Clinical evaluation of the efficacy against helicobacter pylori by amoxicillin from volume-based procurement and potassium amoxicillin clavulanate / 中国临床药理学与治疗学

AIM: To evaluate the clinical efficacy of amoxicillin from volume-based procurement (VBP) and potassium amoxicillin clavulanate in the eradication of helicobacter pylori (Hp) infection, providing basis for the selection of treatment programs. METHODS: Data from the patients who received Hp eradication therapy from May 2021 to May 2022 were recruited from the rational drug use management system. The data from the patients treated by amoxicillin (amoxicillin 1.0 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) and potassium amoxicillin clavulanate (potassium amoxicillin clavulanate 0.914 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) were selected and compared. RESULTS: A total of 171 cases were collected in the group treated by Amoxicillin program, and the eradication rate was 87.8% (150/171). A total of 69 cases were collected in the group of potassium amoxicillin clavulanate, and the eradication rate was 76.8% (53/69). There was no significant difference in baseline data between the two groups (P>0.05). There was a significant difference in clinical efficacy between the two groups (P< 0.05). In addition, the cost-effectiveness ratio (C/E) of the Amoxicillin treatment program was lower than that of the potassium amoxicillin clavulanate program CONCLUSION: The clinical efficacy of VBP Amoxicillin program in eradicating Hp infection is better than that of the potassium amoxicillin clavulanate program, which is worthy of clinical recommendation.

Phenotypic Characterization and Antibiotic Susceptibility Profile of Coagulase Positive Staphylococci from The External Surfaces of Hospital Cockroaches (Periplaneta americana)

A study to phenotypically characterize and determine the antibiogram of coagulase positive Staphylococci (CoPS) from the external surfaces of hospital cockroaches (Periplaneta americana) was conducted using standard microbiological methods. Out of the 50 cockroaches collected from various hospitals in Uyo, sixty-two percent (n = 31) had coagulase positive Staphylococci which consisted of Staphylococcus aureus (44.0 %; n = 22) and Staphylococcus intermedius (18.0 %; n = 9). The CoPS isolates showed 100% resistance to Penicillin, Tetracycline, Clindamycin and 80.6% sensitivity to Amoxicillin-clavulanate. The CoPS showed multiple antibiotic resistances to ≥ 3 antibiotics, with 60 % exhibiting resistance to 6 antibiotics. Out of the 80 % (n = 31) of the multidrug resistant CoPS that were sensitive to Amoxicillin-clavulanate, none of them showed production of beta lactamase. The cockroaches bore multiple antibiotic resistant CoPS on their external surfaces and their contact can initiate contamination of patients' food. Pest control measures in hospital are hereby recommended to minimize cockroach related infections

A clinical trial to study the failure of treating initial Helicobacter pylori eradication with the doxycycline,amoxicillin and clavulanate potassium containing rescue quadruple regimen / 实用医学杂志

Objectives To investigate the efficacy and safety of quadruple regimen containing doxycy-cline,amoxicillin and clavulanate potassium in the treatment of Helicobacter pylori(Hp)after the failed initial eradication. Methods A total of 136 patients who had a failed course of initial eradication therapy were randomly divided into four groups. The 46 patients in group A were given rabeprazole,colloidal bismuth tartrate,doxycy-cline,amoxicillin and clavulanate potassium for 14 days). The 45 cases in group B were treated with rabeprazole, colloidal bismuth tartrate,doxycycline,amoxicillin and clavulanate potassium for 10 days. The 45 cases in control group received rabeprazole,colloidal bismuth tartrate,levofloxacin,amoxicillin for 14 days. After 4 weeks of treat-ment,the 13C-urea breath test was performed. The Hp eradication rates,adverse reactions,treatment compliance and cost-effectiveness ratio of the three groups were evaluated. Results A total of 130 patients completed the study. The intention to treat(ITT)and Per-protocol(PP)analyses revealed that the eradication rates of the three groups were 71.74% and 76.74%(group A),71.11% and 72.72%(group B),51.11% and 53.49%(control group),respectively. The ITT and PP of group were significantly higher than those of control group(P < 0.05). But there was no significant difference between group B and control group(P > 0.05). The rates of adverse reac-tions in each group were not statistically significant(P > 0.05),and the patient compliance of three groups was more than 80%. The cost and cost-effectiveness ratio showed that group B < control group < group A. Conclu-sions The quadruple therapy containing doxycycline,amoxicillin and clavulanate potassium as a rescue regimen given for 14 days is safe,effective and with high patient compliance,which is of high clinical significance.

Treatment progress and prognosis of protracted bacterial bronchitis / 中华实用儿科临床杂志

Protracted bacterial bronchitis (PBB) is an important cause of chronic wet cough.Bacterial infection is the main pathogen of PBB,so antibacterial infection is the main treatment.As the main antibiotic of experiential treatment,Amoxicillin-clavulanate is recommended to be used for at least 2 weeks,usually 4 weeks,and 6 to 8 weeks in part.If the sputum culture or bronchoalveolar lavage fluid is positive,the selection of antibiotic therapy can be according to drug sensitivity test.

Resistance to amoxicillin‑clavulanate and its relation to virulence‑related factors in Yersinia enterocolitica biovar 1A.

Recent studies have reported that the virulence factors (VFs) were detected more frequently in amoxicillin‑clavulanate (AMC) susceptible clinical isolates of Escherichia coli. Here, we have evaluated the relationship between VFs and AMC‑resistance phenotype in clinical isolates of Y. enterocolitica biovar 1A. The presence/absence of VFs was compared with their minimum inhibitory concentrations for AMC in strains of two serovars. We observed that the strains of the serovar O: 6, 30‑6, 31 showed a similar relationship between the number of VFs and resistance to clavulanic acid as in E. coli but not of serovar O: 6, 30. Variations in the promoters/complete coding sequences (CCDSs) of β‑lactamase gene (blaA) or the serological characteristics could not account for unusual susceptibility to AMC displayed by the strains of the serovar O: 6, 30. Therefore, we speculate that since the clinical strains of serovar O: 6, 30‑6, 31 originated from the environment they were less exposed to antibiotics compared to clinical strains of serovar O: 6, 30. Thus, AMC susceptibility seems to be influenced by factors other than serotypes or promoters/CCDS of β‑lactamase genes.

Pharmacoeconomics Evaluation of Azithromycin vs. Amoxicillin Clavulanate in the Treatment of Lower Respi-ratory Tract Infection / 中国药房

OBJECTIVE:To evaluate the economics of azithromycin vs. amocillin clavulante in the treatment of lower respirato-ry tract infections. METHODS:System evaluation was adopted to retrieve the randomized controlled trials(RCT)about azithromy-cin(test group)vs. amoxicillin clavulanate(control group)in the treatment of lower respiratory tract infections. Information was col-lected and Meta-analyses were performed. On this basis and short-term decision tree model,cost factors were added to conduct the pharmacoeconomics by the principle of PICO of Treeage Pro 2011 edition software. RESULTS:Totally 18 RCT were enrolled,in-volving 3 365 patients. Results of Meta-analysis showed that there were no significant differences in the effective rate [RR=0.93, 95%CI(0.55,1.55),P=0.77] and incidence of adverse reactions [RR=0.79,95%CI(0.62,1.0),P=0.05] between 2 groups. The av-erage treatment cost in test group and control group was respectively 790.4 yuan and 884.4 yuan,and cost-effectiveness ratio was respectively 216.0 and 245.7,and the incremental cost-effectiveness ratio(ICER)was -1 392.59. CONCLUSIONS:Azithromycin has similar efficacy and safety to amoxicillin clavulanate in the treatment of lower respiratory tract infection,however,azithromy-cin has better cost-effectiveness.

ß-lactamases produced by amoxicillin-clavulanate-resistant enterobacteria isolated in Buenos Aires, Argentina: A new blaTEMgene / ß-lactamasas producidas por enterobacterias resistentes a amoxicilina-ácido clavulánico aisladas en Buenos Aires, Argentina: un nuevo gen blaTEM

La resistencia a la combinación de ß-lactámico/inhibidor de ß-lactamasa en enterobacterias es un problema creciente que no ha sido estudiado intensamente en Argentina. En el presente trabajo, 54/843 enterobacterias recolectadas en un hospital universitario de la ciudad de Buenos Aires fueron resistentes a ampicilina-sulbactama, pero se mantuvieron sensibles a las cefalosporinas de segunda y tercera generación. Se analizaron los mecanismos enzimáticos presentes en los aislamientos que también fueron resistentes a amoxicilina-ácido clavulánico (AMC) (18/54). La secuenciación reveló dos variantes diferentes de blaTEM-1, donde blaTEM-1b es el alelo más frecuentemente detectado (10 Escherichia coli, 3 Klebsiella pneumoniae, 2 Proteus mirabilis y 1 Raoultella terrigena), seguidos por blaTEM-1a(1 K. pneumoniae). La resistencia a AMC parece estar asociada principalmente con la hiperproducción de TEM-1 (sobre todo en E. coli) o con la coexpresión con ß-lactamasas tipo OXA-2 y/o SHV (K. pneumoniae y P. mirabilis). Se describió una nueva variante de blaTEM(TEM-163) en un aislamiento de E. coli que presentó una CIM frente a AMC de 16/8 µg/ml. La enzima TEM-163 contiene dos sustituciones de aminoácidos respecto de TEM-1, Arg275Gln y His289Leu. Teniendo en cuenta la alta actividad específica observada y la baja IC50 para el ácido clavulánico, el patrón de resistencia de este aislamiento parece obedecer a la hiperproducción de la nueva variante de la ß-lactamasa de amplio espectro, en lugar de vincularse con un comportamiento similar al de una TEM resistente a inhibidores (IRT).

Resistance to ß-lactam/ß-lactamase inhibitors in enterobacteria is a growing problem that has not been intensively studied in Argentina. In the present work, 54/843 enterobacteria collected in a teaching hospital of Buenos Aires city were ampicillin-sulbactam-resistant isolates remaining susceptible to second-and third-generation cephalosporins. The enzymatic mechanisms present in the isolates, which were also amoxicillin-clavulanic acid (AMC)-resistant (18/54) were herein analyzed. Sequencing revealed two different variants of blaTEM-1, being blaTEM-1b the most frequently detected allelle (10 Escherichia coli, 3 Klebsiella pneumoniae, 2 Proteus mirabilis and 1 Raoultella terrigena) followed by blaTEM-1a(1 K. pneumoniae). Amoxicillin-clavulanate resistance seems to be mainly associated with TEM-1 overproduction (mostly in E. coli) or co-expressed with OXA-2-like and/or SHV ß-lactamases (K. pneumoniae and P. mirabilis). A new blaTEMvariant (TEM-163) was described in an E. coli strain having an AMC MIC value of 16/8 µg/ml. TEM-163 contains Arg275Gln and His289Leu amino acid substitutions. On the basis of the high specific activity and low IC50 for clavulanic acid observed, the resistance pattern seems to be due to overproduction of the new variant of broad spectrumß-lactamase rather than to an inhibitor-resistant TEM (IRT)-like behavior.

Clinical efficacy of four kinds drug oral medicine for 10 days sequential therapy for eradication of helicobacter pylori infection of children / 中国综合临床

Objective To investigate the clinical efficacy and safety of four kinds of drug oral medicine for 10 days sequential therapy for eradication of helicobacter pylori (Hp) infection of children.Methods One hundred and thirty children with Hp infection in the First Hospital of Datong from Apr.2013 to Apr.2014 were randomly divided into two groups with 65 cases in each group.Patients in the observation group were treated with four kinds of oral drug 10 d sequential therapy with omeprazole and amoxicillin-clavulanate potassium at first 5 d and then omeprazole,clarithromycin and metronidazole for the late 5 d.Patients in the control group were received standard triple therapy with omeprazole,clarithromycin and amoxicillin clavulanate potassium for 10 d.After treatment for 1 month,the Hp eradication rate,treatment rate,adverse reaction were evaluated and compared by 14C urea breathe test.Result The clinical efficacy rate of observation group was 93.8 ％ (61/65),significantly higher than that in control group (75.4％,49/65).Meanwhile,Hp eradication rate in observation group was 90.8％ (59/65),significantly higher than that in control group (67.7％,44/65).The differences were significant(x2 =8.51,10.52; P ＜ 0.05).The incidence of adverse reaction of observation group was 10.8％ (7/65),lower than that of the control group 15.4％ (10/65),and the differences was significant(x2 =0.61,P ＞ 0.05).Conclusion There are high Hp eradication and relatively safe of four kinds of oral drug 10 d sequential therapy clinical in treatment of Hp infection of children.It is worthy of clinical promotion.

Review of Antibiotics in the Management of Respiratory Infections: Cefaclor vs Amoxicillin- Clavulanate.

Cefaclor, a broad-spectrum semi-synthetic second generation oral cephalosporin with documented activity against many grampositive and gram-negative pathogens, as well as some anaerobes has established a record of efficacy in the management of respiratory tract infections (RTIs). Despite over three decades of widespread use, it remains clinically effective in patients with RTIs, making it competitive with amoxicillin-clavulanate and with macrolides, and fluoroquinolones, including many newer agents used for RTIs. Factors contributing to the efficacy and tolerability of cefaclor include its molecular stability, activity against the most prevalent gram-positive and gram-negative respiratory tract pathogens, rapid absorption, >90% bioavailability and good penetration into respiratory mucosa. When compared to amoxicillin-clavulanate, it is much better tolerated with less gastrointestinal adverse events thus ensuring better patient compliance.

Acute generalized exanthematous pustulosis due to amoxicillin/clavulanate / 대한내과학회지

Acute generalized exanthematous pustulosis (AGEP) was initially named by Beylot to describe a disease entity with sudden- onset amicrobial pustular eruptions accompanied by fever and leukocytosis. Most cases appear to be related to drug reactions, mainly antibiotics, although viral infections and hypersensitivity to mercury also cause AGEP. A 28-year-old woman presented with sudden-onset, multiple, and generally pinhead-sized pustules on an erythematous base scattered on the face and anterior chest wall. The patient had been on amoxicillin/clavulanate for acute pharyngitis. Histopathologically, the skin biopsy specimen revealed subcorneal and subepidermal pustules with neutrophil spongiosis, perivascular neutrophilic infiltration, and karyorrhectic debris. The eruption cleared rapidly after discontinuing the drug and administering systemic corticosteroid therapy.

Intravenous Drip Combined with Oral Administration Versus Sequential Therapy of Amoxicillin/Clavulanate Potassium for Lower Respiratory Tract Infection / 中国药房

0.05),respectively.CONCLUSION:Intravenous drip combined with oral administration of Amoxicillin/Clavulanate Potassium can replace intravenous dip of Amoxicillin/Clavulanate Potassium bid.For those ?-Lactams drugs with short t1/2,the unreasonable intravenous drip of which qd can be replaced by the intravenous drip combined with N-time oral administration or with N-time intramuscular injection.

Bacteriological Efficacy of Amoxicillin/sulbactam on Acute Bacterial Infections / 中华医院感染学杂志

0.05);the bacterial sensitive rates of amoxicillin/(sulbactam),(amoxicillin)/clavulanate,amoxicillin,ampicillin/sulbactam and cefotaxime were 88.42%,86.78%,57.02%,(86.78%) and 85.95%,respectively;the antibacterial potency of amoxicillin/sulbactam was higher than(amoxicillin)/clavulanate that of from the results of MIC_(90).CONCLUSIONS Amoxicillin/sulbactam has good (bacteriological) efficacy.