Short-course versus conventional length antimicrobial therapy for uncomplicated lower urinary tract infections in children: A meta-analysis of 1279 patients
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Abstract Objectives In standard regimens for Helicobacter pylori infection, amoxicillin is dosed twice daily, although the bactericidal effect of amoxicillin depends on the %time‐above‐MIC. We aimed to examine whether dosing schemes of amoxicillin influenced eradication rates of amoxicillin‐based regimens. Methods One hundred eighty‐seven patients infected with clarithromycin‐sensitive strains of H. pylori were treated with PPI, clarithromycin 200 mg bid and amoxicillin 750 mg bid, 500 mg tid or 500 mg qid for 1 week and 125 infected with clarithromycin‐resistant strains were treated with PPI, metronidazole 250 mg bid and amoxicillin 750 mg bid, 500 mg tid or 500 mg qid for 1 week. Results Eradication rates (ITT) of the triple PPI/amoxicillin/clarithromycin therapy with bid, tid and qid dosings of amoxicillin were 77.8% (49/63), 93.5% (58/62), and 91.9% (57/62), respectively. Those of the triple PPI/amoxicillin/metronidazole therapy were 80.5% (33/41), 90.5% (38/42), and 95.2% (40/42), respectively. Eradication rates in regimens with tid and qid dosing of amoxicillin were higher than those of regimens with the bid dosing of amoxicillin. Conclusions The dosing scheme of amoxicillin significantly influenced eradication rates of triple therapies. Although amoxicillin is empirically dosed twice daily, amoxicillin should be dosed at least three times daily in amoxicillin‐based triple therapies.
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Objective To develop a RP - HPLC method for determination of amoxicillin in human plasma and compare the pharmacokinetics of amoxicillin dispersible tablets and amoxicillin tablets in healthy volunteers.Methods Twelve healthy male volunteers were selected and divided into two groups,who received a single oral dose of 500 mg amoxicillin sustained release tablets and amoxicillin tablets respectively.The plasma concentrations of amoxicillin were determined by HPLC.Results The main pharmacokinetic parameters of amoxicillin sustained release tablets and amoxicillin tablets were as follows:C_(max) were(742.8±68.4)μg/L and(676.7±57.2)μg/L,t_(max) were(2.7±0.3) h and(3.4±0.6) h,t_(1/2) were(4.9±1.5) h and(5.9±1.8) h,AUC_0~∞were(6 417.3±167.5)μg/(h·L) and(4 704.8±117.9)μg/(h·L),AUC_0~t were(4 927.4±119.7)μg/(h·L) and(3 436.5±103.5)μg/(h·L) respectively.Conclusion The t_(max) and t_(1/2) of amoxicillin dispersible tablets were significantly smaller than that of amoxicillin tablets,AUC_0~t,AUC_0~∞and C_(max) were significantly higher than that of the amoxicillin tablets.It suggested that the amoxicillin dispersible tablets had a certain property of swift releasing,and it is obvious better than its ordinary tablets.
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We evaluated single-dose regimens of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin as treatment for acute cystitis in 38 women. The trial was prematurely stopped because of frequent treatment failures. At two days after treatment, all 13 patients given trimethoprim-sulfamethoxazole were cured, while four (31%) of 13 given amoxicillin and four (33%) of 12 given cyclacillin had persistent bacteriuria. At two weeks, 11 (85%) of 13 patients given trimethoprim-sulfamethoxazole, six (50%) of 12 given amoxicillin, and three (30%) of ten given cyclacillin were cured. One patient with positive results of antibody-coated bacteria testing who was treated with cyclacillin had signs and symptoms of acute pyelonephritis three days after treatment, and two patients treated with amoxicillin and one treated with trimethoprim-sulfamethoxazole converted antibody-coated bacteria test results from negative to positive after therapy. We conclude that single-dose treatment of cystitis in unselected women with cyclacillin and amoxicillin may result in low cure rates and that progression to acute pyelonephritis may occur following ineffective single-dose therapy.
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[Objective] The study was to explore whether antimicrobial activity of the antimicrobial peptides extracted from immunized Tenebrio molitor vary with different pathogens as inducers.[Method] By inducing hungry T.molitor larvaes to generate immune response via feeding with bacteria and with fungi or actinomycete after pricking,the antimicrobial peptide extract was obtained by grinding and centrifuging the cultures.Its antimicrobial activity against 26 pathogens was measured by bacteriostatic ring,and evaluated by trisection to four types and inhibitory spectrum.[Result] Both the antimicrobial activity and antimicrobial spectrum of the antimicrobial peptide extract varied remarkably among different pathogens as inducers.[Conclusion] Bio-control used strains have obvious advantage in inducing the insect to express body fluid immunity material-antimicrobial peptides.
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Two groups, each of 20 patients, with urinary tract infection were randomly chosen and treated according to a double-blind procedure with either ampicillin, 500 mg, or trimethoprimsulfamethoxazole, either drug being given 4 times daily for 10 days. A number of features of the infections were studied: the occurrence of single or multiple attacks, the presence or absence of complications whether the lower or upper urinary tract was affected, favourably with ampicillin in sterilizing the urine of patients and the bacteria involved. Trimethoprim-sulfamethoxazole was found to compare with multiple and complicated urinary tract infections during a follow-up period of 3 months.
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Amoxicillin have been widely described by dentists in Iraq, especially in treatment of periodontal and other oral bacterial infections. Amoxicillin is the 4-hydroxy analogue of ampicillin and is used in a similar variety of susceptible infections. Clinical pharmacology of amoxicillin in saliva was not sufficiently studied on normal subjects or patients required amoxicillin treatment. The purpose of this study is to determine the amoxicillin concentration in saliva by using an efficient, low cost and reproducible method. The obtained results from high performance liquid chromatography (HPLC) method revealed that salivary concentration of amoxicillin ranged from 0.22 to 0.44 μg. / ml. The HPLC method was proved to be a successful method for monitoring the amoxicillin in saliva with a detection limit reached to 0.08 μg/ml. It is important to suggest further study to know the therapeutic effect of amoxicillin through saliva against certain oral lesions.
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The combination of trimethoprim and sulfamethoxazole (TMP-SMZ) in the proportion of 4 mg of TMP to 20 mg of SMZ was used in 51 children with recurrent urinary-tract infections who had failed to respond to long-term therapy with other antimicrobial regimens. Included were 34 patients with normal urinary tracts or with minimal or no lower tract abnormalities, nine with parenchymal damage but normal renal function, and eight with severe structural abnormalities of the urinary tract and reduced renal function. TMP-SMZ was effective in maintaining the urine sterile in all but the complicated cases for periods up to 22 months. In approximately half the patients infection recurred soon after treatment was discontinued. No adverse effects were observed in any of the patients.
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As antibiotic pressure often triggers bacterial resistance, the use of short-duration therapies is increasingly recommended. The objective of the present study was to evaluate both the clinical efficiency and the impact on oral streptococci of a 3 day versus a 7 day amoxicillin therapy for odontogenic infection requiring tooth extraction. On day 0, patients were randomly assigned to a 3 day or 7 day amoxicillin treatment. The tooth was extracted on day 2 and the post-operative follow-up was carried out on day 9. Oral flora was collected on days 0, 9 and 30, and the susceptibility of the streptococci to amoxicillin was determined. The results showed that treatment with amoxicillin for 3 or 7 days had a similar clinical efficiency, and also induced similar selection of oral streptococci with reduced susceptibility to amoxicillin, suggesting that the selection of strains with reduced susceptibility to amoxicillin is a rapid phenomenon, appearing even with short-duration therapies.
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We evaluated single-dose regimens of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin as treatment for acute cystitis in 38 women. The trial was prematurely stopped because of frequent treatment failures. At two days after treatment, all 13 patients given trimethoprim-sulfamethoxazole were cured, while four (31%) of 13 given amoxicillin and four (33%) of 12 given cyclacillin had persistent bacteriuria. At two weeks, 11 (85%) of 13 patients given trimethoprim-sulfamethoxazole, six (50%) of 12 given amoxicillin, and three (30%) of ten given cyclacillin were cured. One patient with positive results of antibody-coated bacteria testing who was treated with cyclacillin had signs and symptoms of acute pyelonephritis three days after treatment, and two patients treated with amoxicillin and one treated with trimethoprim-sulfamethoxazole converted antibody-coated bacteria test results from negative to positive after therapy. We conclude that single-dose treatment of cystitis in unselected women with cyclacillin and amoxicillin may result in low cure rates and that progression to acute pyelonephritis may occur following ineffective single-dose therapy. (JAMA1985;253:387-390)
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One hundred and sixteen adults with symptoms of acute urinary tract infection were randomly collected into four groups and given single-dose or seven-day treatment with trimethoprim or co-trimoxazole. Of the 105 patients who completed the study, bacterial urinary infection was present in 70 patients (67 per cent). The rates for symptomatic and bacterial cures were high and indistinguishable between the groups, and there was no difference in the rate of recurrence of urinary infection in the six weeks after treatment. Side effects were lower in the group receiving single-dose trimethoprim (P=0.09).
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