scholarly journals Mucogingival Abscess Following Implant Surgery

2018 ◽  
Vol 2 (3) ◽  
pp. 527-530
Author(s):  
Ronald Garrido
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Prophylaxis ◽  
Antibiotic Treatment ◽  
Bacterial Contamination ◽  
Recommended Dose ◽  
Postoperative Infections ◽  
Implant Surgery

The rehabilitation of lost teeth, by means of implants has grown exponentially and thus the use of antibiotic therapy to prevent postoperative infectious pictures. The use of antibiotics has proved beneficial avoiding the failure of a large number of implants from bacterial contamination , in comparison to non-use of these . Although the use of antibiotic prophylaxis or treatment is controversial , studies suggest that antibiotic prophylaxis is more effective than antibiotic treatment in preventing postoperative infections, being 2g amoxicillin one hour before the recommended dose.

scholarly journals Laparoscopic appendectomy versus antibiotic treatment for acute appendicitis—a systematic review

2021 ◽  
Author(s):  
Franziska Köhler ◽  
Anne Hendricks ◽  
Carolin Kastner ◽  
Sophie Müller ◽  
Kevin Boerner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Laparoscopic Appendectomy ◽  
Data Extraction ◽  
Open Appendectomy ◽  
Cochrane Library ◽  
Pubmed Database ◽  
Uncomplicated Appendicitis ◽  
Absence From Work

Abstract Background Over the last years, laparoscopic appendectomy has progressively replaced open appendectomy and become the current gold standard treatment for suspected, uncomplicated appendicitis. At the same time, though, it is an ongoing discussion that antibiotic therapy can be an equivalent treatment for patients with uncomplicated appendicitis. The aim of this systematic review was to determine the safety and efficacy of antibiotic therapy and compare it to the laparoscopic appendectomy for acute, uncomplicated appendicitis. Methods The PubMed database, Embase database, and Cochrane library were scanned for studies comparing laparoscopic appendectomy with antibiotic treatment. Two independent reviewers performed the study selection and data extraction. The primary endpoint was defined as successful treatment of appendicitis. Secondary endpoints were pain intensity, duration of hospitalization, absence from work, and incidence of complications. Results No studies were found that exclusively compared laparoscopic appendectomy with antibiotic treatment for acute, uncomplicated appendicitis. Conclusions To date, there are no studies comparing antibiotic treatment to laparoscopic appendectomy for patients with acute uncomplicated appendicitis, thus emphasizing the lack of evidence and need for further investigation.

The Benefits and Harms of Antibiotic Prophylaxis for Urinary Tract Infection in Older Adults

2021 ◽  
Author(s):  
Bradley J Langford ◽  
Kevin A Brown ◽  
Christina Diong ◽  
Alex Marchand-Austin ◽  
Kwaku Adomako ◽  
...  
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Bloodstream Infection ◽  
Antibiotic Treatment ◽  
Positive Culture ◽  
Clostridioides Difficile

Abstract Background The role of antibiotics in preventing urinary tract infection (UTI) in older adults is unknown. We sought to quantify the benefits and risks of antibiotic prophylaxis among older adults. Methods We conducted a matched cohort study comparing older adults (≥66 years) receiving antibiotic prophylaxis, defined as antibiotic treatment for ≥30 days starting within 30 days of a positive culture, with patients with positive urine cultures who received antibiotic treatment but did not receive prophylaxis. We matched each prophylaxis recipient to 10 nonrecipients based on organism, number of positive cultures, and propensity score. Outcomes included (1) emergency department (ED) visit or hospitalization for UTI, sepsis, or bloodstream infection within 1 year; (2) acquisition of antibiotic resistance in urinary tract pathogens; and (3) antibiotic-related complications. Results Overall, 4.7% (151/3190) of UTI prophylaxis patients and 3.6% (n = 1092/30 542) of controls required an ED visit or hospitalization for UTI, sepsis, or bloodstream infection (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.12–1.57). Acquisition of antibiotic resistance to any urinary antibiotic (HR, 1.31; 95% CI, 1.18–1.44) and to the specific prophylaxis agent (HR, 2.01; 95% CI, 1.80–2.24) was higher in patients receiving prophylaxis. While the overall risk of antibiotic-related complications was similar between groups (HR, 1.08; 95% CI, .94–1.22), the risk of Clostridioides  difficile and general medication adverse events was higher in prophylaxis recipients (HR [95% CI], 1.56 [1.05–2.23] and 1.62 [1.11–2.29], respectively). Conclusions Among older adults with UTI, the harms of long-term antibiotic prophylaxis may outweigh their benefits.

scholarly journals Urinary cytokines in women with refractory detrusor overactivity: A longitudinal study of rotating antibiotic versus placebo treatment

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247861
Author(s):  
Zhuoran Chen ◽  
Samantha Ognenovska ◽  
Ronald Sluyter ◽  
Kate H. Moore ◽  
Kylie J. Mansfield
Keyword(s):  
Antibiotic Therapy ◽  
Receptor Antagonist ◽  
Antibiotic Treatment ◽  
Detrusor Overactivity ◽  
Placebo Treatment ◽  
Symptom Improvement ◽  
Urinary Concentration ◽  
Consecutive Series ◽  
Tnf Α ◽  
Patient Outcome Measures

Over 50% of women with detrusor overactivity (DO), who do not respond to therapy have been shown to have bacteriuria, which may stimulate the release of inflammatory cytokines than can enhance nerve signalling, leading to symptoms of urgency. This study made use of a consecutive series of urine samples collected from women with refractory DO, who participated in a clinical trial of rotating antibiotic therapy. The aim was to determine the effect of bacteriuria and antibiotic treatment on the levels of urinary cytokines, and to correlate the cytokine concentration with patient outcome measures relating to urgency or urge incontinence. The urinary cytokines chosen were IL-1α, IL-1 receptor antagonist, IL-4, IL-6, IL-8, IL-10, CXCL10 (IP-10), MCP-1 and TNF-α. The presence of bacteriuria stimulated a significant increase in the concentrations of IL-1α (P 0.0216), IL-1 receptor antagonist (P 0.0264), IL-6 (P 0.0003), IL-8 (P 0.0043) and CXCL-10 (P 0.009). Antibiotic treatment significantly attenuated the release of IL-1α (P 0.005), IL-6 (P 0.0027), IL-8 (P 0.0001), IL-10 (P 0.049), and CXCL-10 (P 0.042), i.e. the response to the presence of bacteria was less in the antibiotic treated patients. Across the 26 weeks of the trial, antibiotic treatment reduced the concentration of five of the nine cytokines measured (IL-1α, IL-6, IL-8, IL-10 and CXCL-10); this did not reach significance at every time point. In antibiotic treated patients, the urinary concentration of CXCL-10 correlated positively with four of the six measures of urgency. This study has shown that cytokines associated with activation of the innate immune system (e.g. cytokines chemotactic for or activators of macrophages and neutrophils) are reduced by antibiotic therapy in women with refractory DO. Antibiotic therapy is also associated with symptom improvement in these women, therefore the inflammatory response may have a role in the aetiology of refractory DO.

scholarly journals Duration of antibiotic therapy in critically ill patients: a randomized controlled trial of a C-reactive protein-based protocol versus an evidence-based best practice strategy without biomarkers

2020 ◽  
Author(s):  
Isabela Nascimento Borges ◽  
Rafael Carneiro ◽  
Rafael Bergo ◽  
Larissa Martins ◽  
Enrico Colosimo ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Critically Ill ◽  
Antibiotic Treatment ◽  
Median Duration ◽  
Critically Ill Patients ◽  
Treatment Time ◽  
C Reactive Protein ◽  
Daily Monitoring ◽  
Reactive Protein ◽  
To Receive

Abstract Background: The rational use of antibiotics is one of the main strategies to limit the development of bacterial resistance . We therefore sought to evaluate the effectiveness of a C reactive protein-based protocol in reducing antibiotic treatment time in critically ill patients.Methods: A randomized, open-label, controlled clinical trial conducted in two intensive care units of a university hospital in Brazil. Critically ill infected adult patients were randomly allocated to: i) intervention to receive antibiotics guided by daily monitoring of CRP levels, and ii) control to receive antibiotics according to the best practices for rational use of antibiotics.Results : 130 patients were included in the CRP (n=64) and control (n=66) groups. In the intention to treat analysis, the median duration of antibiotic therapy for the index infectious episode was 7.0 (5.0-8.8) days in the CRP and 7.0 (7.0-11.3) days in the control (p = 0.011) groups. A significant difference in the treatment time between the two groups was identified in the curve of cumulative suspension of antibiotics, with less exposure in the CRP group (p = 0.007). In the per protocol analysis, involving 59 patients in each group, the median duration of antibiotic treatment was 6.0 (5.0-8.0) days for the CRP and 7.0 (7.0- 10.0) days for the control (p = 0.011) groups. Conclusions: Daily monitoring of CRP levels may aid in the reduction of antibiotic treatment time of critically ill patients, even in a scenario of judicious use of antimicrobials. Trial Registry : ClinicalTrials.gov Identifier: NCT02987790. Registered 09 December 2016, https://clinicaltrials.gov/ct2/show/NCT02987790 .

"Antibiotic prophylaxis" and "preventive antibiotic therapy": two sides of the same coin.

2021 ◽  
Author(s):  
Angel-Orión Salgado-Peralvo ◽  
Naresh Kewalramani ◽  
Alvaro Garcia-Sanchez ◽  
Juan-Francisco Peña-Cardelles
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Prophylaxis ◽  
Two Sides

scholarly journals 452. Antibiotic Duration, but Not Size, Impacts Clinical Cure of Limited Skin and Soft-Tissue Infection After Incision and Drainage

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S222-S223
Author(s):  
Jason G Lake ◽  
Stephanie Fritz
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Clinical Cure ◽  
Day Treatment ◽  
Treatment Protocol ◽  
Chi Square ◽  
Incision And Drainage ◽  
Exact Test ◽  
Days Of Therapy ◽  
Antibiotic Duration

Abstract Background Incision and drainage (I&D) is the most common treatment for skin abscesses. A recent randomized clinical trial (RCT) of outpatients with limited (≤5 cm) skin abscesses demonstrated antibiotic therapy with clindamycin or trimethoprim-sulfamethoxazole (TMP-SMX) was superior to I&D alone. We performed a subgroup analysis to measure the effect of antibiotic duration and abscess size on clinical cure at 7–10 days after antibiotic completion. Methods Participants with complete data regarding adherence to the 10-day treatment were included. Demographic and baseline clinical features were compared using t-test, Pearson’s chi-square or Fisher’s exact test, or a non-parametric equivalent where appropriate. Largest abscess dimension (cm) was dichotomized by median size. The effect of antibiotic duration, abscess size (≤ median vs. >median) and covariates on clinical cure were measured using logistic regression. Breslow-Day Test for Homogeneity was used to assess the interaction between treatment and abscess size. Results Of 786 participants in the intention-to-treat analysis, complete adherence data were available for 680 (87%) participants. Of these, 463 (68%) received either antibiotic: 421 (91%) completed 10 days of therapy, 29 (6.3%) ≤7 days and 20 (4.3%) ≤5 days. Only antibiotic treatment duration was associated with clinical cure (table). Odds of clinical cure were 1.7 (95% CI: 1.5, 2.0) times higher for each additional day of treatment. Median abscess size was 2.5 cm (range: 0.2–5); 364 participants had abscesses ≤ median vs. 316 >median. Assessed continuously, abscess size was not associated with cure within antibiotic groups (table) or between placebo and treatment groups (OR 0.94, 95% CI: 0.58–1.5). Stratifying on size, no significant interaction was observed with antibiotic treatment (Breslow-Day P = 0.13). Conclusion Adherence to the treatment protocol was high. These data suggest that longer courses of antibiotic therapy in conjunction with I&D are associated with successful treatment of limited skin abscesses. Size was not associated with clinical cure. Prospective RCTs to determine the optimal length of treatment are needed. Disclosures All authors: No reported disclosures.

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