ABSTRACT
The aim of the study was to estimate the diagnostic and treatment patterns in the management of acute nongonococcal urethritis (NGU) in males in some cities of Russia. Retrospective cross-sectional study was conducted in 2009 in 5 centers of 4 cities in the Central Part of Russia (Kaluga, Pskov, Smolensk - 2 centres and Tula). The data on the diagnostic and treatment approaches to the management of NGU in male subjects >16 years old were collected and analyzed with the use of specially designed case report forms. 556 cases of acute urethritis were analyzed during the study. The diagnosis of NGU was confirmed in 401 cases. The average age of the patients was 29.8 years (16-68 years). The following diagnostic methods were used in 95% of the cases: urethral smear microscopy (314/82.4%), C. trachomatis - PCR (113/29.7%), ELISA (155/40.7%); T. vaginalis - PCR (106/27.8%); U. urealyricum and M. hominis, respectively - bacteriology (140/36.7% and 126/33.1%), PCR (110/28.9% and 108/28.3%); M. genitalium - PCR (110/28.9%). The treatment patterns included antimicrobials AMs alone in 60.3, and AMs + non-AMs in 37.8% of the cases. The most frequently prescribed AMs were azithromycin (27.5%), fluconazole (16.4%), doxycycline (13.6%), metronidazole (11.2%), ofloxacine (7.3%), ceftriaxone (4.4%), josamycin (4.2). According to the results use of the standard methods for NGU diagnosis was rather rare. The use of PCR for atypical pathogens was the following: C. trachomatis 29.7%, U. urealyticum 36.7%, M. hominis 28.9%, M. genitalium 28.3%. Doubtful culture methods were used for detection of U. urealyticum and M. hominis (36.7% and 33.1%). The AMs treatment in some cases was not in compliance with the up-to-date practical guidelines for STD and NGU.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Antiprotozoal Agents/therapeutic use , Urethritis/diagnosis , Urethritis/drug therapy , Adolescent , Adult , Aged , Azithromycin/therapeutic use , Ceftriaxone/therapeutic use , Chlamydia trachomatis/isolation & purification , Cross-Sectional Studies , Doxycycline/therapeutic use , Fluconazole/therapeutic use , Guideline Adherence/standards , Humans , Josamycin/therapeutic use , Male , Metronidazole/therapeutic use , Middle Aged , Mycoplasma genitalium/isolation & purification , Mycoplasma hominis/isolation & purification , Ofloxacin/therapeutic use , Polymerase Chain Reaction/methods , Practice Guidelines as Topic/standards , Retrospective Studies , Russia , Trichomonas vaginalis/isolation & purification , Ureaplasma urealyticum/isolation & purification , Urethra/microbiology , Urethritis/microbiologyABSTRACT
Macrolide antibiotics are a safest group of antimicrobial drugs well tolerated by the patients. They have no hemato-, nephro- or cerebrotoxic action, do not cause chondro- or arthropathies, nor do they affect the photosensitizing system. Also, they are/free of many negative effects characteristic of other groups of antibiotics, such as anaphylactic reactions, severe toxico-allergic syndromes, and diarrhea. Most adverse effects of macrolides described in this review are functional disorders of various organs and systems, they are reversible and disappear after the termination of therapy. The beneficial safety profile of macrolides allows prescribing them for the treatment of various infections in inpatients and outpatients including children, pregnant women, elderly persons, and those suffering concomitant diseases.
Subject(s)
Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/therapeutic use , Macrolides/adverse effects , Macrolides/therapeutic use , Aged , Aged, 80 and over , Child , Female , Humans , Male , PregnancyABSTRACT
The data on the microbiological investigation of clinical materials from patients with complicated skin and soft tissue infections in 6 European countries were analysed. The analysis of the bacterial pathogens spectrum provided the microbial view and efficient use of novel antimicrobials in clinical trials.
Subject(s)
Gram-Positive Bacteria/isolation & purification , Gram-Positive Bacterial Infections/microbiology , Skin Diseases, Bacterial/microbiology , Soft Tissue Infections/microbiology , Drug Resistance, Bacterial , Europe, Eastern/epidemiology , Gram-Negative Bacteria/classification , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/classification , Gram-Positive Bacterial Infections/epidemiology , Humans , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Microbial Sensitivity Tests , Prevalence , Skin Diseases, Bacterial/epidemiology , Soft Tissue Infections/epidemiologySubject(s)
Enterococcus/isolation & purification , Drug Resistance, Microbial , Drug Tolerance , Enterococcus/drug effects , Enterococcus/metabolism , Hemolysis , Microbial Sensitivity Tests , Pigmentation , Pyrrolidinones , Pyruvic Acid/metabolism , Streptococcus/drug effects , Streptococcus/isolation & purification , Streptococcus/metabolism , Tellurium/pharmacology , Vancomycin/pharmacologyABSTRACT
To evaluate the adequacy of AGV agar for antimicrobial susceptibility testing, the susceptibility of a range of bacteria to 10 antimicrobials on AGV, Mueller-Hinton and isoSensitest agars, all supplemented with 5 per cent lyzed horse blood was determined. Disc tests were used. In general, AGV agar gave identical susceptibility results to Mueller-Hinton and isoSensitest agars for common gram positive and gram negative bacteria with most of the tested microbials excluding sulphonamides and trimethoprim. With those latter antimicrobials inhibition zones for susceptible organisms were not formed on AGV agar whereas large zones were present on Mueller-Hinton and isoSensitest agars. This discrepancy probably can be explained by the presence of high levels of thymidine in AGV agar; too high to be corrected even by the addition of 5 per cent lysed horse blood. AGV agar is possible to use for susceptibility testing with most of the microbials excluding trimethoprim and sulphonamides.
