Administration Of Amoxicillin Research Articles

Overcoming stability challenges during continuous intravenous administration of high-dose amoxicillin using portable elastomeric pumps.

While treatment of serious infectious diseases may require high-dose amoxicillin, continuous infusion may be limited by lack of knowledge regarding the chemical stability of the drug. Therefore, we have performed a comprehensive study so as to determine the chemical stability of high-dose amoxicillin solutions conducive to safe and effective continuous intravenous administration using portable elastomeric pumps. First, amoxicillin solubility in water was assessed within the range of 25 to 300 mg/mL. Then, amoxicillin solutions were prepared at different concentrations (25, 50, 125, 250 mg/mL) and stored in different conditions (5±2°C, 25±1°C, 30±1°C and 37±1°C) to investigate the influence of concentration and temperature on the chemical stability of amoxicillin. Finally, its stability was assessed under optimized conditions using a fully validated HPLC-UV stability-indicating method. Degradation products of amoxicillin were investigated by accurate mass determination using high-resolution mass spectrometry. Amoxicillin displayed limited water solubility requiring reconstitution at concentrations below or equal to 150 mg/mL. Amoxicillin degradation were time, temperature as well as concentration-dependent, resulting in short-term stability, in particular at high concentrations. Four degradation products of amoxicillin have been identified. Among them, amoxicilloic acid and diketopiperazine amoxicillin are at risk of allergic reaction and may accumulate in the patient. Optimized conditions allowing for continuous infusion of high-dose amoxicillin has been determined: amoxicillin should be reconstituted at 25 mg/mL and stored up to 12 hours at room temperature (22 ± 4°C) or up to 24 hours between 4 and 8°C.

Lateral Sinus Thrombosis as a Complication of Acute Otitis Media, Clinical Case Report in Bogotá, Colombia

Septic thrombosis of the lateral sinus is a rare complication of otitis media; currently, it hasn't been found a case report of septic thrombosis of the lateral sinus in the medical literature of Colombia and, in addition to this, there is no consensus in the management of this pathology. Hence the importance of the present case, which is a 3-year-old male patient, who presented a clinical picture of 7 days of evolution characterized by right otalgia and fever, which after the administration of amoxicillin for 5 days got complicated and showed symptoms of severe headache, photophobia, nausea and vomiting.

Administration of antibiotics can cause dysbiosis in fish gut

Compositions of gastrointestinal microorganisms are known to vary depending on surrounding environment, health status and diet. However, comprehensive analysis of composition and diversity of gut microbiota of fish after treatment with antibiotics has been limited. In this study, therefore, effects of oxytetracycline (OTC) or amoxicillin (AMX) administration on intestinal microbiota of olive flounder, Paralichthys olivaceus, were investigated. Fish were administered with AMX and OTC by oral (80 mg/kg of BW/day for 10 days) or intramuscular injection (12.5 mg/kg bw and 50 mg/kg bw) route. Culture-dependent method and metagenome analysis were performed using samples of gut mucus taken from fish at day 0, 5 and/or 10. A total of 23 and 26 species were isolated from gut mucus of fish in oral and injection groups, respectively. Virbio scophthalmi, V. harveyi and Photobacterium damselae, and V. scophthalmi and Streptococcus parauberis were dominantly isolated from oral and injection treatment groups, respectively. In metagenomics analysis, operating taxonomic unit (OTU) counts obtained from AMX and OTC oral treatment group were 42 and 78, respectively, which are much lower than 178 OTUs retrieved from the control group. OTU counts obtained from fish injected with AMX at day 5 were 22, remarkably lower than those of other samples in injection treatment groups. These results indicate that administration of antibiotics to fish can have great impact on gut microbial community by reducing its diversity and number. Our data also show that AMX might cause changes in microbial community greater than OTC. In some cases, it can lead to significant increase of opportunistic pathogen(s), causing dysbiosis.

Amoxicillin Administration Regimen and Resistance Mechanisms of Staphylococcus aureus Established in Tissue Cage Infection Model

Staphylococcus aureus is a zoonotic pathogen that causes various life-threatening diseases. The mechanisms of action of amoxicillin against S. aureus are unclear. Here, we established a rabbit tissue cage infection model to evaluate the relationship between the pharmacokinetic/pharmacodynamic (PK/PD) parameters of amoxicillin and selective enrichment of resistant strains of S. aureus and to elucidate the evolution of its resistance to amoxicillin. S. aureus was injected into the tissue cages at 1010 colony forming units (CFU)/mL. We injected different intramuscular concentrations of amoxicillin at doses of 5, 10, 20, and 30 mg/kg body weight once a day for 5 days and 5, 10, 20, and 30 mg/kg body weight twice a day for 2.5 days. Differences in gene expression between two differentially resistant strains and a sensitive strain were evaluated using Illumina sequencing followed by COG and KEGG analysis. RT-qPCR was carried out to validate the difference in protein translation levels. Our results demonstrated that the emergence of resistant bacteria was dose dependent within a given time interval. In the same dosage group, the appearance of resistant bacteria increased with time. The resistant bacteria showed cumulative growth, and the level of resistance increased over time. The resistant bacteria were completely inhibited when the cumulative percentage of time over a 24-h period that the drug concentration exceeded the mutant prevention concentration (MPC) (%T > MPC) was ≥52%. We also found that mecA and femX in S. aureus played a leading role in the development of resistance to amoxicillin. In conclusion, it provide references for optimizing amoxicillin regimens to treat infections caused by S. aureus.

Amoxicillin effect on bacterial load in group A streptococcal pharyngitis: comparison of single and multiple daily dosage regimens

BackgroundCulture tests have demonstrated that once-daily administration of amoxicillin may be effective in the treatment of group A streptococcal (GAS) pharyngitis. However, culture methods do not allow accurate assessments of bacterial load changes because of the suppressive effect of the antibiotic on bacterial growth. In this study, we used real-time PCR to compare the effectiveness of once-daily and multiple-daily amoxicillin treatment for pediatric patients with GAS pharyngitis.MethodsThe subjects were children (≧3 years of age) diagnosed with GAS pharyngitis. Amoxicillin was administered at a dose of 40–50 mg/kg/day, divided into one (QD), two (BID), or three (TID) daily doses, for 10 days. Throat swabs were collected before treatment (visit 1), 1 to 3 days after treatment (visit 2), and 9 to 11 days after treatment (visit 3), and GAS copies were quantified by real-time PCR. The main compared parameters were the rate of negative PCR results and the number of GAS determined by PCR in throat swabs between each regimen.ResultsSamples were collected from 34 patients (QD, 12; BID, 15; TID, 7) at visit 1, 32 patients (QD, 11; BID, 14; TID, 7) at visit 2, and 25 patients (QD, 7; BID, 11; TID, 7) at visit 3. The rates of negative PCR result for QD, BID, and TID regimens were 18.2, 0, and 14.3% at visit 2, and 85.7, 72.7, and 85.7% at visit 3, respectively. The median values of bacterial load for QD, BID, and TID groups at visit 1 were 1.4 × 106, 8.2 × 105, and 5.4 × 105 copies/μL. At visit 2, they comprised 3.8 × 103, 1.1 × 103, and 2.8 × 103 copies/μL, respectively, whereas at visit 3, GAS copies were mostly undetectable. There was no statistical difference in the negative results and median value of GAS copies between regimens at any stage.ConclusionsOur results obtained by a molecular biology approach indicated that the QD regimen was as effective in eradicating GAS infection as BID or TID.Trial registrationUMIN000036083 / March 12, 2019.

Comparing Direct Challenge to Penicillin Skin Testing for the Outpatient Evaluation of Penicillin Allergy: A Randomized Controlled Trial

Direct challenge (DC) may be a safe and effective alternative to penicillin skin testing (PST) in low-risk patients. To complete a prospective, randomized, controlled trial comparing PST followed by a challenge to amoxicillin versus a 2-step DC to amoxicillin without preceding skin testing in a predefined low-risk patient population. Penicillin allergy histories were reviewed in patients presenting to an outpatient allergy/immunology practice from April 2018 to August 2018. Patients 5 years or older with a cutaneous-only or unknown reaction (>1 year ago for those aged 5-17 years, >10 years ago for those 18 years or older) were randomized 1:1 to PST or 2-step DC. All children younger than 5 years underwent DC, and patients with extracutaneous reaction histories underwent PST. All groups were monitored 30 minutes after administration of amoxicillin. Penicillin allergy was reported in 363 of 2465 (14.7%) patients, of which 185 consented to further evaluation. Thirteen patients younger than 5 years underwent DC; all were negative. Thirteen patients with angioedema and/or extracutaneous symptoms underwent PST; 2 of 13 patients had positive PST result. A total of 159 patients were randomized to DC (49.7%) or PST (50.3%). PST result was negative in 70 of 80 (87.5%) patients. All 70 patients had a negative amoxicillin challenge. DC was negative in 76 of 79 (96.2%) patients; positive DC reactions were minor. Average time for patients undergoing PST was 72.7 ± 5.3 minutes and for patients undergoing DC was 66.7 ± 4.8 minutes. In low-risk patients, DC provided a safe and effective alternative to PST in delabeling penicillin allergy. Compared with PST, DC may also take less time, cost less money, and lead to fewer penicillin allergy evaluations with false-positive results.

Pharmacokinetic study of amoxicillin in Japanese eel Anguilla japonica by high performance liquid chromatography with fluorescence detection

Amoxicillin (AMX) is widely used for the treatment of gastrointestinal and systemic infections. AMX residues above certain levels may pose a threat to human health. Therefore, this study aimed to understand the pharmacokinetics of AMX in Japanese eel, Anguilla japonica, using high-performance liquid chromatography (HPLC) with fluorescence detection. Japanese eels were treated with AMX at concentrations of 40 or 80 mg kg−1 body weight (BW) daily via oral administration. The results revealed that the recoveries of AMX from the muscle, liver, and sera of eels were 84.7–105.1%, 81.8–104.9%, and 88.6–106.3%, respectively. The observed peak retention time was approximately 4.2 min. After administration of 40 mg kg−1 BW per day of AMX, the pharmacokinetic parameters were detected, respectively. The average drug residue concentration in muscles was 180 and 260 ng mL−1 on day 1 and day 2, respectively, and in the liver, it was 70 and 110 ng mL−1 on day 1 and day 2, respectively, after the 40 mg kg−1 BW daily AMX administration. Residue concentrations in the muscle and liver on day 3 after 40 mg kg−1 BW administrations were below the limit of detection (<30 ng mL−1). On the other hand, the average drug residue concentration in muscles was 930 and 1070 ng mL−1 on day 1 and day 3, respectively, and in the liver, it was 35 and 95 ng mL−1 on day 1 and day 3, respectively, after 80 mg kg−1 BW AMX administration. However, the residue concentrations in the muscle and liver on day 5 after 80 mg kg−1 BW administration were below the detection limit (<30 ng mL−1). The pharmacokinetic information derived from Japanese eel can be used to design rational dosing regimens and can also assist the Taiwan government in formulating laws and regulations for AMX residues in Japanese eels. Additionally, this information will provide greater protection to consumers of aquaculture products.

Effects of Amoxicillin on the Structure and Mineralization of Dental Enamel and Dentin in Wistar Rats.

Objectives:The development of teeth is affected by genetic and environmental factors. Amoxicillin is a widely prescribed semi-synthetic antibiotic. Its most frequent side effects are gastrointestinal disorders and hypersensitivity reactions. The purpose of this study was to determine the effect produced by amoxicillin administration on dental enamel and dentin in Wistar rats.Materials and Methods:Twelve pregnant adult Wistar rats were equally divided into four different groups. Negative controls were prescribed with a saline solution. Positive controls were prescribed with tetracycline (130 mg/kg). The other two groups were treated with amoxicillin doses of 50 and 100 mg/kg (every 8 hours), respectively. The treatments were daily administered by oral gavage from the 13th gestation day to the end of gestation. After birth, the offspring also received the same treatment as their mothers from day one to day twelve. After 24 hours, the newborns were sacrificed, the jaws were dissected, and the first molar teeth were collected. The samples were fixed in 10% formaldehyde solution and were histomorphologically and histopathologically observed to determine enamel and dentin abnormalities.Results:The mean ameloblastic layer thickness, enamel thickness, odontoblastic layer thickness, and dentin thickness were significantly different in the tetracycline group and the amoxicillin 50 and 100 mg/kg groups compared to the control group. Also, dentin hypomineralization and vacuolization of the odontoblastic layer were observed in the tetracycline- and amoxicillin-treated groups.Conclusion:This study showed that amoxicillin interferes with amelogenesis and dentinogenesis and reduces enamel and dentin thickness.

Variations of antibiotic resistance profiles in chickens during administration of amoxicillin, chlortetracycline andflorfenicol.

To assess the effect of antibiotics administered in feed on the resistance phenotypes and genotypes of Escherichia coli in the chicken intestine. Chickens were administered amoxicillin, chlortetracycline and florfenicol in feed and 203 intestinal E.coli were examined for their susceptibility to 11 antimicrobial agents and for the presence of antibiotic resistance genes (ARG) using PCR. DNA was extracted from chicken stool samples in 15, 20, 30 and 40day old chickens. We found that while antibiotic resistance rates increased with time, the relative gene abundance of tet(W), tet(A), cmlA, cfr and sul1 decreased. In contrast, the relative abundance of gene blaTEM and mcr-1 increased over the experimental period. Pearson correlation analysis indicated that sul1 was correlated with tet(W) (R=0·630, P<0·01) and cmlA was correlated with cfr (R=0·587, P<0·01). Interestingly, mcr-1 correlated with tet(W) (R=-0·546, P<0·05). Administration of different antibiotic reduced the relative abundance of ARG in chickens but did not halt the expansion of antibiotic resistance. Changing the pattern of antibiotic types used to prevent antibiotic resistance in chickens is not a viable method to prevent the spread of ARG.

Adjunctive affects of systemic amoxicillin and metronidazole with scaling and root planning

The objective of this study was to investigate the effect of the systemic administration of metronidazole and amoxicillin as an adjunct to initial periodontal therapy in patients with moderate to severe chronic periodontitis.Methods and Materials: This randomized, double blind study, involved 50 adult patients with untreated periodontitis who were randomly assigned to receive either a full-mouth scaling and root planning along with systemic metronidazole and amoxicillin (T group) or scaling and root planning with a placebo (P group). Clinical measurements including probing depth (PD), clinical attachment levels (CAL), Plaque Index (PI), and Bleeding Index (BI) were recorded at baseline and six to eight weeks after therapy. The deepest pocket was selected and samples for microbiological testing were taken. Patients received coded study medications of either 500 mg amoxicillin in combination with 250 mg metronidazole or an identical placebo every eight hours for seven days following scaling and root planning.Results: There was a significant change in PD , CAL, PI, and BI in the T group compared to the placebo group after therapy. Parallel to the clinical changes, treatment significantly reduced the number of Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and P. intermedia (Pi) compared with baseline in the T group. However, in the P group only the Pi colony count was reduced significantly (P=0.0001). After therapy, there was a significant difference between the T and P groups in the number of patients negative for Aa, Pg, and Pi.Conclusions: The significant differences between treatment and placebo groups are in line with other studies and support the considerable adjunctive benefits of the combination of amoxicillin and metronidazole in the treatment of chronic periodontitis.

The ideal time of systemic metronidazole and amoxicillin administration in the treatment of severe periodontitis: study protocol for a randomized controlled trial

BackgroundThe combination of systemic metronidazole (MTZ) and amoxicillin (AMX) with scaling and root planing (SRP) has shown to be an effective periodontal treatment. However, some essential issues associated with the use of these antibiotics remain unanswered, such as the ideal time of administration during the course of periodontal treatment. Although these agents are often prescribed after the healing phase of the SRP procedure, there is biological plausibility to support its use in conjunction with the mechanical treatment. However, to date, no placebo controlled randomized clinical trial (RCT) has directly compared these two protocols. Therefore, the aim of this RCT is to compare the clinical, microbiological and immunological effects of the adjunctive systemic MTZ + AMX administered in different phases of the treatment of severe periodontitis.MethodsSubjects with severe periodontitis (n = 180) are being randomly assigned into three groups (n = 60/group): (i) SRP-only (control group), SRP in combination with 400 mg MTZ + 500 mg AMX, starting (ii) at the first SRP session (active phase group), or (iii) after 3 months of its completion (healing phase group). All volunteers are receiving clinical and microbiological evaluation at baseline, 3, 6 and 12 months, and immunological assessment at baseline and 12 months post-therapy. Nine subgingival biofilm samples are being collected per subject and analyzed for counts and proportions of 40 bacterial species by checkerboard DNA-DNA hybridization, and six gingival crevicular fluid samples are being collected and analyzed for the levels of 20 chemokines by multiplex immunoassay. The primary outcome variable is the number of volunteers reaching the clinical endpoint for treatment (≤ 4 sites with probing depth ≥5 mm) at 1 year post-therapy. Differences in clinical, microbiological and immunological parameters among groups and over time will be evaluated using analysis of variance, analysis of covariance and the Chi-square and Tukey tests. Microbiological and immunological analyses will be performed using adjustments for multiple comparisons. Statistical significance will be set at 5%.Trial registrationClinicalTrials.gov, NCT02954393. Registered on 3 November 2016.

Dramatic Increase of Amoxicillin-Induced Crystal Nephropathy Found in a Cohort Study of French Pharmacovigilance Centers.

An increase in amoxicillin-induced crystal nephropathy (AICN) incidence has been recently suggested. The aims of this study were to investigate the trend of AICN incidence through Paris' regional centers of pharmacovigilance (Paris RCPVs) and better describe this rare adverse drug reaction. Forty-five AICN cases were identified between 1985 and 2016. All cases, except one, were reported since 2010. Amoxicillin (AMX) was administered intravenously (65 [interquartile range {IQR}, 43 to 110] mg/kg of body weight/day) in all patients, either for treating infection (n = 15) or as surgical prophylaxis (n = 30). Delay between AMX administration and AICN onset was 1 (IQR, 1 to 3) day; 30, 4, and 11 patients developed KDIGO stage 1, 2, and 3 acute kidney injury, respectively. Delay between AICN onset and kidney function recovery was 4 (IQR, 2 to 6) days. Precipitating factors were identified in only one-third of cases. Twelve patients required intensive care unit admission, and 8 needed renal replacement therapy. Neither chronic kidney disease nor death was observed. We confirmed the recent and dramatic increase of AICN in the Paris RCPVs since 2010. The absence of precipitating factors in the majority of cases and the onset of AICN in apparent routine indications, such as surgical prophylaxis, are alarming and justify a high vigilance from all AMX prescribers.

Farmacodermia en perro de la raza Dálmata: Reporte deun caso

It is understood as pharmacodermia the hypersensitivity reaction to certain drugs manifested by focal or diffuse dermatological lesions. This paper presents a case of pharmacodermia in dogs after administration of amoxicillin associated with potassium clavulanate. A Dalmatian dog, male, one year and five months old, weighing 33kg was attended at the Veterinary Hospital Professor Mário Dias Teixeira of the Federal Rural University of the Amazon, having as main complaint the presence of constipation about two months ago. From clinical examination and imaging studies it was observed that the patient had narrowing of the rectal ampulla, prostatic cysts and cystitis, and therapeutic anoplasty and orchiectomy were recommended. Tramadol hydrochloride, meloxicam, and amoxicillin associated with potassium clavulanate were instituted for the pre and postoperative period. The presence of scaly lesions on the skin and signs of secondary bacterial infection, mainly concentrated in the lumbar region, was observed on the ninth postoperative day. Meloxicam was replaced by ketoprofen and treatment with amoxicillin and clavulanate was maintained for another five days. After this period, the patient returned with lesion evolution, emaciation and hypophagia. Due to the evolution of the case, clinical history and presentation of the lesions, pharmacodermia was suspected. Subsequently, amoxycillin was replaced with ciprofloxacin and surgical debridement of the lesions. Finally, after surgical treatment, regression of lesions with a good healing process was observed, suggesting that the case may be a pharmacological.

EVALUATION OF SOME ANTIBIOTICS’RESISTANCE OF DIFFERENT ORAL BACTERIA TYPES ISOLATED FROM PATIENTS WITH GINGIVITIS AND PERIODONTITIS

Background Periodontal diseases are highly prevalent in Iraq. They may become serious conditions if they faced by unsuitable treatment and resulting in particularly cardiovascular systemic disorders. Further, antibiotic resistance in general has been witnessed prevalence, which may lead to failure of periodontal disease treatment. The aim of this study is evaluation of susceptibility and resistance to different antibiotics by dental plaque bacterial isolates. Material and methods Thirty seven infected patients were included in this study. From their dental plaque, samples were taken aseptically then bacteria has been isolated as well as antibiotic susceptibility tests agar diffusion methods had been applied. Results Among three types of bacteria, Streptococcus mutans occupied the largest percentage (62%) in dental plaque isolates. Imipenem registered profound susceptibility (78.3%) via Streptococcus mutans followed by each of erythromycin, ciprofloxacin, and ceftriaxone (60.9%). This pathogen isolates showed resistance to amikacin, chloramphenicol, tetracycline and amoxicillin. Pseudomonas aeruginosa appeared the highest susceptibility to chloramphenicol and ceftriaxone by (90%) while Staphylococcus aureus had been existed complete susceptibility to imipenem (100%) followed directly by tetracycline and chloramphenicol by about (75%) of each. The lowest susceptibility was resulted toward amoxicillin, amikacin, and ciprofloxacin with (25%). Generally speaking, amoxicillin exposed to highest resistance (70.3%) in comparison to others, whereas both of imipenem and ceftriaxone witnessed highest susceptibility (67.6%) by the same pathogens. Conclusions Amoxicillin occupied the first position in bacterial resistance, this may support the assumption that improper administration of amoxicillin will lead to therapy failure. KEYWORDS: Antibiotics, Gingivitis, Periodontitis, Resistance, Susceptibility.

Prepartum application of internal teat sealant or intramammary amoxicillin on dairy heifers: Effect on udder health, survival, and performance

Intramammary infusion of antimicrobials (IA) and application of an internal teat sealant (ITS) at the end of the lactation is a common strategy to prevent and treat intramammary infections during the dry period. In heifers, precalving IA has been reported to improve udder health and milk quality; however, the effect of ITS in heifers housed in freestall barns is still unknown. The objective of this study was to investigate the effect of prepartum application of ITS or IA on udder health of dairy heifers. A total of 886 heifers were randomly allocated into 1 of 4 treatment groups when they were 245 ± 3 d pregnant. Control heifers (CON) did not receive any treatment. Heifers in the ITS group received the application of ITS containing 2.6 g of bismuth subnitrate. Animals in the IA group received intramammary administration of 62.5 mg of amoxicillin. Heifers in IA+ITS group received intramammary administration of amoxicillin followed by ITS application. The follow-up period was 270 d in milk (DIM). Clinical mastitis was diagnosed and treated by trained farm personnel throughout the study period. Composite milk somatic cell counts (SCC) were determined monthly for the first 9 mo of lactation by Dairy Herd Improvement Association. Subclinical mastitis was defined as a cow having a SCC >200,000 cells/mL for at least 1 test day and not diagnosed with clinical mastitis during the study period. At 7 ± 3 DIM, composite milk samples were collected for bacteriological analysis for a subset of the study animals. The presence of pathogens in milk at 7 ± 3 DIM was more frequently detected in the CON heifers compared with animals enrolled in the treatment groups. Heifers in IA+ITS group had a decreased incidence of clinical mastitis compared with CON heifers (12.9 vs. 21.4%). Additionally, the incidence of subclinical mastitis was decreased for IA+ITS heifers compared with CON counterparts (20.1 vs. 43.8%). During the first 9 mo of lactation, IA and IA+ITS heifers had lower SCC linear scores compared with ITS and CON counterparts. Although IA+ITS treatment successfully improved udder health, it did not result in better milk yield, fertility, and survivability. In conclusion, ITS alone was not effective in improving udder health; however, the combination of ITS and IA decreased the incidence of clinical and subclinical mastitis during the first 9 mo of lactation. Additionally, IA+ITS had a long-term effect on the SCC linear score throughout the study period.

The Effectiveness of Antibiotics and Hematopoietic Stem Cell Treatment in Periodontitis Rat Model Toward TNF α Expression

Periodontitis is a biofilm-induced chronic inflammatory. The current therapy of periodontitis is scaling root planning and curettage, and followed by administration of antibiotic such as combination of Amoxicillin and Clavulanic acid. Hematopoietic Stem Cell has ability to differentiate into blood cells which is capable of homing and regenerating itself. Research Purpose: The aim of this study was to prove antibiotic and Hematopoietic Stem Cell administration can reduce TNF α expression. Method: This research was divided into four different groups, P1 as negative control group, P2 as positive control group which inoculated with P.gingivalis 109 for three weeks as chronic periodontitis rat model and USP were administered, P3 as chronic periodontitis rat model received Hematopoietic Stem Cell injection into the tail vein of rat, P4 as chronic periodontitis rat models were given Amoxicillin and Clavulanic acid 250 mg/kg BW orally then followed by Hematopoietic Stem Cell 106 injection into the tail vein of rat. After two weeks rat were sacrified and immunohistochemically analysed for expression of TNF α. The data were analysed by using Non-Parametric Test. Result: TNF α expression of negative control group was different as compared to positive control group and treatment group which given Hematopoietic Stem Cell injection, but there is no difference between negative control group with treatment group which given Amoxicillin and Clavulanic acid 250 mg/kg BW orally and followed by Hematopoietic Stem Cell injection. Clonclusion: The administration of Amoxicillin and Clavulanic acid 250 mg/kg BW and Hematopoietic Stem Cell can reduce TNF α expression on periodontitis rat model.Keyword: Hematopoetic Stem Cell, TNF α, Chronic Periodontitis, Antibiotic

Resveratrol improves efficacy of oral amoxicillin against childhood fast breathing pneumonia in a randomized placebo-controlled double blind clinical trial

Childhood pneumonia has been considered as a major cause of child morbidity and mortality worldwide. We aimed to investigate the effect of resveratral in synergizing with oral amoxicillin to improve the treatment outcome of oral amoxicillin administration against childhood fast breathing pneumonia. 647 children diagnosed fast breathing pneumonia were recruited and randomized to receive oral amoxicillin plus either resveratrol (AX + RV) or placebo (AX + placebo). The primary outcome was defined as treatment failure up to day 3, while the secondary outcome was defined as treatment failure at day 6 and 12 upon follow up. Incidences of treatment failure up to day 3 was significantly lower in the AX + RV group than the AX + placebo group. From day 6–12, the incidences of treatment failure were increased in both treatment groups. However, treatment failure cases were still much lower in the AX + RV group on both revisits. No serious adverse reaction to treatment drugs were found in either of the two groups. Resveratrol improves efficacy of oral amoxicillin against childhood fast breathing pneumonia, supporting the clincial potential of reseveratrol as a potent adjuvent of oral amoxicillin in the treatment of childhood pneumonia with no adverse effects.

Severe erythema multiforme-type drug eruption controlled by tumor necrosis factor-α antagonist: A case study.

Using a tumor necrosis factor-α antagonist, the present study successfully treated a case of severe erythema multiform-type drug eruption, which occurred following anti-Helicobacter pylori therapy. A 73-year-old female suffering from upper gastrointestinal bleeding and peptic-ulcer presented with an itchy rash, fever, an increase in leukocytes and eosinophils and lymphadenectasis following oral administration of amoxicillin. Following six subcutaneous injections of etanercept (initially 50 mg, then 25 mg every 3 days), the patient was deemed to have recovered. Following the first injection, the fever was under control. On day 2, the lesions were no longer expanding. On day 4, the rash was markedly less itchy, the swelling decreased, the erythema began to crust and mucosal secretions disappeared. On day 16, the patient was deemed to have recovered and was discharged from the hospital. Her peripheral blood eosinophil count continued to rise following the injection, peaking on day 9. Following this, the count declined slowly, but remained significantly higher than normal when the patient was discharged. The present case indicates that tumor necrosis factor-α antagonist is a safe, fast and effective treatment for severe drug eruption, but it is unable to prevent the rise of peripheral blood eosinophils.

Impact of oral and intramuscular administration amoxicillin on the selection of amoxicillin-resistant &lt;i&gt;Enterobacteriaceae&lt;/i&gt; in the digestive flora of piglets

Objective: The aim of this study was to evaluate the level of selection of amoxicillin-resistant Enterobacteriaceae in the digestive microbiota of piglets during oral and intramuscular administration of amoxicillin. Methodology and Results: Enumeration of Enterobacteriaceae was carried out on MacConkey agar with and without amoxicillin. E. coli isolates were identified and subjected to antimicrobial susceptibility test. The percentages of amoxicillin-resistant Enterobacteriaceae before treatment were between 10-13% for the three groups of piglets. After starting treatment of amoxicillin, from day 1 to day 4, the percentages of resistant Enterobacteriaceae were between 54 to 81% for the intramuscular treated groups and 58 to 87% for those treated orally. In the control group, percentage was 11%. During days of treatments, the percentage of amoxicillin-resistant E. coli strains to the associated antibiotics evolved during the treatments. In the control piglets, the percentages of E. coli resistant antibiotics did not increase. Conclusion and application of findings: Administration of oral amoxicillin resulted in a greater selection of resistant enterobacteria in the digestive microbiota of piglets than those induced by the intramuscular route. Escherichia coli , an important strain in animal and human pathology, was the target of detection in this selection of these resistant enterobacteria. They constitute a public health risk due to the transfer of resistance genes from pathogenic bacteria of porcine origin to the human digestive flora via the food chain. The results obtained from this study are part of a bacterial resistance monitoring policy that will prevent pig farmers from Cote d’Ivoire, the majority user of these antibiotics. Keywords: Piglets, Enterobacteriaceae , Amoxicillin, Resistance, Digestive microbiota

Evaluation of two amoxicillin protocols for antibiotic prophylaxis in implant placement surgeries

ABSTRACT Objective The aim of this study was to evaluate the effectiveness of two amoxicillin protocols for antibiotic prophylaxis in implant placement surgeries. Methods A clinical study was performed with 66 volunteers of both genders (mean 51,9 ± 2,5 years) that met the inclusion criteria and were randomly assigned into 2 groups: Group 1 (n=35) - oral administration of amoxicillin (2g) 1 hour before the surgical procedure and Group 2 (n=31) oral administration of amoxicillin (2g) 1 hour before the surgical procedure and 500mg every 8 hours during 7 days after the surgeries. The following clinical parameters were evaluated: adverse reactions, pain and implants failure. The pain was evaluated in the surgery day (before, immediately after and at night), 24h, 48h, 72h and one week after the surgery and other clinical parameters were evaluated in daily appointments until the third postoperative day, 7 days and three months after the surgeries. Data were analyzed and statistical significance was 5%. Results Adverse reactions (headache, diarrhea, stomachache and nauseas) and implant failure occurred only in G2 (4 volunteers and 3 implants, respectively). Regarding pain, higher values for G2 on “at the night (p=0.0043), 24h (p=0.0013), 48h (p=0.0187) e 72h (p=0.0445) were observed. Conclusion The present study showed that a single dose of amoxicillin was effective in antibiotic prophylaxis in implant placement surgeries, suggesting that the use of amoxicillin in the postoperative period did not bring additional benefit.