amoxicillin-potassium-clavulanate-combination and Laryngeal-Neoplasms

Rothia mucilaginosa is a Gram-positive, coagulase-negative, encapsulated, non-spore-forming coccus considered part of the commensal flora of the oral cavity and the upper respiratory tract in humans. Its involvement has been reported in an increasing spectrum of infections, above all among immunocompromised patients. To date, only 11 cases of pneumonia due to Rothia mucilaginosa have been described in the literature. The authors report a case of pneumonia due to Rothia mucilaginosa in a 72-year-old man with laryngeal cancer and review the published cases of pneumonia due to this pathogen.

Topics: Actinomycetales Infections; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Carcinoma, Squamous Cell; Drug Resistance, Microbial; Humans; Incidental Findings; Laryngeal Neoplasms; Male; Micrococcaceae; Opportunistic Infections; Pneumonia, Bacterial; Preoperative Care; Pulmonary Disease, Chronic Obstructive; Tomography, X-Ray Computed

Perioperative antibiotic prophylaxis has significantly reduced wound infection rates in clean-contaminated head and neck surgical procedures but controversy still remains regarding the optimal antibiotic regime.. To examine the efficacy of different antibiotics in head and neck oncological surgery prophylaxis.. In this prospective, double-blind clinical trial, 189 patients with carcinoma of the upper aerodigestive tract were randomized to receive amoxicillin-clavulanate or cefazolin intravenously up to 1h before surgery and at 8-h intervals for an additional three doses.. An overall wound infection rate of 22% was observed. The infection rate in patients receiving cefazolin was 24% (22/92) vs. 21% (20/97) in those receiving amoxicillin-clavulanate; the difference was not statistically significant. Postoperative overall non-wound infection developed in 12% (22/189) patients; the rate of infection was 9.8% (9/92) in patients receiving cefazolin vs. 13.4% (13/97) in those receiving amoxicillin-clavulanate, without a statistically significant difference between the two groups. Gram-negative bacteria were more often isolated with Pseudomonas aeruginosa as the dominant species. The risk of postoperative infection was more influenced by the type of surgical procedure than by disease stage.. In clean-contaminated head and neck oncologic surgery amoxicillin-clavulanate prophylaxis was at least as efficient as cefazolin. However, when taking into account the fact that beta-lactamase containing strains have recently been spreading, amoxicillin-clavulanate should be the logical first choice.

Topics: Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bronchitis; Carcinoma, Squamous Cell; Cefazolin; Double-Blind Method; Head and Neck Neoplasms; Humans; Injections, Intravenous; Laryngeal Neoplasms; Mouth Neoplasms; Pharyngeal Neoplasms; Pneumonia, Bacterial; Postoperative Complications; Prospective Studies; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections; Surgical Wound Infection; Tracheitis

During the last three years, 79 adults suffering from acute epiglottitis have been treated in the ENT departments of the university hospital Rudolf Virchow, Berlin, 36 women (41 years of age as an average) and 43 men (average age 39 years). Acute epiglottitis developed either all of a sudden, within hours, or gradually, within days. All patients complained of dysphagia and pain in the throat; dyspnea could be observed in 20%. During examination, we could see an inflamed, thickened epiglottis with edema of the arytenoid cartilages. 55 patients reported an infection of the upper airway prior to the onset of symptoms of acute epiglottitis, epiglottic abscess developed in 11 adults. The inflammation responded satisfactorily to conservative antibiotic management (broad spectrum penicillin). Only one patient had to undergo intubation, none of the adults required tracheotomy.

Topics: Acute Disease; Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Deglutition Disorders; Diagnosis, Differential; Drug Therapy, Combination; Dyspnea; Epiglottitis; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged