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Acta Medica Portuguesa Mar 2021Non-necrotizing acute dermo-hypodermal infections are infectious processes that include erysipela and infectious cellulitis, and are mainly caused by group A... (Review)
Review
Non-necrotizing acute dermo-hypodermal infections are infectious processes that include erysipela and infectious cellulitis, and are mainly caused by group A β-haemolytic streptococcus. The lower limbs are affected in more than 80% of cases and the risk factors are disruption of cutaneous barrier, lymphoedema and obesity. Diagnosis is clinical and in a typical setting we observe an acute inflammatory plaque with fever, lymphangitis, adenopathy and leucocytosis. Bacteriology is usually not helpful because of low sensitivity or delayed positivity. In case of atypical presentations, erysipela must be distinguished from necrotizing fasciitis and acute vein thrombosis. Flucloxacillin and cefradine remain the first line of treatment. Recurrence is the main complication, so correct treatment of the risk factors is crucial.
Topics: Anti-Bacterial Agents; Cellulitis; Cephradine; Erysipelas; Floxacillin; Humans; Recurrence; Soft Tissue Infections
PubMed: 33971117
DOI: 10.20344/amp.12642 -
The Cochrane Database of Systematic... Feb 2013Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus aureus. The... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus aureus. The prevalence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment.
OBJECTIVES
This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation.
SEARCH METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2012), contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles.
SELECTION CRITERIA
We selected randomised controlled trials (RCTs) and quasi-RCTs comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trial quality and extracted data. When in dispute, we consulted a third author.
MAIN RESULTS
Two trials met the inclusion criteria. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as 'supportive therapy' versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic.
AUTHORS' CONCLUSIONS
There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded RCTs to determine whether antibiotics should be used in this common postpartum condition.
Topics: Amoxicillin; Anti-Bacterial Agents; Breast Feeding; Breast Milk Expression; Cephradine; Female; Humans; Mastitis; Randomized Controlled Trials as Topic
PubMed: 23450563
DOI: 10.1002/14651858.CD005458.pub3 -
Molecules (Basel, Switzerland) Nov 2020Thiazinanes and its isomeric forms represent one of the most important heterocyclic compounds, and their derivatives represented a highly potent drug in disease... (Review)
Review
Thiazinanes and its isomeric forms represent one of the most important heterocyclic compounds, and their derivatives represented a highly potent drug in disease treatment such as, 1,1-dioxido-1,2-thiazinan-1,6-naphthyridine, which has been shown to have anti-HIV activity by a mechanism that should work as anti-AIDS treatment, while ()-methyl 3-(naphthalen-1-ylimino)- 2-thia-4-azaspiro[5 5]undecane-4-carbodithioate showed analgesic activity, cephradine was used as antibiotic and chlormezanone was utilized as anticoagulants. All publications were interested in the chemistry of thiazine (partially or fully unsaturated heterocyclic six-membered ring containing nitrogen and sulfur), but no one was dealing with thiazinane itself which encouraged us to shed new light on these interesting heterocycles. This review was focused on the synthetic approaches of thiazinane derivatives and their chemical reactivity.
Topics: Analgesics; Animals; Anti-Bacterial Agents; Anticoagulants; Heterocyclic Compounds; Humans; Thiazines
PubMed: 33260625
DOI: 10.3390/molecules25235610 -
The Cochrane Database of Systematic... Jan 2011Urinary tract infections, including pyelonephritis, are serious complications that may lead to significant maternal and neonatal morbidity and mortality. There is a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Urinary tract infections, including pyelonephritis, are serious complications that may lead to significant maternal and neonatal morbidity and mortality. There is a large number of drugs, and combination of them, available to treat urinary tract infections, most of them tested in non-pregnant women. Attempts to define the optimal antibiotic regimen for pregnancy have, therefore, been problematic.
OBJECTIVES
The objective of this review was to determine, from the best available evidence from randomised controlled trials, which agent is the most effective for the treatment of symptomatic urinary tract infections during pregnancy in terms of cure rates, recurrent infection, incidence of preterm delivery and premature rupture of membranes, admission to neonatal intensive care unit, need for change of antibiotic, and incidence of prolonged pyrexia.
SEARCH STRATEGY
We searched the Cochrane Pregnancy and Childbirth Group Trials Register (November 2009) and reference lists of articles.
SELECTION CRITERIA
We considered all trials where the intention was to allocate participants randomly to one of at least two alternative treatments for any symptomatic urinary tract infection.
DATA COLLECTION AND ANALYSIS
Both review authors assessed trial quality and extracted data.
MAIN RESULTS
We included 10 studies, recruiting a total of 1125 pregnant women. In most of the comparisons there were no significant differences between the treatments under study with regard to cure rates, recurrent infection, incidence of preterm delivery, admission to neonatal intensive care unit, need for change of antibiotic and incidence of prolonged pyrexia. When cefuroxime and cephradine were compared, there were better cure rates (29/49 versus 41/52) and fewer recurrences (20/49 versus 11/52) in the cefuroxime group. There was only one other statistically significant difference when comparing outpatient versus inpatient treatment. Gestational age at birth was greater in women from the outpatient group (38.86 versus 37.21), while birthweight was on average greater in the inpatient group (3120 versus 2659).
AUTHORS' CONCLUSIONS
Although antibiotic treatment is effective for the cure of urinary tract infections, there are insufficient data to recommend any specific drug regimen for treatment of symptomatic urinary tract infections during pregnancy. All the antibiotics studied were shown to be very effective in decreasing the incidence of the different outcomes. Complications were very rare. All included trials had very small sample sizes to reliably detect important differences between treatments. Future studies should evaluate the most promising antibiotics, in terms of class, timing, dose, acceptability, maternal and neonatal outcomes and costs.
Topics: Anti-Infective Agents, Urinary; Birth Weight; Cefuroxime; Cephradine; Female; Gestational Age; Humans; Outcome Assessment, Health Care; Pregnancy; Pregnancy Complications, Infectious; Randomized Controlled Trials as Topic; Urinary Tract Infections
PubMed: 21249652
DOI: 10.1002/14651858.CD002256.pub2 -
Clinical and Experimental Immunology May 1979A patient developed acute interstitial nephritis following cephradine administration. The clinical illness preceding the interstitial nephritis and the eosinophilia in...
A patient developed acute interstitial nephritis following cephradine administration. The clinical illness preceding the interstitial nephritis and the eosinophilia in peripheral blood suggested an allergic reaction. Immunological studies demonstrated an allergy to cephradine and penicillins which was IgG2-mediated. It is probable, therefore, that allergy to cephradine caused the renal lesion from which there was full clinical and biochemical recovery.
Topics: Adult; Cephalosporins; Cephradine; Drug Hypersensitivity; Female; Histamine Release; Humans; Immunoglobulin E; Immunoglobulin G; Leukocytes; Lymphocyte Activation; Nephritis, Interstitial
PubMed: 89922
DOI: No ID Found -
Boletin Medico Del Hospital Infantil de... Jun 2021Myiasis is an emerging disease caused by tissue invasion of dipteran larvae. In Uruguay, Cochliomyia hominivorax and Dermatobia hominis are the most frequent species....
BACKGROUND
Myiasis is an emerging disease caused by tissue invasion of dipteran larvae. In Uruguay, Cochliomyia hominivorax and Dermatobia hominis are the most frequent species. This study aimed to describe the epidemiological and clinical characteristics and the follow-up of children < 15 years hospitalized for myiasis in a reference center in Uruguay between 2010 and 2019.
METHODS
We conducted a descriptive and retrospective study by reviewing medical records. We analyzed the following variables: age, sex, comorbidities, origin, the month at admission, clinical manifestations, other parasitoses, treatments, complications, and larva species identified.
RESULTS
We found 63 hospitalized children: median age of 7 years (1 month-14 years), 68% of females. We detected risk comorbidities for myiasis (33%), of which chronic malnutrition was the most frequent (n = 6); 84% were from the south of the country; 76% were hospitalized during the summer. Superficial and multiple cutaneous involvements were found in 86%: of the scalp 50, furunculoid type 51, secondary to C. hominivorax 98.4%, and to D. hominis in 1.6%. As treatments, larval extraction was detected in all of them, surgical in 22%. Asphaltic products for parasites were applied in 94%, ether in 49. Antimicrobials were prescribed in 95%; cephradine and ivermectin were the most frequent. About 51% presented infectious complications, impetigo was found in 29, cellulitis in 2, and abscess in 1.
CONCLUSIONS
Myiasis predominantly affected healthy schoolchildren during the summer months and was frequently associated with ectoparasites. Superficial infestation of the furuncle-like scalp by C. hominivorax was the most frequent form. Infectious complications motivated hospitalizations.
Topics: Animals; Child; Female; Humans; Ivermectin; Larva; Myiasis; Retrospective Studies; Uruguay
PubMed: 34077411
DOI: 10.24875/BMHIM.20000236 -
BMC Microbiology Oct 2020Antibiotic-associated diarrhea (AAD), defined as diarrhea that occurs in association with the administration of antibiotics and without another clear etiology, is one of...
BACKGROUND
Antibiotic-associated diarrhea (AAD), defined as diarrhea that occurs in association with the administration of antibiotics and without another clear etiology, is one of the most common adverse drug events of antibiotics therapy. We established a diarrhea model induced by gentamycin and cefradine to investigate the microbiota characteristics in the intestinal lumen of mice with AAD and provide insights into noteworthy bacteria related to gentamicin and cefradine-associated diarrhea.
RESULTS
The number of OTUs in the model group and the normal group was 983 and 2107, respectively, and 872 identical OTUs were shared between two groups. Species richness and species diversity of intestinal microbe were altered by antibiotics administration. PCoA showed a clear separation between AAD and health control. The dominant phyla of AAD mice were Firmicutes (52.63%) and Proteobacteria (46.37%). Among the genus with top 20 abundance, the relative abundance of 7 genera, Ruminococcus, Blautia, Enterococcus, Eubacterium, Clostridium, Coprococcus, and Aerococcus, were enriched in the model group. Based upon the LEfSe analysis, Enterococcus, Eubacterium, Ruminococcus, and Blautia were identified as potential biomarkers for AAD.
CONCLUSIONS
The bacterial diversity of the intestinal lumen was diminished after gentamicin and cefradine administration. The alterations in the abundance and composition of gut microbiota further led to the dysfunction of gut microbiota. More specifically, gentamicin and cefradine significantly increased the abundance of the opportunistic pathogens, of which Enterococcus and Clostridium were the most prominent and most worthy of attention.
Topics: Animals; Anti-Bacterial Agents; Bacteria; Diarrhea; Female; Gastrointestinal Microbiome; Male; Mice; RNA, Ribosomal, 16S
PubMed: 33059603
DOI: 10.1186/s12866-020-01999-x -
Sao Paulo Medical Journal = Revista... 2016Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus aureus . The...
BACKGROUND
Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus aureus . The prevalence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment.
OBJECTIVES
This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation.
MAIN RESULTS
Two trials met the inclusion criteria. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as 'supportive therapy' versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic.
AUTHORS CONCLUSIONS
There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded RCTs to determine whether antibiotics should be used in this common postpartum condition.
Topics: Anti-Bacterial Agents; Breast Feeding; Female; Humans; Mastitis; Staphylococcus aureus
PubMed: 27355802
DOI: 10.1590/1516-3180.20161343T1