amoxicillin-potassium-clavulanate-combination and Diabetes-Mellitus--Type-2

The literature suggests that an alteration in glucose metabolism occurs as a result of antibacterial periodontal therapy. The objective of this study was to monitor the effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus (DM).. Thirty type 2 DM subjects with periodontitis were randomly divided into two groups. Group 1 (G1), 15 subjects, received one-stage full-mouth scaling and root planing (FMSRP) plus amoxicillin/clavulanic acid 875 mg; group 2 (G2), 15 patients, received only FMSRP. At baseline and after 3 months, the glycated hemoglobin (HbA1c) values, fasting glucose, and clinical parameters (with computerized probing and individualized acrylic stents) were recorded. Following therapy, the subjects were enrolled in a 2-week interval maintenance program for 3 months.. After treatment, both groups showed clinical improvements. A probing depth (PD) reduction of 0.8 +/- 0.6 mm (P < 0.05) occurred in G1 and 0.9 +/- 0.4 mm in G2 (P < 0.05), but there were no significant changes in attachment level. Treatment reduced the HbA1c values after the 3-month observation period in both groups; however, the reduction in HbA1c values for the G2 group was statistically significant, but not for the G1 group. The changes in fasting glucose levels were not significant for either group.. Periodontal therapy improved glycemic control in patients with type 2 DM in both groups; however, the reduction in HbA1c values reached statistical significance only in the group receiving scaling and root planing alone [correction].

Topics: Amoxicillin-Potassium Clavulanate Combination; Analysis of Variance; Blood Glucose; Dental Scaling; Diabetes Mellitus, Type 2; Drug Therapy, Combination; Fasting; Follow-Up Studies; Glycated Hemoglobin; Humans; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Root Planing; Statistics, Nonparametric

Diabetic foot infections are related to severe complications and constitute the main reason for diabetes-related hospitalization and lower limb amputations. A diabetic foot infection requires prompt actions to avoid progression of the infected wound; a soft tissue sample has to be taken for microbiological culture and empiric antibiotic therapy must be started immediately. Empiric antibiotic schemes should be chosen based on the severity of the infection and the local prevalence of microbial causal agents. Therefore, it is important to monitor these indicators. The aim of this study was to determine which microorganisms were more prevalent in cultures of diabetic foot infections during 2018 and what antibiotic combination was better to cover local microbiology, compared with data available from 2015 for a similar cohort. A total of 68 positive cultures were obtained of 72 soft tissue specimens analyzed. The most frequent microorganisms were Gram negative (47.1%), and resulted significantly more frequent than in 2015 (24.6%) p = 0.01. These Gram negative germs also resulted more sensitive to ciprofloxacin than in 2015 (62.5% vs. 25.0%) p = 0.03. Amoxicillin-clavulanate plus ciprofloxacin was the optimal combination therapy in 2018, while in 2015 it was amoxicillin-clavulanate plus trimethoprim sulfamethoxazole. In agreement with these results, we recommend amoxicillin-clavulanate plus ciprofloxacin as the empiric antibiotic regimen of choice for soft tissue infections in diabetic foot. We consider surveillance of local microbiology to be an important tool in the management of diabetic foot infections.. Las infecciones del pie diabético se asocian a complicaciones graves y constituyen la principal causa de hospitalización relacionada con diabetes y amputación de miembros inferiores. Para evitar su progresión, se requiere una conducta inicial rápida y adecuada que incluye toma de muestras para cultivos e inicio inmediato de tratamiento antibiótico empírico, según las características de las lesiones y la prevalencia local de microorganismos. Por ello, es necesario conocer y vigilar la microbiología local y la resistencia a los antimicrobianos. El objetivo de este trabajo fue describir la frecuencia de gérmenes en infecciones de pie diabético en pacientes ambulatorios asistidos en nuestro hospital en 2018 e identificar el esquema antibiótico con mayor cobertura, en comparación con los resultados de un estudio similar realizado en 2015. Fueron analizadas 72 muestras tomadas mediante punción por piel sana de partes blandas. Entre los 68 gérmenes aislados, los Gram negativos fueron los más frecuentes (47.1%), lo que representa un aumento significativo en relación a la frecuencia observada en 2015 (24.6%) p = 0.01 y un aumento de la sensibilidad a ciprofloxacina de 25% a 62.5% (p=0.03). El esquema con mayor cobertura fue amoxicilina-clavulánico con ciprofloxacina (77.9%) mientras que en 2015 fue amoxicilina-clavulánico con trimetoprima sulfametoxazol. La vigilancia de la microbiología local es fundamental para la elección del antibiótico empírico en las infecciones de pie diabético. En nuestro hospital, cuando la infección es de partes blandas, se recomienda la combinación amoxicilina-clavulánico más ciprofloxacina como esquema antibiótico empírico según los hallazgos de este estudio.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Ciprofloxacin; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Foot; Drug Therapy, Combination; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Microbial Sensitivity Tests; Trimethoprim, Sulfamethoxazole Drug Combination; Wound Infection

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacteremia; Cholecystectomy; Diabetes Mellitus, Type 2; Gram-Positive Bacterial Infections; Humans; Lacticaseibacillus paracasei; Liver Abscess, Pyogenic; Male; Treatment Outcome

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Antidotes; beta-Lactamase Inhibitors; Bites and Stings; Diabetes Mellitus, Type 2; Diabetic Foot; Diagnosis, Differential; Foot; Foot Injuries; Humans; Male; Middle Aged; Rats; Tetanus Antitoxin; Treatment Outcome

The case of a diabetic foot infection caused by Raoultella ornithinolytica is reported.. A 68-year-old Caucasian man arrived at the hospital with a fever (38.5 °C) and a foul-smelling pressure ulcer on his left foot and was admitted for treatment of a moderate diabetic foot infection. The patient's medical history included type II diabetes mellitus, hypertension, chronic kidney disease, dyslipidemia, cataract surgery, and total hip arthroplasty. A tissue biopsy of the diabetic foot lesion was performed, and a blood sample was cultured. Empirical antimicrobial treatment consisting of amoxicillin-clavulanate 1.2 g (of amoxicillin) i.v. every 12 hours and ciprofloxacin 200 mg i.v. every 12 hours was initiated to target aerobic gram-positive and gram-negative and anaerobic microorganisms. After 48 hours, the results of the blood culture were negative, but the left ankle wound culture grew R. ornithinolytica. Although the isolated R. ornithinolytica was relatively sensitive, showing resistance only to cefazolin and ampicillin, the antibiotic regimen was not changed. The patient showed clinical and laboratory improvement during his 5-day hospitalization. Subsequently, i.v. antibiotics were discontinued, and the patient was discharged on oral amoxicillin-clavulanate 1 g (of amoxicillin) twice daily and oral ciprofloxacin 750 mg twice daily for an additional 9 days to complete a total duration of 14 days of treatment, after which the infection was completely resolved.. A 68-year-old man diagnosed with a diabetic foot infection caused by R. ornithinolytica was successfully treated with amoxicillin-clavulanate and ciprofloxacin.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Diabetes Mellitus, Type 2; Diabetic Foot; Enterobacteriaceae; Enterobacteriaceae Infections; Humans; Male

Leclercia adecarboxylata is being increasingly diagnosed as a causative agent of infection due to the availability of rapid molecular diagnostic techniques Few cases of bacteraemia in subjects with underlying medical conditions have been reported. We report a case of L. adecarboxylata bacteraemia in an immunocompromised patient with metabolic syndrome.

Topics: Amoxicillin-Potassium Clavulanate Combination; Bacteremia; Body Mass Index; Debridement; Diabetes Mellitus, Type 2; Enterobacteriaceae; Enterobacteriaceae Infections; Female; Humans; Hypertension; Immunocompromised Host; Leg; Metabolic Syndrome; Middle Aged; Risk Factors; Treatment Outcome

We describe melioidosis associated with travel to Nigeria in a woman with diabetes, a major predisposing factor for this infection. With the prevalence of diabetes projected to increase dramatically in many developing countries, the global reach of melioidosis may expand.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Burkholderia pseudomallei; Diabetes Mellitus, Type 2; DNA, Bacterial; Female; Fever; Humans; Melioidosis; Meropenem; Middle Aged; Multilocus Sequence Typing; Nigeria; Phylogeny; Risk Factors; Thienamycins; Travel; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Atrial Fibrillation; Diabetes Mellitus, Type 2; Fasciitis, Necrotizing; Female; Humans; Middle Aged

Melioidosis is a tropical disease caused by infection with the bacterium Burkholderia pseudomallei. Most cases present as an acute febrile illness with severe pneumonia and sepsis. Sub-acute and late onset disease can also occur Melioidosis has been diagnosed among travellers who contracted the disease while staying in endemic areas during the rainy season. We report a case of travel-associated B. pseudomallei cutaneous infection in a febrile 90-year-old woman with diabetes mellitus, with early stage manifestations of an isolated inoculation lesion. A 32 weeks' treatment with oral amoxicillin-clavulanate and doxycycline combination regimen led to resolution of the lesion and lack of relapse over fifteen months of follow-up. Melioidosis should be considered in the differential diagnosis of unusual subacute cutaneous lesions in a febrile patients returning from endemic areas, as successful management largely depends on early diagnosis and specific long-term suppressive antimicrobial therapy at an early stage of the course of the disease.

Topics: Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Bangladesh; Belgium; Burkholderia pseudomallei; Diabetes Mellitus, Type 2; Disease Susceptibility; Doxycycline; Drug Resistance; Drug Therapy, Combination; Elbow; Female; Humans; Melioidosis; Skin Diseases, Bacterial; Travel

Emphysematous pyelonephritis is a necrotizing renal infection characterized by bacterial gas production in the renal and perirenal area. It is a rare infection diagnosed in diabetic patients in most cases. Emphysematous pyelonephritis has a high mortality rate. We herein report one case of bilateral emphysematous pyelonephritis managed by medical therapy alone.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Back Pain; Bacteremia; Bacteriuria; Consciousness Disorders; Diabetes Mellitus, Type 2; Emphysema; Female; Fever; Humans; Klebsiella Infections; Middle Aged; Pyelonephritis; Remission Induction

Necrotizing soft tissue infections constitute some of the most potentially threatening infections that may be acquired in the community or in the hospital milieu as they are associated with a high mortality rate. In most cases they are produced by Streptococcus pyogenes. We report a case of a necrotizing soft tissue infection caused by Streptococcus agalactiae (group B beta hemolytic streptococcus) that involved the leg of an elderly man with chronic lymphatic leukemia and diabetes mellitus. The lesions notably improved after initiating intravenous antibiotic treatment with amoxicillin-clavunate and clindamycin.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clindamycin; Combined Modality Therapy; Debridement; Diabetes Mellitus, Type 2; Elbow Injuries; Fasciitis, Necrotizing; Humans; Immunocompromised Host; Leg; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Soft Tissue Infections; Streptococcus agalactiae; Wound Infection

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