was perforation in plates, forming 6 mm wells, where the samples were inoculated. The plates were incubated for 48 hours at 30°C. After this period, by visual plates analysis, was observed that L. gasseri is resistant to S. terebinthifolia Raddi vaginal gel since no inhibition halo was observed. However, L. gasseri was moderately susceptible to Metronidazole vaginal gel and highly sensitive to Clindamycin vaginal cream. As lactobacilli, of which L. gasseri stands out, represent over 95% of the microorganisms 3/16 that inhabit the vaginal environment, maintaining the health of this microbiome, the action of Clindamycin and Metronidazole can lead to an imbalance in the vaginal microbiota, allowing relapses when these therapeutic agents are used to treat BV.
A vaginose bacteriana (VB) é muito prevalente e é a causa mais comum de corrimento vaginal em todo o mundo. Trata-se de uma disbiose resultante da substituição dos lactobacilos produtores de peróxido de hidrogênio e ácido lático por bactérias anaeróbicas em altas concentrações, incluindo Gardnerella vaginalis, Prevotella, Mobiluncus, Atopobium e outros anaeróbios. A VB pode ser autodiagnosticada, quando a paciente apresenta a sintomatologia clássica, ou clínica e laboratorialmente obedecendo aos critérios de Amsel ou pela determinação do escore de Nugent. Os tratamentos recomendados para a VB são o Metronidazol, o Secnidazol e o Tinidazol por via oral, bem como o metronidazol gel, a clindamicina creme e o gel de S. terebinthifolia Raddi por via vaginal. O presente estudo teve por objetivo determinar a capacidade da Clindamicina creme vaginal, do Metronidazol gel vaginal e do S. terebinthifolia Raddi gel vaginal em inibir o crescimento ou preservar a população dos microrganismos Lactobacillus gasseri ATCC 19992 in vitro. A metodologia utilizada foi de perfuração em placa, formando poços de 6mm, onde as amostras foram inoculadas. As placas foram incubadas por 48 horas à temperatura de 30°C. A análise visual das placas, após o período de incubação, evidenciou que L. gasseri é resistente ao gel vaginal de S. terenbithifolia Raddi gel, uma vez que não foi observado qualquer halo de inibição. Contudo, L. gasseri foi moderadamente susceptível ao gel vaginal de Metronidazol e altamente sensível ao creme vaginal de Clindamicina. Como os lactobacilos, dos quais se destaca L. gasseri, representam acima de 95% dos microrganismos que habitam o meio vaginal, mantendo a higidez desse microbioma, a ação da Clindamicina e do Metronidazol pode levar ao desequilíbrio da microbiota vaginal, permitindo as recidivas quando esses agentes terapêuticos são usados para o tratamento da VB.
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El empiema pleural es una de las complicaciones de las infecciones del tracto respiratorio inferior y se caracteriza por la presencia de pus en la toracocentesis. Raramente Trichomonas hominis está asociada al empiema como agente causal. En este artículo presentamos el caso de una mujer de 39 años que desarrolló un empiema causado por T. hominis, además de una revisión de la literatura disponible de esta rara infección. Hasta donde sabemos, este es el primer caso de empiema pleural causado por Trichomona hominis reportado en México (AU)
Pleural empyema is one of the complications of lower respiratory tract infections and is characterized by the presence of pus on thoracentesis. Trichomonas hominis is rarely associated with empyema as the causative agent. In this article we present the case of a 39-year-old woman who developed an empyema caused by T. hominis, as well as a review of the available literature on this rare infection. To the best of our knowledge, this is the first case of pleural empyema caused by Trichomona hominis reported in Mexico (AU)
Assuntos
Humanos , Feminino , Adulto , Trichomonas/patogenicidade , Empiema Pleural/etiologia , Empiema Pleural/tratamento farmacológico , Tricomoníase/diagnóstico por imagemRESUMO
INTRODUCCIÓN: En la diarrea asociada a Clostridioides dfficile (DACD) leve-moderada se recomienda tratar con vancomicina por sobre metronidazol, a pesar de su difícil acceso y poca evidencia en el medio ambulatorio. OBJETIVO: Comparar la tasa de cura clínica y recurrencia entre vancomicina y metronidazol en adultos chilenos con primer episodio leve-moderado de DACD de manejo ambulatorio. MÉTODOS: Cohorte retrospectiva entre enero 2015 y diciembre 2020 en centros de una red de salud universitaria de pacientes de ≥ 18 años con DACD tratados ambulatoriamente. RESULTADOS: Se obtuvieron 161 pacientes, 59% mujeres, edad promedio de 53 años (entre 18 y 94 años). De ellos, 109 (67,7%) usaron metronidazol y 52 (32,3%) vancomicina. En el análisis multivariado ajustado por edad y comorbilidades se obtuvo un OR 3,00 (IC 95% 1,12-9,59) para cura clínica y 0,27 (IC 95% 0,06-0,88) para recurrencia a ocho semanas, ambos a favor de vancomicina, sin diferencias en recurrencia a 12 meses, necesidad de hospitalización o mortalidad. CONCLUSIÓN: La terapia con vancomicina comparada contra metronidazol en el tratamiento ambulatorio de la infección leve-moderada por C. dfficile se asocia a mayor cura clínica y menor tasa de recurrencia a corto plazo, sin diferencias en desenlaces a largo plazo.
BACKGROUND: Recommended treatment against mild cases of Clostridioides difficile associated diarrhea is vancomycin despite the difficulties of access compared to metronidazole. AIM: To compare the effectiveness of vancomycin and metronidazole in Chilean adults with first mild-moderate episode of Clostridiodes difficile infection (CDI). METHODS: Retrospective cohort of patients with CDI between January 2015 and December 2020 treated in centers of a university health network. The patients were adults treated for C. difficile infection on an outpatient basis. Recurrent and severe cases were excluded. Outcomes included clinical cure and recurrence rate. RESULTS: Data from 161 patients was recovered. Fifty-nine percent were women and average age was 53 (18-94). One hundred and nine patients were treated with metronidazole (67.7%) and 52 (32.3%) used vancomycin. Multivariate analysis adjusted by age and comorbidities showed an Odds Ratio of 3.00 (IC 95% 1.12-9.59) for clinical cure and 0.27 (IC 95% 0.06-0.88) for 8-week recurrence rate, both in favor of vancomycin, without differences in 12-month recurrence rate, hospitalization rate nor mortality. CONCLUSIONS: Vancomycin is associated with better short-term outcomes in the treatment of outpatient mild-moderate first episode C. difficile infection, without differences in long term recurrence or mortality when compared with metronidazole.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Vancomicina/uso terapêutico , Infecções por Clostridium/tratamento farmacológico , Diarreia/tratamento farmacológico , Metronidazol/uso terapêutico , Pacientes Ambulatoriais , Recidiva , Análise Multivariada , Análise de Regressão , Estudos Retrospectivos , Assistência Ambulatorial , Antibacterianos/uso terapêuticoRESUMO
BACKGROUND: Pleural empyema secondary to a ruptured amoebic liver abscess is a rare complication in the pediatric population. CASE REPORT: We report the case of a 13-year-old male with right flank abdominal pain, productive cough with foul-smelling sputum, fever, and respiratory distress. Physical examination revealed breathlessness, decreased vesicular murmur in the right hemithorax, abdominal distension, hepatomegaly, and lower limb edema. Laboratory tests revealed mild anemia, leukocytosis without eosinophilia, elevated alkaline phosphatase, hypoalbuminemia, and positive immunoglobulin G antibodies against Entamoeba histolytica in pleural fluid. He required a chest tube and treatment with metronidazole. After 2 months of follow-up, the abscesses disappeared, and the empyema decreased. CONCLUSIONS: Massive pleural empyema secondary to a ruptured liver abscess is a rare complication. The epidemiological link associated with the symptoms and serological tests can help in the diagnosis.
INTRODUCCIÓN: El empiema pleural secundario a ruptura de absceso amebiano hepático es una complicación poco frecuente en la población pediátrica. CASO CLÍNICO: Se reporta el caso de un paciente de sexo masculino de 13 años que presentó dolor abdominal en flanco derecho, tos productiva con esputo de mal olor, fiebre y dificultad respiratoria. Al examen físico se encontró amplexación y murmullo vesicular disminuido en hemitórax derecho, distensión abdominal, hepatomegalia y edema de miembros inferiores. Los resultados del laboratorio evidenciaron anemia leve, leucocitosis sin eosinofilia, elevación de fosfatasa alcalina, hipoalbuminemia y anticuerpos IgG contra Entamoeba histolytica positivo en líquido pleural. Requirió tubo de drenaje torácico y tratamiento con metronidazol. A los dos meses de seguimiento los abscesos desaparecieron y el empiema disminuyó. CONCLUSIONES: El empiema pleural masivo secundario a ruptura de absceso hepático es una complicación poco frecuente. El nexo epidemiológico asociado con la sintomatología y pruebas serológicas pueden ser de ayuda en el diagnóstico.
Assuntos
Empiema Pleural , Abscesso Hepático Amebiano , Criança , Masculino , Humanos , Adolescente , Abscesso Hepático Amebiano/complicações , Abscesso Hepático Amebiano/diagnóstico , Empiema Pleural/diagnóstico , Empiema Pleural/etiologia , Abscesso , Dor AbdominalRESUMO
Abstract Background: Pleural empyema secondary to a ruptured amoebic liver abscess is a rare complication in the pediatric population. Case report: We report the case of a 13-year-old male with right flank abdominal pain, productive cough with foul-smelling sputum, fever, and respiratory distress. Physical examination revealed breathlessness, decreased vesicular murmur in the right hemithorax, abdominal distension, hepatomegaly, and lower limb edema. Laboratory tests revealed mild anemia, leukocytosis without eosinophilia, elevated alkaline phosphatase, hypoalbuminemia, and positive immunoglobulin G antibodies against Entamoeba histolytica in pleural fluid. He required a chest tube and treatment with metronidazole. After 2 months of follow-up, the abscesses disappeared, and the empyema decreased. Conclusions: Massive pleural empyema secondary to a ruptured liver abscess is a rare complication. The epidemiological link associated with the symptoms and serological tests can help in the diagnosis.
Resumen Introducción: El empiema pleural secundario a ruptura de absceso amebiano hepático es una complicación poco frecuente en la población pediátrica. Caso clínico: Se reporta el caso de un paciente de sexo masculino de 13 años que presentó dolor abdominal en flanco derecho, tos productiva con esputo de mal olor, fiebre y dificultad respiratoria. Al examen físico se encontró amplexación y murmullo vesicular disminuido en hemitórax derecho, distensión abdominal, hepatomegalia y edema de miembros inferiores. Los resultados del laboratorio evidenciaron anemia leve, leucocitosis sin eosinofilia, elevación de fosfatasa alcalina, hipoalbuminemia y anticuerpos IgG contra Entamoeba histolytica positivo en líquido pleural. Requirió tubo de drenaje torácico y tratamiento con metronidazol. A los dos meses de seguimiento los abscesos desaparecieron y el empiema disminuyó. Conclusiones: El empiema pleural masivo secundario a ruptura de absceso hepático es una complicación poco frecuente. El nexo epidemiológico asociado con la sintomatología y pruebas serológicas pueden ser de ayuda en el diagnóstico.
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Objetivo: El objetivo de este estudio es evaluar los resultados entérminos de complicaciones infecciosas y estancia hospitalaria de lainstauración de una guía clínica para el tratamiento y alta precoz enpacientes con apendicitis aguda complicada.Material y métodos: Se elaboró una guía para el tratamiento delas apendicitis en función de su grado de severidad. Las complicadas setrataron con ceftriaxona-metronidazol durante 48h, siendo alta si cumplen ciertos criterios clínicos y analíticos. Se realizó un estudio analíticoretrospectivo comparando la incidencia de abscesos intraabdominalespostquirúrgicos (AIA) e infección del sitio quirúrgico (ISQ) en pacientesmenores de 14 años sometidos a la nueva guía (Grupo A), respecto a unacohorte histórica (Grupo B), en la que la pauta de tratamiento era gentamicina-metronidazol 5 días. Además, se realizó un estudio de cohortesprospectivas para evaluar qué antibioterapia (amocilina-clavulánico ocefuroxima-metronidazol) es más eficaz en los pacientes que cumplencriterios de alta precoz. Resultados: Se incluyeron 205 pacientes menores de 14 años en elGrupo A y 109 en el Grupo B. Presentaron AIA un 14,3% en el grupoA, frente al 13,8% en el B (p= 0,83); e ISQ un 1,9% y un 8,25% respectivamente (p= 0,008). Cumplieron criterios de alta precoz el 62,7%de los pacientes del Grupo A. La mediana de estancia disminuyó a de6 a 3 días. Al alta, el 57% recibieron amoxicilina-clavulánico y el 43%cefuroxima-metronidazol, sin hallarse diferencias en términos de ISQ(p= 0,24) ni de AIA (p= 0,12).Conclusiones: El alta precoz disminuye la estancia hospitalariasin aumentar el riesgo de complicaciones infecciosas postquirúrgicas.La amoxicilina-clavulánico es una opción segura para la antibioterapiaoral domiciliaria.(AU)
Objective: The objective of this study was to assess the results of aclinical guideline for the treatment and early discharge of patients withcomplicated acute appendicitis in terms of infectious complicationsand hospital stay. Materials and methods: A guideline for appendicitis treatmentaccording to severity was created. Complicated appendicitis caseswere treated with ceftriaxone-metronidazole for 48h, with dischargebeing approved if certain clinical and blood test criteria were met. Aretrospective analytical study comparing the incidence of postoperative intra-abdominal abscess (IAA) and surgical site infection (SSI) inpatients under 14 years of age to whom the new guideline was applied(Group A) vs. the historical cohort (Group B, treated with gentamicinmetronidazole for 5 days) was carried out. A prospective cohort study toassess which antibiotic therapy (amoxicillin-clavulanic acid or cefuroxime-metronidazole) proved more effective in patients meeting earlydischarge criteria was also conducted.Results: 205 patients under 14 years of age were included in GroupA, whereas 109 patients were included in Group B. IAA was presentin 14.3% of patients from Group A vs. 13.8% from Group B (p=0.83),while SSI was present in 1.9% of patients from Group A vs. 8.25%from Group B (p=0.008). Early discharge criteria were met by 62.7%of patients from Group A. Median hospital stay decreased from 6 to 3days. At discharge, 57% of patients received amoxicillin-clavulanic acid,whereas 43% received cefuroxime-metronidazole, with no differencesbeing found in terms of SSI (p=0.24) or IAA (p=0.12). Conclusions: Early discharge reduces hospital stay without increas-ing the risk of postoperative infectious complications. Amoxicillin-clavulanic acid is a safe option for at-home oral antibiotic therapy.(AU)
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Humanos , Masculino , Feminino , Criança , Apendicite/complicações , Apendicite/tratamento farmacológico , Tempo de Internação , Ceftriaxona/administração & dosagem , Metronidazol/administração & dosagem , Abscesso Abdominal , Pediatria , Cirurgia Geral , Estudos Retrospectivos , Estudos de Coortes , Alta do PacienteRESUMO
Resumen ANTECEDENTES: Las quemaduras son la forma más severa de estrés que el cuerpo puede sufrir; pueden generarse por diferentes agentes térmicos y químicos. CASO CLÍNICO: Paciente de 25 años, con dolor intenso en la región genital de 12 horas de evolución, secundario a la introducción en la vagina de una piedra de alumbre. Se le hicieron múltiples irrigaciones con solución salina al 0.9% sin obtener el resto de la piedra de alumbre. Se le aplicó sulfadiazina de plata en la cavidad vaginal cada 12 horas, óvulos vaginales de ketanserina, miconazol y metronidazol cada 8 horas, ketorolaco por vía oral 10 mg cada 8 horas. Durante su estancia hospitalaria tuvo buena evolución, con disminución de la inflamación en la zona genital, epitelización adecuada. Al tercer día se dio de alta del hospital con cita para valoración a los siete días. CONCLUSIÓN: El tratamiento de las quemaduras en el área genital, por agentes químicos, tiene como piedra angular la identificación del agente causante de la lesión que permita actuar de forma inmediata y evitar las secuelas físicas, sexuales y psicológicas mediante el lavado exhaustivo con solución o agua estéril para remover el agente causal y disminuir que continúe actuando en el sitio afectado.
Abstract BACKGROUND: Burns are the most severe form of stress that the body can suffer; they can be caused by various thermal and chemical agents. CLINICAL CASE: A 25-year-old female patient presented with severe genital pain of 12 hours' duration, secondary to the introduction of an alum stone into the vagina. She underwent several irrigations with 0.9% saline without obtaining the rest of the alum stone. She was given vaginal silver sulfadiazine every 12 hours, vaginal ketanserin, miconazole and metronidazole every 8 hours and oral ketorolac 10 mg every 8 hours. During her stay in hospital, she progressed well, with a decrease in genital inflammation and adequate epithelialisation. She was discharged on the third day with an appointment for a seven-day follow-up. CONCLUSION: The management of genital burns caused by chemical agents is based on the identification of the agent causing the lesion, which allows immediate action and prevents physical, sexual and psychological sequelae by thorough washing with sterile solution or water to remove the causative agent and reduce its continued action in the affected area.
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INTRODUCTION: Dientamoeba (D.) fragilis is a common intestinal protozoan with an unresolved clinical significance. The association between D. fragilis and the etiology of gastrointestinal symptoms in children is unclear. Metronidazole is often used for treatment. The aims of this study are to clarify the clinical relevance of D. fragilis in children with gastrointestinal symptoms, and to determine the clinical and microbiological efficacy of metronidazole in D. fragilis-infected children with gastrointestinal complaints. METHODS: A prospective case-control study was performed from October 2017 to February 2019. A total of 106 individuals aged 1-17 were included. Out of the 106; 59 showed gastrointestinal symptoms (case group), and 47 were without gastrointestinal symptoms (control group). We excluded 2 patients from the case group. D. fragilis was diagnosed by real-time PCR in stool samples. A 10-day course of oral Metronidazole was prescribed in D. fragilis positive children with GI symptoms. Clinical data before and after the treatment as well as peripheral eosinophilia in previous blood samples, were recorded. RESULTS: Of the 104 participants, D. fragilis was found in 17 (29.8%) children from the case group, whereas in the control group the parasite was detected in 11 patients (23.4%) with an odds ratio (OR) of 1.39 (IC 95% 0.53-3.75, p=0.46). The most prevalent clinical manifestation was abdominal pain (46/57, 80.7%). Seventeen cases with a positive PCR received anti-parasitic treatment according to the established protocol, although during the collection period we received only 11 stool samples to perform the post-treatment follow-up. The PCR of the D. fragilis remained positive in 3 patients (3/11, 27.27%). Despite achieving the eradication of the parasite, 4/8 patients (50%) continued with digestive symptoms. CONCLUSIONS: According to our study there were no differences between the D. fragilis infection in children with or without gastrointestinal symptoms. No relation was found between the clinical and microbiological responses after said D. fragilis treatment. Therefore, we conclude that it is not justified to look specifically for D fragilis in pediatric patients with abdominal symptoms.
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Dientamoeba , Dientamebíase , Estudos de Casos e Controles , Criança , Dientamebíase/diagnóstico , Humanos , Metronidazol/uso terapêutico , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Introduction: Dientamoeba (D.) fragilis is a common intestinal protozoan with an unresolved clinical significance. The association between D. fragilis and the etiology of gastrointestinal symptoms in children is unclear. Metronidazole is often used for treatment. The aims of this study are to clarify the clinical relevance of D. fragilis in children with gastrointestinal symptoms, and to determine the clinical and microbiological efficacy of metronidazole in D. fragilis-infected children with gastrointestinal complaints. Methods: A prospective casecontrol study was performed from October 2017 to February 2019. A total of 106 individuals aged 117 were included. Out of the 106; 59 showed gastrointestinal symptoms (case group), and 47 were without gastrointestinal symptoms (control group). We excluded 2 patients from the case group. D. fragilis was diagnosed by real-time PCR in stool samples. A 10-day course of oral Metronidazole was prescribed in D. fragilis positive children with GI symptoms. Clinical data before and after the treatment as well as peripheral eosinophilia in previous blood samples, were recorded. Results: Of the 104 participants, D. fragilis was found in 17 (29.8%) children from the case group, whereas in the control group the parasite was detected in 11 patients (23.4%) with an odds ratio (OR) of 1.39 (IC 95% 0.533.75, p=0.46). The most prevalent clinical manifestation was abdominal pain (46/57, 80.7%). Seventeen cases with a positive PCR received anti-parasitic treatment according to the established protocol, although during the collection period we received only 11 stool samples to perform the post-treatment follow-up. The PCR of the D. fragilis remained positive in 3 patients (3/11, 27.27%). Despite achieving the eradication of the parasite, 4/8 patients (50%) continued with digestive symptoms.(AU)
Introducción: Dientamoeba (D.)fragilis es un protozoo intestinal muy común pero con una relevancia clínica incierta. El papel etiopatogénico de la D. fragilis en sintomatología gastro-intestinal no está claramente establecido. El metronidazol es con frecuencia el fármaco de elección. El objectivo de nuestro estudio fue determinar la relación entre D. fragilis y la presencia de clínica digestiva en población pediátrica así como valorar la eficacia del metronidazol en la resolución de los síntomas. Material y métodos: Estudio prospectivo caso-control realizado entre octubre 2017 y febrero 2019. Se incluyeron un total de 106 pacientes entre 1-17 años. 59 pacientes presentaban síntomas digestivos (grupo caso) y 47 pacientes asintomáticos (grupo control). Se excluyeron 2 pacientes del grupo caso. La presencia de D. fragilis se determinó por técnica de PCR real-time(PCR-RT) en muestra de heces. En los pacientes del grupo caso con PCR-RT positiva se realizó tratamiento con metronidazol durante 10 dias. Se recogieron datos clínicos antes y después del tratamiento asi como presencia de eosinofilia periférica. Resultados: De los 104 participantes, se detectó D. fragilis en el 17/59 (29,8%) en el grupo caso y en 11/47 pacientes del grupo control (23,4%) con una odds ratio (OR) de 1.39 (IC95% 0.53-3.75, p=0.46). El síntoma más frecuente fue el dolor abdominal (46/57, 80,7%). Los 17 pacientes del grupo caso recibieron metronidazol según protocolo y se realizó PCR-TR D. fragilis post-tratamiento en 11/17 pacientes. La PCR-RT persistió positiva en 3 pacientes (3/11, 27,27%). De los 8 pacientes que negativizaron PCR-RT, 4 (50%) continuaron con dolor abdominal. Conclusión: Según nuestro estudio no se encontró relación significativa entre la presencia de infección por D.fragillis y la existencia de sintomatología digestiva. Tampoco se observó mejoría clínica significativa en aquellos pacientes infectados que recibieron tratamiento.(AU)
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Humanos , Criança , Dientamebíase , Doenças do Sistema Digestório , Metronidazol , Dor Abdominal , Infecções por Bacteroides , Estudos Prospectivos , Estudos de Casos e ControlesRESUMO
The antidiabetic effect and potential mechanisms of the polysaccharides from the fruits of Lycium barbarum L. (LBPs) by the mouse model of high-fat diet/streptozotocin-induced diabetes were investigated. Six-week oral administration of LBPs (200 mg/kg/day) resulted in improvement in the levels of fasting blood glucose (13.51% decrease) and glycated hemoglobin and ß-cell function in diabetic mice, and simultaneously induced a 3.3-fold increment in one taxon belonging to genus Allobaculum in gut bacterial community. The experiments of fecal microbiota transplantation and antibiotics treatment confirmed that the LBPs-mediated gut microbiota participated in the glycemic control of the diabetes management. Moreover, LBPs intervention guarded the intestinal barrier function via upregulating the expression of zonula occludens 1 both in vivo (analyzing the gut permeability in diabetic mice) and in vitro (using intestinal-like Caco-2/RAW264.7 cells co-culture inflammation model). Collectively, our study showed that LBPs could confer anti-diabetic effect through modifying gut microbiota and intestinal barrier.
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Diabetes Mellitus Experimental , Microbioma Gastrointestinal , Lycium , Animais , Células CACO-2 , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/tratamento farmacológico , Frutas , Humanos , Camundongos , Polissacarídeos/farmacologia , Polissacarídeos/uso terapêuticoRESUMO
La infección por Helicobacter pylori es muy frecuente entre la población española y representa la causa fundamental de gastritis crónica, úlcera péptica y cáncer gástrico. Previamente se han llevado a cabo cuatro reuniones de Consenso sobre el manejo de la infección por H. pylori en España, la última de ellas en 2016. Los cambios en los esquemas de tratamiento y la creciente evidencia disponible al respecto han justificado la organización de esta V Conferencia Española de Consenso en mayo de 2021, centrada en el tratamiento de esta infección. Participaron 14 expertos sobre el tema, que realizaron una búsqueda sistemática de la evidencia científica y elaboraron una serie de recomendaciones que fueron sometidas a un proceso de interacción de votaciones anónimas seriadas mediante metodología Delphi. Para clasificar la evidencia científica y la fuerza de las recomendaciones, se utilizó el sistema GRADE. Este consenso establece, como punto de partida, un aumento de la exigencia en la eficacia de los tratamientos recomendados, que deben alcanzar, o preferiblemente superar, el 90% de curación al ser administrados empíricamente. De este modo, tanto en primera como en segunda línea se recomiendan tratamientos cuádruples con o sin bismuto, generalmente prescritos durante 14 días. Como tratamiento de primera línea se recomienda una pauta cuádruple concomitante sin bismuto (inhibidor de la bomba de protones, claritromicina, amoxicilina y metronidazol) o una combinación cuádruple con bismuto (inhibidor de la bomba de protones, bismuto, tetraciclina y metronidazol). En el presente consenso se revisan también con detalle otras alternativas de tratamiento de rescate.(AU)
Helicobacter pylori infection is very common in the Spanish population and represents the main cause of chronic gastritis, peptic ulcer, and gastric cancer. The last iteration of Spanish consensus guidelines on H. pylori infection was conducted in 2016. Recent changes in therapeutic schemes along with increasing supporting evidence were key for developing the V Spanish Consensus Conference (May 2021). Fourteen experts performed a systematic review of the scientific evidence and developed a series of recommendations that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. An eradication therapy, when prescribed empirically, is considered acceptable when it reliably achieves, or preferably surpass, 90% cure rates. Currently, only quadruple therapies (with or without bismuth) and generally lasting 14 days, accomplish this goal in first- and second-line therapies. A non-bismuth quadruple concomitant regimen (proton pump inhibitor, clarithromycin, amoxicillin, and metronidazole) or a quadruple bismuth-based combination (proton pump inhibitor, bismuth, tetracycline, and metronidazole), are recommended as first-line regimens. Rescue therapies after eradication failure and management of H. pylori infection in peptic ulcer disease were also reviewed.(AU)
Assuntos
Humanos , Masculino , Feminino , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Claritromicina/uso terapêutico , Quimioterapia Combinada , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Metronidazol/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico , Gastroenterologia , Doenças Transmissíveis , Consenso , EspanhaRESUMO
Helicobacter pylori infection is very common in the Spanish population and represents the main cause of chronic gastritis, peptic ulcer, and gastric cancer. The last iteration of Spanish consensus guidelines on H. pylori infection was conducted in 2016. Recent changes in therapeutic schemes along with increasing supporting evidence were key for developing the V Spanish Consensus Conference (May 2021). Fourteen experts performed a systematic review of the scientific evidence and developed a series of recommendations that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. An eradication therapy, when prescribed empirically, is considered acceptable when it reliably achieves, or preferably surpass, 90% cure rates. Currently, only quadruple therapies (with or without bismuth) and generally lasting 14 days, accomplish this goal in first- and second-line therapies. A non-bismuth quadruple concomitant regimen (proton pump inhibitor, clarithromycin, amoxicillin, and metronidazole) or a quadruple bismuth-based combination (proton pump inhibitor, bismuth, tetracycline, and metronidazole), are recommended as first-line regimens. Rescue therapies after eradication failure and management of H. pylori infection in peptic ulcer disease were also reviewed.
Assuntos
Infecções por Helicobacter , Helicobacter pylori , Úlcera Péptica , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Bismuto/uso terapêutico , Claritromicina/uso terapêutico , Quimioterapia Combinada , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Humanos , Metronidazol/uso terapêutico , Úlcera Péptica/complicações , Inibidores da Bomba de Prótons/uso terapêuticoRESUMO
Introducción: Las resistencias antibióticas de Helicobacter pylori(H. pylori) son el principal factor que afecta a la eficacia de los regímenes terapéuticos actuales. El objetivo principal del estudio es describir el patrón de resistencias antibióticas en niños con infección por H. pylori.Pacientes y métodos: Estudio observacional retrospectivo de 2014 a 2019 en el que se incluyen pacientes entre 5-17 años a los que se realizó gastroscopia, con cultivo de biopsia gástrica positivo para H. pylori y estudio de sensibilidad a antibióticos. Los estudios de sensibilidad antibiótica se realizaron mediante E-test. Los puntos de corte para definir las resistencias fueron los propuestos por el EUCAST. El estudio de erradicación se realizó con test del aliento con urea marcada con C 13 o test monoclonal de antígeno de H. pylori en heces a las 6-8 semanas de finalizar el tratamiento.Resultados: Ochenta pacientes (63,8% mujeres). Media de edad 11,9 años (±2,7DS). Un 38,8% habían recibido tratamiento previo para H. pylori. Un 10% presentaron en la endoscopia lesiones ulcerosas pépticas. El 67,5% presentaba resistencia al menos a un fármaco. Un 16,3% presentaron doble resistencia. Las resistencias primarias fueron: claritromicina 44,9%, metronidazol 16,3%, levofloxacino 7,9% y amoxicilina 2%. Los pacientes que recibieron tratamiento acorde a las nuevas guías ESPGHAN 2017 presentaron tasas de erradicación significativamente superiores en comparación con los que recibieron tratamiento acorde a las guías previas (80% vs. 55,8% p=0,04). (AU)
Introduction: The resistance to antibiotics of Helicobacter pylori (H. pylori) is the main factor that affects current therapeutic treatments. The main objective of this study is to describe the pattern of antibiotic resistances in children with an infection due to H. pylori.Patients and methods: An observational, retrospective study was conducted from 2014 to 2019, which included patients between 5 and 17 years old, on whom a gastroscopy, with a gastric biopsy culture positive for H. pylori, and an antibiotic sensitivity study was performed. The antibiotic sensitivity studies were performed using an epsilometer (E-test). The cut-off points to define the resistances were those proposed by the European Committee on Antimicrobial Susceptibility Testing EUCAST. The eradication study was performed using the 13C-urea breath test or the H. pylori monoclonal test in faeces 6-8 weeks after finalising the treatment.Results: The study included 80 patients (63.8% females), with a mean age of 11.9 years (SD±2.7DS). Over one-third (38.8%) of the patients had received previous treatment for H. pylori. In the endoscopy, peptic ulcer lesions were observed in 10% of patients. More than two-thirds (67.5%) had resistance to at least one drug. 16.3% presented double resistance. The primary resistances were: clarithromycin, 44.9%, metronidazole 16.3%, levofloxacine 7.9%, and amoxicillin 2%. Patients that received treatment according to the new ESPGHAN 2017 guidelines had significantly higher eradication rates compared to those that received treatment according to previous guidelines (80% vs. 55.8%, P=.04). (AU)
Assuntos
Humanos , Criança , Adolescente , Helicobacter pylori , Resistência Microbiana a Medicamentos , Claritromicina , Estudos RetrospectivosRESUMO
INTRODUCTION: The resistance to antibiotics of Helicobacter pylori (H. pylori) is the main factor that affects current therapeutic treatments. The main objective of this study is to describe the pattern of antibiotic resistances in children with an infection due to H. pylori. PATIENTS AND METHODS: An observational, retrospective study was conducted from 2014 to 2019, which included patients between 5 and 17 years old, on whom a gastroscopy, with a gastric biopsy culture positive for H. pylori, and an antibiotic sensitivity study was performed. The antibiotic sensitivity studies were performed using an epsilometer (E-test). The cut-off points to define the resistances were those proposed by the European Committee on Antimicrobial Susceptibility Testing - EUCAST. The eradication study was performed using the 13C-urea breath test or the H. pylori monoclonal test in faeces 6-8 weeks after finalising the treatment. RESULTS: The study included 80 patients (63.8% females), with a mean age of 11.9 years (SD⯱â¯2.7 DS). Over one-third (38.8%) of the patients had received previous treatment for H. pylori. In the endoscopy, peptic ulcer lesions were observed in 10% of patients. More than two-thirds (67.5%) had resistance to at least one drug. 16.3% presented double resistance. The primary resistances were: clarithromycin, 44.9%, metronidazole 16.3%, levofloxacine 7.9%, and amoxicillin 2%. Patients that received treatment according to the new ESPGHAN 2017 guidelines had significantly higher eradication rates compared to those that received treatment according to previous guidelines (80% vs. 55.8%, Pâ¯=â¯0.04). CONCLUSIONS: The high rate of H. pylori resistances, and as a result, the low eradication rates, are still a very important cause for concern. The first line treatment, when this is indicated must be given following the antibiotic sensitivity studies, and in the cases where these cannot be done or are not available, at least in accordance with the regional resistance rates. The correct application of the new guidelines significantly improves the eradication rate.
Assuntos
Infecções por Helicobacter , Helicobacter pylori , Adolescente , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Claritromicina/uso terapêutico , Feminino , Infecções por Helicobacter/tratamento farmacológico , Humanos , Masculino , Estudos RetrospectivosRESUMO
INTRODUCCIÓN. La apendicitis aguda es una patología pediátrica quirúrgica que en su fase complicada requiere uso de antibióticos en el postoperatorio; encontrar la mejor opción como experiencia local, fue necesario. OBJETIVO. Comparar un esquema de antibioticoterapia triple vs un doble respecto a variables: demográficas, clínicas y de costos en pacientes pediátricos con apendicitis complicada. MATERIALES y MÉTODOS. Estudio analítico transversal. Población de 133 pacientes y una muestra de 93, operados por apendicitis complicada; 58 recibieron ampicilina + metronidazol + gentamicina y 35 ceftriaxona + metronidazol. Se comparó las variables: estadía hospitalaria, complicaciones y costo monetario de cada esquema. Se realizó en la Unidad de Cirugía Pediátrica del Hospital de Especialidades Carlos Andrade Marín, en el periodo enero de 2017 a octubre de 2018. Los datos fueron analizados con R-Studio 1.8.366 para Windows. RESULTADOS. No hubo diferencia estadística con respecto a: estadía hospitalaria (p=0,261); complicaciones como infección del sitio quirúrgico (p=0,196), re-intervención quirúrgica (p=0,653) y costo (p=0,059). CONCLUSIÓN. Se comparó el esquema de antibioticoterapia triple vs un doble, utilizados en apendicitis complicada en pediatría. No se encontró diferencias estadísticamente significativas en este reporte preliminar, con la diferencia de que con el esquema doble la frecuencia de administración fue menor y se evitó la exposición a los efectos colaterales de los aminoglicósidos.
INTRODUCTION. Acute appendicitis is a pediatric surgical pathology that in its complicated phase requires the use of antibiotics during the postoperative period; finding the best option as local experience was a must. OBJECTIVE. Compare a triple vs a double antibiotic therapy scheme respect demographic, clinical and cost variables in pediatric patients whit complicated apendicitis. MATERIALS AND METHODS. Cross-sectional analytical study. Population of 133 patients and sample of 93, with complicated appendicitis; 58 received ampicillin + metronidazole + gentamicin and 35 ceftriaxone + metronidazole. The following variables were compared; hospital stay, complications and monetary cost of each scheme. It was performed in the Pediatric Surgery Unit of the Hospital of Specialties Carlos Andrade Marin, during january 2017, through october 2018. The data were analyzed with R-Studio 1.8.366 for Windows. RESULTS. There was no statistical difference regarding hospital stay (p=0.261); complications such as surgical site infection (p=0.196), re-surgical intervention (p=0.653); nor cost (p=0.059). CONCLUSION. Triple vs. Double antibiotic therapy scheme used in complicated appendicitis in pediatrics was compared. No statistically significant differences were found in this preliminary report, how ever with the double scheme the frequency of administration was lower and exposure to side effects of aminoglycosides was avoided.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Apendicite/complicações , Gentamicinas , Cefalexina , Ampicilina , Metronidazol , Antibacterianos/uso terapêutico , Pediatria , Complicações Pós-Operatórias , Cirurgia Geral , Análise Custo-BenefícioRESUMO
Introdução: Tumores fétidos são uma complicação devastadora do câncer e causam muito desconforto e isolamento para o paciente. Eles geralmente se desenvolvem nos últimos seis meses de vida e são muito difíceis de tratar com sucesso. O objetivo desta revisão sistemática foi analisar as evidências da efetividade do metronidazol tópico e/ou sistêmico no tratamento de mau odor em feridas tumorais malignas. Resultados: Foram encontrados inicialmente 62 artigos, e destes, apenas 4 artigos na íntegra contemplaram os critérios de inclusão. Dois deles foram ensaios clínicos, sendo 1 duplo-cego, randomizado e 1, não controlado de fase III. Um artigo foi retrospectivo com coleta de dados de 10 anos e 1 foi de coorte prospectivo. Destes, 3 analisaram a eficácia do tratamento de tumores malignos com mau odor com o uso de metronidazol tópico e apenas 1 comparou o uso de metronidazol tópico com sistêmico. Discussão: Um fator que contribui para o mau odor não ser controlado de forma adequada, diz respeito a falta de protocolos padronizados para tal. Ao longo dos anos, estudiosos no assunto, tentam encontrar intervenções acessíveis e eficazes para reduzir as graves recorrências do mau odor em feridas necróticas. Conclusão: Tanto a via tópica quanto à sistêmica demonstram ser eficazes no controle do mau odor. Os resultados desta revisão destacam a falta de pesquisa nesta área com pouca evidência para direcionar a prática clínica no tratamento dessas lesões. Outros estudos se fazem necessários, para se estabelecer protocolos mais efetivos no controle desta condição angustiante, vivenciada por alguns pacientes oncológicos.
Introduction: Fetid tumors are a devastating complica-tion of cancer and cause much discomfort and patient isolation. They usually develop themselves in the last six months of life and they are very difficult to be success-fully treated. The aim of this systematic review was to analyze the evidence on the effectiveness of topical and/or systemic metronidazole for the treatment of bad odor in malignant tumor wounds. Results: Sixty-two articles were initially found, and of these, only 4 articles met the inclusion criteria. Two of them were clinical trials, being 1 double-blind, randomized and 1 non-controlled phase III studies. One study was retrospective with a 10-years data collection period and 1 was a cohort prospective study. Of these, 3 analyzed the efficacy of treating malignant tumors with a bad odor using topical metronidazole and only 1 compared the use of topical and systemic metronidazole. Discussion: A factor that contributes to the bad odor not being properly controlled is the lack of standardized protocols. Over the years, studies have tried to find affordable and effective interventions to reduce serious recurrences of bad odor in necrotic wounds.Conclusion: Both topical and systemic routes have been shown to be effective in controlling bad odor. The results of this systematic review highlight the lack of research in this area with little evidence to guide clinical practice in the treatment of these injuries. Further studies are needed to establish more effective protocols to control this distressing condition, experienced by some cancer patients.
Assuntos
Efetividade , Odor Corporal , Metronidazol/farmacologia , NeoplasiasRESUMO
Blastocystis es un stramenopile o cromista, pleomórfico no móvil. Se han identificado diecinue-ve subtipos de este organismo (ST1-ST19). Tiene una presencia a nivel mundial. Este microor-ganismo tiene un metabolismo intermediario anaeróbico. Un aspecto interesante de la bioquími-ca de este stramenopile está dado por la presencia de organelas similares a mitocondrias con un conjunto de rutas: cadena de fosforilación oxidativa incompleta, ciclo de Krebs parcial, metabo-lismo de ácidos grasos (anabolismo y catabolismo), metabolismo de aminoácidos y ensamblaje de proteínas con centros hierro/azufre. El tratamiento se ha basado tradicionalmente en metroni-dazol y otros imidazoles. Sin embargo, hay un número creciente de cepas resistentes a esos medicamentos. La reciente obtención del genoma nuclear y los estudios bioquímicos, proteómi-cos, metabolómicos, interactómicos permitirán el desarrollo racional de nuevos fármacos curati-vos. El objetivo de esta revisión es describir el metabolismo de Blastocystis spp
Blastocystis is a stramenopile or chromist, nonmobile pleomorphic. Nineteen subtypes of this organism (ST1-ST19) have been identified worldwide. This microorganism has an intermediate anaerobic metabolism. An interesting aspect of the biochemistry of this stramenopile is given by the presence of mitochondrial-like organelles with a set of pathways: incomplete oxidative phos-phorylation chain, partial Krebs cycle, fatty acid metabolism (anabolism and catabolism), amino acid metabolism and protein assembly with iron / sulfur centers. Treatment has traditionally been based on metronidazole and other imidazoles. However, there are a growing number of strains resistant to these drugs. The recent obtaining of the nuclear genome and the biochemical, proteomic, metabolomic and interactomic studies will allow the rational development of new curative drugs. The objective of this review is to describe the metabolism of Blastocystis spp.
Assuntos
Humanos , Masculino , Feminino , Doenças Parasitárias , Blastocystis , Metabolismo , Anaerobiose , Metronidazol , Antígenos de ProtozoáriosRESUMO
Introducción: La osteomielitis mandibular crónica es considerada como una infección odontogénica que cursa con tumefacción de la cara, limitación de la abertura bucal y dolor. Pocas veces es tratada a través de gammagrafías con fijación a ciprofloxacino con la consiguiente obtención de resultados efectivos. Objetivo: Describir un caso clínico de osteomielitis mandibular crónica tratada con terapia antibiótica y quirúrgica. Presentación de caso: Paciente femenina de 63 años de edad que acudió al servicio de estomatología del Hospital María Auxiliadora, Lima, Perú; con un historial de tres meses de hinchazón creciente a nivel del borde inferior izquierdo de la mandíbula desde que le realizaron una extracción dentaria. Los exámenes tomográficos, gammagrafía, biopsia y antibiograma confirmaron la osteomielitis y la susceptibilidad bacteriana. La decorticación, debridamiento, exodoncia y la administración de metronidazol más vancomicina por dos meses permitió la remisión del cuadro. Conclusiones: El seguimiento clínico de dos años y las gammagrafías de evaluación permitieron verificar la presencia de regeneración ósea y ausencia de focos de reactivación. La osteomielitis crónica puede ser provocada por restos de exodoncias dentarias. Su diagnóstico y seguimiento clínico requiere de múltiples exámenes y controles a largo plazo(AU)
Introduction: Chronic mandibular osteomyelitis is considered to be an odontogenic infection manifesting as facial tumefaction, limited mouth opening and pain. It is not often enough treated with ciprofloxacin fixation gammagraphies with the consequent achievement of effective results. Objective: Describe a clinical case of chronic mandibular osteomyelitis treated with antibiotic and surgical therapy. Case presentation: A female 63-year-old patient attends the dental service at María Auxiliadora Hospital in Lima, Peru, with a history of three-months' swelling of the lower left edge of her mandible upon performance of a dental extraction. Tomographic examination, gammagraphy, biopsy and antibiograms confirmed the presence of osteomyelitis and bacterial susceptibility. Decortication, debridement, exodontia and administration of metronidazole plus vancomycin for two months led to remission of the patient's status. Conclusions: Two-year clinical follow-up and evaluation gammagraphies made it possible to verify the presence of bone regeneration and the absence of reactivation foci. Chronic osteomyelitis may be caused by remains of dental exodontias. Its diagnosis and clinical follow-up require a large number of long-term tests and controls(AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Osteomielite/diagnóstico por imagem , Cirurgia Bucal/métodos , Vancomicina/uso terapêutico , Antibacterianos/administração & dosagem , Metronidazol/uso terapêuticoRESUMO
INTRODUCTION: The resistance to antibiotics of Helicobacter pylori (H. pylori) is the main factor that affects current therapeutic treatments. The main objective of this study is to describe the pattern of antibiotic resistances in children with an infection due to H. pylori. PATIENTS AND METHODS: An observational, retrospective study was conducted from 2014 to 2019, which included patients between 5 and 17 years old, on whom a gastroscopy, with a gastric biopsy culture positive for H. pylori, and an antibiotic sensitivity study was performed. The antibiotic sensitivity studies were performed using an epsilometer (E-test). The cut-off points to define the resistances were those proposed by the European Committee on Antimicrobial Susceptibility Testing - EUCAST. The eradication study was performed using the 13C-urea breath test or the H. pylori monoclonal test in faeces 6-8 weeks after finalising the treatment. RESULTS: The study included 80 patients (63.8% females), with a mean age of 11.9 years (SD±2.7DS). Over one-third (38.8%) of the patients had received previous treatment for H. pylori. In the endoscopy, peptic ulcer lesions were observed in 10% of patients. More than two-thirds (67.5%) had resistance to at least one drug. 16.3% presented double resistance. The primary resistances were: clarithromycin, 44.9%, metronidazole 16.3%, levofloxacine 7.9%, and amoxicillin 2%. Patients that received treatment according to the new ESPGHAN 2017 guidelines had significantly higher eradication rates compared to those that received treatment according to previous guidelines (80% vs. 55.8%, P=.04). CONCLUSIONS: The high rate of H.pylori resistances, and as a result, the low eradication rates, are still a very important cause for concern. The first line treatment, when this is indicated must be given following the antibiotic sensitivity studies, and in the cases where these cannot be done or are not available, at least in accordance with the regional resistance rates. The correct application of the new guidelines significantly improves the eradication rate.
RESUMO
Introdução: A eliminação do Enterococcus faecalis dos canais radiculares é fundamental para o sucesso do tratamento endodôntico, uma vez que esses microrganismos são de difícil eliminação, principalmente quando organizados em forma de biofilmes. A busca por drogas ou suas combinações que possam eliminar esses microrganismos é um dos principais objetivos terapêuticos. Objetivo: O presente estudo avaliou a ação antimicrobiana de medicações intracanal experimentais sobre biofilmes de Enterococcus faecalis. Métodos: Quarenta dentes bovinos unirradiculares foram utilizados; suas coroas foram seccionadas e as raízes foram instrumentadas e esterilizadas. As raízes foram contaminadas com suspensão contendo Enterococcus faecalis, mantidas em estufa a 37°C por 30 dias e divididas em quatro grupos, de acordo com a medicação intracanal: GI) medicação experimental 1 (clorexidina [CHX] 0,2%/metronidazol, doxiciclina); GII) medicação experimental 2 (CHX 0,2%/metronidazol, minociclina); GIII) clorexidina a 2% (CHX 2%); e GIV) solução salina. As raízes foram seladas e mantidas em estufa por 7 dias, em tubos contendo TSB. Dentina foi coletada e semeada por 24 h, para formação de UFCs. Os valores obtidos foram comparados pelos testes ANOVA e Tukey (p<0,05). Quando comparados os resultados, não houve diferenças entre os Grupos I, II e III; no entanto, eles foram significativamente diferentes do Grupo IV. Conclusão: As medicações intracanal experimentais exerceram ação antimicrobiana sobre biofilmes de Enterococcus faecalis (AU).
Background: The elimination of Enterococcus faecalis of the root canals is fundamental for endodontic success, since these microorganisms are difficult to killed, especially when organized in biofilms. The search for drugs or their combinations that can eliminate these microorganisms is one of the main therapeutic aim. This study evaluated the antimicrobial action of experimental intracanal medications on Enterococcus faecalis biofilms. Methods: Forty uniradicular bovine teeth were used; their crowns were removed, and the roots were instrumented and sterilized. The roots were contaminated with suspension containing Enterococcus faecalis and kept in an oven at 37°C for 30 days. The roots were divided into 4 groups according to the intracanal medication: I- experimental medication 1 (0.2% CHX/metronidazole/ doxycycline); II- experimental medication 2 (0.2% CHX/ metronidazole/minocycline), III- 2% chlorhexidine (2% CHX), and IV- saline solution. The roots were sealed and kept in tubes containing TSB in an oven for 7 days. Dentin was collected and seeded for 24 h for perform of CFUs. The values obtained were compared using ANOVA and Tukeys tests (p<0.05). When comparing the results, there were no differences among groups I, II and III; however, they were significantly different from group IV. Conclusion: The experimental intracanal medications exerted an antimicrobial action on Enterococcus faecalis biofilms (AU).