Deep neck space infections in  Adolescents

Adolescent deep neck space infection is an important pathology that often requires hospitalization for antimicrobial therapy. The aim of the study was to identify the inciting organisms and their resistance profiles in the adolescent population of patients with deep neck space infection. We performed a single-center cross-sectional retrospective analysis of patients between 10 and 16 years of age, with deep neck space infections. From the 319 cases of deep neck space infections that presented over the study period, nine patients met the criteria to be included in the study. The mean age being 11.8 years. The microbiology of the specimens revealed mainly Staphylococcus and Streptococcus species and in some patients microscopy and culture showed no predominant bacteria. There was an overall 86% resistance of organisms to penicillin and ampicillin but most organisms were sensitive to amoxicillin-clavulanic acid Deep neck space infections in adolescents can initially be managed with amoxicillin-clavulanic acid, source control and surgical drainage if required. Culture directed therapy can be initiated after microbiology results. The spaces involved are similar to adults with 44% of patients having deep neck abscess secondary odontogenic infection. The microbiology however is similar to that of children with Streptococcus and staphylococcus species being the most predominant.

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Adherence to guideline recommendations for urinary tract infections in adult women: a cross-sectional study

Primary Health Care Research & Development ◽

10.1017/s1463423621000116 ◽

2021 ◽

Vol 22 ◽

Author(s):

Rian Lelie- van der Zande ◽

Marcel Bouvy ◽

Martina Teichert

Keyword(s):

Urinary Tract ◽

Clavulanic Acid ◽

Cross Sectional Study ◽

Adult Women ◽

Sectional Study ◽

Cross Sectional ◽

First Choice ◽

Febrile Uti ◽

Amoxicillin Clavulanic Acid ◽

Tract Infections

Abstract Aim: To study whether changes in drug preferences in the Dutch guideline for the treatment of Urinary Tract Infection (UTI) for General Practitioners (GPs) in 2013, resulted in corresponding changes in antibiotic dispensing. Background: For the treatment of uncomplicated UTI, nitrofurantoin remained the first choice, while fosfomycin became the second choice and changed ranks with trimethoprim. For a subsequent febrile UTI, ciprofloxacin became the first choice and changed ranks with amoxicillin/clavulanic acid, co-trimoxazole remained the third choice. Methods: In this observational cross-sectional study, routinely collected dispensing data from the Dutch Foundation of Pharmaceutical Statistics from 2012 to 2017 were used. The number of women 18 years and older, treated with one of the guideline antibiotics for uncomplicated UTI and subsequent febrile UTI were analysed annually. Proportions were calculated. Data were stratified for age categories. Failure of uncomplicated UTI treatment was defined as the dispensing of an antibiotic for febrile UTI within 14 days after the dispensing of an antibiotic for uncomplicated UTI. Findings: Data were available from 81% of all pharmacies in 2012 to 89% in 2017. Percentages of women dispensed nitrofurantoin were relatively stable with 87.4% in 2012 and 84.4% in 2017. Percentages of women dispensed fosfomycin increased from 5.4% in 2012 to 21.8% in 2017, whereas percentages of women dispensed trimethoprim decreased from 17.8% to 8.0%. Within age categories, the percentage of women dispensed fosfomycin increased from 12.4% in women 18–30 years old to 36.7% in women above 80 years old. Percentages of women dispensed antibiotics for febrile UTI remained stable at 5% annually. Percentages of women receiving ciprofloxacin increased from 1.9% in 2012 to 3.3% in 2017, while those receiving amoxicillin/clavulanic acid decreased from 2.9% to 1.8%. New guideline recommendations resulted in corresponding changes in dispensed antibiotics for uncomplicated UTI and subsequent febrile UTI. Drug choices differed for age categories.

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Trends in Antibiotic Self-Medication for Dental Pathologies among Patients in the Dominican Republic: A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm10143092 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3092

Author(s):

Juan Manuel Aragoneses ◽

Javier Aragoneses ◽

Cinthia Rodríguez ◽

Juan Algar ◽

Ana Suárez

Keyword(s):

Dominican Republic ◽

Clavulanic Acid ◽

Bacterial Resistance ◽

Antibiotic Use ◽

World Health Organisation ◽

World Health ◽

Binary Logistic Regression Analysis ◽

Self Medication ◽

Cross Sectional ◽

Amoxicillin Clavulanic Acid

The World Health Organisation has warned of the increase in antibiotic resistance, estimating that by 2050 it could become the leading cause of death worldwide. Several studies and literature reviews show a correlation between antibiotic use and bacterial resistance, with unnecessary broad-spectrum antibiotics, such as amoxicillin/clavulanic acid and azithromycin, being one of the main causative factors. An interview-based survey of 2160 participants was conducted to assess the prevalence in the practice of self-medication with antibiotics among dental patients in the Dominican Republic. A series of open-ended questions regarding self-medication and class of antibiotics were put to the patients. Over a third of the study population (39.7%) admitted to the practice of antibiotic self-medication. Most of the respondents (58.4%) who indulged in self-medication were females, and it was prevalent in the older adults between 32–42 years old (36%). There was a negative correlation between age and self-medication practice (p < 0.001) observed with point biserial correlation test. Binary logistic regression analysis found an odds ratio of 0.97 (p < 0.001). The most consumed antibiotics were amoxicillin/clavulanic acid (52%), amoxicillin (31.1%), and azithromycin (10.1%). It is imperative to educate patients about the harmful effects of self-medication and to stress the need for governments to implement stricter laws on non-prescription drug availability.

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Patterns of Antimicrobial therapy in acute tonsillitis: A cross-sectional Hospital-based study from UAE

Anais da Academia Brasileira de Ciências ◽

10.1590/0001-3765201420120036 ◽

2014 ◽

Vol 86 (1) ◽

pp. 451-457 ◽

Cited By ~ 2

Author(s):

LISHA J. JOHN ◽

MEENU CHERIAN ◽

JAYADEVAN SREEDHARAN ◽

TAMBI CHERIAN

Keyword(s):

Clavulanic Acid ◽

Antimicrobial Agents ◽

Median Number ◽

Cross Sectional Study ◽

Current Sensitivity ◽

Acute Tonsillitis ◽

Cross Sectional ◽

Sensitivity Pattern ◽

Amoxicillin Clavulanic Acid ◽

Culture And Sensitivity

Background: Diseases of the ear, nose and throat (ENT) are associated with significant impairment of the daily life and a major cause for absenteeism from work. Aim: The study determined antimicrobial prescription pattern in patients with acute tonsillitis. Materials and Methods: A cross-sectional study was carried out among all the patients attending the ENT department with acute tonsillitis. Data were retrieved from the medical records using a proforma. Statistical analysis was carried out using SPSS.19. Results: Total of 238 patients included (Males 138; females 100). About 96% of total drugs were prescribed by generic name. Median number of drugs prescribed was four (range 1-7). Eighty eight percent of prescriptions contained antimicrobials, (78.5%) analgesics and (57.9%) antipyretics. Amoxicillin / Clavulanic acid (24.8%) and Ceftriaxone (12.2%) were the most commonly prescribed antimicrobials. Parenteral route was preferred in 41.6%. About 23.7% of the patients on Amoxicillin / Clavulanic acid had received the drug as intravenous injection. Culture and sensitivity tests were carried out in 106 (44.5%) of the cases. Antimicrobials were changed / added after the culture and sensitivity test in 25 patients. Conclusion: Study findings highlighted rational practices in drug prescribing. Therapeutic guidelines based on current sensitivity pattern optimize the use of antimicrobial agents.

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A comparative study between amoxicillin + clavulanic acid and levofloxacin in the management of acute maxillary sinusitis at RIMS, Ranchi

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175622 ◽

2017 ◽

Vol 4 (1) ◽

pp. 185

Author(s):

Sandeep Kumar ◽

Abha Kumari

Keyword(s):

Clavulanic Acid ◽

Maxillary Sinusitis ◽

Medical Sciences ◽

Oral Amoxicillin ◽

Group I ◽

Amoxicillin Clavulanate ◽

Amoxicillin Clavulanic Acid ◽

The Mean ◽

Group Ii ◽

And Gender

Background: Acute rhinosinusitis is an acute viral or bacterial in which there is inflammation of the mucosa of the nose and paranasal sinuses. The aim of study was to compare the efficacy of oral amoxicillin-clavulanate with levofloxacin in the management of acute maxillary sinusitis.Methods: The present prospective study was conducted in the Department of ENT, Rajendra Institute of Medical Sciences, Ranchi during a period of 8 months i.e. from July 2016 to June 2017. In Group I patients 1 gm of amoxicillin-clavulanate was given two times a day and in Group II, 500 mg of Levofloxicin was given once a day for a period of 10 days. Patient’s complete demographic details were recorded including name, age and gender. Xylometazoline nasal spray and steam inhalations were given to all the patients. Results: The mean age of the subjects was 36.43±6.43 years. In both the groups, majority of the subjects were between 36-45 years of age. There were 34.7% (52) in Group I and 38.7% (n=58) in Group II who belonged to this age group. Least number of subjects was those aged more than 48 years. There were 88% subjects (n=132) in group I and 86% (n=129) subjects in Group II in whom complete resolution of symptoms was seen.Conclusions: From the above study we can conclude that both amoxicillin–clavulanic acid and levofloxacin are equally efficacious in managing cases of acute sinusitis. In this study there was no difference in the rate and duration of resolution amongst both the groups.

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Deep neck space infection: an iceberg

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180951 ◽

2018 ◽

Vol 4 (3) ◽

pp. 644

Author(s):

Venkatesh Patil ◽

Rashmi Patil ◽

R. N. Karadi

Keyword(s):

Dental Caries ◽

Early Stage ◽

Incision And Drainage ◽

Space Infection ◽

Intravenous Antibiotics ◽

Life Threatening ◽

Deep Neck Space Infections ◽

Deep Neck Space Infection ◽

Extent Of Disease ◽

Morbid Conditions

Background: The aim of the study was to review pre-disposing factors and clinical features in deep neck space infections so as to avoid life threatening complications associated with it. Assessment and management of 55 cases of deep neck space infection.Methods: Retrospective study of 55 cases of deep neck space infection from January 2010 to June 2017. Results: Submandibular space/Ludwig’s angina is most commonly occurring neck space infection. Dental caries and poor oral hygiene is major contributing factor for infection. Parapharyngeal lymphadenitis followed by abscess formation is second most reason for neck space infection.Conclusions: Immediate active intervention is required to prevent progress of the disease. Early stage of cellulitis needs intravenous antibiotics with control of secondary co-morbid conditions like diabetes mellitus, immunocompromised states and dental caries. Ultrasound of neck and CT scan of neck is useful to know the extent of disease. Surgical intervention in the form of incision and drainage is required if abscess is detected either clinically or radiologically. Tracheostomy is required if airway is compromised.

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The landscape of antibiotic usage among COVID-19 patients in the early phase of pandemic: a Malaysian national perspective

Journal of Pharmaceutical Policy and Practice ◽

10.1186/s40545-022-00404-4 ◽

2022 ◽

Vol 15 (1) ◽

Author(s):

Izzati-Nadhirah Mohamad ◽

Calvin Ke-Wen Wong ◽

Chii-Chii Chew ◽

E-Li Leong ◽

Biing-Horng Lee ◽

...

Keyword(s):

Clavulanic Acid ◽

Early Phase ◽

Antibiotic Use ◽

Blood Parameters ◽

Cross Sectional Study ◽

Antibiotic Usage ◽

Binary Logistic Regression Analysis ◽

Cross Sectional ◽

Severe Stage ◽

Amoxicillin Clavulanic Acid

Abstract Background During the early phase of the COVID-19 pandemic, antibiotic usage among COVID-19 patients was noted to be high in many countries. The objective of this study was to determine the prevalence of antibiotic usage and factors affecting antibiotic usage among COVID-19 patients during the early phase of the COVID-19 pandemic in Malaysia. Methods This was a cross-sectional study that involved reviewing medical records of COVID-19 Malaysian patients aged 12 and above who were diagnosed with COVID-19 and received treatment in 18 COVID-19 hospitals from February to April 2020. A minimum sample of 375 patients was required. A binary logistic regression analysis was performed to determine factors associated with antibiotic usage. Variables with p < 0.05 were considered statistically significant. Results A total of 4043 cases were included for analysis. The majority of the patients (87.6%) were non-smokers, male (65.0%), and had at least one comorbidity (37.0%). The median age was 35 years (IQR: 38). The prevalence of antibiotic usage was 17.1%, with 5.5% of them being prescribed with two or more types of antibiotics. The most frequent antibiotics prescribed were amoxicillin/clavulanic acid (37.8%), ceftriaxone (12.3%), piperacillin/tazobactam (13.3%), azithromycin (8.3%), and meropenem (7.0%). Male patients (adjusted OR 1.53), who had a comorbidity (adjusted OR 1.36), associated with more severe stage of COVID-19 (adjusted OR 6.50–37.06), out-of-normal range inflammatory blood parameters for neutrophils, lymphocytes, and C-reactive protein (adjusted OR 2.04–3.93), corticosteroid use (adjusted OR 3.05), and ICU/HDU admission (adjusted OR 2.73) had higher odds of antibiotic use. Conclusions The prevalence of antibiotic usage in the early phase of the COVID-19 pandemic was low, with amoxicillin/clavulanic acid as the most common antibiotic of choice. The study showed that clinicians rationalized antibiotic usage based on clinical assessment, supported by relevant laboratory parameters.

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Antibiogram Development in the Setting of a High Frequency of Multi-Drug Resistant Organisms at University Teaching Hospital, Lusaka, Zambia

Antibiotics ◽

10.3390/antibiotics10070782 ◽

2021 ◽

Vol 10 (7) ◽

pp. 782

Author(s):

Brenna M. Roth ◽

Alexandra Laps ◽

Kaunda Yamba ◽

Emily L. Heil ◽

J. Kristie Johnson ◽

...

Keyword(s):

Clavulanic Acid ◽

Teaching Hospital ◽

Clinical Decision Making ◽

Clinical Decision ◽

Antibiotic Use ◽

Cross Sectional Study ◽

University Teaching ◽

World Health ◽

Cross Sectional ◽

Amoxicillin Clavulanic Acid

Antimicrobial resistance is a global challenge requiring reliable surveillance data collection and use. Prior studies on resistance in Zambia depended on laboratory methods with limited standardization. Since 2015, the University Teaching Hospital (UTH) microbiology laboratory has used the Vitek 2 Compact (bioMerieux, Inc., Marcy-l’Étoile, France) for standardized identification and susceptibility testing. We conducted a cross-sectional study of 2019 bacterial isolates collected from July 2015 to April 2017 to identify bacterial causes of infections, their susceptibility to commonly used antibiotics at UTH, and develop hospital antibiograms with a multidisciplinary team using World Health Organization guidance. We found high levels of antibiotic resistance among Gram negative bacteria. Escherichia coli and Klebsiella pneumoniae were highly resistant to all antibiotics except amikacin and carbapenems. E. coli had susceptibilities of 42.4% to amoxicillin/clavulanic acid, 41.4% to ceftriaxone, 40.2% to ciprofloxacin, and 10.4% to trimethoprim/sulfamethoxazole (TMP/SMX). K. pneumoniae had susceptibilities of 20.7% to amoxicillin/clavulanic acid, 15.6% to ceftriaxone, 48.5% to ciprofloxacin, and 12.3% to TMP/SMX. The high resistance to 3rd generation cephalosporins indicates high rates of beta-lactamase production. This is information that clinicians need to inform clinical decision making and choice of empiric antibiotics and that UTH requires to inform antimicrobial stewardship such as improvements in antibiotic use.

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Safety and efficacy of different drug forms of amoxicillin / clavulanic acid in treatment of lower respiratory tract infections in adults: an open prospective randomized trial

Russian Pulmonology ◽

10.18093/0869-0189-2008-0-2-73-80 ◽

2008 ◽

pp. 73-80

Author(s):

I. A. Guchev ◽

R. S. Kozlov

Keyword(s):

Respiratory Tract ◽

Randomized Trial ◽

Clavulanic Acid ◽

Clinical Efficacy ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Amoxicillin Clavulanic Acid ◽

The Mean ◽

Tract Infections

Amoxicillin/clavulanic acid (ACA) is one of the drugs of choice for treatment of lower respiratory tract infections (LRTI) in adults. One of the serious disadvantages of ACA is relatively high rate of gastrointestinal adverse events (AE). A new form of ACA, which is dispersable tablets Solutab, could potentially reduce the rate of AE because of more rapid and predictable absorption of clavulanic acid from intestine and improve clinical outcomes due to higher adherence to treatment. This trial was aimed to compare AE rate and clinical efficacy of the new dispersable ACA form Solutab with those of traditional ACA tabs in adult patients with non-severe LRTI. The treatment regimen comprised 500/125 mg t.i.d. during 5 to12 days. This was an open, prospective randomized trial performed at 4 clinical centres. Adults with clinically and radiologically detected non-severe community-acquired pneumonia or I or II types COPD exacerbations with purulent sputum received dispersable ACA tablets (the 1st group) or traditional coated tabs of ACA (the 2nd group) in a random proportion of 1 : 1. Clinical efficacy was evaluated with clinical signs, physical symptoms, additional laboratory and instrumental testing. The safety was assessed based on the patient's complaints and results of physical and laboratory examination in visits 2 (Day 3 or 4), 3 (Day 5 to 12), and 4 (Day 30 to 40 after taking the first dose of the drug). The trial involved 200 patients, the mean age, 32.7 ± 18.7 and 33.3 ± 18.6 yrs in the 1st and the 2nd groups, respectively. The groups were similar for history, severity, and clinical course of the disease. Clinical efficacy was 96.9 % in both groups in visit 3, 95.9 % and 96.9 % in the 1st and the 2nd group, respectively, in visit 4. The mean duration of antibacterial therapy was 7.1 ± 1.5 days in the 1st group and 7.2 ± 1.4 days in the 2nd group. AE were reported in 15 % and 31 % of the patients, respectively (p = 0.01). Gastrointestinal AE predominated in both the groups but the rate of diarrhea was lower in patients receiving dispersable ACA: 6 % vs. 17 % in the 2nd group (p = 0.027). Therefore, the new dispersable drug form of ACA has better safety profile in adult patients with non-severe LRTI compared to traditional ACA that was demonstrated by reduction in the AE, mainly diarrhea, rate. Both drug forms showed equally high clinical efficacy.

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Relationship of Sense of Coherence to Other Psychosocial Indices

European Journal of Psychological Assessment ◽

10.1027/1015-5759.20.4.227 ◽

2004 ◽

Vol 20 (4) ◽

pp. 227-236 ◽

Cited By ~ 19

Author(s):

Sara Holmberg ◽

Anders Thelin ◽

Eva-Lena Stiernström

Keyword(s):

Social Support ◽

Psychosocial Factors ◽

Sense Of Coherence ◽

Living Conditions ◽

Strong Negative Correlation ◽

Cross Sectional ◽

Positive Correlation ◽

Work Related ◽

Job Demand ◽

The Mean

Summary: The concept of “sense of coherence” (SOC) has been widely recognized since it was first introduced by Antonovsky. The originality and usefulness of the SOC scale and its relation to other psychosocial measures has been the subject of lively debate. The aim of this paper was to test for associations between SOC and work-related psychosocial factors (mainly the Job Demand-Control model), general living conditions, education, and social network factors. Cross-sectional data from a population-based sample of 1782 rural males from nine counties in Sweden were analyzed with a multiple regression technique. The subjects were occupationally active at inclusion and the mean age was 50 years (range 40-60). SOC was assessed with the original 29-item questionnaire. Psychosocial variables and lifestyle factors were assessed using questionnaires and structured interviews. The mean SOC among the subjects was 152.3 (standard deviation, 19.4). A strong negative correlation was found between SOC and job demand, whereas a positive correlation with job control was demonstrated. A positive correlation with general living conditions and with social support was also found. However, there was no correlation to education and occupation. Thus, SOC was shown to be strongly correlated to work-related psychosocial factors and social support, but independent of sociodemographic factors.

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Age related volume of cadaver-prostates in Bangladesh

Ibrahim Medical College Journal ◽

10.3329/imcj.v4i2.6501 ◽

1970 ◽

Vol 4 (2) ◽

pp. 74-77

Author(s):

Rukshana Ahmed ◽

Shamim Ara

Keyword(s):

Prostate Gland ◽

Age Groups ◽

Clinical Settings ◽

Cross Sectional ◽

Medical College ◽

Age Related ◽

Group A ◽

Key Words Prostate ◽

The Mean ◽

Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

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