Clinical Observation of Three Kinds of Drug Regimens in the Treatment of Active Chronic Gastritis with Heli-cobacter Pylori Infection / 中国药房

OBJECTIVE:To observe the Hp eradication situation and safety of three kinds of drug regimen in the treatment of active chronic gastritis with helicobacter pykori(Hp)infection. METHODS:150 active chronic gastritis patients with Hp infection were randomly divided into group A(50 cases),group B(50 cases)and group C(50 cases). Group A received Omeprazole enter-ic-coated capsule 20 mg,orally,twice a day+Amoxycillin capsules 1.0 g,orally,3 times a day+Clarithromycin tablet 0.5 g,oral-ly,once a day. Group B additionally received Colloidal bismuth pectin capsule 150 mg,orally,3 times a day. Group C received Omeprazole enteric-coated capsule 20 mg,orally,twice a day+Amoxycillin capsules 1.0 g,orally,3 times a day,1-5 d,Omepra-zole enteric-coated capsule 20 mg,orally,twice a day+ Clarithromycin tablets 0.5 g,orally,once a day+Metronidazole tablet 0.4 g,twice a day,6-10 d. All patients treated for 10 d. Effective rate of pain relief,relief time of pain and gastrointestinal symptoms, Hp eradication rate,recurrence after 12 follow-up and the incidence of adverse reactions in all groups were observed. RESULTS:Effective rate of pain relief and Hp eradication rate in group C were higher than group B,followed by group A,relief time of pain and gastrointestinal symptoms,recurrence rate in group C were lower than group B,which was lower than group A,with signifi-cant differences (P0.05). CONCLUSIONS:Taking omeprazole in stages combined with antibiotics can effectively relieve abdominal pains,shorten disease course,improve Hp eradica-tion rate,reduce long-term recurrence rate in the treatment of active chronic gastritis with Hp infection,with good safety.

Efeito da antibioticoterapia sistêmica com amoxicilina e tetraciclina no processo de reparo da injúria de luxação extrusiva / Effect of systemic antibiotic therapy with amoxicillin and tetracycline in the healing process of the injury extrusive luxation

A luxação extrusiva é uma injúria do ligamento periodontal caracterizada pelo deslocamento parcial do dente do seu alvéolo sendo que o tratamento preconizado consiste no reposicionamento, contenção e alguns autores recomendam a antibioticoterapia sistêmica (ATS). No entanto, não há nenhuma evidência para a utilização da ATS no reparo tecidual após a injúria de luxação extrusiva. O objetivo da pesquisa foi avaliar o efeito da ATS com Amoxicilina e Tetraciclina no processo de reparo da injúria de luxação extrusiva. Noventa ratos (Rattus norvegicus albinus), adultos, machos tiveram seus incisivos superiores direito luxados, deslocados 3mm no sentido axial e após 5 minutos reposicionados. Os animais foram aleatoriamente divididos em três grupos: Soro, Amoxicilina (25mg/Kg) e Tetraciclina (2,5mg/Kg). A medicação foi administrada de 12/12h por gavagem por um período de 7 dias. Os animais sofreram eutanásia nos períodos de 7, 15 e 30 dias após a luxação. A análise estatística foi realizada por meio dos testes de Kruskal-Wallis e pós-teste de Dunn’s de múltipla comparação ao nível de 5%. O tecido conjuntivo subjacente à inserção epitelial apresentou um infiltrado inflamatório agudo que foi de menor intensidade e extensão no grupo Amoxicilina nos três períodos pós-operatório analisados. Em todos os grupos o ligamento periodontal estava organizado e o infiltrado inflamatório agudo só apresentou diferença significante aos 7 e 15 dias com melhor resultado para o grupo Amoxicilina. Com relação ao infiltrado inflamatório crônico, tanto na intensidade quanto na extensão, foi maior no grupo Soro. Ocorreram poucas áreas de reabsorção radicular em todos os grupos sem diferença significante. O tecido pulpar na maioria dos espécimes em todos os grupos apresentou calcificações. Pode-se concluir que a antibioticoterapia sistêmica tem um efeito positivo noprocesso de reparo da luxação extrusiva e que a amoxicilina é uma boa opção.

The extrusive luxation is a periodontal ligament injury characterized by partial dislocation of the tooth its alveolus and that the recommended treatment consists of repositioning, contain and some authors recommend systemic antibiotic therapy (SAT). However, there is no evidence for the use of SAT in tissue repair after injury extrusive luxation. The objective is to evaluate the effect of SAT with Amoxicillin and Tetracycline in the repair process of the injury of extrusive luxation. Ninety rats (Rattus norvegicus albinus), adult male had his dislocated right incisor, moved 3 mm in the axial direction and after 5 minutes repositioned. The animals were randomly divided into three groups: Saline, Amoxycillin (25mg/kg) and Tetracycline (2,5mg/kg). The drug is administered of 12/12h by gavage for a period of 7 days. The animals were euthanized at 7, 15 and 30 days after the dislocation. Statistical analysis was performed using the Kruskal-Wallis test and Dunn’s post-test for multiple comparison to the level of 5%. The underlying connective tissue to the epithelial attachment presented an acute inflammatory infiltrate that was less intensity and extent in the Amoxicillin group in the three postoperative periods analyzed. In all groups the periodontal ligament was organized and acute inflammatory infiltrate showed only significant difference at 7 and 15 days with best result for the amoxicillin group. In relation to the chronic inflammatory infiltrate in both the intensity and the extent was greater in the Saline group. There have been few areas of root resorption in all groups with no significant difference. The pulp tissue in most specimens in all groups had calcifications. It can be concluded that systemic antibiotic therapy has a positive effect on the extrusive luxation repair process and that amoxicillin is an good option.

Asymptomatic Bacteriuriain Pregnant Women: Screening Bya Simple Method and Treatment with Single Dose Antimicrobial Therapy

The term asymptomatic bacteriuria in pregnancy indicates persistent actively multiplying bacteria within the urinary tract without showing any symptom in pregnancy. A total of 500 pregnant women were screened for the incidence of asymptomatic bacteriuria by comparing the reliability of urine dip stick evaluation for nitrites and leukocyte esterase activity with that of urine culture in diagnosing asymptomaticbacteriuria. The efficacy of single dose antimicrobial therapy (2 g of Cephalexin or 3 g of Amoxycillin) was evaluated for eradicating asymptomatic bacteriuria. The incidence was found to be 9.2% among the 500 cases in the study group. The dip stick screening could detect the bacteriuric patients correctly in 89.1% of cases. Single dose therapy cured 76.1% of asymptomatic bacteriuria patients. Amoxycillin was found to be more effective when compared to Cephalexin as a single dose antimicrobial therapy.

Amoxycillin Clavulanic Acid Induced Hepatotoxicity.

Drug-related hepatotoxicity is a serious health problem, with broad implications for patients, healthcare providers, the pharmaceutical industry and governmental regulatory agencies. Herein we report a rare case of amoxycillinclavulanic acid combination induced liver injury of cholestatic pattern in 40 years old, well educated male patient. Patient gave history that though other drugs were given to him by his physician for fever with chills & rigors, malaise, bodyache, except amoxycillin-clavulanic acid combination all other drugs were well tolerated previously by the patient, without appearance of jaundice. So jaundice in this patient was most probably due to amoxycillinclavulanic acid combination. Though severe liver injury is rare, proper history should be taken while prescribing amoxycillin-clavulanic acid combination. Attention must be paid to potential side-effects of the drugs and close follow-up with patients is a medical necessity to evaluate adverse reactions, especially in case of amoxycillinclavulanic acid combination.

Sensibilidad a la amoxicilina de bacterias anaerobias de pacientes con periodontitis agresiva / Susceptibility to amoxycillin of anaerobic bacteria in patientswith aggressive periodontitis

Introducción y ObjetivoSe han utilizado los antibióticos como terapia adjunta al tratamiento periodontal. La amoxicilina y la amoxicilina/ ácido clavulánico son algunos de los más utilizados. Establecer el tipo de bacterias y su sensibilidad a la amoxicilina y a la amoxicilina/ácido clavulánico en pacientes con periodontitis agresiva. Materiales y MétodosEste estudio in vitro estableció la sensibilidad a la amoxicilina y a la amoxicilina/ácido clavulánico de las bacterias aisladas de 19 pacientes con periodontitis agresiva. Se obtuvieron muestras de 6 sitios con bolsas iguales o mayores a 7 mm de profundidad, se realizó cultivo y aislamiento de colonias en condiciones anaeróbicas. Laidentificación de los microorganismos se realizó a través de la coloración de Gram y el Sistema Crystal paraanaerobios; para determinar la sensibilidad a los antibióticos se utilizó la técnica descrita por Wilkins y Thiel.ResultadosEn la periodontitis localizada los microorganismos que se presentaron con mayor frecuencia fueron Veillonellaspecies, Peptostreptococcus prevotii, Staphylococcus saccharoliticus, Bacteroides fragilis, Bacteroidesureolyticus. En la periodontitis generalizada se encontró Fusobacterium nucleatum, Veillonella species, Peptostreptococcus prevotii, Peptostreptococcus saccharolitucus, Staphylococcus saccharoliticus. De las 21 especies identificadas, en la periodontitis localizada 4 fueron resistentes a la amoxicilina y 1 resistente a la amoxicilina/Acido clavulánico. En la periodontitis generalizada se encontró 1 microorganismo resistente a laamoxicilina y 1 resistente a la amoxicilina/Acido clavulánico.ConclusiónSe encontraron bacterias resistentes a la amoxicilina y a la amoxicilina/ácido clavulánico.

Introduction and ObjectiveAntibiotics have been used as an adjunct to periodontal treatment. Amoxicillin and amoxicillin/clavulanicacid are some of the most used.To define the type of bacteria and their susceptibility to amoxycillin and to amoxicillin/clavulanic acid inpatients with aggressive periodontitis.Materials and MethodThis descriptive study stated susceptibility to amoxycillin and to amoxicillin/clavulanic acid of bacteriaisolated from 19 patients with aggressive periodontitis, selected by convenience. Samples from six(6) different sites with periodontal pockets equal or greater than 7 mm of depth were obtained. Thesamples were cultured anaerobically and the isolated colonies were identified by means of the Gramstaining procedure and the Crystal System for anaerobics. The Wilkins and Thiel test was used to assesssusceptibility.ResultsThe microorganisms with the highest presence in localized periodontitis were Veillonella species,Peptostreptococcus prevotii, Staphylococcus saccaharolyticus, Bacteroides fragilis and Bacteroidesureolyticus. Fusobacterium nucleatum, Veillonella species, Peptostreptococcus prevotii, Peptostreptococcussaccharolyticus and Staphylococcus saccharolyticus were found in generalized periodontitis. Four out ofthe 21 microorganisms species identified in localized periodontitis 4 were resistant to amoxycillin and oneto amoxicillin/clavulanic acid. One microorganism was identified as resistant to amoxycillin and one toamoxicillin/clavulanic acid in generalized periodontitis.ConclusionAmoxycillin-resistant and amoxycillin/clavulanic acid-resistant bacteria were found.

Bacillus claussi: en el tratamiento de erradicación del Helicobacter pylori: para reducir los síntomas adversos del tratamiento triple / Bacillus claussi: in the treatment of Helicobacter pylori eradication: to reduce the adverse symptoms of triple therapy

El tratamiento aceptado para la infección por Helicobacter pylori es el uso de inhibidores de bomba de protones (IBP), más dos antibióticos, siendo considerado de primera línea la amoxicilina y la claritromicina. Para el éxito del tratamiento es indispensable el cumplimiento dle mismo y es aquí donde el fracaso en la erradicación del Helicobacter pylori está relacionado al incumplimiento del tratamiento debido a los efectos adversos: náuseas, vómitos, diarrea y alteraciones del gusto. Para investigar la eficacia de la terapia triple para el Helicobacter pylori asociada a un probiótico ( Bacullus Claussi) se realizó un estudio prospectivo, con muestreo no probabilístico, intencional en 100 pacientes desde agosto de 2010 hasta febrero de 2011. Los pacientes fueron distribuidos en 2 grupos de 50 cada uno para recibir: grupo A. Esomeprazol, amoxicilina y claritromicina y grupo B; Esomeprazol, amoxicilina, claritromicina y Bacillus claussi. Se logró la erradicación del Helicobacter pylori en 96% de los pacientes del grupo B en comparación del 80% del grupo A (P = 0,027). El efecto adverso más importante fue la diarrea en el grupo A. La asociación de inhibidores de bomba de protones, antibióticos y Bacillus calussi aumentó el porcentaje de erradicación de Helicobacter pylori, evitando el abandono del tratamiento por la presencia de efectos adversos.

The consensus treatment for Helicobacter pylori infection is based on a Proton Pump Inhibitor plus two antibiotics being considered as first choice amoxicillin and clarithromycin. For a succesfull treatment is primordial its completion and here is where the failure on the Helicobacter pylori infection eradication is relationed to the non fulfillment because of its adverse effects: nauseas, vomiting, diarrhea and alterations of testing. In order to investigate the efficiency of triple therapy treatment associated to a probiotic (Bacillus claussi), its was made a prospective study with no probabilistic and intentional sampling in 100 patients since august, 2011 to february, 2011. Patients were distribuited in two groups of 50 each one, in order to receive the following treatment: Group A: Esomeprazole, amoxicillin and clarithromycin. Group B: Esomeprazole, amoxicillin, clarithromycin and Bacillus claussi. Eradications of helicobacter pylori infections was obtained in 96% of group patients, in comparation to 80% of group a patients (P = 0,027). The adverse effect most important was diarrhea on the group A. The association of PPI, antibiotics and Bacillus claussi improved the percentage of eradication of Helicobacter pylori infection, avoiding the give up of treatment because the presence of adverse effects.

Treatment of Uncomplicated Male Gonococcal Urethritis with Clavulanate: Potentiated Amoxycillin / 대한피부과학회지

At the Venereal Disease Clinic of Choong-ku Public Health Center in Seoul ]03 male patients with uncomplicated gonococcal urethritis were allocated randomly into one of 2 treatment regimens and 101 patients were followed. All 51 patients, including PPNG infections, treated with clavulanate-potentiated amoxycillin, 375 mg, PO, t.i.d. for 5 days recovered(100%), Two(4%) of 50 patients treated with clavulanate-potentiated amoxycillin, 3. 25g, PO plus probenecid, lg, PO failed to recover. These cases were 2 of 25 Penicillinase Froducing Neisseria gonorrhoeae(PPNG) infections(failure rate of 8%) and all 25 non-PPNG infections recovered(100%). It is suggested that both of these clavulanate-potentiated amoxycillin regimens ha.ve similarly good effect with minimal side effects in the treatment of gonococcal urethritis and, because of high rate of PPNGs among circulating N, gonorrhoeae, they can be recommended as the first line treatment for gonorrhoa ir Korea.