Administration Of Amoxycillin Research Articles

Effectiveness of Systemic Administration of Amoxycillin and Metronidazole versus Azithromycin in Generalized Aggressive Periodontitis – A Randomized Controlled Clinical Trial

Aim: To evaluate the effect of systemic Amoxycillin and Metronidazole against Azithromycin as an adjunct to non-surgical therapy and correlate the clinical periodontal parameters at baseline, 10 days and 30 days in subjects with generalized aggressive periodontitis (GAP). Study Design: Randomized controlled clinical trial. Place and Duration of the Study: The study was conducted in Saveetha Dental College and Hospitals from February 2015 to August 2015. Methods: Subjects were recruited from the outpatient department of Periodontics and were categorized as GAP according to AAP criteria. A total of 16 patients with GAP were included in the study. Clinical periodontal parameters like sulcus bleeding index [SBI], gingival index [GI], Probing depth [PD] and clinical attachment loss [CAL] were recorded at baseline. The subjects were then randomly allotted into Group 1 [Amoxycillin+Metronidazole] and Group II [Azithromycin]. After evaluation of clinical parameters at baseline, scaling and root planning [SRP] was done in both the Groups and systemic antibiotics, namely combination of Amoxycillin and Metronidazole in Group I and Azithromycin in Group II were administered. Subjects were recalled at day 10 and 30 for re-evaluation of clinical parameters. Within Group comparison was made using paired “t test” and inter Group comparison was made using Un-paired “t test”. Results: Intra-Group comparisons of clinical parameters between baseline and 30 days, in both the Groups were statistically significant (P 0.05). Conclusion: Systemic administration of Azithromycin as an adjunct to SRP in subjects with GAP resulted in better improvement of clinical periodontal parameters compared to a combination of Amoxycillin and Metronidazole.

Antibiotics prior to embryo transfer in ART.

Embryo transfer (ET) involves the placement of one or more embryos into the uterine cavity, usually by passing a catheter through the cervical os. ET is the final step in an assisted reproductive technology (ART) cycle, where a woman has undergone controlled ovarian stimulation, egg retrieval and in vitro fertilisation of her eggs. Despite the transfer of high quality embryos, many ETs do not result in a pregnancy. There are many factors which may affect the success of ET, including the presence of upper genital tract microbial colonisation. The administration of antibiotics prior to ET has been suggested as an intervention to reduce levels of microbial colonisation and hence improve pregnancy rates. To evaluate the effectiveness and safety of antibiotic administration prior to ET during ART cycles. We searched the Menstrual Disorders and Subfertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library, MEDLINE, Ovid MEDLINE® In-Process & Other Non-Indexed Citations, Ovid MEDLINE® Daily and Ovid MEDLINE® (from inception to February 2011), Ovid EMBASE (January 2010 to February 2011), Ovid PsycINFO, CINAHL, LILACS, trial registers for ongoing and registered trials, citation indexes, ClinicalStudyResults, PubMed, OpenSIGLE database and for for herbal and complimentary therapy protocols and reviews. Only randomised controlled trials were included. The titles and abstracts of articles identified by the search were screened by one review author for eligibility. Two review authors then independently examined the full text articles for suitability for inclusion in the review. Data were extracted independently by two review authors. We identified four potential studies, of which three were excluded.The included trial reported clinical pregnancy rates but not live births. There was no evidence of a difference in clinical pregnancy rate between those receiving an amoxycillin and clavulanic acid antibiotic combination (64/178: 36%) and those not (61/172: 35.5%) (OR1.02, 95% CI 0.66 to 1.58). Genital tract colonisation was significantly reduced in women receiving this antibiotic regimen (OR 0.59, 95% CI 0.37 to 0.95). This review suggests that the administration of amoxycillin and clavulanic acid prior to embryo transfer reduced upper genital tract microbial contamination but did not alter clinical pregnancy rates. The effect of this intervention on live birth is unknown. There are no data from randomised controlled trials to support or refute other antibiotic regimens in this setting.Future research is warranted to assess the efficacy of alternative antibiotic regimens. Researchers should assess live birth as the primary outcome and address quantitative microbial colonization as a secondary outcome.

Postoperative bacteremia in periodontal flap surgery, with and without prophylactic antibiotic administration: A comparative study

Objectives:Many a times in clinical periodontology, the decision whether to prescribe prophylactic antibiotics or not, is perplexing.The present study was conducted to compare the bacteremias induced after periodontal flap surgeries with and without prophylactic antibiotics.Materials and Methods:The occurrence of postoperative bacteremia following periodontal flap surgery was studied in 30 patients. On these patients, 30 quadrant wise flap surgeries were carried out without any preoperative prophylactic antibiotics and 30 surgeries carried out after prophylactic administration of amoxycillin preoperatively. A blood sample was taken from each patient at the time of maximum surgical trauma and was cultured for micro-organisms and antibiotic sensitivity.Results:18 out of 60 blood samples were positive for micro-organisms. There was a significant reduction in post operative bacteremia after amoxycillin prophylaxis (x2 - 7.96 with P<0.01) as post operative bacteremia was found in 14 of the non medicated patients as compared to only 4 of the pre medicated patients. The micro-organisms encountered in the study are as follows:- 1) Staphylococcus albus coagulase negative, 2) Klebsiella, 3) Psedomonas aerugenosa, 4) Streptococcus viridans, 5) Alpha hemolytic streptococcus, 6) Neisseria catarrhalisConclusion:On the basis of the study, it is concluded that the incidence of postoperative bacteremia following periodontal flap surgery is not as high as previously reported. The clinical results show that Amoxicillin is highly effective in reducing postoperative bacteremia in periodontal flap surgery and thus in preventing the possible sequelae (Infective Endocarditis and other systemic maladies) in susceptible patients. However, cefotaxime and cephalexin may prove to be more effective in preventing the same.

What's new in streptococcal pharyngitis

Upper respiratory tract infections are most frequent reason for a visit to a paediatrician. In Italy more than 5 million visits are made by children annually for pharyngitis and in 86% of cases an antibiotic is prescribed. Data from in 17 European countries show the rate of antibiotic prescription at such visits can be as high as 90% [1]. Prevention of acute rheumatic fever (ARF) has been a consideration in deciding whether to treat acute pharyngitis. Because ARF is increasingly rare and the prevalence of group A beta haemolytic streptococci (GABHS) in acute sore throat is only 20–30%, more than 70 000 patient treatments would be required to prevent one case of ARF. The benefits of effective antibiotic treatment include: reduction of suppurative complications, earlier resolution of fever and symptoms and limitation of person to person transmission of the organism [2,3]. The resurgence of serious infections due to GABHS have promoted interest in alternative treatments to penicillin and especially in their ability to eradicate the pathogen by the end of treatment. Failure of a standard 10-day course with penicillin V may be due to penicillin tolerance or increased virulence of the GABHS strain, inactivation by beta lactamases liberated in the tonsillary area by indigenous flora, or to non-compliance with treatment [4,5]. Favourable compliance with oral therapy is aided by a short duration of treatment, once or twice daily dosing schedule, lack of gastrointestinal reactions and taste. Penicillin V, is administered three times daily for 10 days [6] to achieve its maximal antimicrobial effect. Some studies suggest that penicillin taken twice daily is an effective treatment for streptococcal pharyngitis [7]. This dosage schedule is not standard and should be used only in families with known high compliance with treatment [6]. Patient compliance with standard penicillin treatment can be as low as 19% [8] or as 33% of those enrolled in a controlled study against amoxycillin [9]. GABHS pharyngitis is a self-limiting disease in which signs and symptoms tend to disappear spontaneously. Nelson [10] showed that 24 h after the start of therapy, fever and other symptons were present in less than 10% of the treated patients and in less than 20% of those receiving placebo. With the improvement of symptoms, the carer is tempted to modify or stop treatment [11]. Compliance may be improved with oral cephalosporins or the simplificationof dose schedules, e.g. administration of amoxycillin once daily for 10 consecutive days [12,13] or for 6 days bd [9]. The clinical and bacteriological results are comparable to standard penicillin V treatment of tds for 10 days.

A novel method for collecting and detecting amoxycillin in urine: a tool for testing antibiotic compliance in the community.

Assessing compliance to prescribed antibiotics in community studies of respiratory tract infections is difficult. We describe a simple method for collecting and detecting amoxycillin in urine using urine dip-sticks in conjunction with a bioassay. Urine was collected at timed intervals from eight healthy volunteers following oral amoxycillin administration. Dip-sticks inoculated with urine collected 1 and 8 h after antibiotic resulted in mean zones of inhibition of 1.75 and 1.37 cm, respectively. Amoxycillin activity remained demonstrable 14 days after inoculation of dip-sticks with urine. Dip-sticks inoculated with urine from control subjects who had not taken amoxycillin did not cause inhibition.

Gastric cytoprotection by amoxycillin in the rat.

Amoxycillin in combination with anti-ulcer agents has been shown to prolong duodenal ulcer remission. While this effect can be related to the eradication of Helicobacter pylori, it is not known if amoxycillin might possess cytoprotective properties. Protection against ethanol-induced gastric mucosal damage by intragastric instillation of amoxycillin suspension (prepared from capsule form) and solution (from injection form, 100% pure amoxycillin), and by intraperitoneal injection of amoxycillin solution was studied using an ex vivo gastric chamber in the rat. Intragastric and intraperitoneal administration of amoxycillin dose-dependently protected the rat gastric mucosa from damage by absolute ethanol. This protection was lost when the rats were pretreated with indomethacin. Gastric mucosal blood flow as measured by laser Doppler flowmetry and gastric acid output were unaffected by amoxycillin. Amoxycillin imparts gastric cytoprotection, and one possible mechanism is by the release of prostaglandins.

The role ofHelicobacter pylori in peptic ulcer disease

The linking of relapse of duodenal as well as gastric ulcers with Helicobacter pylori (H. pylori) has been a considerable advance in managing patients with peptic ulcer disease. However, pathogenetic role of H. pylori in peptic ulcer still remains unclear. The aim of this study was to assess the relationship between H. pylori infection and inflammatory cell infiltration in gastric mucosa in peptic ulcer disease. Sixty-four patients with endoscopically proven gastric ulcer and 26 patients with duodenal ulcer were evaluated by prospective study. Biopsy specimens were taken from the ulcer margin, corpus and antrum. Eradication of H. pylori was attempted by concomitant administration of amoxycillin 500 mg, metronidazole 250 mg and bismuth subnitrate 1 g twice daily for 2 weeks. H. pylori positive rates in clinical stages of gastric and duodenal ulcer showed almost the same values of more than 90%. The prevalence of H. pylori at the antrum and corpus was almost the same as that between gastric and duodenal ulcer patients, whereas a dramatic difference in the positive rates at the ulcer margin was observed between gastric and duodenal ulcer patients (83.9% and 35.0%, respectively). The prevalence of polymorphonuclear (PMN) cell infiltration at the ulcer margin was still high even at the scarring stage of gastric and duodenal ulcer with positive H. pylori, whereas a dramatic decrease of PMN cell infiltration was observed at the ulcer margin after successful eradication of H. pylori. These results suggest that H. pylori may play an important role in the pathogenesis of gastric and duodenal ulcer by inducing inflammatory cells such as PMN cells in gastric mocosa.

A randomized multicenter trial to compare the influence of cefaclor and amoxycillin on the colonization resistance of the digestive tract in patients with lower respiratory tract infection

Eighty-four patients with lower respiratory tract infections participated in a randomised double-blind parallel multicenter trial in order to compare the efficacy of cefaclor and amoxycillin as treatment for lower respiratory tract infections and their ability to influence colonization resistance. Cefaclor was given to 40 patients and amoxycillin to 44 patients perorally in doses of 250 mg t.i.d. for seven days in a double-blind fashion. Sputum, oropharyngeal and intestinal specimens were taken for microbial analysis to isolate the causative pathogen of the lower respiratory tract infection and to follow the microflora changes before, during and after antibiotic treatment. The clinical outcome showed 92.5% cured or improved patients on cefaclor versus 88.4% on amoxycillin. The difference in clinical outcome between the two treatment groups was not statistically significant. Among the pathogenic bacteria isolated,Haemophilus influenzae, Branhamella catarrhalis andStreptococcus pneumoniae dominated. There was no difference between the two treatments with regard to microbiological efficacy. Treatment with cefaclor did not cause any significant impact on the oropharyngeal microflora. Administration of amoxycillin caused a significant reduction of the number ofStreptococcus salivarius andVeillonella cocci, while an increase in number of enterobacteria was seen in the oropharyngeal microflora. In the intestinal flora, cefaclor significantly reduced the number of streptococci, staphylococci and anaerobic cocci, while the number of enterococci, enterobacteria, bacteroides andCandida albicans significantly increased. The intestinal microflora was partly influenced by amoxycillin treatment. Thus there was a significant increase in the number of enterobacteria, anaerobic gram-positive rods and bacteroides. In conclusion, none of these agents caused any major disturbances in the colonization resistance in patients with lower respiratory tract infections.

Antibiotic-resistant oral streptococci in dental patients susceptible to infective endocarditis

The aim of this study was to determine the incidence of amoxycillin and erythromycin resistance in oral streptococci in patients at risk from infective endocarditis. Samples of gingival crevicular flora were taken from 65 patients at the site of dental treatment, prior to the prophylactic administration of amoxycillin (54 patients) or erythromycin (11 patients). Samples were also taken from 65 dental patients who were not considered to be at risk from infective endocarditis. No isolate had a minimum inhibitory concentration (MIC) of amoxycillin greater than 24 mg/L. However, erythromycin-resistant oral streptococci with MIC values greater than 3.5 mg/L were isolated from 22% of patients receiving amoxycillin prophylaxis, 9% of patients receiving amoxycillin prophylaxis, 9% of patients given erythromycin prophylaxis and 9% of patients not at risk from infective endocarditis. The antibiotic-resistant streptococci comprised mainly Streptococcus sanguis biotype II, although S. sanguis biotype I, S. mitis and S. salivarius were also frequently recovered.

Pharmacokinetics of intravenous amoxycillin and potassium clavulanate in seriously ill children

The pharmacokinetics of amoxycillin and potassium clavulanate were studied in 15 sick children after a 30 min iv infusion of 50 mg/kg amoxycillin and 5 mg/kg clavulanic acid as the potassium salt. Levels of both compounds in plasma were assayed microbiologically. Mean peak concentrations at the end of the infusion were 121.0 mg/l of amoxycillin and 12.0 mg/l of clavulanate, falling to a mean of 15.8 and 1.92 mg/l respectively after 2 h. Mean beta phase T 1/2 was 0.88 h for amoxycillin and 0.79 h for clavulanate. The elimination half-life of clavulanate in some individuals was much shorter because of higher plasma clearance. The data suggest that the treatment of some infections due to beta-lactamase producing organisms in such severely ill children may require more frequent iv administration of amoxycillin and potassium clavulanate, than in less severely affected children.

A localized, recurrent pustular eruption following amoxycillin administration

An unusual localized pustular reaction to amoxycillin is reported. Although the rash was recurrent and localized to the identical site on each occasion, the clinical and histological appearances were not those of a typical fixed drug eruption.

Resistance in oral streptococci after repetition of a single-dose amoxycillin prophylactic regimen.

Ten healthy volunteers received 3 g amoxycillin each week for up to four weeks. One volunteer carried streptococci resistant to amoxycillin in small numbers before the first dose was administered. After one administration of amoxycillin, this volunteer and one other yielded streptococci resistant to 1 mg/l amoxycillin on direct culture of dental plaque; after two administrations, resistant streptococci were detected in one further volunteer; and a total of six volunteers yielded resistant streptococci after the fourth week of amoxycillin administration. Repeated use of the single-dose prophylactic regimen encourages the emergence of streptococci considerably more resistant to amoxycillin than those generally encountered in the oral cavity, but the clinical significance of these results is uncertain as the peak serum concentrations of amoxycillin achieved after a 3 g oral dose for prophylaxis exceed the minimum bactericidal concentrations of amoxycillin for these strains.

Effect of ampicillin or amoxycillin administration on plasma and urinary estrogen levels during normal pregnancy.

Urinary estrogen excretion and plasma levels of conjugated and unconjugated 17 beta-estradiol and estriol were measured in 10 healthy, pregnant women before, during and after a 5-day course of orally administered ampicillin (2 g/day) or the same dose of amoxycillin. On the second and third day of ampicillin treatment the plasma level of conjugated estriol and the urinary estrogen level were lower than pretreatment values, but then returned to basal values despite continuing treatment. Plasma concentrations of conjugated and unconjugated 17 beta-estradiol and of unconjugated estriol did not show any significant change during treatment. Hormone changes in women on amoxycillin were qualitatively similar to but smaller and less consistent than those induced by ampicillin. The results indicate (1) that the use of amoxycillin instead of ampicillin in pregnancies that require estrogen monitoring of feto-placental function, has little clinical advantage, and (2) that the adverse effect of therapeutic doses of ampicillin (and amoxycillin) on estrogen levels during pregnancy may be less important than is commonly assumed.

Oral Administration of Amoxycillin

Oral Administration of Amoxycillin