amoxicillin-potassium-clavulanate-combination and Inflammation

To find out whether the frequency of postoperative infectious and inflammatory complications (IC) in subjects treated with placebo (Pl) is greater than those treated with antibiotic (Ab) after extraction of an impacted mandibular third molar (M3). Our hypothesis is there are more IC in Pl than in Ab, with a maximum ratio difference of 0.067.. A double-blind placebo-controlled randomized clinical trial. The sample was derived from the population of subjects attending Cruces Hospital for evaluation and extraction of 1 M3 under local anesthesia. Patients were treated with postoperative placebo or amoxicillin/clavulanic acid 500/125 mg 3 times a day during 4 days. The outcome variable was infectious and inflammatory complications. Sex, age, smoking, molar depth, angulation, need for sectioning, ostectomy, and operation time were recorded. Analysis was by intention to treat, risk measures, and logistic regression.. In 490 subjects (259 Ab and 231 Pl), the frequency of IC was 1.9% in the Ab and 12.9% in the Pl group (OR 7.6, 95%CI 2.9-19.9; P < .001). The number needed to treat was 10 (7-16). Unadjusted relative risk was 0.15 (0.06-0.38) (P < .001). Absolute reduction risk was 0.11(0.066-0.155)]. Therefore, the hypothesis cannot be rejected. Multivariate analysis shows treatment with antibiotic (OR = 8.66 (3.17-23.67); P < .001) and age (OR = 1.08 (1.00-1.16); P = .029) are the only variables to be included in the logistic regression model.. Amoxicillin/clavulanic acid is efficacious in reducing the incidence of IC following third molar extraction but should not be prescribed in all cases.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Double-Blind Method; Female; Humans; Inflammation; Logistic Models; Male; Middle Aged; Molar, Third; Multivariate Analysis; Postoperative Care; Prospective Studies; Smoking; Surgical Wound Infection; Tooth Extraction; Tooth, Impacted

Augmentin (amoxycillin/clavulanate) was used in the treatment of 88 patients with mild and moderate infections of the urogenital organs. The drug was administered in a single dose of 375 mg thrice daily for 6 to 12 days. The renal function in 62 patients (70.5 per cent) was normal and in 26 patients (29.5 per cent) the chronic renal insufficiency latent stage was stated (the decrease of the glomerular filtration up to 55-70 ml/min). When augmentin was used before lithotripsy in 35 patients for 6 days, all the laboratory and clinical indices came to normal in 30 patients (85.7 per cent) and only in 4 patients (11 per cent) leukocyturia and in 1 patient bacteriuria persisted. When augmentin was used in 26 patients before adenomectomy or after transurethral resection for 7 to 9 days, all the indices came to normal in 13 patients (50 per cent) and in the other 13 patients leukocyturia persisted, while no bacteriuria was recorded. When augmentin was used in the treatment of 19 patients with pyelonephritis exacerbation during the postoperative period for 7 to 12 days, all the clinical and laboratory indices came to normal in 13 patients (68.4 per cent), leukocyturia persisted in 6 patients and bacteriuria persisted in 2 patients. When augmentin was used in the treatment of 8 patients with acute orchiepididymitis for 7 to 10 days, the clinical effect was stated in all the patients. As a rule, the drug was well tolerated by the patients.

Topics: Acute Disease; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chronic Disease; Drug Therapy, Combination; Humans; Inflammation; Male; Male Urogenital Diseases; Middle Aged

Augmentin (SmithKline Beecham) was used in the treatment of 24 patients after operations on the otorhinolaryngologic organs. The drug was administered orally, intravenously or applied locally. After a radical operation on the maxillary sinus the use of augmentin resulted in a marked decrease of the wound secretion and soft tissue edema on the 6th-7th days. After tonsillectomy cleaning of the tonsil niche from the fibrin patches and the epithelialization started on the 4th-5th days. After operations on the temporal bone cleaning of the postoperative cavity and beginning of the epithelialization were observed on the 9th-10th days. On the whole, the use of augmentin accelerated the cure which was recorded 3-4 days earlier.

Topics: Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Combined Modality Therapy; Drug Therapy, Combination; Female; Humans; Infections; Inflammation; Male; Middle Aged; Otorhinolaryngologic Diseases; Postoperative Care; Time Factors

The use of antibiotics may induce the changes in gut microbiota. Previous studies have shown conflicting results on whether the changed gut microbiota by antibiotics can be recovered. Our study aims to investigate whether the gut microbiota could be recovered after a single dose of oral co-amoxiclav before transrectal ultrasound-guided transperineal prostate biopsy (TPPBx) in 5 weeks' time.. Fifteen patients with elevated serum prostate-specific antigen (PSA) were recruited to provide pre-antibiotic and post-antibiotic fecal samples. The V4 region of 16S rRNA was sequenced. Analysis was performed by QIIME2. Alpha- and beta-diversities were analyzed, as well as the differential enrichment by Linear discriminant analysis Effect Size (LEfSe) analysis.. Both the alpha- and beta-diversities of the pre- and post-antibiotic fecal samples were significantly different. Genera that are associated with alleviation of inflammation were enriched in the pre-antibiotic fecal samples, while the inflammation-associated genera were more enriched in the post-antibiotic fecal samples.. A single dose of oral co-amoxiclav before TPPBx could have led to a change of gut microbiota that cannot be recovered in 5 weeks' time. Microbiome studies on prostate cancer patients should be cautioned on the use of post-prostate biopsy fecal sampling. Further studies should be conducted for the impact on gut microbiome for TPPBx alone.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Biopsy; Feces; Gastrointestinal Microbiome; Humans; Inflammation; Male; Prostate; RNA, Ribosomal, 16S

Osteomyelitis is not an uncommon emergency department diagnosis in pediatric patients, and most cases are in the lower extremities. Children can present with acute, subacute, or chronic erythema, pain, swelling, or decreased use of the extremity; some patients will also have fever or elevated serum inflammatory markers, or both.. We present the case of a healthy 5-year-old girl who presented to the emergency department with 3 weeks of painless chin swelling and 2 days of erythema and pain. While laboratory testing was normal, magnetic resonance imaging demonstrated osteomyelitis of the mandible, later confirmed by biopsy. After 4 weeks of intravenous antibiotics and an additional 2 weeks of oral antibiotics, the patient recovered completely without any residual findings. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case demonstrates that osteomyelitis can develop in previously healthy, fully vaccinated children with competent immune systems. Systemic findings (ie, fever and elevated serum inflammatory markers) may be absent, and osteomyelitis should always be considered in the differential diagnosis for a child presenting with subacute to chronic cutaneous findings without other clear explanation.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Biopsy; Child, Preschool; Chin; Emergency Service, Hospital; Female; Humans; Inflammation; Osteomyelitis; Radiography; Ultrasonography

The aim of this study was to demonstrate and assess C-reactive protein (CRP) changes in dogs with induced bacterial cystitis with or without antibiotics. We also evaluated availability of CRP levels to serve as an indicator for monitoring or diagnosing bacterial cystitis. Serial CRP concentrations in dogs with induced bacterial cystitis were higher than those of controls (p < 0.001). CRP concentrations peaked on day 7 and gradually decreased thereafter. In the treatment group, CRP concentrations decreased after medication compared to the untreated group (p = 0.032). CRP levels had a linear correlation with urine white blood cell counts among all groups (r = 0.837, p < 0.001, n = 140). Compared to the negative urine culture group, dogs with positive urine culture results had higher CRP concentrations (median 43.8 mg/L vs. 5.9 mg/L; p < 0.001). Area under the receiver operating characteristic curve was 0.955; when cut-off value was 12.2 mg/L, CRP measurements were found to have a sensitivity of 92.3% and specificity of 86.4%. This result indicates that rapid increases of CRP occurred after inducing bacterial cystitis and CRP may be a useful indicator for monitoring or diagnosing canine bacterial cystitis together with sediment urinalysis and urine bacterial culture.

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Anti-Bacterial Agents; C-Reactive Protein; Cystitis; Dogs; Gene Expression Regulation; Inflammation; Male; Proteus Infections; Proteus mirabilis

The administration of indometacin to rats increases intestinal permeability and induces inflammatory pathology of the small bowel. This represents a potential model for Crohn's disease.. To analyse the pathogenic role of T cells, tumour necrosis factor and bacterial flora in indometacin-induced changes in small bowel permeability and inflammation.. Rats were given indometacin, 13 mg/kg, on day 1 and day 2. The effects of antibiotic (metronidazole, aztreonam and amoxicillin/clavulanic acid), anti- tumour necrosis factor and interleukin-10 therapy were evaluated. The parameters used were weight change, serum haemoglobin, chromium-51 ethylenediaminetetra-acetate permeability and macro-and microscopic score on day 5. Results in conventionally harboured rats were compared with those in T-cell-free rats. Additional in vitro experiments were carried out to test the effect of metronidazole on tumour necrosis factor production.. Indometacin administration resulted in small bowel ulcers and inflammation, independently of T cells. Metronidazole was more potent than amoxicillin/clavulanic acid and anti-tumour necrosis factor in improving the indometacin-induced small bowel inflammation. Only part of the efficacy was through improvement of increased intestinal permeability. Aztreonam and interleukin-10 had no effect. Metronidazole also suppressed in vitro lipopolysaccharide-induced tumour necrosis factor production, suggesting a therapeutic effect of this drug through the inhibition of tumour necrosis factor.. These data implicate anaerobic bacteria and tumour necrosis factor production, but not T cells, as essential elements of the pathogenesis of indometacin-induced small bowel inflammation. Tumour necrosis factor is also involved in the change in intestinal permeability. Metronidazole was the most efficacious drug in this model, probably because it suppressed anaerobic bacteria and directly inhibited tumour necrosis factor production.

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Aztreonam; Bacteria, Anaerobic; Crohn Disease; Disease Models, Animal; Drug Therapy, Combination; Female; Indomethacin; Inflammation; Interleukin-10; Metronidazole; Monobactams; Permeability; Rats; Rats, Wistar; T-Lymphocytes; Tumor Necrosis Factor-alpha

We report eight cases of liver injury related to amoxycillin-clavulanate. Liver biopsy performed in seven patients revealed varying degrees of injury to interlobular bile ducts in all cases. Lesions included irregularity of the nuclei, vacuolization of the cytoplasm, lymphocytic infiltration, destruction and endothelialization of the bile duct epithelium. Ductopenia was not observed. In two patients liver injury was accompanied by prominent extrahepatic manifestations (acute interstitial nephritis in one and acute lacrimal gland inflammation and sialadenitis with prolonged xerostomia in the other). We conclude that interlobular bile-duct lesions of varying severity are a common feature in liver injury related to amoxycillin-clavulanate. Side effects of the drug include acute interstitial nephritis and sialadenitis.

Topics: Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Bile Ducts, Intrahepatic; Chemical and Drug Induced Liver Injury; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Inflammation; Lacrimal Apparatus Diseases; Male; Middle Aged; Nephritis, Interstitial; Sialadenitis; Xerostomia