amoxicillin-potassium-clavulanate-combination and Colitis--Ulcerative

The inflammatory activity of colonic mucosal lesions may be stimulated by intraluminal bacteria. Our aim was to investigate whether administration of broad-spectrum antibiotics decreases inflammatory activity in ulcerative colitis. To this end, we performed a randomized, 5-day study with either oral enterically coated amoxicillin-clavulanic acid (1 g + 250 mg, t.i.d.); i.v. methylprednisolone (40 mg/day) and oral placebo (t.i.d.); or both i.v. methylprednisolone and oral amoxicillin-clavulanic acid as above, in 30 patients with clinically active ulcerative colitis. Before and after 5 days of treatment, intestinal inflammation was assessed by the quantification of mucosal release of eicosanoids and interleukin-8 by rectal dialysis in each patient. Breath H2 excretion after oral lactulose was determined as an index of metabolic activity of colonic flora. The total release of (IL-8) interleukin-8 and eicosanoids significantly decreased in patients treated with antibiotic or steroids and antibiotic. Antibiotic treatment, but not steroids, markedly inhibited breath H2 excretion. In conclusion, short-term treatment with enteric-coated amoxicillin-clavulanic acid decreases the intraluminal release of IL-8 and other inflammatory mediators.

Topics: Adolescent; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Inflammatory Agents; Colitis, Ulcerative; Drug Therapy, Combination; Eicosanoids; Female; Humans; Interleukin-8; Male; Methylprednisolone; Middle Aged; Tablets, Enteric-Coated

A 41-years-old female, with ulcerative colitis, presented to the emergency department with 7-days history of abdominal pain, bloody stools (> 10/day). The patient referred the appearance of a cutaneous lesion, on her left thigh, with subsequent appearance of similar lesions on the lower limbs. No improvement after amoxicillin/clavulanic acid. On admission, she was febrile (38.2 ºC) and tachycardic. She had three cutaneous lesions, the largest one with 8cm in the left thigh - a deep and painful lesion, with extensive ulceration, necrosis, exudative edges and with marked pathergia, compatible with pyoderma gangrenosum.

Topics: Abdominal Pain; Adult; Amoxicillin-Potassium Clavulanate Combination; Colitis, Ulcerative; Female; Humans; Pyoderma Gangrenosum

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Antibodies, Monoclonal; Colitis, Ulcerative; Female; Hidradenitis Suppurativa; Humans; Stomatitis

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Biopsy; Colitis, Ulcerative; Colon; Diagnosis, Differential; Fever; Humans; Male; Pilonidal Sinus; Postoperative Complications; Purpura; Retinal Vasculitis; Skin; Thrombophlebitis; Vasculitis; Vision Disorders