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1.
Rev. cuba. estomatol ; 58(1): e2919, ene.-mar. 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156427

ABSTRACT

Introducción: La osteomielitis mandibular crónica es considerada como una infección odontogénica que cursa con tumefacción de la cara, limitación de la abertura bucal y dolor. Pocas veces es tratada a través de gammagrafías con fijación a ciprofloxacino con la consiguiente obtención de resultados efectivos. Objetivo: Describir un caso clínico de osteomielitis mandibular crónica tratada con terapia antibiótica y quirúrgica. Presentación de caso: Paciente femenina de 63 años de edad que acudió al servicio de estomatología del Hospital María Auxiliadora, Lima, Perú; con un historial de tres meses de hinchazón creciente a nivel del borde inferior izquierdo de la mandíbula desde que le realizaron una extracción dentaria. Los exámenes tomográficos, gammagrafía, biopsia y antibiograma confirmaron la osteomielitis y la susceptibilidad bacteriana. La decorticación, debridamiento, exodoncia y la administración de metronidazol más vancomicina por dos meses permitió la remisión del cuadro. Conclusiones: El seguimiento clínico de dos años y las gammagrafías de evaluación permitieron verificar la presencia de regeneración ósea y ausencia de focos de reactivación. La osteomielitis crónica puede ser provocada por restos de exodoncias dentarias. Su diagnóstico y seguimiento clínico requiere de múltiples exámenes y controles a largo plazo(AU)


Introduction: Chronic mandibular osteomyelitis is considered to be an odontogenic infection manifesting as facial tumefaction, limited mouth opening and pain. It is not often enough treated with ciprofloxacin fixation gammagraphies with the consequent achievement of effective results. Objective: Describe a clinical case of chronic mandibular osteomyelitis treated with antibiotic and surgical therapy. Case presentation: A female 63-year-old patient attends the dental service at María Auxiliadora Hospital in Lima, Peru, with a history of three-months' swelling of the lower left edge of her mandible upon performance of a dental extraction. Tomographic examination, gammagraphy, biopsy and antibiograms confirmed the presence of osteomyelitis and bacterial susceptibility. Decortication, debridement, exodontia and administration of metronidazole plus vancomycin for two months led to remission of the patient's status. Conclusions: Two-year clinical follow-up and evaluation gammagraphies made it possible to verify the presence of bone regeneration and the absence of reactivation foci. Chronic osteomyelitis may be caused by remains of dental exodontias. Its diagnosis and clinical follow-up require a large number of long-term tests and controls(AU)


Subject(s)
Humans , Female , Middle Aged , Osteomyelitis/diagnostic imaging , Surgery, Oral/methods , Vancomycin/therapeutic use , Anti-Bacterial Agents/administration & dosage , Metronidazole/therapeutic use
2.
Femina ; 49(2): 109-114, 20210228. ilus
Article in Portuguese | LILACS | ID: biblio-1224067

ABSTRACT

A endometrite crônica (EC) é uma doença que, apesar de ainda pouco investigada, tem sido associada a resultados reprodutivos desfavoráveis. Estudos têm mostrado que a EC pode prejudicar a receptividade endometrial, levando a falhas de implantação e perdas gestacionais recorrentes. Os métodos padronizados para diagnóstico incluem histeroscopia, histologia para pesquisa de plasmócitos e cultura endometrial para identificação de agentes bacterianos. O tratamento com antibióticos para EC parece melhorar as taxas de gestação e nascidos vivos em pacientes com falhas de implantação e perdas gestacionais recorrentes sem causa conhecida. Esta publicação tem por objetivo fazer uma revisão da etiologia, fisiopatologia, diagnóstico e tratamento da EC, seu impacto no microambiente endometrial e sua associação com infertilidade. Esta revisão narrativa da literatura atualizada sintetiza os achados encontrados em bases de dados computadorizadas.(AU)


Chronic endometritis (CE) is a poorly investigated disease, which has been related to adverse reproductive outcomes. Published studies have shown that CE can impair endometrial receptivity, which is associated with implantation failure and recurrent pregnancy loss. The standard tools for diagnosis include hysteroscopy, histology to identification of plasma cells and endometrial culture for identification of bacterial pathogens. Effective antibiotic treatment for CE seems to improve the pregnancy and live birth rates in patients with implantation failure and unexplained recurrent pregnancy loss. This paper intends to provide an overview of etiology, pathophysiology, diagnosis and treatment of CE, its impact on endometrial microenvironment and its association with infertility. This narrative review of the current literature synthesizes the findings retrieved from searches in computerized databases.(AU)


Subject(s)
Humans , Female , Endometritis/diagnosis , Endometritis/etiology , Endometritis/physiopathology , Endometritis/drug therapy , Ceftriaxone/therapeutic use , Ciprofloxacin/therapeutic use , Hysteroscopy , Doxycycline/therapeutic use , Azithromycin/therapeutic use , Infertility, Female/complications , Metronidazole/therapeutic use
3.
Rev. fac. cienc. méd. (Impr.) ; 17(2): 31-36, jul.-dic. 2020.
Article in Spanish | LILACS, BIMENA | ID: biblio-1292596

ABSTRACT

La dermatitis periorificial, es una erupción acneiforme que comúnmente afecta la región perioral y con frecuencia se extiende alrededor de la nariz y los ojos. Los mayores reportes son en mujeres de 20 a 45 años y en menor proporción en menores de 18 años. Su etiología es desconocida, pero se ha asociado al uso de glucocorticoides tópicos, inhalados y sistémicos. Objetivo: presentar una serie de casos de dermatititis periorificial, asociados con el uso indiscriminado de glucocorticoides, que respondieron eficazmente al tratamiento con metronidazol tópico, solo o combinado con doxiciclina. Presentación de casos clínicos: se describen cinco pacientes de sexo femenino, edades comprendidas entre 4 y 18 años, atendidos en la consulta ambulatoria de Dermatología. En cuatro casos, se documentó el uso prolongado de glucocorticoides tópicos/inhalados, de estos, tres presentaron lesiones papulares eritematosas o color piel, escasas pústulas, asintomáticas o prurito leve, localizadas a nivel perioral, perinasal y periocular; perioral y perinasal en uno y solamente perioral en otro. El tratamiento con metronidazol tópico fue exitoso en los cinco pacientes y en uno se combinó con doxiciclina oral. Conclusiones: el manejo de la dermatitis periorificial puede responder eficazmente al metronidazol tópico y dada su asociación al uso de glucocorticoides, se recomienda evitar el uso injustificado y prolongado de los mismos, tanto en forma tópica como inhalada o sistémica...(AU)


Subject(s)
Humans , Female , Child, Preschool , Adolescent , Dermatitis, Perioral , Glucocorticoids , Dermatitis, Atopic , Metronidazole/therapeutic use
4.
Prensa méd. argent ; 105(9 especial): 576-581, oct 2019.
Article in English | LILACS, BINACIS | ID: biblio-1046621

ABSTRACT

This work is aimed at studying the problems of timely diagnostics and therapy of various forms of rosacea, identifying the factors that influence the compliance, prognosis, and quality of life of the patients, as well as the stages of combination therapy. The efficiency of rosacea therapy is determined by the timely identification of patients, as well as the clinical variety of the disease. Complex therapy of rosacea includes identification of the precipitating factors, basic skincare, and the use of systemic and local pathogenetic preparations. The "Gold Standard" of topical rosacea therapy is the antimicrobial and antiprotozoal drug called metronidazole. An important role in disease therapy is played by active cooperation between the doctor and the patient. Comprehensiveness, timeliness, and rationality of rosacea therapy are defined not only by the mechanisms of the disease development but also by aggravating factors, the need for basic care and photosensitivity of the patients


Subject(s)
Photosensitivity Disorders , Retinoids/therapeutic use , Isotretinoin/therapeutic use , Patient Compliance , Tacrolimus/therapeutic use , Rosacea/diagnosis , Combined Modality Therapy , Metronidazole/therapeutic use
5.
Rev. medica electron ; 41(4): 979-992, jul.-ago. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1094102

ABSTRACT

RESUMEN La infección por helicobacter pylori afecta aproximadamente al 50% de la población mundial, es causante de gastritis crónica, úlcera péptica, cáncer gástrico y linfoma del tejido linfoide asociado a la mucosa. Desde su descubrimiento, la erradicación ha sido uno de los más importantes retos en Gastroenterología. En muchos países se desconoce la prevalencia de resistencia primaria del microorganismo a los diferentes antibióticos que empíricamente se utilizan, y por no realizar pruebas de rutina que verifican su erradicación en la práctica diaria, se ignora la efectividad de los esquemas prescritos. El incremento progresivo de la resistencia a la claritromicina y metronidazol, unido a una ausencia de antibioticoterapia alternativa, desafía la capacidad para eliminar de manera efectiva a ésta bacteria. El subcitrato de bismuto ha resurgido y su adición en la terapia ha permitido aumentar las tasas de curación por encima del 90%. Actualmente se invoca que para mejorar la eficacia en el tratamiento se debe combinar una supresión potente del ácido gástrico en tratamientos combinados cuádruples con una duración de 14 días, para la mayoría de los casos. La adherencia al tratamiento es crucial para obtener buenos resultados terapéuticos.


ABSTRACT The infection for helicobacter pylori affects approximately to the world population's 50%, it is causing of chronic gastritis, peptic ulcer, gastric cancer and linfoma associated to the mucous one. From their discovery, the eradication has been one of the most important challenges in Gastroenterología. In many countries the prevalencia of primary resistance is ignored from the microorganism to the different antibiotics that empirically they are used, and for not carrying out routine tests that verify its eradication in the daily practice, the effectiveness of the prescribed outlines it is ignored. The progressive increment of the resistance to the claritromicina and metronidazol, together to an absence of alternative antibioticotherapy, challenges the capacity to eliminate from an effective way to this bacteria. The bismuth subcitrato has resurged and its addition in the therapy has allowed to increase the cure rates above 90%. At the moment it is invoked that to improve the effectiveness in the treatment, that is should combine a potent suppression of the gastric acid in combined quadruple treatments with a duration of 14 days, for most of the cases. The adherence to the treatment is crucial to obtain therapeutic good results.


Subject(s)
Humans , Drug Resistance, Microbial , Risk Factors , Helicobacter Infections/etiology , Helicobacter Infections/drug therapy , Helicobacter Infections/epidemiology , Treatment Outcome , Drug Therapy, Combination , Disease Eradication , Peptic Ulcer/diagnosis , Stomach Neoplasms/diagnosis , Tetracycline/therapeutic use , Bismuth/therapeutic use , Adenocarcinoma/diagnosis , Clarithromycin , Lymphoma, B-Cell, Marginal Zone/diagnosis , Acidity Regulator , Proton Pump Inhibitors/therapeutic use , Treatment Adherence and Compliance , Gastritis/diagnosis , Gastroenterology , Metronidazole , Metronidazole/therapeutic use
6.
Braz. oral res. (Online) ; 33(supl.1): e080, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039310

ABSTRACT

Abstract The aim of this study was to evaluate the effects of adjunct systemic antibiotic treatment with metronidazole (MTZ) and amoxicillin (AMX) in patients receiving non-surgical subgingival debridement (NSD) for peri-implantitis. Forty subjects presenting with at least one implant with severe peri-implantitis were randomized into an experimental group [treated with NSD plus MTZ (400 mg) and AMX (500 mg) three times a day for 14 days] and a control group treated with NSD plus placebo. Clinical parameters and submucosal biofilm profiles were evaluated up to 1 year post-treatment. Overall, both treatments improved clinical parameters over time. At 1 year, mean probing depth (PD), mean clinical attachment (CA) level and proportions of red complex pathogens did not differ significantly between the two groups. In addition, mean PD and CA changes to 1-year posttreatment did not differ significantly between the two groups between baseline and 1-year post-treatment. These results suggest that the addition of MTZ and AMX to the treatment protocol of patients undergoing NSD for with severe peri-implantitis does not improve the clinical and microbiological outcomes of NSD. The fact that half of the implants in both groups did not achieve clinical success (PD < 5 mm, no BoP, no bone loss) suggest that neither of the tested protocols were effective for treating severe peri-implantitis.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Peri-Implantitis/drug therapy , Amoxicillin/therapeutic use , Metronidazole/therapeutic use , Anti-Bacterial Agents/therapeutic use , Reference Values , Time Factors , Periodontal Index , Reproducibility of Results , Follow-Up Studies , Treatment Outcome , Statistics, Nonparametric , Drug Combinations , Peri-Implantitis/microbiology , Middle Aged
8.
Gastroenterol. latinoam ; 29(supl.1): S63-S67, 2018. tab
Article in Spanish | LILACS | ID: biblio-1117866

ABSTRACT

The management of Clostridium difficile (CD) infection has changed in recent years. The latest clinical guidelines and systematic reviews suggest the use of vancomycin orally as the first line of treatment regardless the severity of the crisis (main difference compared to previous recommendations), this is due to changes in its epidemiology, the decrease in effectiveness and the increase of recurrences with the use of metronidazole, particularly in severe crisis. In addition, the use of new agents such as fidaxomicin has been approved. Fulminant crisis require an aggressive management combining oral treatment, enemas and intravenous therapy in addition to a collaborative management with the surgery team. With respect to recurrences, the use of vancomycin in pulses and with extended therapy schemes is suggested; fecal microbiota transplantation (FMT) is also an attractive therapy for patients with multiple recurrences. The following is a summary of the latest recommendations and available evidence regarding the management of CD infection in the most frequent situations, both in first crisis and in its recurrences.


El manejo de la infección por Clostridium difficile (CD) ha tenido modificaciones los últimos años. Las últimas guías clínicas y revisiones sistemáticas sugieren el uso de vancomicina vía oral como primera línea de tratamiento independiente de la severidad de la crisis (diferencia principal con recomendaciones previas), esto debido a cambios en su epidemiología, la disminución de la efectividad y al aumento de las recurrencias con el uso de metronidazol, particularmente en crisis severas. Además, han sido aprobados el uso de nuevos agentes como la fidaxomicina. Las crisis de carácter fulminante requieren un manejo agresivo combinando terapia oral, vía enemas e intravenosa, además de un manejo en conjunto con el equipo de cirugía. Respecto a las recurrencias se sugiere el uso de vancomicina en pulsos y con esquemas de terapia extendida siendo además, el trasplante de microbiota fecal (FMT) una terapia atractiva para pacientes con múltiples recurrencias. A continuación se resumen las últimas recomendaciones y evidencia disponible respecto del manejo de la infección por CD en las situaciones más frecuentes, tanto en la primera crisis como en sus recurrencias.


Subject(s)
Humans , Vancomycin/therapeutic use , Clostridium Infections/drug therapy , Diarrhea/drug therapy , Fidaxomicin/therapeutic use , Anti-Bacterial Agents/therapeutic use , Recurrence , Vancomycin/administration & dosage , Clostridioides difficile/drug effects , Clostridium Infections/complications , Diarrhea/microbiology , Fecal Microbiota Transplantation , Fidaxomicin/administration & dosage , Rifaximin/therapeutic use , Metronidazole/therapeutic use , Anti-Bacterial Agents/administration & dosage
9.
Gastroenterol. latinoam ; 29(supl.1): S58-S62, 2018. tab
Article in Spanish | LILACS | ID: biblio-1117863

ABSTRACT

Pouchitis is a frequent complication following proctocolectomy with ileal pouch-anal anastomosis, mainly in patients with ulcerative colitis. Though etiology is still unknown, evidence shows that there is a relation with host microbiota. Management of chronic refractory pouchitis is challenging, and current evidence showns that the use of biologic agents may have a favourable response.


La reservoritis es una complicación frecuente en pacientes en quienes se ha practicado una proctocolectomía con reservorio ileal, principalmente en pacientes con colitis ulcerosa. La etiología si bien es desconocida, la evidencia actual apunta a que exista una relación con la microbiota del huésped. La reservoritis refractaria crónica es un desafio en el manejo y actualmente ha surgido evidencia que apunta que el uso de biológicos puede tener una respuesta favorable.


Subject(s)
Humans , Pouchitis/diagnosis , Pouchitis/drug therapy , Postoperative Complications/etiology , Ciprofloxacin/therapeutic use , Risk Factors , Proctocolectomy, Restorative/adverse effects , Pouchitis/classification , Pouchitis/etiology , Probiotics/therapeutic use , Diagnosis, Differential , Metronidazole/therapeutic use , Anti-Bacterial Agents/therapeutic use
10.
Gastroenterol. latinoam ; 29(supl.1): S49-S52, 2018.
Article in Spanish | LILACS | ID: biblio-1117784

ABSTRACT

Amebiasis is the infection by Entamoeba histolytica, a protozoan capable of invading the colonic mucosa causing a diarrheic syndrome, although most of the time is mild, it can lead to a fulminating colitis. Sometimes it can spread to other organs; among extra-intestinal manifestations of this parasite, the most frequent is the amebic liver abscess. In the next pages, general aspects of this protozoan, its epidemiology, clinical findings, diagnosis and treatment are reviewed, emphasizing the possibilities of diagnosis and treatment available in Chile.


La amebiasis corresponde a la infección por Entamoeba histolytica, protozoo capaz de invadir la mucosa del colon provocando un cuadro diarréico que, si bien la mayoría de las veces es leve, puede llegar a una colitis fulminante. En algunas oportunidades puede diseminarse a otros órganos; dentro de las manifestaciones extra-intestinales de este parásito, la más frecuente es el absceso hepático amebiano. A continuación se revisan aspectos generales de este protozoo, su epidemiología, cuadro clínico, diagnóstico y tratamiento, destacando las posibilidades de diagnóstico y tratamiento disponibles en Chile.


Subject(s)
Humans , Dysentery, Amebic/diagnosis , Dysentery, Amebic/drug therapy , Liver Abscess, Amebic/diagnosis , Liver Abscess, Amebic/drug therapy , Diarrhea/parasitology , Dysentery, Amebic/parasitology , Entamoeba histolytica/pathogenicity , Liver Abscess, Amebic/parasitology , Metronidazole/therapeutic use , Antiparasitic Agents/therapeutic use
12.
IJCBNM-International Journal of Community Based Nursing and Midwifery. 2018; 6 (2): 101-110
in English | IMEMR | ID: emr-192428

ABSTRACT

Background: The present study was conducted on the effect of prangos ferulacea vaginal cream on accelerating the recovery of bacterial vaginosis


Methods: This randomized controlled clinical trial was conducted on 100 non-pregnant women referring to health centers affiliated to Lorestan University of Medical Sciences in 2016 with the diagnosis of bacterial vaginosis based on the patient's complaints, Amsel's clinical criteria, and the Nugent microscopic criteria. The women were randomly divided into two groups of 50. One group was treated with oral metronidazole plus Prangos ferulacea vaginal cream and the other with oral metronidazole plus a placebo vaginal cream for seven days. The patient's complaints, Amsel's clinical criteria and the Nugent microscopic criteria were assessed seven days after treatment. The data were analyzed using SPSS, version 20, with a significance level of 0.05


Results: The response to oral metronidazole plus Prangos ferulacea vaginal cream treatment was 94% according to Amsel's clinical criteria and 88% according to the Nugent microscopic criteria. The response to oral metronidazole plus placebo vaginal cream treatment was 94% according to Amsel's criteria and 86% according to the Nugent criteria. The analysis of the patients' complaints, Amsel's clinical criteria and the Nugent microscopic criteria showed significant differences in each group before and after the treatment


Conclusion: This trial showed that Prangos ferulacea vaginal cream accelerated the recovery of bacterial vaginosis of patients with bacterial vaginosis. It can be used effectively as a complementary treatment with oral metronidazole in cases of medication resistance and also in people wishing to use herbal remedies


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Metronidazole/therapeutic use , Phytotherapy , Herbal Medicine , Vagina , Vaginal Creams, Foams, and Jellies
13.
Med. leg. Costa Rica ; 34(1): 265-271, ene.-mar. 2017. tab
Article in Spanish | LILACS | ID: biblio-841452

ABSTRACT

Resumen:La infección por Clostridium difficile es la principal causa de diarrea infecciosa en pacientes hospitalizados. Los pacientes pueden ser portadores asintomáticos o presentar desde una diarrea leve a una colitis pseudomembranosa, megacolon tóxico, sepsis y muerte. El manejo de esta infección sigue presentando puntos de controversia, tanto en la elección del mejor método diagnóstico como en el tratamiento. En los casos en los cuales la infección por este agente fue confirmada la primera y más efectiva medida es suspender la antibioticoterapia que el paciente este recibiendo, en la medida de lo posible. El tratamiento se basa en tres agentes clásicos: metronidazol, vancomicina y teicoplanina con la más reciente adición de fidaxomicina y ridinilazol. Pacientes con presentación severa muchas veces requieren resolución quirúrgica además de las medidas de soporte y monitoreo. El objetivo de esta revisión es ofrecer información actualizada sobre la patogénesis y estrategias terapéuticas sobre el manejo de la infección por este patógeno.


Abstract:Clostridium difficile infection is the leading cause of hospital acquired diarrhea. The patients can be asymptomatic carriers or present a mild diarrhea, a pseudomembranous colitis, toxic megacolon, sepsis and death. There is controversy in this infection's including the best method of diagnosis and also regarding therapeutic regimen.In cases in which Clostridium infection is confirmed, the first and most effective measure is the withdrawal of any antibiotic treatment the patient is receiving, if possible. The antimicrobial treatment is based on three classic agents: metronidazole, vancomycin and teicoplanin, along with the recent addition of fidaxomicin and ridinilazol.Patients presenting serious symptoms, in addition to appropriate support and monitoring measures, may require surgical treatment. This review's aim is to provide an update on the pathogenesis, and therapeutic strategies on the management of this pathogen.


Subject(s)
Humans , Enterocolitis, Pseudomembranous , Vancomycin/therapeutic use , Clostridioides difficile/virology , Clostridium Infections , Teicoplanin/therapeutic use , Colitis , Diarrhea , Dysentery , Metronidazole/therapeutic use
14.
Arab Journal of Gastroenterology. 2017; 18 (2): 58-61
in English | IMEMR | ID: emr-189165

ABSTRACT

Background and study aims: Standard sequential treatment for Helicobacter pylori [H. pylori] eradication has less success because of increasing clarithromycin resistance. Extended treatment and bismuth containing regimens were, therefore, investigated


Patients and methods: Consecutive H. pylori-positive patients with dyspepsia were randomly allocated to one of the three sequential regimens: The first group was given lansoprazole 30 mg b.i.d. plus amoxicillin 1 g b.i.d. for the first 5 days, followed by lansoprazole 30 mg b.i.d., clarithromycin 500 mg b.i.d., and metronidazole 500 mg t.i.d. for the second 5 days [standard sequential, SS]. The second group was given the same regimen but for 7 + 7 days instead of 5 + 5 days [extended sequential, ES]. In the third group, colloidal bismuth 600 mg b.i.d. was added to the second regimen for 14 days [extended sequential + bismuth subcitrate, ES + B]. Urea breath test or histology was performed before enrolment and 6 weeks after the end of treatment to detect H. pylori


Results: A total of 280 patients were included in the study. Per-protocol eradication rates were 62% [56/90], 72% [56/78], and 75% [54/72] in patients who received SS, ES, and ES + B regimens, respectively. Moreover, intention-to-treat eradication rates were 53% [56/104], 62% [56/90] and 62% [54/86], respectively. The differences in eradication rates between the groups were not statistically significant


Conclusion: Although prolonging of the sequential treatment to 14 days may be considered, addition of bismuth to the regimen is of no avail


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Helicobacter pylori , Lansoprazole/therapeutic use , Amoxicillin/therapeutic use , Metronidazole/therapeutic use , Bismuth/therapeutic use , Clarithromycin
15.
Arab Journal of Gastroenterology. 2017; 18 (2): 62-67
in English | IMEMR | ID: emr-189166

ABSTRACT

Background and study aims: The success rate of Helicobacter pylori [H. pylori] eradication with the classical triple therapy is gradually declining. In this study, we aimed to compare and assess the efficacies of six different eradication regimens including sequential protocols


Patients and methods: Endoscopically confirmed nonulcer dyspepsia patients were enrolled. H. pylori presence was determined either histologically or by a rapid urease test. Treatment-naive patients were randomly assigned to an either one of three 10-day [OAC, OTMB, and OACB] or one of three sequential protocols [OA + OCM, OA + OCMB, and OA + OMDB] [O = omeprazole, A = amoxicillin, C = clarithromycin, T = tetracycline, M = metronidazole, B = bismuth, D = doxycycline]. The eradication was assessed 6-8 weeks after the completion of the treatment by a 14C-urea breath test


Results: In total, 301 patients were included. Fifty-two percent of the participants [n = 157] were female, and the mean age was 44.9 years [range = 18-70]. The intention to treat [ITT] and per protocol [PP] eradication rate for each regimen is as follows: OAC [ITT = 61.2%, PP = 75%], OTMB [83.3%, 87%], OACB [76.5%, 79.6%], OA + OCM [72.3%, 73.9%], OA + OCMB [82.7%, 89.6%], and OA + OMDB [59.3%, 65.3%]. Smoking significantly affected the eradication rate [P = 0.04]


Conclusion: In this study, OTMB and OA + OCMB were significantly superior to the triple therapy and succeeded to reach the eradication rate proposed by the Maastricht consensus [over 80%]. These two bismuth-containing regimens could be considered for first-line therapy in the regions with high clarithromycin resistance


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Helicobacter pylori , Disease Eradication , Omeprazole/therapeutic use , Amoxicillin/therapeutic use , Metronidazole/therapeutic use , Bismuth/therapeutic use , Clarithromycin/therapeutic use , Tetracycline/therapeutic use , Doxycycline/therapeutic use , Prospective Studies
16.
IBJ-Iranian Biomedical Journal. 2017; 21 (5): 285-293
in English | IMEMR | ID: emr-188485

ABSTRACT

Trichomonas vaginalis is a flagellated parasite affecting about 276 million people annually worldwide. Tricomoniasis is associated with different complications in pregnant women and infants. S'-nitroimidazole derivatives [metronidazole, ornidazole, and tinidazole] are FDA approved drugs recommended for trichomoniasis treatment. Treatment with metronidazole S'-nitroimidazole derivatives is associated with many side effects, and drug resistance to metronidazole has been reported in some cases. Recently, many attempts have been made to evaluate the effects of plants on causative agents of vaginal infections. In our research, the national and international databases were searched and the effects of various herbal extracts on T. vaginalis in Iran were reviewed from 2006 to 2016. In articles investigated, some plants had favorable antitrichomonal effects and needed to be further investigated. All the plant extracts have only been evaluated in vitro. Surveys of different articles in this review show that the active ingredients present in different parts of plants, including aerial parts, leaves, flowers, stems, and root can be suitable sources for introducing and developing new antitrichomonal compounds


Subject(s)
Plant Extracts , Pregnant Women , Parasites/drug effects , Metronidazole/therapeutic use , Surveys and Questionnaires , Database
17.
Gastroenterol. latinoam ; 28(3): 165-169, 2017. tab
Article in Spanish | LILACS | ID: biblio-1118762

ABSTRACT

Standard triple therapy (TT), used massively as first-line empirical therapy for Helicobacter pylori (H. pylori) eradication, has shown a progressive decrease in its effectiveness, probably due to increasing resistance to clarithromycin. Recent studies in Chile show eradication under 90%, a limit suggested as adequate efficacy. The so-called concomitant therapy (CT) comprising a proton pump inhibitor, amoxicillin, clarithromycin and metronidazole is the non-bismuth first-line therapy most recommended in current guidelines. However, we have no local data to assess the effectiveness of this regimen. The aim of this study was to prospectively evaluate the effectiveness of CT in a group of patients controlled at a private health center in Santiago, Chile. Patients received 40 mg esomeprazole, 1 g amoxicillin, 500 mg clarithromycin and 500 mg metronidazole, every 12 hours, for 14 days. Sixty-six patients were included, of these patients, 36 returned to control. CT was successful in 33/36 patients, corresponding to 92% (95% CI: 82.5-100%, per protocol analysis). The frequency of significant side effects was 25% (mainly diarrhea and abdominal pain) and only one patient discontinued the treatment. In conclusion, 14-days CT therapy is effective to eradicate H. pylori and could be recommended as first-line empirical regimen, at least in the studied population segment and geographical area. Additional studies are necessary to confirm its efficacy in other socioeconomic and/or geographical settings.


La terapia triple estándar (TT), utilizada masivamente como terapia de primera línea empírica para erradicación de Helicobacter pylori (H. pylori) ha mostrado una progresiva disminución de su efectividad, probablemente por resistencia creciente a claritromicina. Los últimos estudios en Chile muestran erradicación bajo 90%, límite sugerido como eficacia adecuada. Esto ha motivado la búsqueda de esquemas alternativos más eficaces, siendo la así llamada terapia concomitante (TC), que consiste en un inhibidor de la bomba de protones, amoxicilina, claritromicina y metronidazol, el esquema sin bismuto más recomendado en guías clínicas recientes. Sin embargo, no contamos con datos locales que evalúen su efectividad. El objetivo del presente estudio fue evaluar prospectivamente la efectividad de TC en un grupo de pacientes controlados en un centro de salud privado de Santiago de Chile. Los pacientes recibieron esomeprazol 40 mg, amoxicilina 1 g, claritromicina 500 mg y metronidazol 500 mg cada 12 h, por 14 días. Se incluyeron 66 pacientes, de los cuales 36 volvieron a control. La TC fue exitosa en 33/36 pacientes, correspondientes al 92% (IC 95%: 82,5-100%; análisis por protocolo). La frecuencia de efectos colaterales significativos fue 25% (principalmente diarrea y dolor abdominal) y sólo un paciente suspendió el tratamiento por esta causa. En conclusión, la TC por 14 días es efectiva para erradicar H. pylori, al menos en el segmento poblacional y área geográfica estudiados y es un esquema empírico que pudiera recomendarse como primera línea en nuestro medio, aunque se requiere confirmar su eficacia en otros grupos poblacionales.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Helicobacter Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Stomach Neoplasms/prevention & control , Remission Induction , Drug Administration Schedule , Chile , Prospective Studies , Helicobacter pylori , Treatment Outcome , Clarithromycin/therapeutic use , Proton Pump Inhibitors/therapeutic use , Amoxicillin/therapeutic use , Metronidazole/therapeutic use
20.
Journal of the Egyptian Society of Parasitology. 2016; 46 (1): 185-200
in English | IMEMR | ID: emr-180174

ABSTRACT

Cryptosporidiosis parvum is a zoonotic protozoan parasite infects intestinal epithelial cells of man and animals causing a major health problem. This study was oriented to evaluate the protective and curative capacity of garlic, ginger and mirazid in comparison with metronidazole drug [commercially known] against Cryptosporidium in experimental mice. Male Swiss Albino mice experimentally infected with C. parvum were treated with medicinal plants extracts [Ginger, Mirazid, and Garlic] as compared to chemical drug Metronidazole. Importantly, C. parvum- infected mice treated with ginger, Mirazid, garlic and metronidazole showed a complete elimination in shedding oocysts by 9[th] day PI. The reduction and elimination of shedding oocysts in response to the treatments might be attributable to a direct effect on parasite growth in intestines, sexual phases production and/ or the formation of oocysts. The results were evaluated histopathological examination of ileum section of control mice [uninfected, untreated] displayed normal architecture of the villi. Examination of infected mice ileum section [infected, untreated] displayed histopathological alterations from uninfected groups. Examination of ileum section prepared from mice treated with garlic, ginger, mirazid, and metronidazole displayed histopathological alterations from that of the control groups, and showed marked histologic correction in the pattern with the four regimes used in comparison to control mice. Garlic successfully eradicated oocysts of infected mice from stool and intestine. Supplementation of ginger to infected mice markedly corrected elevation in the inflammatory risk factors and implied its potential antioxidant, anti-inflammatory and immunomodulatory capabilities. Infected mice treated with ginger, mirazid, garlic and metronidazole showed significant symptomatic improvements during treatment


Subject(s)
Animals, Laboratory , Male , Cryptosporidiosis , Mice , Antiprotozoal Agents/therapeutic use , Garlic , Ginger , Plants, Medicinal , Resins, Plant , Metronidazole/therapeutic use
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