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1.
BMJ ; 367: l5654, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619437

RESUMO

OBJECTIVE: To assess the efficacy of three months of antibiotic treatment compared with placebo in patients with chronic low back pain, previous disc herniation, and vertebral endplate changes (Modic changes). DESIGN: Double blind, parallel group, placebo controlled, multicentre trial. SETTING: Hospital outpatient clinics at six hospitals in Norway. PARTICIPANTS: 180 patients with chronic low back pain, previous disc herniation, and type 1 (n=118) or type 2 (n=62) Modic changes enrolled from June 2015 to September 2017. INTERVENTIONS: Patients were randomised to three months of oral treatment with either 750 mg amoxicillin or placebo three times daily. The allocation sequence was concealed by using a computer generated number on the prescription. MAIN OUTCOME MEASURES: The primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (range 0-24) at one year follow-up in the intention to treat population. The minimal clinically important between group difference in mean RMDQ score was predefined as 4. RESULTS: In the primary analysis of the total cohort at one year, the difference in the mean RMDQ score between the amoxicillin group and the placebo group was -1.6 (95% confidence interval -3.1 to 0.0, P=0.04). In the secondary analysis, the difference in the mean RMDQ score between the groups was -2.3 (-4.2 to-0.4, P=0.02) for patients with type 1 Modic changes and -0.1 (-2.7 to 2.6, P=0.95) for patients with type 2 Modic changes. Fifty patients (56%) in the amoxicillin group experienced at least one drug related adverse event compared with 31 (34%) in the placebo group. CONCLUSIONS: In this study on patients with chronic low back pain and Modic changes at the level of a previous disc herniation, three months of treatment with amoxicillin did not provide a clinically important benefit compared with placebo. Secondary analyses and sensitivity analyses supported this finding. Therefore, our results do not support the use of antibiotic treatment for chronic low back pain and Modic changes. TRIAL REGISTRATION: ClinicalTrials.gov NCT02323412.


Assuntos
Amoxicilina , Degeneração do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/complicações , Dor Lombar , Vértebras Lombares , Adulto , Amoxicilina/administração & dosagem , Amoxicilina/efeitos adversos , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Dor Crônica/diagnóstico , Dor Crônica/tratamento farmacológico , Dor Crônica/etiologia , Avaliação da Deficiência , Método Duplo-Cego , Feminino , Humanos , Dor Lombar/diagnóstico , Dor Lombar/tratamento farmacológico , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Masculino , Pessoa de Meia-Idade , Noruega , Medição da Dor/métodos , Resultado do Tratamento
3.
Interdiscip Sci ; 11(2): 273-281, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31106388

RESUMO

In nearly 50% of patients with drug-induced liver injury, the bile flow is impaired known as cholestasis. Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease that happens in pregnancy. Some of the clinical symptoms include pruritus, dark urine, and abnormal liver function tests. A rise of serum bile acids is the most accurate diagnostic evidence. ICP may lead to premature birth, fetal distress, and even postpartum hemorrhage or stillbirth in some severe cases. Higher bile acid levels (> 40 µmol/L) are associated with higher rates of adverse fetal outcomes. Due to the multifactorial nature of ICP, its etiology is still not fully understood. Therefore, the current treatments of ICP are limited to control symptoms and protect fetuses. Among various causing factors, drug exposure during pregnancy is one common factor, and it can be prevented if we know drugs with increasing risk of cholestasis. Here we analyzed over 9.5 million FDA adverse effect reports to identify drugs with increasing risks of cholestasis as an adverse effect. Patients treated for cholestasis or liver diseases were removed. The odds ratio analysis reveals that lansoprazole (LSPZ), omeprazole (OMPZ) and amoxicillin (AMXC) are associated with an increased risk of cholestasis. LSPZ is associated with increased reported cholestasis by a factor of 2.32 (OR with 95% confidence interval [2.21, 2.43]). OMPZ is associated with increased reported cholestasis by a factor of 2.61 [2.54, 2.69]. AMXC is associated with increased reported cholestasis adverse effect by a factor of 6.79 [6.49, 7.11]. The risk of cholestasis associated with these three drugs is further increased in pregnant women. These findings justify careful reassessment of the safety of the three identified drugs.


Assuntos
Amoxicilina/efeitos adversos , Colestase/induzido quimicamente , Lansoprazol/efeitos adversos , Omeprazol/efeitos adversos , Adolescente , Adulto , Criança , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Gravidez , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
5.
Perm J ; 232019.
Artigo em Inglês | MEDLINE | ID: mdl-30939286

RESUMO

BACKGROUND: A large number of patients with iron deficiency anemia have no known cause of their anemia despite a full evaluation. Optimal management and follow-up for this issue is unclear. Results of previous studies have implicated Helicobacter pylori infection as a potential cause of iron deficiency anemia. OBJECTIVES: To investigate whether H pylori infection could be a cause of unexplained iron deficiency anemia. METHODS: All adult patients with both unexplained iron deficiency anemia and H pylori infection diagnosed between January 1, 2008 and April 30, 2015 were identified from Kaiser Permanente Northern California's electronic medical records database and were followed-up for up to 2 years. We employed bivariate statistics to analyze demographic and clinical characteristics between H pylori treatment groups (treated and untreated). Multivariable logistic regression was used to assess the odds of continued presence of anemia at follow-up. RESULTS: Of 508 subjects who fit our inclusion criteria, 408 subjects were treated for H pylori. The median initial level of hemoglobin was 10.5 g/dL and ferritin was 7.0 ng/mL. No difference existed in the continued presence of iron deficiency anemia at follow-up between those treated for H pylori and those not treated (24.3% vs 26.5%, p = 0.71). Both groups had improved levels of hemoglobin (25.4% mean increase in treated vs 27.5% mean increase in untreated) at follow-up. CONCLUSION: In contrast to the findings of previous studies, we found no evidence that H pylori is involved in causing iron deficiency anemia. Iron deficiency anemia resolved in most subjects regardless of H pylori treatment status.


Assuntos
Anemia Ferropriva/epidemiologia , Antibacterianos/efeitos adversos , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/epidemiologia , Inibidores da Bomba de Prótons/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amoxicilina/efeitos adversos , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , California , Causalidade , Claritromicina/efeitos adversos , Claritromicina/uso terapêutico , Estudos de Coortes , Comorbidade , Feminino , Helicobacter pylori , Humanos , Masculino , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Omeprazol/efeitos adversos , Omeprazol/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico , Estudos Retrospectivos , Adulto Jovem
8.
J Gastrointestin Liver Dis ; 28(1): 11-14, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30851166

RESUMO

BACKGROUND AND AIM: Standard 10-day sequential therapy is advised as first-line therapy for Helicobacter pylori (H. pylori) eradication by current Italian guidelines. Some data suggested that a 14-day regimen may achieve higher eradication rates. This study compared the efficacy of sequential therapy administered for either 10- or 14-days. METHODS: This prospective, multicenter, open-label study enrolled patients with H. pylori infection without previous treatment. Patients were receiving a sequential therapy for either 10 or 14 days with esomeprazole 40 mg and amoxicillin 1 g (5 or 7 days) followed by esomeprazole 40 mg, clarithromycin 500 mg and tinidazole 500 mg (5 or 7 days), all given twice daily. Bacterial eradication was checked using 13C-urea breath test. Eradication cure rates were calculated at both Intention-to-treat (ITT) and per-protocol (PP) analyses. RESULTS: A total of 291 patients were enrolled, including 146 patients in 10-day and 145 in the 14-day regimen. The eradication rates were 87% (95% CI = 81.5-92.4) and 90.3% (95% CI = 85.5-95.1) at ITT analysis with the 10- and 14-day regimen, respectively, and 92.7% (95% CI = 88.3-97) and 97% (95% CI = 94.2-99.9) at PP analysis (p =0.37). Among patients, who earlier had interrupted therapy, bacterial eradication was achieved in 8 out of 9 who completed the first therapy phase and performed at least >/=3 days of triple therapy in the second phase. CONCLUSION: This study found that both 10- and 14-day sequential therapies achieved a high eradication rate for first-line H. pylori therapy in clinical practice.


Assuntos
Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Claritromicina/administração & dosagem , Esomeprazol/administração & dosagem , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Inibidores da Bomba de Prótons/administração & dosagem , Tinidazol/administração & dosagem , Adulto , Amoxicilina/efeitos adversos , Antibacterianos/efeitos adversos , Carga Bacteriana , Claritromicina/efeitos adversos , Esquema de Medicação , Quimioterapia Combinada , Esomeprazol/efeitos adversos , Feminino , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/microbiologia , Helicobacter pylori/patogenicidade , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inibidores da Bomba de Prótons/efeitos adversos , Fatores de Tempo , Tinidazol/efeitos adversos , Resultado do Tratamento
10.
BMJ Case Rep ; 12(3)2019 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-30852498

RESUMO

We present a case of a possible amoxicillin-induced anaphylaxis in a sensitive woman triggered by an instance of oral sexual contact with a man who was taking amoxicillin-clavulanic acid treatment.To our knowledge, this is the first case reported of a suspicion of amoxicillin-induced anaphylaxis in a woman after a sexual contact with a man who was taking the drug, we hypothesised an oral drug transfer through semen.Studies about amoxicillin concentrations achieved in semen after a drug intake are scarce. There are few cases reported of hypersensitivity reactions induced by drugs transported in semen but we have found some concern in sensitive patients about the possibility of transference of allergens via sexual intercourse. As clinicians, we consider that it is important to be aware of the existence of this possibility both in the diagnosis and in the prevention of anaphylactic reactions.


Assuntos
Amoxicilina/efeitos adversos , Anafilaxia/induzido quimicamente , Antibacterianos/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Doenças Sexualmente Transmissíveis/induzido quimicamente , Adulto , Feminino , Humanos , Masculino , Comportamento Sexual
11.
Diagn Microbiol Infect Dis ; 94(2): 192-194, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30728096

RESUMO

Although a 14-day treatment course with amoxicillin is in wide clinical usage to treat early Lyme disease, only a few published studies exist to validate its efficacy and safety, with none in the United States. In this study, we reviewed the records of 24 prospectively followed adult patients with erythema migrans who were prescribed a 14-day course of amoxicillin, 500 mg 3 times daily. Treatment with amoxicillin was well tolerated and uniformly successful in resolving the erythema migrans skin lesion and in preventing the development of an objective neurologic, cardiac, or rheumatologic manifestation. Although the study was relatively small and only involved a single center, the findings provide additional evidence that a 14-day course of 500 mg amoxicillin given 3 times per day is highly effective therapy for patients with early Lyme disease.


Assuntos
Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Eritema Migrans Crônico/tratamento farmacológico , Adulto , Idoso , Amoxicilina/efeitos adversos , Antibacterianos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Estados Unidos
13.
Gastroenterology ; 156(6): 1707-1716.e2, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30664875

RESUMO

BACKGROUND & AIMS: We performed genetic analyses of a multiethnic cohort of patients with idiosyncratic drug-induced liver injury (DILI) to identify variants associated with susceptibility. METHODS: We performed a genome-wide association study of 2048 individuals with DILI (cases) and 12,429 individuals without (controls). Our analysis included subjects of European (1806 cases and 10,397 controls), African American (133 cases and 1,314 controls), and Hispanic (109 cases and 718 controls) ancestry. We analyzed DNA from 113 Icelandic cases and 239,304 controls to validate our findings. RESULTS: We associated idiosyncratic DILI with rs2476601, a nonsynonymous polymorphism that encodes a substitution of tryptophan with arginine in the protein tyrosine phosphatase, nonreceptor type 22 gene (PTPN22) (odds ratio [OR] 1.44; 95% confidence interval [CI] 1.28-1.62; P = 1.2 × 10-9 and replicated the finding in the validation set (OR 1.48; 95% CI 1.09-1.99; P = .01). The minor allele frequency showed the same effect size (OR > 1) among ethnic groups. The strongest association was with amoxicillin and clavulanate-associated DILI in persons of European ancestry (OR 1.62; 95% CI 1.32-1.98; P = 4.0 × 10-6; allele frequency = 13.3%), but the polymorphism was associated with DILI of other causes (OR 1.37; 95% CI 1.21-1.56; P = 1.5 × 10-6; allele frequency = 11.5%). Among amoxicillin- and clavulanate-associated cases of European ancestry, rs2476601 doubled the risk for DILI among those with the HLA risk alleles A*02:01 and DRB1*15:01. CONCLUSIONS: In a genome-wide association study, we identified rs2476601 in PTPN22 as a non-HLA variant that associates with risk of liver injury caused by multiple drugs and validated our finding in a separate cohort. This variant has been associated with increased risk of autoimmune diseases, providing support for the concept that alterations in immune regulation contribute to idiosyncratic DILI.


Assuntos
Afro-Americanos/genética , Doença Hepática Induzida por Substâncias e Drogas/genética , Grupo com Ancestrais do Continente Europeu/genética , Hispano-Americanos/genética , Proteína Tirosina Fosfatase não Receptora Tipo 22/genética , Adulto , Amoxicilina/efeitos adversos , Antibacterianos/efeitos adversos , Estudos de Casos e Controles , Ácido Clavulânico/efeitos adversos , Feminino , Frequência do Gene , Estudo de Associação Genômica Ampla , Antígeno HLA-A2/genética , Cadeias HLA-DRB1/genética , Humanos , Masculino , Pessoa de Meia-Idade , Mutação de Sentido Incorreto , Polimorfismo de Nucleotídeo Único , Fatores de Risco
14.
Eur J Clin Pharmacol ; 75(5): 639-645, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30694338

RESUMO

AIM: To determine the effect of Saccharomyces boulardii CNCM I-745 (S. boulardii) plus sequential therapy on Helicobacter pylori (H. pylori) eradication rate. METHODS: This open-label prospective study randomized (1:1) patients with confirmed H. pylori infection to standard sequential therapy of twice-daily (bid) omeprazole 20 mg plus amoxicillin 1 g for 5 days, followed by bid omeprazole 20 mg, clarithromycin 500 mg and metronidazole 500 mg for the next 5 days (control group), or sequential therapy plus bid S. boulardii 250 mg (experimental group). Adverse events (AEs) were recorded throughout the study, and the H. pylori eradication rate was determined 4 weeks after treatment. RESULTS: The study was conducted from May 2013 to May 2016 and included 199 patients (51.3% male; mean age 44.6 ± 13.6 years). The H. pylori eradication rate was higher in the experimental group than the control group (86.0% vs. 74.7%; P = 0.02). Compared with the control group, patients in the experimental group experienced a significantly lower overall incidence of AEs (17.0% vs. 55.7%; p < 0.001) and the incidence of antibiotic-associated diarrhea (2.0% vs. 46.4%; P = 0.02). The experimental group showed improved treatment compliance over the 10-day study period compared with the control group (95.0% vs. 91.2%, P < 0.001). CONCLUSION: Addition of S. boulardii to sequential therapy improved H. pylori eradication rate and reduced the incidence of treatment-associated AEs in Moroccan patients with H. pylori infection.


Assuntos
Infecções por Helicobacter/terapia , Helicobacter pylori/efeitos dos fármacos , Probióticos/uso terapêutico , Saccharomyces boulardii , Adulto , Amoxicilina/efeitos adversos , Amoxicilina/uso terapêutico , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Claritromicina/efeitos adversos , Claritromicina/uso terapêutico , Feminino , Infecções por Helicobacter/tratamento farmacológico , Humanos , Masculino , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Omeprazol/efeitos adversos , Omeprazol/uso terapêutico , Estudos Prospectivos , Inibidores da Bomba de Prótons/efeitos adversos , Inibidores da Bomba de Prótons/uso terapêutico , Distribuição Aleatória
15.
Mucosal Immunol ; 12(3): 720-732, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30651577

RESUMO

Inflammatory bowel disease (IBD) etiology involves genetic susceptibility, environmental triggers, and the gut microbiome. Antibiotic exposure is associated with IBD, both in early life and adulthood. Here, we investigated whether Nod2-deficiency influenced response of the gut microbiota to antibiotics and subsequent colitis susceptibility. Wild-type and Nod2-/- littermate mice were treated with amoxicillin as adults or neonates, and fecal samples were collected for 16S rRNA sequencing. Five weeks after antibiotic exposure, dextran sulfate sodium (DSS) colitis was induced. Antibiotic treatment altered the microbiota of adult WT and Nod2-/- mice, but recovery was delayed in Nod2-/- mice. Neonatal antibiotic treatment significantly changed the microbiota at weaning in WT and Nod2-/- littermates; however, Nod2-/- mice maintained reduced microbial diversity 14 days after cessation of antibiotics. Although treatment of adult mice did not influence susceptibility to colitis, neonatally treated Nod2-/- mice developed a more severe colitis. Moreover, the colitis phenotype was transferable through fecal transplantation into germ-free Nod2-/- recipients, and was associated with changes in intestinal T cells and the cytokine milieu following inflammation. These data demonstrate that neonatal antibiotic exposure has long-lasting influence on the microbiota and mucosal immunity, and may explain how NOD2 contributes to the risk of intestinal inflammation.


Assuntos
Amoxicilina/efeitos adversos , Antibacterianos/efeitos adversos , Colite/metabolismo , Microbioma Gastrointestinal/efeitos dos fármacos , Doenças Inflamatórias Intestinais/metabolismo , Proteína Adaptadora de Sinalização NOD2/metabolismo , Amoxicilina/administração & dosagem , Animais , Animais Recém-Nascidos , Antibacterianos/administração & dosagem , Colite/genética , Modelos Animais de Doenças , Suscetibilidade a Doenças , Transplante de Microbiota Fecal , Microbioma Gastrointestinal/fisiologia , Interação Gene-Ambiente , Humanos , Doenças Inflamatórias Intestinais/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteína Adaptadora de Sinalização NOD2/genética , Risco
16.
JAMA ; 321(2): 188-199, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30644987

RESUMO

Importance: ß-Lactam antibiotics are among the safest and most effective antibiotics. Many patients report allergies to these drugs that limit their use, resulting in the use of broad-spectrum antibiotics that increase the risk for antimicrobial resistance and adverse events. Observations: Approximately 10% of the US population has reported allergies to the ß-lactam agent penicillin, with higher rates reported by older and hospitalized patients. Although many patients report that they are allergic to penicillin, clinically significant IgE-mediated or T lymphocyte-mediated penicillin hypersensitivity is uncommon (<5%). Currently, the rate of IgE-mediated penicillin allergies is decreasing, potentially due to a decreased use of parenteral penicillins, and because severe anaphylactic reactions to oral amoxicillin are rare. IgE-mediated penicillin allergy wanes over time, with 80% of patients becoming tolerant after a decade. Cross-reactivity between penicillin and cephalosporin drugs occurs in about 2% of cases, less than the 8% reported previously. Some patients have a medical history that suggests they are at a low risk for developing an allergic reaction to penicillin. Low-risk histories include patients having isolated nonallergic symptoms, such as gastrointestinal symptoms, or patients solely with a family history of a penicillin allergy, symptoms of pruritus without rash, or remote (>10 years) unknown reactions without features suggestive of an IgE-mediated reaction. A moderate-risk history includes urticaria or other pruritic rashes and reactions with features of IgE-mediated reactions. A high-risk history includes patients who have had anaphylaxis, positive penicillin skin testing, recurrent penicillin reactions, or hypersensitivities to multiple ß-lactam antibiotics. The goals of antimicrobial stewardship are undermined when reported allergy to penicillin leads to the use of broad-spectrum antibiotics that increase the risk for antimicrobial resistance, including increased risk of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus. Broad-spectrum antimicrobial agents also increase the risk of developing Clostridium difficile (also known as Clostridioides difficile) infection. Direct amoxicillin challenge is appropriate for patients with low-risk allergy histories. Moderate-risk patients can be evaluated with penicillin skin testing, which carries a negative predictive value that exceeds 95% and approaches 100% when combined with amoxicillin challenge. Clinicians performing penicillin allergy evaluation need to identify what methods are supported by their available resources. Conclusions and Relevance: Many patients report they are allergic to penicillin but few have clinically significant reactions. Evaluation of penicillin allergy before deciding not to use penicillin or other ß-lactam antibiotics is an important tool for antimicrobial stewardship.


Assuntos
Antibacterianos/efeitos adversos , Hipersensibilidade a Drogas/diagnóstico , Testes Imunológicos , Penicilinas/efeitos adversos , Amoxicilina/efeitos adversos , Amoxicilina/uso terapêutico , Antibacterianos/imunologia , Antibacterianos/uso terapêutico , Dessensibilização Imunológica , Hipersensibilidade a Drogas/imunologia , Hipersensibilidade a Drogas/terapia , Feminino , Humanos , Imunoglobulina E , Gravidade do Paciente , Penicilinas/imunologia , Penicilinas/uso terapêutico , Gravidez , beta-Lactamas/efeitos adversos , beta-Lactamas/imunologia
17.
Clin Oral Investig ; 23(1): 161-167, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29654563

RESUMO

OBJECTIVES: To investigate teeth's antibiotic-induced color differences after bleaching using two different techniques. MATERIALS AND METHODS: One hundred twenty extracted maxillar human incisors were examined. The specimens were randomly divided into six groups, each receiving one of six antibiotic paste fillings: (1) triple antibiotic paste (TAP) with minocycline, (2) double antibiotic paste (DAP), (3) TAP with amoxicillin, (4) TAP with cefaclor, (5) TAP with doxycycline, and (6) no filling (control group). Spectrophotometric measurements were obtained at baseline and then during the first, second, and third weeks after paste placement. The specimens discolored by antibiotics pastes were randomly divided into two subgroups: (1) internal bleaching with hydrogen peroxide (H2O2) and (2) internal bleaching with H2O2 plus Nd-YAG laser irradiation. The ∆E value was calculated and analyzed using a two-way analysis of variance and post-hoc Tukey's test (α = 0.05). RESULTS: The ∆E for all groups showed color differences exceeding the perceptibility threshold (∆E Ëƒ 3.7) at all time points except in the control and DAP groups. Minocycline-induced TAP showed the most severe coronal discoloration (32.42). When the ∆E was examined, thermo/photo bleaching (22.01 ± 8.23) caused more bleaching than walking bleaching (19.73 ± 5.73) at every time point (P = 0.19). No group returned to the original color after bleaching (P < 0.05). CONCLUSIONS: Except for DAP, all antibiotic pastes caused discoloration. Internal bleaching with Nd-YAG laser can be useful for bleaching/removing this discoloration. CLINICAL RELEVANCE: For clinically successful final appearances, understanding the effects of bleaching procedures on antibiotic paste discoloration is important.


Assuntos
Antibacterianos/efeitos adversos , Lasers de Estado Sólido/uso terapêutico , Espectrofotometria/métodos , Clareamento Dental/métodos , Descoloração de Dente/induzido quimicamente , Descoloração de Dente/terapia , Amoxicilina/efeitos adversos , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Cefaclor/efeitos adversos , Cefaclor/uso terapêutico , Ciprofloxacino/efeitos adversos , Ciprofloxacino/uso terapêutico , Doxiciclina/efeitos adversos , Doxiciclina/uso terapêutico , Humanos , Peróxido de Hidrogênio/uso terapêutico , Técnicas In Vitro , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Minociclina/efeitos adversos , Minociclina/uso terapêutico
19.
Arch Physiol Biochem ; 125(5): 447-455, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29925282

RESUMO

The present study was designed to explain the impact of amoxicillin, gentamicin, and cefazolin on the oxidative stress (OS) and reproductivity in the mouse testes. Our data showed that reduced glutathione (GSH) level, which is a marker for OS, strikingly reduced and hydrogen peroxide (H2O2) level, which acts as a signaling molecule in mammalian germ cells, strikingly increased with amoxicillin, gentamicin, and cefazolin treatment. The gene expression and enzymatic activity of superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), glucose-6-phosphate dehydrogenase (G6PD), and glutathione-S-transferases (GST) were significantly affected in the presence of these antibiotics. Also, spermatogenesis was adversely affected by suppressing Deleted in Azoospermia (Dazl) gene expression. Finally, oxidative stress and spermatogenesis failure distorted to sperm viability, motility, and morphology in amoxicillin and gentamicin-treated mice.


Assuntos
Amoxicilina/efeitos adversos , Antibacterianos/efeitos adversos , Fertilidade/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Gentamicinas/efeitos adversos , Estresse Oxidativo/efeitos dos fármacos , Proteínas de Ligação a RNA/genética , Animais , Antioxidantes/metabolismo , Peso Corporal/efeitos dos fármacos , Glutationa/metabolismo , Peróxido de Hidrogênio/metabolismo , Masculino , Camundongos , Tamanho do Órgão/efeitos dos fármacos , Sêmen/efeitos dos fármacos , Espermatogênese/efeitos dos fármacos , Testículo/efeitos dos fármacos , Testículo/enzimologia , Testículo/metabolismo , Testículo/fisiologia
20.
Br J Clin Pharmacol ; 85(1): 236-239, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30216492

RESUMO

The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia-like symptoms with fluoroquinolones (FQs) but no large epidemiologic study is to date available. We undertook a case-control study using a random sample of 9 053 240 subjects obtained from the PharMetrics Plus health claims database in the United States. Cases received at least two fibromyalgia diagnoses coded by a rheumatologist matched to ten randomly selected controls. After identifying 5148 cases of fibromyalgia and 51 480 controls, the adjusted rate ratio (RR) of fibromyalgia for use of any fluoroquinolones, amoxicillin and azithromycin were 1.63 (95% CI: 1.41-1.87), 1.64 (95% CI: 1.46-1.85) and 1.68 (95% CI, 1.49-1.89), respectively. The adjusted RR for any use of FQ compared to any use of amoxicillin or azithromycin was 0.99 (95% CI: 0.83-1.18) and azithromycin is 0.97 (95%CI: 0.82-1.16), respectively. The risk of fibromyalgia with FQs is similar to that with amoxicillin and azithromycin.


Assuntos
Antibacterianos/efeitos adversos , Fibromialgia/epidemiologia , Fluoroquinolonas/efeitos adversos , Adulto , Amoxicilina/efeitos adversos , Azitromicina/efeitos adversos , Estudos de Casos e Controles , Feminino , Fibromialgia/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos/epidemiologia
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