Regular Antibiotics Research Articles

Antibacterial Activity of Some Medicinal Plants of Iran Against Pseudomonas aeruginosa and P. fluorescens

Increase of antibacterial resistance is a global growing-problem. Isolation of microbial agents less susceptible to regular antibiotics and recovery of increasing resistant isolates during antibacterial therapy is rising throughout the world which highlights the need for new principles. In treating burns, dermatophytes and infectious diseases, use of plants is common in traditional medicine of Iran. According to the collected information about herbal remedies of such plants, antibacterial activities of methanol extracts of the plants were determined by in vitro bioassays using agar diffusion-method against standard strains of Pseudomonas aeruginosa and P. fluorescens at 20 mg ml-1. From 160 plant species in 65 families, 13 species (8.1%) in 12 families (18.4%) showed anti-Pseudomona activities. Activities included 6.2% against P. aeruginosa and 7.5% against P. fluorescens. Minimum inhibitory concentrations (MIC) of the actives were determined using two fold serial dilutions. Most active plants against both bacterial species were Dianthus caryophyllus L., Terminalia chebula (Gaertner) Retz. and Myrtus communis L. with the MIC of 3.75, 1.87 and 7.5 mg ml-1 against P. aeruginosa; 0.46, 0.93 and 1.87 mg ml-1 against P. fluorescens, respectively.

Follow up of serial urea breath test results in patients after consumption of antibiotics for non-gastric infections.

The widespread use of antibacterial therapy has been suggested to be the cause for the decline in the prevalence of Helicobacter pylori infection. This study examine the serial changes of urea breath test results in a group of hospitalized patients who were given antibacterial therapy for non-gastric infections. Thirty-five hospitalized patients who were given antibacterial therapy for clinical infections, predominantly chest and urinary infections, were studied. Most (91 %) patients were given single antibiotic of either a penicillin or cephalosporin group. Serial (13)C-urea breath tests were performed within 24 hours of initiation of antibiotics, at one-week and at six-week post-therapy. H. pylori infection was diagnosed when one or more urea breath tests was positive. All 35 patients completed three serial urea breath tests and 26 (74 %) were H. pylori-positive. Ten (38 %) H. pylori-infected patients had at least one negative breath test results during the study period. The medium delta (13)C values were significantly lower at baseline (8.8) than at one-week (20.3) and six-week (24.5) post-treatment in H. pylori-positive individuals (P=0.022). Clearance of H. pylori at six-week was only seen in one patient who had received anti-helicobacter therapy from another source. Our results suggested that one-third of H. pylori-infected individuals had transient false-negative urea breath test results during treatment with antibacterial agent. However, clearance of H. pylori infection by regular antibiotic consumption is rare.

Elective versus symptomatic antibiotic treatment in cystic fibrosis patients with chronic Pseudomonasinfection of the lungs

BACKGROUNDA previous retrospective study suggested that a policy of regular anti-pseudomonal antibiotic treatment improved pulmonary function and increased survival in patients with cystic fibrosis chronically infected with Pseudomonas species. The...

Impact and future of screening for haemoglobin disorders

Haemoglobin disorders (the thalassaemias and sickle cell disorders) are common and severe, and are increasingly important in the UK. Modern management leads to long-term survival in many cases, but the treatment remains complex, burdensome and expensive. Neonatal screening is recommended for sickle cell disorders, since early diagnosis, regular medical supervision and prophylactic antibiotics greatly reduce the risk of sudden death from infection or splenic sequestration? Haemoglobin disorders can also be prevented by carrier screening, followed by genetic counselling and the option of prenatal diagnosis. The Department of Health has advised Districts to develop a policy for treatment and prevention of these disorders, and recommended universal carrier screening of all antenatal patients in Districts where the proportion of births in risk groups exceeds 14%. 2 Though prevention programmes have led to a fall of over 75% in affected births in several Mediterranean countries the effect in the UK has been far smaller? ,4 Consequently, haemoglobin disorders continue to be an important concern for paediatricians, as the number of children requiring treatment continues to increase. In this article we discuss why this is so, and identify ways in which paediatricians can promote services for haemoglobin disorders.

Possible synergistic effect of metformin and enalapril on the development of hyperkaliemic lactic acidosis

A 71 year old hypertensive, non insulin-dependent diabetic patient with moderate renal insufficiency taking 500 mg/d of metformin and 5 mg/d of enalapril, developed metabolic acidosis characterized by fairly elevated anion gap, hyperchloremia, severe hyperkaliemia, normal plasma level of 3-hydroxybutyric acid, absence of ketonuria and high plasma level of lactic acid. This biochemical feature allowed us to ascribe the pathogenesis of metabolic acidosis, both to the increased plasma level of lactic acid and to the type IV renal tubular acidosis syndrome, the precipitating factor being an infection of urinary tract (as we assumed on the basis of the urine culture). The patient was dehydrated and lethargic; the ECG revealed the presence of nonparoxysmal junctional tachycardia. The clinical evolution was favorable under the treatment with an infusion of isotonic saline solutions, mild alkalinizing solutions, low-dose regular insulin and antibiotics. It is likely that metformin and enalapril, regularly taken by this nephropathic patient, could have played an iatrogenic role, even if the doses were low. This case highlights the importance of complying with the contraindications of these drugs, to avoid the rare but reported life-threatening complications of metformin administration.

Subungual exostosis presenting as an ingrowing toenail

Ingrowing toenail of the great toe is a common condition, which is often managed conservatively with excellent results. Chiropodists frequently treat this condition and often only simple measures are required. Regular dressings and antibiotics are often all that is needed to treat the infected edge. Patients should then be taught the correct way to trim the nail. More definitive procedures are required if the condition is recurrent and conservative measures fail. Wedge excision of the nail and phenolisation,‘*z nail avulsions and Zadik’s procedures are often used.

Treatment of adult asthma: is the diagnosis relevant?

The diagnosis and management of chronic respiratory symptoms was studied in all adults aged 40-70 years in a group general practice. A respiratory symptoms screening questionnaire was sent to 2387 men and women, of whom 1444 (85% of those who had not moved or died) responded. The 509 subjects reporting symptoms were sent a detailed questionnaire and invited to have their respiratory function tested. Of these, 324 (64%) responded, of whom 256 (79%) had spirometry. A diagnosis of chronic bronchitis was reported by 3.9% of the men and 2.1% of the women, and a diagnosis of asthma by 4.7% of the men and 3.3% of the women. Wheezing in the preceding year was reported by 18% of the men and 15% of the women, and 16.7% of the men and 7.1% of the women satisfied the Medical Research Council criteria for chronic bronchitis. Bronchodilator treatment was being taken by 12% of the patients with symptoms, regular cough linctus by 10%, and regular antibiotics by 5%. After the frequency and severity of respiratory symptoms had been controlled for wheezing patients reporting a diagnosis of asthma were prescribed bronchodilatory drugs three times more often than those labelled as having chronic bronchitis and 12 times more often than those without a diagnostic label. Eleven per cent of general practitioner consultations resulted in a referral to hospital. Referral was unrelated to the diagnosis given, but depended on the degree of respiratory disability and handicap experienced by the patient. Our findings confirm the relevance of the diagnostic label to the drug management of chronic wheezing disorders, but further investigation of the diagnostic process is needed to establish why some patients with severe wheeze remain untreated.

Large Cell Carcinoma Mimicking Non Resolving Pneumonia

Fever, chest pain, cough in a young lady usually does not ring any alarm bell. We present here a case of a young lady who had typical symptoms of community acquired pneumonia who initially responded to regular antibiotics but later was investigated to have large cell carcinoma. Presentation of lung cancer as non-resolving pneumonia is not a very common phenomenon and diagnosis can present a diagnostic challenge to the clinician. Keyword: Non-resolving pneumonia, Young lady, Chest pain, fever, Large cell Carcinoma, Bangladesh. DOI: http://dx.doi.org/10.3329/jom.v12i2.8423 JOM 2011; 12(2): 166-169