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1.
World J Gastroenterol ; 27(31): 5247-5258, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34497448

RESUMO

BACKGROUND: Antibiotic resistance to Helicobacter pylori (H. pylori) infection, which ultimately results in eradication failure, has been an emerging issue in the clinical field. Recently, to overcome this problem, an antibiotic sensitivity-based tailored therapy (TT) for H. pylori infection has received attention. AIM: To investigate the efficacy and safety profiles of TT for H. pylori infection treatment compared to a non-bismuth quadruple therapy, concomitant therapy (CT) regimen. METHODS: We included patients (> 18 years) with an H. pylori infection and without a history of Helicobacter eradication who visited the Gil Medical Center between March 2016 and October 2020. After being randomly assigned to either the TT or CT treatment group in 1 to 1 manner, patient compliance, eradication success rate (ESR), and patient-reported side effects profiles were assessed and compared between the two groups. H. pylori infection was diagnosed using a rapid urease test, Giemsa stain, or dual priming oligonucleotide polymerase chain reaction (DPO-PCR). Tailored eradication strategy based through the presence of a 23S ribosomal RNA point mutation. For the TT group, a DPO-PCR test, which detected A2142G and/or A2143G point mutations, and a clarithromycin resistance test were performed. Patients in the clarithromycin-resistant group were treated with a bismuth-containing quadruple combination therapy, while those with sensitive results were treated with the standard triple regimen. RESULTS: Of the 217 patients with a treatment naive H. pylori infection, 110 patients [mean age: 58.66 ± 13.03, men, n = 55 (50%)] were treated with TT, and 107 patients [mean age: 56.67 ± 10.88, men, n = 52 (48.60%)] were treated with CT. The compliance (TT vs CT, 100% vs 98.13%, P = 0.30), and follow-up loss rates (8.18% vs 9.35%, P = 0.95) were not significantly different between the groups. The ESR after treatment was also not statistically different between the groups (TT vs CT, 82.73% vs 82.24%, P = 0.95). However, the treatment-related and patient-reported side effects were significantly lower in the TT group than in the CT group (22.77% vs 50.52%, P < 0.001). CONCLUSION: The DPO-based TT regimen shows promising results in efficacy and safety profiles as a first-line Helicobacter eradication regimen in Korea, especially when physicians are confronted with increased antibiotic resistance rates.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Idoso , Amoxicilina/uso terapêutico , Antibacterianos/efeitos adversos , Claritromicina/efeitos adversos , Quimioterapia Combinada , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores da Bomba de Prótons/efeitos adversos , República da Coreia
2.
Chin J Dent Res ; 24(3): 191-198, 2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34491014

RESUMO

OBJECTIVE: To investigate various factors affecting the clinical outcome of nonsurgical periodontal treatment and evaluate the treatment effects of adjunctive amoxicillin and metronidazole (AMX + MET) in patients with generalised aggressive periodontitis (GAgP). METHODS: Forty-two patients with GAgP were recruited and randomly assigned to three groups: scaling and root planing (SRP) only, AMX + MET after SRP, and AMX + MET during SRP. The patients were assessed every 2 months post-therapy. Periodontal clinical and subgingival microbiological parameters were analysed at baseline and 6 months post-therapy. The impacts of different covariates on pocket probing depth (PD) reduction were evaluated. RESULTS: A multilevel analysis revealed that 58% of the variability in PD reduction was attributed to site-level parameters, 27.3% to patient-level parameters and 18.7% to tooth-level parameters. Greater PD reduction can be expected at initially deeper PD sites and sites with intrabony defects, and in patients with adjunctive use of AMX + MET. Persistent Tannerella forsythia infection and tooth mobility after treatment were negatively associated with PD reduction. CONCLUSION: The clinical outcomes of nonsurgical periodontal treatment were mainly influenced by site-level parameters, and adjunctive use of AMX + MET can lead to better clinical results in patients with GAgP in a short time.


Assuntos
Periodontite Agressiva , Periodontite Agressiva/terapia , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Raspagem Dentária , Humanos , Análise Multinível , Aplainamento Radicular , Resultado do Tratamento
3.
Anal Chim Acta ; 1177: 338760, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34482897

RESUMO

Beta-lactam antibiotics are of vital importance for the treatment of infections in a broad range of patients. Although most systemically administered antibiotics will be excreted renally, a fraction will reach the gastro-intestinal tract, affecting the intestinal microbiome by eradicating a wide range of bacterial species while facilitating the growth of antimicrobial-resistant species. A better understanding of the kinetics of beta-lactam antibiotics in the gastro-intestinal tract is essential to study their role in the development of antibiotic resistance in bacteria and to help develop future therapies to prevent damage to, or restore, the intestinal microbiome. Analysis of beta-lactam antibiotics in faeces is particularly challenging due to the heterogeneous nature of the matrix, rapid degradation of some beta-lactam antibiotics in faeces and very strong ion suppression when using mass spectrometry. Sample preparation was optimized using a sequential strategy of experimental designs. It resulted in lyophilization, a MOPS buffer system and the addition of the beta-lactamase inhibitor avibactam to minimize degradation of antibiotics allowing sensitive quantification. The developed liquid chromatography method with high-resolution mass spectrometric detection was successfully validated according to bioanalytical EMA guidelines and had a linear range of 1-200 µg g-1 lyophilized faeces for amoxicillin, piperacillin and meropenem; and 0.5-100 µg g-1 lyophilized faeces for tazobactam. Despite the highly complex and heterogeneous composition of faeces, the accuracy (0.1-15%) and precision (1.7-12.1%) were in line with those obtained for quantification methods of beta-lactam antibiotics in plasma, the golden standard matrix for therapeutic drug monitoring. The applicability of the method was illustrated by successful quantification of piperacillin and tazobactam in faeces from an intensive care unit patient receiving piperacillin/tazobactam in a continuous intravenous infusion. Both piperacillin and tazobactam were still present six days after discontinuation of the therapy.


Assuntos
Amoxicilina , Piperacilina , Antibacterianos , Cromatografia Líquida , Fezes , Humanos , Espectrometria de Massas , Meropeném , Projetos de Pesquisa , Tazobactam
4.
Molecules ; 26(17)2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34500607

RESUMO

Based on the adsorption performance of a porous nanocomposite with limestone (LS), activated carbon (AC) and sodium alginate (SG), a unique, multifunctional LS-AC-SG nanocomposite absorbent was designed and prepared for extracting antibiotics and drugs from aqueous solutions. The composite exhibited the following advantages: quick and simple to prepare, multifunctionality and high efficiency. Amoxicillin (AMX) and diclofenac (DCF) were chosen as the conventional antibiotic and the drug, respectively. The prepared nanocomposite's physicochemical characteristics were calculated through numerous characterization methods. The structure of the surface was made up of interconnected pores that can easily confine pollutants. The surface area was measured to be 27.85 m2/g through BET analysis. The results show that the maximum absorption capacity of amoxicillin and diclofenac was 99.6% and 98.4%, respectively, at a contact time of 40 min. The maximum removal of amoxicillin and diclofenac was reached at pH = 2. Adsorption analysis revealed that adsorption isotherm and kinetic data matched the pseudo-first-order kinetic and the Langmuir isotherm models. The results imply that the synthesized nanocomposites have the capacity to remove amoxicillin (AMX) and diclofenac (DCF) from aqueous solutions.


Assuntos
Alginatos/química , Antibacterianos/química , Carbonato de Cálcio/química , Carvão Vegetal/química , Nanocompostos/química , Preparações Farmacêuticas/química , Soluções/química , Água/química , Adsorção , Amoxicilina/química , Diclofenaco/química , Concentração de Íons de Hidrogênio , Cinética , Porosidade , Poluentes Químicos da Água/química , Purificação da Água/métodos
5.
J Environ Manage ; 299: 113594, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34467868

RESUMO

Nowadays, releasing the Emerging Pollutants (EPs) in the nature is one of the main reasons for many health and environmental disasters. Amoxicillin as an antibiotic is one of the EPs and categorized as the Endocrine Disrupting Compounds (EDCs) in hazardous materials. Accumulation of amoxicillin in the soil bulk increases the cancer risk, drug resistances and other epidemiological diseases. Hence, the soil bioremediation of antibiotics can be a solution for this problem which is more environmental-friendly system. This study technically creates a bio-engine setup in soil bulk for remediation of amoxicillin based on Aspergillus Flavus (AF) activities and Removal Percentage (RP) of amoxicillin with Aflatoxin B1 Generation (AG) controls. The main novelty is to propose a hybrid computational intelligence approach to do optimization for mechanical and biological aspects and to predict the behavior of bio-engine's effective mechanical and biological features in an intelligent way. The optimization model is formulated by the Central Composite Design (CCD) which is set by the Response Surface Methodology (RSM). The prediction model is formulated by the Random Forest (RF), Adaptive Neuro Fuzzy Inference System (ANFIS) and Random Tree (RT) algorithms. According to the experimental practices from real soil samples in different times and places, concentration of amoxicillin and Aflatoxin B1 are set equal to 25 mg/L (ppm) and 15 µg/L (ppb). Likewise, the outcomes of experiments in CCD-RSM computations are evaluated by curve fitting comparisons between linear, 2FI, quadratic and cubic polynomial equations with considering to regression coefficient and predicted regression coefficient values, ANOVA and optimization by sequential differentiation. Based on the results of CCD-RSM, the RP performance in the optimum conditions is measured around 86% and in 25 days after runtime, the RP and AG are balanced in the safe mode. The proposed hybrid model achieves the 0.99 accuracy. The applicability of the research is done using real field evaluations from drug industrial park in Mashhad city in Iran. Finally, a broad analysis is done and managerial insights are concluded. The main findings of the present research are: (I) with application of bioremediation from fungus activities, amoxicillin amounts can be control in soil resources with minimum AG, (II) ANFIS model has the best accuracy for smart monitoring of amoxicillin bioremediation in soil environments and (III) based on the statistical assessments Aeration Intensity and AF/Biological Waste ratio are most effective on the amoxicillin removal percentage.


Assuntos
Aflatoxina B1 , Solo , Amoxicilina , Inteligência Artificial , Biodegradação Ambiental , Fungos
6.
Tohoku J Exp Med ; 255(1): 41-48, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34526429

RESUMO

Effective Helicobacter pylori (H. pylori) eradication is a major public health concern; however, eradication failure rates with the standard triple therapy remain high. We aimed to investigate the effectiveness and tolerability of ranitidine bismuth citrate (RBC) pretreatment before standard triple therapy for H. pylori eradication. A prospective, randomized, controlled, and open-label clinical trial was conducted from June to December 2019. H. pylori eradication rate, safety, and tolerability were compared between the standard treatment group (esomeprazole, amoxicillin, and clarithromycin for 7 days) and RBC pretreatment group (RBC for 2 weeks before standard triple therapy). This trial ended earlier than estimated owing to the N-nitrosodimethylamine concerns with ranitidine. Success rates of H. pylori eradication were 80.9% and 67.3% in the RBC pretreatment (n = 47) and standard treatment (n = 52) (p = 0.126) groups, respectively. Our trial was discontinued earlier than planned; however, a statistical significance would be achieved by expansion of our data (p = 0.031) if patient enrollment numbers reached those initially planned. Adverse event rates were comparable between groups (25.5% in the pretreatment group vs. 28.8% in the standard treatment group), without serious event. Tolerability was excellent in both groups, recorded as 97.9% and 100% in the pretreatment and standard treatment groups, respectively. Compared with the standard triple regimen, RBC pretreatment for 2 weeks may achieve higher H. pylori eradication rates, with excellent safety and tolerability. However, this study necessitates further validation as it was discontinued early owing to the N-nitrosodimethylamine issues of ranitidine.


Assuntos
Bismuto/administração & dosagem , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Ranitidina/análogos & derivados , Adulto , Idoso , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Carga Bacteriana/efeitos dos fármacos , Claritromicina/administração & dosagem , Esquema de Medicação , Quimioterapia Combinada , Esomeprazol/administração & dosagem , Feminino , Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Antagonistas dos Receptores H2 da Histamina/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ranitidina/administração & dosagem , Falha de Tratamento , Resultado do Tratamento
7.
Int J Mol Sci ; 22(17)2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34502136

RESUMO

Plasmids play a crucial role in spreading antimicrobial resistance genes. Plasmids have many ways to incorporate various genes. By inducing amoxicillin resistance in Escherichia coli, followed by horizontal gene transfer experiments and sequencing, we show that the chromosomal beta-lactamase gene ampC is multiplied and results in an 8-13 kb contig. This contig is comparable to a transposon, showing similarities to variable regions found in environmental plasmids, and can be transferred between E. coli cells. As in eight out of nine replicate strains an almost completely identical transposon was isolated, we conclude that this process is under strict control by the cell. The single transposon that differed was shortened at both ends, but otherwise identical. The outcome of this study indicates that as a result of exposure to beta-lactam antibiotics, E. coli can form a transposon containing ampC that can subsequently be integrated into plasmids or genomes. This observation offers an explanation for the large diversity of genes in plasmids found in nature and proposes mechanisms by which the dynamics of plasmids are maintained.


Assuntos
Elementos de DNA Transponíveis , Proteínas de Escherichia coli/genética , Resistência beta-Lactâmica , beta-Lactamases/genética , Amoxicilina/toxicidade , Antibacterianos/toxicidade , Escherichia coli , Transferência Genética Horizontal
9.
Bioresour Technol ; 340: 125687, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34358986

RESUMO

The purpose of this study was to identify the relationship between core bacteria and metabolites during aerobic composting and analyze the effects of metabolites on plant growth. The results revealed that amoxicillin might affect the generation and transformation of metabolites by reconstructs the bacterial communities. The peak area ratios (PAR) of esters and fatty acids (FAs) were increased, while sterols decreased during composting. Furthermore, the correlation analysis showed that the production of FAs, esters and sterols is strongly correlated with Oceanobacillus, Corynebacterium, Psychrobacter, Xanthomonadaceae, Pusillimonas and Gracilibacillus. Moreover, 36 key metabolites were screened out, the PAR of the propanoic acid ethyl ester and oleic acid that benefit plant growth were increased in amoxicillin groups. However, the PAR of environmental pollutants, such as n-hexadecanoic acid and 3ß, 5ß-Cholestan-3-ol is the opposite. Therefore, composting can eliminate the environmental risks caused by antibiotic residues in feces and promote plant growth.


Assuntos
Compostagem , Amoxicilina , Cromatografia Gasosa-Espectrometria de Massas , Esterco , RNA Ribossômico 16S/genética , Solo
10.
J Infect Chemother ; 27(11): 1621-1625, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34376349

RESUMO

BACKGROUND: In 2016, the Japanese government set the National Action Plan on antimicrobial resistance to reduce antibiotic prescriptions. However, the trends and variations of antibiotic prescription patterns in a routine healthcare setting during the fiscal year 2013-2018 across different clinics at a national level are unclear. METHODS: This retrospective cohort study included all clinics with >100 pediatric outpatients with infectious diseases per month during the fiscal year 2013-2018 using a national database in Japan. We investigated the trends in antibiotic prescription rates and their patterns and variations across different clinics over the six years following the 2019 World Health Organization Access, Watch, Reserve antibiotic groups, and Amoxicillin Index. RESULTS: A total of 2278 clinics with 94,414,170 infectious disease-related visits were eligible for the study. Most clinics showed higher Watch percentages (median 85.4%; IQR, 68.5-95.1) than Access percentages (median, 13.8%; IQR, 4.2-30.7) and Amoxicillin Index (median, 13.3%; IQR, 3.9-30.4). The introduction of the Action Plan changed annual absolute reductions in the antibiotic prescription rates from -16.0 DOTs/1000 visitors (95%CI, -16.4-15.6) to -239.3 per 1000 visitors (95%CI, -240.0-238.6). However, these impacts were heterogeneous across clinics. From 2013 to 2018, 41.4% reduced the antibiotic prescription rates by >33.3% (median, -1035.5 DOTs/1000 visitors; IQR, -1519.4-680.2), 18.7% did not change the rates (median, -40.3 DOTs/1000 visitors; IQR, -168.4-68.6), and 7.3% increased the rates by >10% (499.5 DOTs per 1000 visitors; IQR, 232.6-837.5). CONCLUSIONS: We observed the National Action Plan's impacts and extensive prescription variations across different pediatric clinics. However, one-fourth of clinics did not improve antibiotic prescription patterns even after introducing the Action Plan.


Assuntos
Antibacterianos , Prescrições de Medicamentos , Amoxicilina , Antibacterianos/uso terapêutico , Criança , Humanos , Japão , Padrões de Prática Médica , Estudos Retrospectivos
11.
J Pediatr Gastroenterol Nutr ; 73(2): 178-183, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34402809

RESUMO

BACKGROUND: The revised ESPGHAN/NASPGHAN 2016 guideline on the diagnosis and management of Helicobacter pylori (H pylori) infection discourages a "test and treat" strategy. Instead, upper endoscopy (EGD) is recommended when a valid clinical indication is present. Likewise, new treatment recommendations for first-line therapies strongly encourage obtaining antimicrobial susceptibility before treatment. We conducted this study to assess the effect of revised guidelines on clinical practice at our center. METHODS: Retrospective chart review of patients with H pylori infection diagnosis either by serology, stool antigen test, urea breath test, or EGD at Boston Children's Hospital between January 2013 and July 2019. We compared demographic and clinical data between initial guideline and 2016 revision (January 2013 to November 2016) and period after revised guideline (December 2016 to July 2019). RESULTS: Two hundred and fifty-six patients were included. EGD was the initial diagnostic test in 49% (50/103, prerevised guideline) and in 52% (79/153, postrevised guideline). Biopsy culture was sent in 3% of patients for both periods (3/103 and 4/153, respectively). PPI-clarithromycin-amoxicillin triple therapy was the most common regimen in both periods. Clarithromycin use was lower in postrevised guideline period (P = 0.003) whereas the opposite was noted for metronidazole and tetracycline (P = 0.009 and P = 0.02, respectively). There was no significant difference in eradication rate between periods (86% vs 81%). CONCLUSIONS: Low adherence to the updated H pylori guideline recommendations was observed among pediatric gastroenterologists at our center with low use of gastric biopsy culture. The guideline revision was associated with avoidance of clarithromycin use as a second-line therapy, but no change in eradication rates. Future interventions should address the importance of obtaining gastric biopsy culture for antibiotic susceptibilities to guide therapy.


Assuntos
Gastroenterologistas , Infecções por Helicobacter , Helicobacter pylori , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Criança , Claritromicina/uso terapêutico , Quimioterapia Combinada , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/tratamento farmacológico , Humanos , Metronidazol/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico , Estudos Retrospectivos
12.
BMJ Glob Health ; 6(8)2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34417274

RESUMO

INTRODUCTION: Young infants 7-59 days old with fast breathing pneumonia presented to a primary level health facility receive a 7-day course of amoxicillin as per the WHO guideline. However, community-level health workers (CLHW) are not allowed to treat these infants. This trial evaluated the community level treatment of non-hypoxaemic young infants with fast breathing pneumonia by CLHWs. METHODS: This cluster-randomised, open-label, non-inferiority trial was conducted in rural areas of Bangladesh, Ethiopia, India and Malawi. We randomly allocated clusters (first-level health facility) 1:1, stratified by the population size, to an intervention group (enhanced community case management) or control group (standard community case management). Infants aged 7-59 days with a respiratory rate of ≥60 breaths/min and oxygen saturation (SpO2) ≥90% were enrolled. In the intervention clusters, these infants were treated with a 7-day course of oral amoxicillin (according to WHO weight bands) and were regularly followed up by CLHWs. In the control clusters, CLHWs continued the standard management (assess and refer after pre-referral antibiotic dose) and followed up according to the national programme guideline. The primary outcome of treatment failure was assessed in both groups by independent outcome assessors on days 6 and 14 after enrolment. Secondary outcomes (accuracy and impact of pulse oximetry) were also assessed. RESULTS: Between September 2016 and December 2018, we enrolled 2334 infants (1168 in intervention and 1166 in control clusters) from 208 clusters (104 intervention and 104 control). Of 2334, 22 infants with fast breathing were excluded from analysis, leaving 2312 (1155 in intervention clusters and 1157 in control clusters) for intention-to-treat analysis. The proportion of treatment failure was 5.4% (63/1155) in intervention and 6.3% (73/1157) in the control clusters, including two deaths (0.2%) in each group. The adjusted risk difference for treatment failure between the two groups was -1.0% (95% CI -3.0% to 1.1%). The secondary outcome showed that CLHWs in the intervention clusters performed all recommended steps of pulse oximetry assessment in 94% (1050/1115) of enrolled patients. CONCLUSIONS: The 7-day amoxicillin treatment for 7-59 days old non-hypoxaemic infants with fast breathing pneumonia by CLHWs was non-inferior to the currently recommended referral strategy. TRIAL REGISTRATION NUMBERS: CTRI/2017/02/007761 and ACTRN12617000857303.


Assuntos
Amoxicilina , Pneumonia , Amoxicilina/uso terapêutico , Bangladesh/epidemiologia , Etiópia/epidemiologia , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Malaui/epidemiologia , Pneumonia/tratamento farmacológico
14.
Molecules ; 26(15)2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34361680

RESUMO

Necrotic enteritis (NE) caused by Clostridium perfringens is one of the most important enteric diseases in poultry. The antibacterial activity of two different essential oil (EO) blends against C. perfringens was investigated both in vitro and in vivo. Additionally, the immunological response to EO treatment was assessed. In the in vitro study, the antibacterial activity of EO formulas and commonly used antibiotics was evaluated against C. perfringens using disk diffusion assay, minimum inhibitory concentration (MIC) assay, and minimum bactericidal concentration (MBC) assay. In the in vivo study, NE experimental infection was performed on 440 Ross broiler chicks at 19 days of age for 4 continuous days. The chicks were treated with either EOs or amoxicillin at 22 days of age for 5 continuous days. One day after the end of treatment, the birds' performance was evaluated by calculating the feed conversion ratio. Serum samples from 120 birds were collected to measure the levels of IL-1ß, IFN-γ, IL-8, IL-10, and IL-17. After that, all birds were slaughtered, and their small intestines were subjected to gross and histopathological evaluation. In addition, bacterial counts in the small intestines were evaluated. In the in vitro study, EOs showed higher antimicrobial activities in comparison with antibiotics against C. perfringens. In the in vivo study, birds treated with EOs showed a significant decrease in bacterial counts, a significant decrease in intestinal lesions, and a significant improvement in performance compared with untreated birds (p < 0.05). Moreover, treating birds with EOs directed the immune system toward an anti-inflammatory pathway. None of the treated birds died due to NE compared with the 10% mortality rate in untreated birds. In conclusion, EOs might be an effective and safe alternative to antibiotics in the treatment of chicken NE.


Assuntos
Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Galinhas/microbiologia , Infecções por Clostridium/tratamento farmacológico , Infecções por Clostridium/imunologia , Clostridium perfringens/efeitos dos fármacos , Enterite/tratamento farmacológico , Enterite/imunologia , Imunidade , Óleos Voláteis/administração & dosagem , Doenças das Aves Domésticas/tratamento farmacológico , Doenças das Aves Domésticas/imunologia , Ração Animal , Animais , Infecções por Clostridium/microbiologia , Infecções por Clostridium/veterinária , Enterite/patologia , Enterite/veterinária , Testes de Sensibilidade Microbiana , Necrose , Óleos Voláteis/química , Projetos Piloto , Doenças das Aves Domésticas/microbiologia , Resultado do Tratamento
15.
Int J Pediatr Otorhinolaryngol ; 148: 110824, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34229149

RESUMO

OBJECTIVE: To evaluate whether the use of anti-inflammatory or antibiotic in the postoperative period modifies pain in children undergoing tonsillectomy. METHODS: 225 children who underwent cold knife tonsillectomy ± adenoidectomy were randomized into five groups, receiving #1 metamizole/acetaminophen, #2 amoxicillin, #3 ibuprofen, #4 prednisolone, or #5 amoxicillin plus prednisolone. All groups received oral analgesics (metamizole/acetaminophen) to use as needed. Pain was monitored during the 7 days following surgery using the Parents' Postoperative Pain Measurement (PPPM) and the Faces Pain Scale - Revised (FPS-R). Pain was also indirectly evaluated by the dose of analgesics administered on each day and by the time needed to return to a solid diet. RESULTS: After losses (24%), 170 individuals were submitted for analysis. Multiple comparisons demonstrated that the evolution of pain between the different groups, as matched day-per-day, was not significantly different by either PPPM or FPS-R (p > 0.05). The instances of analgesic intake were also similar in all the groups (p > 0.05), as was the return to solid food ingestion (p = 0.41). All groups presented a similar standard of clinical improvement at intervals of 2 days (p < 0.01). Independent of postoperative pain management, patients developed significant pain up to the day 4 following surgery. CONCLUSION: The addition of amoxicillin, ibuprofen, prednisolone, or amoxicillin and prednisolone does not modify postoperative pain in children undergoing cold-knife tonsillectomy. Special pain control should be performed on the first 4 days following tonsillectomy in children.


Assuntos
Analgésicos não Narcóticos , Tonsilectomia , Amoxicilina , Analgésicos não Narcóticos/uso terapêutico , Criança , Humanos , Ibuprofeno/uso terapêutico , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Prednisolona , Estudos Prospectivos , Tonsilectomia/efeitos adversos
16.
J Hazard Mater ; 417: 126147, 2021 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-34229410

RESUMO

Integrating microalgae culture and wastewater purification is a promising technology for sustainable bioresource production. However, the challenge is that toxins in wastewater usually limit risk elimination and cause poor bioresource production. Easy-to-biodegrade substrates could alleviate the resistant stress on a bacterial community but we know little about how they function with microalgae. In this study, we tested if Easy-to-biodegrade substrates could simultaneously promote Chlorella to degrade antibiotic amoxicillin (AMO) and produce bioresources. Sodium acetate (NaAC) was used as the representative co-substrate. The results showed NaAC could enhance AMO removal by 76%. The ß-lactam structure was destroyed and detoxified to small molecules, due to the up-regulation of hydrolase, oxidoreductase, reductase, and transferase. Chlorella biomass production increased by 36%. The genes encoding the glutathione metabolism and peroxisome pathways were significantly up-regulated to alleviate the antibiotic stress, and the DNA replication pathway was activated. As a result, the production of lipid, carbohydrate, and protein was enhanced by 61%, 122%, and 34%, respectively. This study provides new insights for using microalgae to recover bioresources from toxic wastewater and reveals the critical underlying mechanisms.


Assuntos
Chlorella , Microalgas , Amoxicilina , Biomassa , Acetato de Sódio , Águas Residuárias
17.
BMJ Case Rep ; 14(7)2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34301686

RESUMO

A male patient, aged over 75 years, was referred to the emergency room for pain in his right hypochondrium. This pain, which persisted for approximately 3 days, radiated to his right flank and right iliac quadrant and worsened after meals. The patient reported no nausea, vomiting, diarrhoea, fever or recent traumatic events. Blood laboratory tests, ultrasonography, an MRI and a CT scan were performed, leading to the diagnosis of a mass in the Morrison's pouch with ultrasound features of adipose tissue compatible with a liposarcoma, infiltrating the liver and the right kidney. Subsequent CT-guided needle aspiration and a histological examination led to the diagnosis of actinomycosis. The patient was initially treated with a daily dose of 18 million IU of benzylpenicillin for 4 weeks and subsequently prescribed the oral administration of 3 g/day of amoxicillin for 11 months. A monitoring CT scan was performed after 1, 5, 8 and 12 months, and a CT scan re-evaluation confirmed that the mass had completely healed.


Assuntos
Actinomicose , Fístula , Doenças da Vesícula Biliar , Actinomicose/diagnóstico , Actinomicose/tratamento farmacológico , Idoso , Amoxicilina , Humanos , Masculino , Ultrassonografia
18.
BMC Infect Dis ; 21(1): 679, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256734

RESUMO

BACKGROUND: Oral beta-lactam antimicrobials are not routinely tested against Streptococcus pneumoniae due to presumed susceptibility based upon penicillin minimum inhibitory concentration (MIC) testing. Currently, Clinical and Laboratory Standards Institute provides comments to use penicillin MIC ≤0.06 to predict oral cephalosporin susceptibility. However, no guidance is provided when cefotaxime MIC is known, leading to uncertainty with interpretation. The purpose of this study was to evaluate cefotaxime and penicillin MICs and their respective correlation to oral beta-lactam categorical susceptibility patterns. METHODS: 249 S. pneumoniae isolates were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-ToF) and then tested by broth microdilution method to penicillin, cefotaxime, amoxicillin, cefdinir, cefpodoxime, and cefuroxime. RESULTS: Using Clinical and Laboratory Standards Institute (CLSI) non-meningitis breakpoints for cefotaxime, 240/249 isolates were classified as susceptible. Of the cefotaxime susceptible isolates, 23% of the isolates are misrepresented as cefdinir susceptible. Amoxicillin correlated well with penicillin MIC breakpoints with only 1 discordant isolate out of 249. CONCLUSION: The correlation between amoxicillin and penicillin creates a very reliable predictor to determine categorical susceptibility. However oral cephalosporins were not well predicted by either penicillin or cefotaxime leading to the possible risk of treatment failures. Caution should be used when transitioning to oral cephalosporins in cefotaxime susceptible isolates, especially with higher cefotaxime MICs.


Assuntos
Amoxicilina/farmacologia , Cefotaxima/farmacologia , Testes de Sensibilidade Microbiana/métodos , Penicilinas/farmacologia , Pneumonia Pneumocócica , Streptococcus pneumoniae , Administração Oral , Antibacterianos/farmacologia , Cefalosporinas/classificação , Cefalosporinas/farmacologia , Humanos , Pneumonia Pneumocócica/tratamento farmacológico , Pneumonia Pneumocócica/microbiologia , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação , beta-Lactamas/farmacologia
19.
Zhonghua Yi Xue Za Zhi ; 101(26): 2060-2065, 2021 Jul 13.
Artigo em Chinês | MEDLINE | ID: mdl-34275239

RESUMO

Objective: To investigate the Helicobacter pylori (H. pylori) eradication rate and improvement of dyspepsia in patients who were newly diagnosed with H. pylori infection and dyspepsia and treated by bismuth-containing quadruple therapy followed by Jing-Hua-Wei-Kang(JHWK). Methods: Patients who were newly diagnosed with dyspepsia and H. pylori infection and treated in 16 medical centers in China between December 1, 2017 and September 30, 2019 were randomly divided into two groups. The experimental group received bismuth-containing quadruple therapy (esomeprazole+amoxicillin+furazolidone+colloidal bismuth pectin capsule, 14 days), followed by JHWK (30 days), and the course of treatment was 44 days in total. In the control group, the administration regimen was bismuth-containing quadruple therapy (esomeprazole+amoxicillin+furazolidone+colloidal bismuth pectin capsule, 14 days). The main outcome measure was H. pylori eradication rate, while the secondary outcome measures were dyspepsia symptom changes and adverse events during the treatment and the 1st month after treatment. Results: A total of 1 054 patients were included in the study. There were 522 cases enrolled in the experimental group, including 224(42.91%) men and 298(57.09%) women, and the age was 53(26, 73) years old; 532 cases enrolled in the control group, including 221(41.54%) men and 311(58.46%) women, and the age was 46(22, 71) years old. Based on PP analysis, it was found that the H. pylori eradication rate in the experimental group was significantly higher than those in the control group (93.85% vs 87.88%, P=0.001). In the group of all enrolled patients, the symptom dyspepsia after H. pylori eradication was significantly improved compared with that before treatment [4(4, 7) vs 15(10, 22), P<0.001], so was the superior and middle abdominal pain [1(1, 4) vs 4(1, 8), P<0.001], the postprandial fullness [1(1, 4) vs 4(4, 9), P<0.001], the early satiety [1(1, 1) vs 4(1, 4), P<0.001], and the heartburn [1(1, 1) vs 1(1, 4), P<0.001]. The symptom dyspepsia after treatment was significantly improved compared with that before treatment in the experimental, the control groups, the successful and the unsuccessful H. pylori eradication groups. The superior and middle abdominal pain after treatment was signifcantly improved than that before treatment [1(1, 2) vs 1(1, 4), P<0.001], so were the postprandial fullness [1(1, 3) vs 1(1, 4), P=0.002] and the dyspepsia[4(4, 7) VS 7(4, 10), P<0.001]. There was no statistically significant difference in the incidence of adverse events between the experimental group and the control group (1.34% vs 0.38%, P=0.09). Conclusions: Compared with bismuth-containing quadruple therapy, bismuth-containing quadruple therapy followed by JHWK significantly improves the H. pylori eradication rate without increasing the incidence of adverse events. H. pylori eradication therapy can improve symptoms of patients with H. pylori infection and dyspepsia.


Assuntos
Dispepsia , Infecções por Helicobacter , Helicobacter pylori , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Bismuto/uso terapêutico , China , Quimioterapia Combinada , Dispepsia/tratamento farmacológico , Feminino , Infecções por Helicobacter/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
20.
Colloids Surf B Biointerfaces ; 207: 111979, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34303995

RESUMO

Featured with a three-dimensional network structure, electrostatic spinning nanofibrous membranes can maintain the hygroscopic balance in the wound place and promote the wound healing, thus have been extensively studied as a promising wound healing dressing. In this study, amoxicillin (AMX), MXene, and polyvinyl alcohol (PVA) were mixed and electrospun into an antibacterial nanofibrous membrane (MXene-AMX-PVA nanofibrous membrane). In the composite nanofibrous membrane, the PVA matrix could control the release of AMX to combat bacterial infection, while the MXene could transform the near-infrared laser into heat, leading to local hyperthermia to promote the AMX release. Meanwhile, the local hyperthermia could also destroy the noncellular components of bacteria and synergistically cause the bacterial inactivation. The bacteriostatic activity and wound healing ability of the composite nanofibrous membrane were systematically verified on the S. aureus in vitro and the S. aureus-infected mouse skin defect model in vivo. This membrane not only functioned as a physical barrier to co-load the AMX and MXene, but also exhibited the high antibacterial and accelerated wound healing capacity, which will advance the design of novel wound healing dressings and antibacterial strategies.


Assuntos
Anti-Infecciosos , Nanofibras , Infecção dos Ferimentos , Amoxicilina , Animais , Antibacterianos/farmacologia , Camundongos , Álcool de Polivinil , Staphylococcus aureus , Infecção dos Ferimentos/tratamento farmacológico
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