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Drugs causing cutaneous necrosis
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Broad-spectrum antibiotics are preferred as most of the infections are polymicrobial. Options include combinations such as ampicillin, gentamicin, and clindamycin or metronidazole. Ampicillin-sulbactam, ticarcillin-clavulanate potassium, and piperacillin-tazobactam also provide adequate anaerobic and aerobic coverage. Piperacillin-tazobactam or ticarcillin-clavulanate potassium therapy has the advantage of providing gram-negative and pseudomonas coverage. Nafcillin plus agents with anaerobic and gram-negative coverage has also been used in the treatment of such infections [83–86]. Skin necrosis may be due to necrotizing infections secondary to neutropenia caused by various drugs.
Drug Therapy in Rhinology
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Gehanno et al. 7 looked at the effectiveness of systemic steroids in the treatment of ARS. Eight milligrams of methylprednisolone was given three times a day for 5 days as an adjunct to 10 days’ treatment with amoxicillin clavulanate potassium in patients with ARS. The diagnostic criteria consisted of facial pain, purulent nasal discharge and purulent secretions from the middle meatus, together with opacities on CT scan. The conclusion was that there was no difference in the therapeutic outcome at day 14 between the steroid group and the placebo group, although 4 days after initiating treatment, the headache and facial pain was significantly less in the steroid group. A Cochrane review suggests systemic steroids may be a useful adjunctive therapy to oral antibiotics in the short-term relief of symptoms of ARS.8
Amoxicillin–Clavulanic Acid
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Amoxicillin–clavulanic acid is a combination product consisting of the semisynthetic antibiotic amoxicillin with the beta-lactamase-inhibitor clavulanic acid as a potassium salt. Clavulanic acid is a naturally occurring beta-lactamase inhibitor isolated from Streptomyces clavuligerus (Brown et al., 1976; Reading and Cole, 1977; see Chapter 13, Beta-Lactamase inhibitors). It contains a beta-lactam ring, and the sulfur of the penicillin thiazolidine ring is replaced with oxygen to form an oxazolidine ring (see Figure 14.1). Clavulanic acid has weak intrinsic beta-lactam activity, but its clinical utility relates to its potent inhibition of many beta-lactamases (Reading et al., 1983) and its ability to protect substrate drugs from hydrolysis (Bush, 1988). The molecular formula of clavulanic acid is C8H8KNO5. Chemically, clavulanate potassium is potassium –(2R,5R)-3-(2-hydroxyethylidine)-7-oxo-4-oxa-1-azabicyclo[3.2.0]-heptane-2-carboxylate and has a molecular weight of 237.25.
Iatrogenic factors of Helicobacter pylori eradication failure: lessons from the frontline
Published in Expert Review of Anti-infective Therapy, 2023
Jinliang Xie, Dingwei Liu, Jianxiang Peng, Shuang Wu, Dongsheng Liu, Yong Xie
In addition, amoxicillin-clavulanate potassium and other uncommonly used or ineffective antibiotics were used in H. pylori eradication. It was irrational for some patients to treat H. pylori infection using amoxicillin-clavulanate potassium instead of amoxicillin. In an RCT study, bismuth quadruple therapy with amoxicillin-clavulanate and tetracycline showed 17.4% eradication rate by per-protocol analyses [31]. Clavulanate potassium is known as a β-lactamase inhibitor, while H. pylori do not produce β- lactamase, the addition of clavulanate potassium agent in the H. pylori treatment is maybe ineffective. Secondly, clavulanate potassium will exceed the normal dosage to meet the amoxicillin standard dose and increase the risk of drug-induced liver damage consequently. Otherwise, an insufficient dose of amoxicillin may reduce the efficacy and lead to eradication failure. At present, there is no consensus to recommend amoxicillin-clavulanate potassium to treat H. pylori infection. Besides, some patients used other not recommended or ineffective antibiotics, such as gentamicin, azithromycin, roxithromycin, etc. These antibiotics are not verified by clinical trials so they may affect the efficacy [9,22]. Moreover, some other not recommended treatments were used, such as non-high dual dose therapy, only one antibiotic therapy, etc. These informal treatments with an insufficient dose of regimens should be avoided to reduce the risk of treatment failure.
Longitudinal gut microbiome changes in alcohol use disorder are influenced by abstinence and drinking quantity
Published in Gut Microbes, 2020
Nancy J. Ames, Jennifer J. Barb, Kornel Schuebel, Sarah Mudra, Brianna K. Meeks, Ralph Thadeus S. Tuason, Alyssa T. Brooks, Narjis Kazmi, Shanna Yang, Kelly Ratteree, Nancy Diazgranados, Michael Krumlauf, Gwenyth R. Wallen, David Goldman
Three of the 22 participants received antibiotics (AB) during the course of the study. As shown in Figure 5, oral ciprofloxacin may have reduced Shannon diversity index within and following the window of AB exposure (p =.03). One received amoxicillin/clavulanate potassium 875 mg/125 mg day 4 through week 2 (See Figure 5; Supplemental Table S1). The second received ciprofloxacin 500 mg day 4 through week 2. The third received ophthalmic antibiotic ofloxacin 0.3% eye drops at week 2 to 3. No genera were found to be significantly more or less abundant in patients that received antibiotics during the AB timeframe. Time points at weeks two and three were used for comparison because this was the time frame that most of the AB patients were treated with antibiotics. Transit time (measured by the BSS) was not affected by antibiotic treatment (Supplementary Figure S2).
Fatal congenital tuberculosis owing to late diagnosis of maternal tuberculosis: case report and review of congenital tuberculosis in China
Published in Paediatrics and International Child Health, 2020
Jing-min Sun, Chang Wang, Dan-qun Jin, Fang Deng
Previously, the infant’s mother had been healthy with no history of TB contact. She presented at FPH with a history of a chronic non-productive cough and low-grade fever at 30 weeks gestation. Haemoglobin was 11.2 g/dL, white cell count (WCC) 13.2 × 109/L (neutrophils 40.6%, lymphocytes 51.3%, monocytes 3%) and serum C-reactive protein (CRP) was 54 mg/L (<5). Other results of routine chemical pathology were within normal limits. Serology was negative for chlamydia, herpes simplex virus, rubella and cytomegalovirus. Screening for humoral and cellular immunity was normal and HIV was negative. Blood cultures were negative. Tuberculin skin test (TST) and chest radiography were not performed. She did not have a BGG scar. She was diagnosed with community-acquired pneumonia and amoxicillin and clavulanate potassium were prescribed. However, her respiratory symptoms did not improve during the remainder of her pregnancy. Immediately after giving birth, she was transferred to the intensive care unit because of a high fever and dyspnoea. She had no contact with her infant and did not breastfeed.