scholarly journals Antibacterial therapy of endometritis after cesarian section: optimizing the dosing regime

Author(s):  
Nikolay A. Korobkov ◽  
Natal'ya V. Bakulina

Purpose. To study the pharmacokinetics of -lactam antibiotics in the development of endometritis after cesarean section to select the optimal dosage regimen. Methods. A prospective, randomized, single-center study included 52 women in puerperas with endometritis after a caesarean section, divided into four groups. The patients of the first group (n = 17) received a course of ceftriaxone bolus in a single dose of 2.0 g (n = 10) and in the mode of prolonged perioperative infusion (n = 7). The patients of the second group (n = 10) received cefepim bolus at a dose of 2.0 g 2 times a day (n = 5) and in the extended infusion mode (n = 5). The patients of the third group (n = 14) received amoxicillin / clavulanic acid (Amoxiclav 1000 mg + 200 mg) bolus at a dose of 1.0 g 3 times a day (n = 7) and in the extended infusion regimen (n = 7). The patients of the fourth group (n = 11) received ampicillin / sulbactam (Ampisid 1000 mg + 500 mg) bolus at a dose of 1.0 g 4 times a day (n = 6) and in the extended infusion regimen (n = 5). We have compared the concentration of the studied antibiotics in the uterine cavity in the four groups using high performance liquid chromatography. Results. The effective bactericidal concentration (C 4MIC) was not maintained throughout the entire dose interval in any of the treatment groups. The clinical efficacy and safety of the studied antibiotic regimens were similar. However, prolonged infusion of cefepime and aminopenicillins provided significantly higher concentrations in lochia. Conclusion. Prolonged intravenous infusion of cefepime, ceftriaxone, amoxicillin / clavulanic acid and ampicillin / sulbactam in the treatment of endometritis after a caesarean section improves the pharmacokinetic / pharmacodynamic characteristics of these -lactams in the uterine cavity, compared with the traditional bolus administration.

10.3823/818 ◽  
2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Amine Ousaid ◽  
Jaouad Akrim ◽  
Youssef Khayati

Introduction: The aim of this work was to control the quality of some antibiotics cartridges (ampicillin, amoxicillin-clavulanic acid, ciprofloxacin and vancomycin) used for antibiotic susceptibility testing by disk diffusion method. Antibiotics were determined in disks and two techniques were compared for this purpose, chromatographic and microbiological method. Methods: Chromatographic method (High-Performance Liquid Chromatography: HPLC) was used for determining ampicillin, amoxicillin-clavulanic acid and ciprofloxacin, and microbiological method for vancomycin and ampicillin. We used the European Pharmacopoeia 8th edition monographs and a simple and adapted method published in 2015 by Ramli Y. et Al. Results: Dosage results reveal that 35% of unexpired cartridges had low content and all the expired AB’s disks gave low results. Conclusion: Our study demonstrated that the content of antibiotics in disks could decrease if the storage and transport conditions (temperature and relative humidity) of disk cartridges were not respected. Therefore, properly performed quality control of antibiotic disks before use in laboratories would aid in providing accurate and reproducible results of dosage. Keywords: Antibiotic disks, Quality control, Antibiogram, High Performance Liquid Chromatography, Microbiological method.


Author(s):  
Elçin Bedeloğlu ◽  
Mustafa Yalçın ◽  
Cenker Zeki Koyuncuoğlu

The purpose of this non-random retrospective cohort study was to evaluate the impact of prophylactic antibiotic on early outcomes including postoperative pain, swelling, bleeding and cyanosis in patients undergoing dental implant placement before prosthetic loading. Seventy-five patients (45 males, 30 females) whose dental implant placement were completed, included to the study. Patients used prophylactic antibiotics were defined as the experimental group and those who did not, were defined as the control group. The experimental group received 2 g amoxicillin + clavulanic acid 1 h preoperatively and 1 g amoxicillin + clavulanic acid twice a day for 5 days postoperatively while the control group had received no prophylactic antibiotic therapy perioperatively. Data on pain, swelling, bleeding, cyanosis, flap dehiscence, suppuration and implant failure were analyzed on postoperative days 2, 7, and 14 and week 12. No statistically significant difference was detected between the two groups with regard to pain and swelling on postoperative days 2, 7, and 14 and week 12 ( p >0.05), while the severity of pain and swelling were greater on day 2 compared to day 7 and 14 and week 12 in both groups ( p =0.001 and p <0.05, respectively). Similarly, no significant difference was found between the two groups with regard to postoperative bleeding and cyanosis. Although flap dehiscence was more severe on day 7 in the experimental group, no significant difference was found between the two groups with regard to the percentage of flap dehiscence assessed at other time points. Within limitations of the study, it has been demonstrated that antibiotic use has no effect on implant failure rates in dental implant surgery with a limited number of implants. We conclude that perioperative antibiotic use may not be required in straightforward implant placement procedures. Further randomized control clinical studies with higher numbers of patients and implants are needed to substantiate our findings.


Author(s):  
Muhammad Ali

The research was aimed to evaluate the antibiotic susceptibility pattern of Staphylococcus species from clinical samples obtained from some hospitals in Kano metropolis, Nigeria. The ear swab, high vaginal swab (HVS), wound swab and urine samples from the patients attending the hospitals were collected and inoculated onto the surface of freshly prepared Nutrient agar for bacterial isolation. The bacteria isolated were identified by conventional microbiological methods namely; Gram staining, biochemical test (such as catalase, coagulase, and DNase test), mannitol salt agar and heamolysis test. The isolates were subjected to antibiotic susceptibility testing using the agar disc diffusion method. The result showed that S. aureus was highly susceptible to Ciprofloxacin 105 (68.63%), Gentamicin 102 (66.67%), Levofloxacin 95 (62.08%) and Amikacin 90 (58.82%), S. epidermidis was highly susceptible to Gentamicin 13 (61.90%), Levofloxacin 12 (57.14%) and Nitrofurantoin 11 (52.38%) while S. saprophyticus was highly susceptible to Cefoxitin 7 (77.78%), Gentamicin 6 (66.67%) and Nitrofurantoin 5 (55.56%). On the other hand, S. aureus was highly resistant to Cefuroxime 153 (100%), Ceftazidime 150 (98.04%), Amoxicillin/clavulanic acid 120 (78.43%) and Cloxacillin 111 (72.55%), S. epidermidis was highly resistant to Ceftazidime 20 (95.24%), Cloxacillin 19 (90.48%) then Cefoxitin, Erythromycin and Amoxicillin/clavulanic acid with 15 (71.43%) both. S. saprophyticus was highly resistant to Cefepime 9 (100%), Cloxacillin 8 (88.89%), Ceftazidime 7 (77.78%), Imipenem and Erythromycin with 6 (66.67%) respectively. There is a statistical difference in the sensitivity of the isolates against the antibiotics used at p<0.05. It is concluded that Staphylococcus species develop resistance to some classes of antibiotics.


2017 ◽  
Vol 68 (2) ◽  
pp. 228-231 ◽  
Author(s):  
Renata Maria Varut ◽  
Luciana Teodora Rotaru

The study objectives were to determine the chemical composition and the synergistic / antagonistic effect of the association between hydroalcoholic extract from the Dorycnii pentaphylli herba (DPH) and the antibiotics of choice, on five reference strains. The tincture contains flavonoids and polyphenol carboxylic acids in low concentrations. DPH has an antagonistic effect on three of the drugs tested (amoxicillin + clavulanic acid, levofloxacin, amikacin), the therapeutic effect being completely canceled and has no significant effect on two of them (ceftazidime, cefotaxime).


This article discusses the augmenting influence of Artesunate (ART) in combination with β-lactams (amoxicillin/clavulanic acid) antibiotic in sepsis mice models infected by a lethal challenge dose of live coagulase positive enterotoxigenic (Sec) MRSA that was isolated from a case of chronic bovine mastitis. The main goal is to find an appropriate treatment to overcome resistance mechanism of MRSA towards β-lactams antibiotic. Fifty healthy adult Swiss mice divided into 5 equal groups were used in the experimental procedure. The infected group that treated with both ART and β-lactams (amoxicillin/clavulanic acid) antibiotic revealed complete inhibition of MRSA count with complete normal macroscopic and histopathological features. We suggest that ART can potentiate the antibacterial action of β-lactams (amoxicillin/Clavulanic) acid against MRSA infection. The combination of ART and antibiotic can overcome MRSA resistance mechanism and so could be considered a novel candidate to overcome mastitis and/or sepsis caused by MRSA.


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