amoxicillin-potassium-clavulanate-combination and Cellulitis

The rate of infection after a human bite is 10%-30%. Streptococcus spp. are the most common pathogens that may cause serious infections, such as necrotizing fasciitis. The authors describe a 5-year-old girl admitted to the emergency room with cellulitis due to S. pyogenes after human bites. She presented with fever and pain in her left arm, and her medical history revealed a human bite by her cousin on the arm 3 days prior. The wound culture yielded S. pyogenes. She was successfully treated with intravenous ampicillin-sulbactam regimen. S. pyogenes may cause serious wound infections following human bites. In such cases, the patient should be closely followed. Chemoprophylaxis should be initiated in an appropriate clinical setting to prevent secondary bacterial infections. This case was first reported as cellulitis due to S. pyogenes after a human bite.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Arm; Bites, Human; Cellulitis; Child, Preschool; Female; Humans; Streptococcal Infections; Streptococcus pyogenes; Treatment Outcome

Lemierre syndrome is a rare but serious illness that associates throat infection and thrombosis of the internal jugular vein (IJV) or one of its tributaries with subsequent distant septic emboli. The purpose of our study was to review the pathogenesis, clinical presentation, and treatment of this disease.. Patients with confirmed Lemierre syndrome were included in our retrospective monocentric study. All patients had bacteriologic analyses as well as radiologic imaging.. There were 11 patients in our study (from 1998-2012). Fusobacterium necrophorum was responsible for the infection in 45% of cases. Surgical drainage of pharyngeal, cervical, or mediastinal abscesses was carried out in 8 cases. All patients received broad-spectrum antibiotics. Six patients were admitted to the intensive care unit (ICU). One patient (9%) died.. Treatment with broad-spectrum antibiotics is the primary choice of treatment of Lemierre syndrome. Surgery is indicated in case of abscess formation.

Topics: Abscess; Adolescent; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anticoagulants; Ceftriaxone; Cellulitis; Drainage; Female; Humans; Intensive Care Units; Lemierre Syndrome; Length of Stay; Male; Mediastinitis; Metronidazole; Middle Aged; Retrospective Studies; Tonsillitis; Young Adult

The science of antibiotic therapy for infectious diseases continues to evolve. In many instances where empiric coverage is necessary, treatment with more than one agent is considered prudent. If an etiology is identified, antibiotics are modified based on culture and susceptibility data. Even when the organism is known, more than one antibiotic may be needed. Decisions about antibiotics should be made after assessments of pertinent clinical information, laboratory and microbiology information, ease of administration, patient compliance, potential adverse effects, cost, and available evidence supporting various treatment options. Clinicians also need to consider synergy and local resistance patterns in selecting therapeutic options. In this article, the authors outline monotherapy and combination therapy options for several common infectious diseases.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; Cellulitis; Cephalosporins; Ciprofloxacin; Diverticulitis; Drug Therapy, Combination; Endocarditis, Bacterial; Enterococcus faecalis; Humans; Meningitis, Bacterial; Neutropenia; Osteomyelitis; Pneumonia; Staphylococcus aureus; Viridans Streptococci

The study was undertaken to characterize the microbiology of dental abscesses in children and to compare clindamycin and ampicillin/sulbactam in the treatment of facial cellulitis of odontogenic origin. Sixty children with acute facial cellulitis of dental origin underwent surgery (extraction or root canal procedure) within 24 hours of presentation. Pus samples were cultured aerobically and anaerobically. Patients were randomized (1:1) to receive intravenous ampicillin/sulbactam or clindamycin for 48 hours followed by oral amoxicillin/clavulanate or clindamycin for 7 days. A total of 211 bacterial isolates were recovered from 54 samples. The most common aerobic and facultative organisms were viridans streptococci, Neisseria, and Eikenella species. Among anaerobes, Prevotella and Peptostreptococcus species were the most frequent. No treatment failure occurred in either group. Dental abscesses in children are polymicrobial aerobic/anaerobic infections. Treatment of complicated dental infections with ampicillin plus a beta-lactamase inhibitor or clindamycin in combination with surgical drainage is very effective.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Anti-Bacterial Agents; Bacterial Infections; Cellulitis; Child; Child, Preschool; Clindamycin; Face; Female; Humans; Male; Single-Blind Method; Sulbactam; Tooth Diseases

This study aimed to ascertain the microbiology, severity stratification, and clinical outcomes of cellulitis based on our current management for comparison with international reports.. A retrospective chart review was conducted of all patients with cellulitis treated by the department of surgery at Ngwelezana Hospital over an 18-month period. Severity of cellulitis was graded, and a comparison was made of the Eron and Modified Dundee classifications. Superficial swabs were taken for culture on patients who had cellulitis with open wounds or blisters. Culture results, antibiotics used, need for surgical intervention, and length of hospital stay were documented and analysed.. One hundred and thirty-four patients had cellulitis. Severity grading for classes I-IV in the Eron classification was 3%, 57%, 39% and 1%, respectively, and for the Modified Dundee classification, 47%, 11%, 38%, and 4%, respectively. Co-amoxiclav was the most used antibiotic (73%). Superficial skin swabs were taken from 49 patients and 34 cultured 44 specific organisms. The most common organism identified was. The Dundee classification triages fewer patients as class 2 severity than the Eron system and its use has the potentail to reduce the number of patients hospitalised. Gram-positive organisms predominated in those cultured, but gram-negative cultures were frequent compared to other reported series. Co-amoxiclav is effective as first-line antimicrobial therapy in our environment.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents; Cellulitis; Humans; Retrospective Studies; South Africa

Outside areas of S. aureus strains resistant to methicillin (MRSA) in the community, no studies showed a relationship between the treatment for erysipelas or cellulitis and the outcome. We aimed to measure the impact of an internal therapeutic protocol, based on national guidelines on patients' outcome. This study was based on the dashboard of the infectious diseases department, which prospectively includes 28 parameters for all admitted patients. We included community-acquired erysipelas and cellulitis; exclusion criteria were abscesses at admission; ear, nose, throat, or dental cellulitis; pyomyositis; and length of stay ≤ 2 days. Adherence to guidelines was defined by the use of amoxicillin, amoxicillin/clavulanic acid, clindamycin, or pristinamycin, alone or in combination or successively. A poor outcome was defined by surgical procedure or intensive care requirement or death occurring after 5 days or more of antibiotic therapy. From July 2005 to June 2017, 630 cases of erysipelas or cellulitis were included. Blood cultures performed in 567 patients (90%) were positive in 39 cases (6.9%). Adherence rate to guidelines was 65% (410 cases). A poor outcome was recorded in 54 (8.5%) patients, less frequently in case of adherence to guidelines: 26/410 (6.3%) vs 28/220 (12.7%), p = 0.007. In logistic regression analysis, two risk factors were associated with a poor outcome: peripheral arterial disease, AOR 4.80 (2.20-10.49); and bacteremia, AOR 5.21 (2.31-11.76), while guideline adherence was the only modifiable protective factor, OR 0.48 (0.26-0.89). In erysipelas and cellulitis, adherence to guidelines was associated with a favorable outcome.

Topics: Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacteremia; Blood Culture; Cellulitis; Clindamycin; Erysipelas; Female; France; Guideline Adherence; Hospitalization; Humans; Logistic Models; Male; Middle Aged; Retrospective Studies; Risk Factors; Staphylococcal Infections; Staphylococcus aureus; Treatment Outcome

Nasal vestibulitis (NV) is a common infection; however, scant data is available in the literature as it pertains to NV. We aim to describe the clinical characteristics of NV in respect to its potential complications.. A retrospective chart review of 118 NV cases admitted to a tertiary medical center between 2008 and 2015.. Identified risk factors for NV included nasal hair plucking (n=15, 14.41%), nose blowing (n=10, 9.32%), nose picking (n=9, 8.47%) and nose piercing (n=5, 3.39%). Twelve patients (10.17%) were diabetic, and 3 patients were immunosuppressed. Mid-facial cellulitis was observed in the majority of patients (78.81%), and abscess of the nasal vestibule was observed in almost half (48.30%). Cultures were taken from 33.33% of patients demonstrated MSSA as the most common isolate (81.25%). No complications were observed.. Even in complicated cases of NV requiring admission, the risk of major complications is extremely low.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cellulitis; Child; Female; Humans; Male; Middle Aged; Nose; Respiratory Tract Infections; Retrospective Studies; Risk Factors; Tertiary Care Centers; Young Adult

Topics: Amoxicillin-Potassium Clavulanate Combination; Cefazolin; Cellulitis; Clavulanic Acid; Drug Eruptions; Female; Humans; Japan; Middle Aged; Skin Tests; T-Lymphocytes; Withholding Treatment

Topics: Adenoids; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Anti-Bacterial Agents; Cellulitis; Child, Preschool; Clindamycin; Cranial Fossa, Posterior; Diagnosis, Differential; Drug Therapy, Combination; Female; Fever; Humans; Lymphadenitis; Magnetic Resonance Imaging; Neck Pain; Occipital Bone; Osteomyelitis; Pharyngitis; Skull Neoplasms; Sulbactam; Tomography, X-Ray Computed

In recent years, the market for resorbable injectables has been steadily expanding. The European Community's seal of approval (CE) is a sufficient guaranty to get them distributed. These injectables do not require official approval because they are considered to be "implantable medical devices" and not medicines. Macrolane(®)is a hyaluronic acid in gel form (NASHA [non-animal stabilized hyaluronic acid]) and has been on the French market since 2007. It can be injected into all areas except the face. It is highly cross-linked which, while slowing its absorption into the body, can also leave long-lasting residues. We report the first case of cellulitis after injection into the calf by a practitioner in his office.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cellulitis; Cosmetic Techniques; Female; Humans; Hyaluronic Acid; Iatrogenic Disease; Injections, Intramuscular; Leg; Middle Aged; Suction; Therapeutic Irrigation; Treatment Outcome; Viscosupplements

Topics: Administration, Oral; Adult; Amoxicillin-Potassium Clavulanate Combination; Bites, Human; C-Reactive Protein; Cellulitis; Doxycycline; Edema; Humans; Injections, Intravenous; Lymphadenitis; Male; Middle Aged; Penile Diseases; Penis; Pristinamycin; Sexual Behavior; Wound Infection

Lemierre's syndrome is a classical presentation of human necrobacillosis. It is characterized by a primary infection in the face including a septic thrombophlebitis of the internal jugular vein and disseminated metastatic abcesses. Fusobacterium necrophorum is the main pathogen found in that syndrome. The diagnosis is based on clinical features, then on the microbiology with positive anaerobic blood cultures as key role and finally on the computed tomography. Most of the time a well-chosen antibiotic treatment against anaerobic pathogens and Gram negative bacilli is efficient but surgery can be useful. We report a case of a 73 years old man, which seems to be unique because it is the first case reported of a Lemierre's syndrome characterized by a parotitis infected by F. necrophorum.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Inflammatory Agents; Anticoagulants; Cellulitis; Humans; Hypnotics and Sedatives; Lemierre Syndrome; Male; Methylprednisolone; Otorhinolaryngologic Surgical Procedures; Parotid Gland; Parotitis; Tomography, X-Ray Computed

Community-acquired methicillin-resistant Staphylococcus aureus is emerging as an important pathogen. However, methicillin-resistant Staphylococcus aureus rarely causes nasal septal abscess.. We present a case of severe, community-acquired, methicillin-resistant Staphylococcus aureus infection causing rapidly progressing sinusitis, nasal septal abscess and facial cellulitis.. This report serves to remind the clinician of the expanding spectrum of severe infections caused by methicillin-resistant Staphylococcus aureus, all requiring prompt diagnosis and appropriate medical and/or surgical management.

Topics: Abscess; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cellulitis; Drainage; Facial Dermatoses; Female; Humans; Methicillin-Resistant Staphylococcus aureus; Nasal Septum; Radiography; Sphenoid Sinusitis; Staphylococcal Infections; Vancomycin; Young Adult

Topics: Abscess; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cellulitis; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pneumococcal Infections; Streptococcus pneumoniae

The skin infections are common in pediatrics, ranging from furonculosis or impetigo to the severe forms of necrotizing dermohypodermitis. The general antibiotic treatments are not always indicated but when they are, they must take into account the resistance of two main species of bacteria (Staphylococcus aureus and Streptococcus pyogenes), the pharmacokinetics-pharmacodynamic parameters and the severity and type of infection. Two situations should be treated by topical treatements: limited impetigo and furonculosis. The two topical antibiotics used preferentially are mupirocine and fucidic acid. Soon, a third topical antibiotic, reptamuline will complete these. For uncomplicated superficial skin infections justifying an oral antibiotic, amoxicillin-clavulanate offers the best guarantee of efficiency. Poor pharmacodynamic-pharmacokinetic must lead to not prescribe oral M penicillins. In case of allergy, a first-generation cephalosporin, a macrolide (if the susceptibility of the strain was checked) or pristinamycine (after 6 years of age) are acceptable alternatives. For dermohypodermitis bacterial antibiotic of choice remains amoxicillin-clavulanate through IV route, to be active against S. pyogenes but also S. aureus and anaerobic bacteria. The IV route is maintained until regression general signs and a relay orally by the same drug is then possible. For toxinic syndromes and necrozing fascitis clindamycin should be added to a beta-lactam because of its action on protein synthesis in particular reducing the toxins production.

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cellulitis; Cephalosporins; Child; Drug Resistance, Bacterial; Fasciitis, Necrotizing; Furunculosis; Fusidic Acid; Humans; Impetigo; Injections, Intravenous; Macrolides; Methicillin-Resistant Staphylococcus aureus; Mupirocin; Penicillins; Pristinamycin; Skin Diseases, Bacterial; Soft Tissue Infections; Staphylococcal Scalded Skin Syndrome; Staphylococcal Skin Infections; Staphylococcus aureus; Stevens-Johnson Syndrome; Streptococcal Infections; Streptococcus pyogenes

Non-traumatic nasal septal abscess is rare, commonly seen in patients with poor immunity, and presents as isolated nasal septal abscess. Further, nasal septal abscess complicated with acute sinusitis is rather rare. Very little literature has been generated for non-traumatic nasal septal abscess complicated with acute sinusitis in healthy patients. Prompt diagnosis and adequate treatment will help to prevent the complications associated with nasal septal abscess such as saddle nose and intracranial involvement. Herein, to our knowledge, we present the first case involving an otherwise healthy little girl with nasal septal abscess complicated with acute sinusitis and facial cellulitis.

Topics: Abscess; Acute Disease; Amoxicillin-Potassium Clavulanate Combination; Cellulitis; Cheek; Child; Ethmoid Sinusitis; Eyelid Diseases; Female; Humans; Maxillary Sinusitis; Nasal Obstruction; Nasal Septum; Nose Diseases; Postoperative Care; Streptococcal Infections; Tomography, X-Ray Computed; Viridans Streptococci

Pediatric neck infections are frequently treated by Otolaryngologists, Head and Neck surgeons. The relative role of medical versus surgical treatment of pediatric neck infections is debated. The aims of this study are to analyze the management of pediatric neck infections with respect to clinical assessment, radiological assessment and treatment.. Medical records from January 1999 to June 2005 were reviewed and analyzed.. Two hundred and five children with lateral neck infections were included in the study. The clinical diagnosis correlated with the radiology finding in 73.6% with a sensitivity of 28% and a specificity of 92% for lateral neck abscess recognition. The ultrasound finding correlated with the surgical finding in 65.2% with a sensitivity of 70% and a specificity of 33%. When an ultrasound scan was used it changed the intended treatment plan in 10.5% of children.. Accurate clinical assessment of lateral neck infections is poor, generally under estimating suppuration. However, when an abscess is diagnosed clinically this correlates highly with the surgical finding. Radiological assessment has inaccuracy in identifying suppuration and this should be borne in mind when being used as a diagnostic tool for neck infections.

Topics: Abscess; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cellulitis; Child; Child, Preschool; Drainage; Female; Humans; Infant; Infant, Newborn; Length of Stay; Lymphadenitis; Male; Outcome Assessment, Health Care; Predictive Value of Tests; Retrospective Studies; Sensitivity and Specificity; Staphylococcal Infections; Staphylococcus aureus; Tomography, X-Ray Computed

To describe a case of orbital cellulitis arising in a patient treated with an anti-TNFalpha agent.. Single interventional case report.. A 42-year-old man developed severe unilateral orbital cellulitis while receiving infliximab (Remicade, Centocor) treatment for Ankylosing spondylitis (AS) as part of the open-label phase of a trial conducted at our tertiary referral center. Cultures grew Staphylococcus aureus.. Infliximab treatment was stopped and the patient made a full recovery after receiving appropriate antibiotic therapy. Infliximab therapy was resumed after three weeks.. Clinical vigilance is warranted when treating patients with anti-TNFalpha agents as these are associated with a diverse and growing number of ophthalmic complications. Resolved infection does not preclude the use of such agents.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibodies, Monoclonal; Cefotaxime; Cellulitis; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Infliximab; Male; Microbial Sensitivity Tests; Orbital Diseases; Randomized Controlled Trials as Topic; Spondylitis, Ankylosing; Staphylococcal Infections; Staphylococcus aureus; Tumor Necrosis Factor-alpha

The pathologic processes involving the parotid gland include a vast group of lesions, acute and chronic inflammations, benign and malign tumors, traumas or degenerative processes. We report the case of a 55 years old male diagnosed as left parotid phlegmon with involvement of both lobes, especially the deep one, who required admission and endovenous medical treatment for 6 days up to the resolution of the symptoms.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Cellulitis; Ciprofloxacin; Dipyrone; Drug Therapy, Combination; Humans; Male; Methylprednisolone; Middle Aged; Omeprazole; Parotid Diseases; Pregnenediones; Severity of Illness Index; Tomography, X-Ray Computed

We report here a rare case of simultaneous onset of preseptal cellulitis in twins. The absence of any infection in three other siblings during this period would suggest that the twins may not have developed simultaneous lid infection by sheer coincidence. The authors discuss the possible mechanism and emphasize the need for close surveillance of the twin of an index case with ocular infection.

Topics: Amoxicillin-Potassium Clavulanate Combination; Blepharitis; Cefotaxime; Cellulitis; Diseases in Twins; Drug Therapy, Combination; Follow-Up Studies; Humans; Infant; Infusions, Intravenous; Male; Risk Assessment; Severity of Illness Index; Treatment Outcome; Twins, Monozygotic

Topics: Acute Disease; Aged; Amoxicillin-Potassium Clavulanate Combination; Blood Vessel Prosthesis; Cellulitis; Cloxacillin; Confusion; Diabetes Mellitus, Type 2; Diabetic Foot; Drug Therapy, Combination; Femoral Artery; Hallucinations; Humans; Ischemia; Leg; Male; Popliteal Artery; Prosthesis-Related Infections; Radiography; Staphylococcal Infections; Vitamin B 12 Deficiency

Patients hospitalized in the authors' institution for erysipelas or cellulitis between January 1995 and December 2002 were included in this retrospective review. Two hundred cases of soft tissue infections were hospitalized during the study period. The mean age of the patients was 58 years. The most commonly involved site was the leg (66%), followed by the arm (24%) and face (6%). Most patients (71%) had a recognized risk factor for soft tissue infection. Fever was present in 71% of cases, with a mean duration of 3 days. Blood cultures were positive in 3 out of 141 (2%) cases, whereas cutaneous swabs were positive in 73 out of 92 (79%) cases. On admission, white blood cells counts (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were elevated above normal levels in 100 out of 191 (50%) cases, 151 out of 176 (85%) cases, and 150 out of 154 (97%) cases, respectively. Patients with a hospital stay of more than 10 days had significantly higher CRP and ESR values than patients hospitalized for 10 days or less (P<0.01). A single antibiotic was used as treatment in 115 cases, whereas in the remaining 85 cases a combination of two antibiotics was administered. The most commonly used antibiotics were amoxicillin-clavulanic acid as single agent and penicillin with clindamycin as combination therapy. The mean duration of hospitalization was 7 days for patients treated with a single antibiotic and 11 days for patients treated with an antibiotic combination. A recurrence of infection occurred in 34 (17%) patients. Soft tissue infections are common and have a high degree of morbidity and require prolonged hospitalization and antibiotic treatment. Microbiological diagnosis is difficult and treatment is based on empiric evidence. ESR and CPR levels on admission may predict the severity of the disease and duration of hospitalization.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Blood Sedimentation; C-Reactive Protein; Cellulitis; Clindamycin; Erysipelas; Female; Humans; Italy; Length of Stay; Leukocyte Count; Male; Middle Aged; Penicillins; Recurrence; Retrospective Studies; Risk Factors; Treatment Outcome

Orbital cellulitis is uncommon. It may arise as a sequel to eyelid infection, or from direct spread of infection from the paranasal sinuses; it may be of odontogenic origin and has been reported after meningitis and after nasoorbital fractures with pre-existing sinusitis. Clinically, orbital cellulitis is of great importance, as it is a severe disease with potentially disastrous consequences. It may lead to optic neuritis, optic atrophy, blindness, cavernous sinus thrombosis, superior orbital fissure syndrome, meningitis, subdural empyema, and even death. We report two cases of severe post-traumatic orbital cellulitis with subperiosteal abscesses. These were managed surgically and vision was preserved. We describe the anatomy, a classification of orbital infection, and the importance of multidisciplinary management of these cases.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Cellulitis; Decompression, Surgical; Drainage; Drug Therapy, Combination; Humans; Injections, Intravenous; Male; Orbit; Orbital Diseases; Skull Fractures

A Gram-negative rod was isolated from the blood cultures of an 84-year-old man with foot cellulitis. The bacterium was first identified as Sphingobacterium spiritivorum on the basis of standard assimilation tests. However, sequencing analysis of its 16S rRNA genes and whole genome hybridization studies with other related bacteria showed that this isolate belongs to a so far undescribed species of Sphingobacterium, close to S. mizutae. This bacterium was susceptible to most of the antibiotics tested, including glycopeptides, but was resistant to aminoglycosides and polymyxins. Treatment with amoxicillin-clavulanate cured the infection.

Topics: Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Bacteremia; Cellulitis; Drug Therapy, Combination; Gram-Negative Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Sphingobacterium

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Cefotaxime; Cellulitis; Clavulanic Acids; Conjunctivitis, Acute Hemorrhagic; Conjunctivitis, Bacterial; Drug Therapy, Combination; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male