Amoxicillin-clavulanate-induced Kounis syndrome

The aim of the study was to evaluate the effectiveness of antibiotic chemotherapy regimens and the dynamics of the nature of microbial associations of the operating area at the surgical stages of treatment of patients using dental implants in conditions of limited bone tissue. The study involved 37 patients (17 m and 20 w, from 32 to 68 years). According to the tactics of the treatment and the type of antibacterial effect, the patients were divided into 3 groups. Per os was prescribed antibiotics as a step therapy: amoxicillin (flemoxin 500 mg 1 tablet 2 per day for 7 days) and amoxicillin / clavulanate (flemoclav 625 mg 1 table 2 per day 7 days), doxycycline (unidox 100 mg 1 table 1 per day 5 days). The 1st group of patients (n1=12; 31.9%) — a multi-stage approach (MA), where the 1st operation is bone grafting (BG) (Flemoxin 500 mg), after 6—9 months, the 2nd dental implantation (DI) (flemoklav 625 mg), after 3—6 months the 3rd — installation of gingival formers (GF) (unidox 100 mg). The 2nd group of patients (n2=14; 36.2%) — a one-stage approach (OA), where the 1st operation is BG with simultaneous DI (flemoxin 500 mg), after 6—9 months — the 2nd — installation of GF (flemoklav 625 mg). 3rd group — narrow/short implants (N/S) without BG were installed (n3=11; 31.9%). The 1st operation — DI (Flemoxin 500 mg), the 2nd — installation of GF (Flemoklav 625 mg). A bacteriological study with the identification of pure cultures of bacteria and determination of sensitivity to antibacterial drugs was performed for all patients before treatment and in dynamics. In MA, there was a suppression of the growth of certain types of bacteria and an increase in the number of species resistant to this antibiotic. In the framework of the OA, when prescribing antibiotics, the results were comparable. With N/S implants, growth inhibition of a number of species present at the beginning of treatment was noted. In multi-stage operations, we consider it reasonable to use beta-lactamase-protected drugs, or drugs of another group that include representatives of parodontopathogenic species and potential carriers of multiple resistance genes in their spectrum of action.

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Should beta‐blockers be continued as a treatment for myocardial infarction in the case of kounis syndrome?

Annals of Noninvasive Electrocardiology ◽

10.1111/anec.12837 ◽

2021 ◽

Author(s):

Mari Amino ◽

Tomokazu Fukushima ◽

Atsushi Uehata ◽

Chiemi Nishikawa ◽

Seiji Morita ◽

...

Keyword(s):

Myocardial Infarction ◽

Beta Blockers ◽

Kounis Syndrome

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PRO: Carbapenems should be used for ALL infections caused by ceftriaxone-resistant Enterobacterales

JAC-Antimicrobial Resistance ◽

10.1093/jacamr/dlab013 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

David L Paterson ◽

Burcu Isler ◽

Patrick N A Harris

Keyword(s):

Antibiotic Resistance ◽

Observational Studies ◽

Randomized Trials ◽

Antibiotic Resistance Genes ◽

Definitive Treatment ◽

In Vitro Activity ◽

Genes Encoding ◽

Amoxicillin Clavulanate ◽

Trial Outcomes

Abstract Ceftriaxone resistance in the Enterobacterales is typically the result of production of ESBLs or AmpC β-lactamases. The genes encoding these enzymes are often co-located with other antibiotic resistance genes leading to resistance to aminoglycosides, quinolones and trimethoprim/sulfamethoxazole. Carbapenems are stable to ESBLs and AmpC giving them reliable in vitro activity against producers of these β-lactamases. In contrast, piperacillin/tazobactam and amoxicillin/clavulanate are compromised by co-production of OXA-1, which is not inhibited by tazobactam or clavulanate. These in vitro findings provide an explanation for the MERINO trial outcomes, where 3.7% (7/191) randomized to meropenem died compared with 12.3% (23/187) randomized to piperacillin/tazobactam as definitive treatment of bloodstream infection due to ceftriaxone-resistant organisms. No randomized trials have yet put cefepime and carbapenems head to head, but some observational studies have shown worse outcomes with cefepime. We argue that carbapenems are the antibiotics of choice for ceftriaxone-resistant Enterobacterales.

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Gemifloxacin versus Amoxicillin/Clavulanate in the Treatment of Acute Exacerbations of Chronic Bronchitis

Journal of Chemotherapy ◽

10.1179/joc.2000.12.4.314 ◽

2000 ◽

Vol 12 (4) ◽

pp. 314-325 ◽

Cited By ~ 24

Author(s):

T. File ◽

B. Schlemmer ◽

J. Garau ◽

H. Lode ◽

S. Lynch ◽

...

Keyword(s):

Chronic Bronchitis ◽

Acute Exacerbations ◽

Amoxicillin Clavulanate

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Cisplatin-induced bradycardia: Cardiac toxicity or cardiac hypersensitivity and Kounis syndrome?

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.10.027 ◽

2016 ◽

Vol 202 ◽

pp. 817-818 ◽

Cited By ~ 6

Author(s):

Nicholas G. Kounis ◽

Gianfranco Cervellin ◽

Giuseppe Lippi

Keyword(s):

Cardiac Toxicity ◽

Kounis Syndrome

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1463. Activity of Delafloxacin against Multi-Drug-Resistant Fastidious Respiratory Pathogens from European Medical Centers (2014-2019)

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1644 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S733-S733

Author(s):

Dee Shorttidge ◽

Jennifer M Streit ◽

Michael D Huband ◽

Robert K Flamm

Keyword(s):

Active Agent ◽

The United States ◽

Multidrug Resistant ◽

Respiratory Pathogens ◽

Services Research ◽

In Vitro Susceptibility ◽

Amoxicillin Clavulanate ◽

Tract Infections ◽

Research Grant

Abstract Background Delafloxacin (DLX) is an anionic fluoroquinolone (FQ) that has been approved in the United States and in Europe for the treatment of acute bacterial skin and skin structure infections and was recently approved in the US for treatment of community-acquired bacterial pneumonia (CABP). In the present study, in vitro susceptibility (S) results for DLX and comparator agents were determined for CABP pathogens including Streptococcus pneumoniae (SPN), Haemophilus influenzae (HI), H. parainfluenzae (HP) and Moraxella catarrhalis (MC) clinical isolates from European hospitals participating in the SENTRY Program during 2014-2019. Methods A total of 2,835 SPN, 1,484 HI, 959 MC, and 20 HP isolates were collected from community-acquired respiratory tract infections (CARTI) during 2014-2019 from European hospitals. Sites included only 1 isolate/patient/infection episode. Isolate identifications were confirmed at JMI Laboratories. Susceptibility testing was performed according to CLSI broth microdilution methodology, and EUCAST (2020) breakpoints were applied where applicable. Other antimicrobials tested included levofloxacin (LEV) and moxifloxacin (MOX; not tested in 2015). Multidrug-resistant (MDR) SPN isolates were categorized as being nonsusceptible (NS) to amoxicillin-clavulanate, erythromycin (ERY), and tetracycline; other SPN phenotypes were ERY-NS, or penicillin (PEN)-NS. β-lactamase (BL) presence was determined for HI, HP, and MC. Results The activities of the 3 FQs are shown in the table. The most active agent against SPN was DLX, with the lowest MIC50/90 values of 0.015/0.03 mg/L. DLX activities were the same when tested against the MDR or PEN-NS for SPN phenotypes. ERY-NS isolates had DLX MIC50/90 results of 0.015/0.03 mg/L. DLX was the most active FQ against HI, HP, and MC. BL presence did not affect FQ MIC values for HI or MC; only 1 HP isolate was BL-positive. Conclusion DLX demonstrated potent in vitro antibacterial activity against SPN, HI, HP, and MC. DLX was active against MDR SPN that were NS to the agents commonly used as treatments for CABP. These data support the utility of DLX in CABP including when caused by antibiotic resistant strains. Table 1 Disclosures Jennifer M. Streit, BS, A. Menarini Industrie Farmaceutiche Riunite S.R.L. (Research Grant or Support)A. Menarini Industrie Farmaceutiche Riunite S.R.L. (Research Grant or Support)Allergan (Research Grant or Support)Melinta Therapeutics, Inc. (Research Grant or Support)Melinta Therapeutics, Inc. (Research Grant or Support)Melinta Therapeutics, Inc. (Research Grant or Support)Merck (Research Grant or Support)Paratek Pharma, LLC (Research Grant or Support) Robert K. Flamm, PhD, A. Menarini Industrie Farmaceutiche Riunite S.R.L. (Research Grant or Support)Amplyx Pharmaceuticals (Research Grant or Support)Basilea Pharmaceutica International, Ltd (Research Grant or Support)Department of Health and Human Services (Research Grant or Support)Melinta Therapeutics, Inc. (Research Grant or Support)

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