Antibiotic sensitivity pattern of bacterial isolates in patients with chronic rhinosinusitis in Kaduna, Nigeria

Introduction: A common practice in the management of patients with chronic rhinosinusitis (CRS), the empirical use of antibiotics may contribute to treatment failure and to the development of antimicrobial resistance. Objective: To determine the antibiotic sensitivity pattern of aerobic and anaerobic bacteria associated with CRS. Methods: This was a prospective cross-sectional study in which endoscopically guided middlemeatal swabs (IBMSpss, version 16.0, Chicago, IL, USA) were aseptically taken from patients diagnosed with CRS after obtaining informed consent and ethical clearance. The samples were sent to the laboratory for qualitative and semiquantitative analysis via gram stain, aerobic, anaerobic cultures and antibacterial sensitivity tests. The collected data was analyzed using SPSS for Windows, version 16 (SPSS Inc, Chicago, IL, USA). Simple statistical parameters and paired sample t-test were used, as appropriate. Results: There were 74 (56.92%) bacterial growths, out of which 55 (74.32%) were aerobic and 19 (25.68%) were anaerobic isolates, from a total of 130 patients. About 13 (17.5%- 18%) of these bacterial growths yielded a mixed growth of aerobic and anaerobic isolates. Themost common bacterial isolates were 26 (35.14%) Staphylococcus aureus, Haemophilus influenzae 9 (12.16%), Streptococcus viridians 8 (10.81%), and Streptococcus pneumoniae 5 (6.76%). Augmentin, ciprofloxacin, and Peflacine were found to bemost effective, followed by levofloxacin, Rocephin, erythromycin and Zinat in that order (AU)

Susceptibilidad antimicrobiana de dos periodontopatógenos a moxifloxacina y amoxicilina ácido clavulánico / Antimicrobial susceptibility of moxifloxacin and amoxicillin clavulanic acid against two periodontopathogens

Fundamento: se ha documentado un aumento importante de la resistencia de algunos perio-dontopatógenos a los antimicrobianos usados de forma tradicional como coadyuvantes en la terapia periodontal. Objetivo: evaluar la susceptibilidad de Aggregatibacter actinomycetemcomitans y Porphyromonas gingivalis a la moxifloxacina y amoxicilina ácido clavulánico en pacientes con periodontitis crónica. Métodos: se realizó un estudio observacional de corte transversal el universo estuvo constitui-do por 30 pacientes con periodontitis crónica. La toma y procesamiento de las muestras microbiológicas se realizaron mediante protocolos descritos de forma previa. Para evaluar la susceptibilidad de A. actinomycetemcomitans y P. gingivalis frente a la moxifloxacina y amoxicilina ácido clavulánico, se usaron pruebas de difusión en disco. Resultados: P. gingivalis fue el microorganismo más prevalente en la población estudiada. Los dos periodontopatógenos cultivados fueron muy sensibles a los dos antimicrobianos evaluados. Conclusiones: A. actinomycetemcomitans y P. gingivalis son muy susceptibles a la moxifloxacina y la amoxicilina ácido clavulánico en la población estudiada, donde se convierte de esta manera en una alternativa coadyuvante para el tratamiento de la periodontitis.

Background: a significant increase in the resistance of some antimicrobial periodontopathogens traditionally used as adjuncts in periodontal therapy has been reported. Objective: to assess the susceptibility of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis to moxifloxacin and amoxicillin clavulanic acid in patients with chronic periodontitis. Methods: an observational cross-sectional study of the universe composed of 30 patients with chronic periodontitis was conducted. Microbiological samples processing were performed following protocols described previously. Disk diffusion tests were used to assess the susceptibility of A. actinomycetemcomitans and P. gingivalis against moxifloxacin and amoxicillin clavulanic acid. Results: P. gingivalis was the most prevalent microorganism in the population studied. The two periodontopathogens grown were highly sensitive to both antimicrobials tested. Conclusions: A. actinomycetemcomitans and P. gingivalis are highly susceptible to moxifloxacin and amoxicillin clavulanic acid in this population, therefore it is an alternative adjuvant for the treatment of periodontitis.

A Randomized, Double-blinded, Open Label Study of the Efficacy and Safety of Cefcapene Pivoxil and Amoxicillin, Clavulanate in Acute Presumed Bacterial Rhinosinusitis

OBJECTIVES: Currently established first line therapy of acute (presumed bacterial) rhinosinusitis (ARS) consists of 10 to 14 days of oral amoxicillin or cephalosporins. This study compared the clinical efficacy and tolerance of cefcapene pivoxil (CP) and amoxicillin-clavulanate (AMC) in patients with ARS. METHODS: A randomized, open labeled, double-blinded trial of ARS patients over 15 years of age was performed. Patients diagnosed with ARS received paranasal sinus X-rays and nasal endoscopies and 2 weeks of either CP (150 mg, 3 times/ day) or AMC (625 mg, amoxicillin 500 mg, 3 times/day). All patients revisited the clinic on days 7, 14, and 28 for evaluation of changes in symptoms, endoscopy, and monitoring of any adverse reactions. Demographics, clinical characteristics and drug efficacy were also compared between the two groups. RESULTS: Among the 60 initially enrolled patients (CP 30, AMC 30), 5 patients in the CP group and 6 in the AMC group were excluded due to poor compliance. There were no significant differences in demographic data including age, sex, initial signs and symptoms, endoscopic and X-ray findings between the two groups. Rates of improvement after 2 weeks were 96% and 95.8% in the CP and AMC group, respectively. Sinus symptoms were changed significantly after 2 and 4 weeks, however, there was no difference between groups (P=0.41). The most common adverse reaction was gastrointestinal complication, diarrhea occurred in 1 patient in the CP group and 6 in the AMC group (P=0.04). CONCLUSION: CP and AMC were both effective in treating ARS. The difference of treatment outcome was not found between the two groups, however, gastrointestinal complications were less prevalent in the CP group.

Amoxicillin Clavulanic Acid Induced Stevens-Johnson Syndrome / 대한이비인후과학회지

The Stevens-Johnson syndrome is a severe form of erythema multiforme associated with multiple organ involvement that can result in severe mortality. Various etiologic factors have been reported to include drugs, bacteria, virus, etc. We experienced a case of amoxicillin clavulanic acid induced Stevens-Johnson syndrome with the involvement of oral mucosa, skin, and conjunctiva. This patient was treated with steroid and supportive care.