Comparison of the effect of dapagliflozin on contrast to standard therapy of the patients with type 2 diabetes mellitus and concomitant obesity, their effect on laboratory and anthropometric parameters.

OBJECTIVE: The aim: Evaluate clinical and laboratory parameters of the patients with type 2 diabetes mellitus and concomitant obesity after a course of dapagliflozin treatment and compare with a standard treatment regimen. PATIENTS AND METHODS: Materials and methods: Conducted a comprehensive clinical laboratory examination and measurement of the anthropometric parameters of the patients with type 2 diabetes mellitus and concomitant obesity, with subsequent statistical calculations. RESULTS: Results: The data obtained at different stages of the study revealed a statistically significant effect of glucose treatment and glycosylated hemoglobin (HbA1c). Since the 6th month of dapagliflozin treatment, we have shown a tendency to lose weight compared to baseline in this group of patients and controls. CONCLUSION: Conclusions: Type 2 diabetes mellitus and obesity significantly increase the risk of developing a number of complications. Complex control and effects on clinical laboratory and anthropometric parameters can statistically significantly influence the development of the complications, and in this context, dapaglifloflozin showed statistically better results than standard metformin monotherapy.

Antimicrobial susceptibility patterns of escherichia coli in children and adults with urinary tract infections.

OBJECTIVE: Introduction: Urinary tract infections (UTIs) are common pathology in children and adults that is caused mainly by Gram-negative bacteria among which Escherichia coli plays an outstanding role. UTIs treatment demands empiric antibiotic therapy and knowing of antimicrobial local susceptibility and resistance patterns is crucial for making a decision about an agent for the first line therapy. The aim of this study was to evaluate the local susceptibility patterns of uropathogenic E. coli isolates to antibiotics in patients with UTIs. PATIENTS AND METHODS: Materials and methods: A total of 129 E. coli isolates obtained from 44 children (under the age of 18) and 85 adults with community-acquired UTIs were included in this retrospective study during January and December 2017. Antimicrobial susceptibility testing to17 antimicrobials was performed using disc diffusion method on Mueller-Hinton agar. Statistical analyses were performed using Microsoft Excel 2010 and Statistica 10 software. 95% confidence intervals (CI) for proportions were determined using the Agresti-Coull method. P-values were obtained using two-tailed Fisher's exact test. The difference was considered to be statistically significant if p<0.05. RESULTS: Results: E. coli was highly susceptible to levofloxacin and gatifloxacin (93.18% [95% CI 81.11-98.32%] for each) with the lowest susceptibility to amoxicillin/clavulanic acid (2.27%, 95% CI 0.00-12.89%) in children. Susceptibility to the tested cephalosporins ranged from 34.09% (cefuroxime, 95% CI 21.82-48.92%) to 65.91% (cefepime, 95% CI 51.08-78.18%). In adults the highest susceptibility was to gatifloxacin and ceftriaxone (80.00% [95% CI 70.19-87.22%] for both) and the lowest one to amoxicillin/clavulanic acid (2.35%, 95% CI 0.14-8.68%). CONCLUSION: Conclusions: Aminopenicillins are not suitable for UTIs treatment unless susceptibility is confirmed by testing. Fluoroquinolones cannot be used for the empirical treatment either of complicated or uncomplicated pyelonephritis in adults. Cefotaxime and ceftriaxone can be recommended for initial treatment of complicated UTIs in adults. The efficacy of cephalosporins in children is doubtful due to high local resistance rates.

Susceptibility of streptococcus pneumoniae to fluoroquinolones and macrolides in upper respiratory tract infections.

INTRODUCTION: Streptococcal species are known as the most common cause of bacterial upper respiratory tract infections (URTI). Once bacterial infection is diagnosed it demands empirical antibiotic prescription. On the other hand antimicrobial resistance is a global burden in today's medicine. For that reason, knowing of antimicrobial susceptibility patterns in population is an important background for successful treatment of bacterial caused URTI. The aim of this study was to analyze S. pneumoniae resistance and susceptibility patterns to fluoroquinolones and macrolides in URTI. MATERIALS AND METHODS: The results of microbiological examination of 2,055 pharyngeal swabs taken from patients with bacterial caused tonsillitis, pharyngitis and laryngitis were analyzed. Antimicrobial susceptibility testing for levofloxacin, ofloxacin, gatifloxacin, erythromycin, clarithromycin, azithromycin was performed with the disk-diffusion method. RESULTS: The incidence of S. pneumoniae in the etiological structure of bacterial caused URTI was increasing from 22.47% of cases in 2011 to 36.48% in 2015. The susceptibility of this microorganism to ofloxacin, gatifloxacin and levofloxacin decreased from 96.25%, 100% and 95.00% in 2011 to 44.22%, 65.99% and 62.59% in 2015 respectively. The susceptibility of S. pneumoniae to erythromycin, azithromycin and clarithromycin also decreased from 30.00%, 63.75% and 41.25% in 2011 to 6.80%, 26.53%, 27.21 in 2015. CONCLUSIONS: Among investigated antibiotics levofloxacin can be recommended for empiric therapy of URTI because of high pneumococci susceptibility to this drug.