amoxicillin-potassium-clavulanate-combination and Salpingitis

One-stage retrospective analysis of 350 primary medical documents of the female patients treated under hospital conditions for salpingo-oophoritis in 2010-2011 was performed. The results were compared with those of the investigation of the present etiological pattern of pelvic inflammatory diseases (PID) by the data of the microbiological examination of 117 patients with PID and susceptibility of the isolates to the antibacterials. The frequency and efficiency of the use of antibacterials alone or in combinations were analysed in the treatment of various clinical forms of PID. The ovarian reserve was estimated in 87 patients after recovery from salpingo-oophoritis. 52 of them had an episode of the chronic process exacerbation and 35 had the first episode of acute PID. The ovarian reserve was estimated by determination of the anti-Mullerian hormone (AMH), basal FSH level, ovarian volume and antral follicle count. A statistically significant decrease of the ovarian reserve in the patients with chronic salpingo-oophoritis confirmed the necessity of rational treatment of the acute inflammatory process.

Topics: Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Mullerian Hormone; Bacteroides; Candida albicans; Enterococcus; Female; Follicle Stimulating Hormone; Gardnerella vaginalis; Humans; Length of Stay; Macrolides; Microbial Sensitivity Tests; Oophoritis; Ovarian Follicle; Ovary; Pelvic Inflammatory Disease; Retrospective Studies; Salpingitis; Treatment Outcome; Young Adult

To evaluate the efficacy and safety of ofloxacin+coamoxiclav versus doxycycline-coamoxiclav in the treatment of chlamydial pelvic infections.. An open, comparative, randomised, monocentric study.. A hundred and eighteen patients (85 endometritis and 33 salpingitis) were included. Clinical, laparoscopic and bacteriological assessments were performed before treatment. 30.4% of salpingitis were considered as severe (COGIT score > 6). 25.4% of acute pelvic infections were only caused by Chlamydia trachomatis.. A hundred and eighteen patients were treated orally with 3 week combination ofloxacin (200 mg b.i.d.) + coamoxiclav (1 g b.i.d.) (n = 60) or with a 6 week coamoxiclav (1 g b.i.d.) + doxycycline (100 mg b.i.d.) (n = 58).. Oral combination ofloxacin-coamoxiclav is as effective as oral combination doxycycline+coamoxyclav with respectively 96.7% versus 96.6% and 100% versus 98.4% satisfactory clinical et bacteriological results.

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Chlamydia Infections; Chlamydia trachomatis; Clavulanic Acids; Doxycycline; Drug Therapy, Combination; Endometritis; Female; Humans; Ofloxacin; Salpingitis; Severity of Illness Index; Treatment Outcome

110 patients suffering from laparoscopical verified salpingitis and desire for a baby, were treated with tetracycline (oxytetracycline or doxycycline; TC)/metronidazole (n = 67), augmentan (n = 22) or cipropfloxacin/metronidazole (n = 21). After an average period of 11.6 weeks, all patients underwent second-look laparoscopy with dye insufflation. In 34 patients treated with TC/metronidazole, the effects of additional physio-therapeutical measures were examined under conditions as they prevail in a Spa. 33 patients without balneotherapy served as controls. All the 4 groups were comparable (p greater than 0.05) in respect of mean age, percentage, share of nulliparous women, salpingitis gonorrhoica, contraceptive behaviour and also of the stage of salpingitis. All antibiotic regimens used resulted in a prompt decrease of inflammatory clinical signs after five days (temperature, blood sedimentation rate, leukocytes). Only 2 of 34 patients treated by additional cure at a Spa reported complaints, whereas complaints were reported by 14 of 33 control patients (p less than 0.01), 7 of 22 (p less than 0.01) treated with augmentan and to 7 of 21 (p less than 0.01) treated with ciprofloxacin/metronidazole. The tubal occlusion rates amounted to 33.3% (TC/metronidazole), 32.3% (TC/metronidazole and balneotherapy), 22.7% (augmentan) and 23.8% ciprofloxacin/metronidazole. The differences did not attain statistical significance (p greater than 0.05). With regard to adhesions, there were, likewise, no significant differences between findings at first laparoscopy and second look-laparoscopy, respectively. It is concluded, that additional physiotherapeutic measures, after antibiotic therapy of acute salpingitis, reduce the frequency of lower abdominal pain, but do not result in an improvement of tubal occlusion and reduction of adhesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Balneology; Clavulanic Acids; Combined Modality Therapy; Drug Therapy, Combination; Female; Humans; Laparoscopy; Metronidazole; Pelvic Inflammatory Disease; Prospective Studies; Recurrence; Reoperation; Salpingitis; Tetracycline

In a randomised second look laparoscopic study, concomitant antibiotic--anti-inflammatory therapy for the treatment of pelvic inflammatory disease (P.I.D.) was studied. Six weeks after medical treatment results were evaluated during second look laparoscopy based on three parameters: residual inflammation, pelvic adhesions and tubal patency. The combination treatment resulted in decreased pelvic adhesion and tubal occlusion in severe forms of P.I.D. Anti-inflammatory agents combined with anti-biotics are not more beneficial than anti-biotics alone in mild and moderate forms of P.I.D. so combination therapy must be reserved for severe forms of P.I.D.

Topics: Administration, Oral; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Doxycycline; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Laparoscopy; Piroxicam; Pregnancy; Pregnancy Outcome; Prognosis; Salpingitis; Severity of Illness Index

Eighty-two patients with laparoscopically confirmed salpingitis were randomly divided into two groups in a multicentre and prospective trial. Single drug therapy with the amoxicillin-clavulanic acid combination was used in 42 patients (group A). The other 40 patients were given a combination of penicillin, aminoside and metronidazole (group B). For each case a secondary prescription for a tetracycline was discussed. Clinical results were comparable in both groups: sooner (at the end of the hospitalization period) in group A: 10 cured, 30 improved and 2 failures against 9 cured, 30 improved in group B. Later (evaluation after 5 to 8 weeks) a relapse was noted in five patients in group A and included one case of angioedema in group B. It is concluded that amoxicillin-clavulanic acid combination is a satisfactory alternative to the penicillin-aminoside-metronidazole combination, especially as it is simpler to use.

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Evaluation; Drug Therapy, Combination; Drug Tolerance; Female; Humans; Metronidazole; Middle Aged; Multicenter Studies as Topic; Paromomycin; Penicillins; Prospective Studies; Random Allocation; Salpingitis

78 cases of acute salpingitis were treated with the association Oflocet-Augmentin in a multicenter study. An accurate clinical and bacteriological evaluation was carried out prior to the treatment and a control laparoscopy was performed in 31 cases. A Chlamydia infection was responsible in 56 p. cent of the cases; only one bacteria was identified in 56 cases and an association of two or three bacteria in 15 cases; in 7 cases, no bacteria was identified. The antibiotic association was effective in 96 p. cent of the cases, with a good clinical and biological tolerance. Three failure were reported: one in an infection secondary to a non identified bacteria, and two in Chlamydia infections where, despite the clinical cure, a positive culture persisted in the abdomen. The association Oflocet-Augmentation is therefore recommended in the treatment of high genital infections.

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Chlamydia Infections; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Microbial Sensitivity Tests; Middle Aged; Multicenter Studies as Topic; Ofloxacin; Salpingitis; Severity of Illness Index

An open randomised comparative trial of the efficacy and safety of Augmentin as against the triple therapy of penicillin-gentamicin-metronidazole in acute salpingitis was conducted in forty women admitted to hospital. Laparoscopy was performed routinely to confirm the diagnosis. The two groups of patients were comparable as to age and clinical and biological symptoms and the severity of the salpingitis (grade I to IV, with the presence or absence of Fitz-Hugh-Curtis syndrome). Treatment was started immediately after the laparoscopy, first by parental route until the patient had been apyrexic for 48 hours. Oral follow-up was then commenced. Twenty women received Augmentin and twenty the triple antibiotic therapy. Specimens for bacteriological study were obtained before treatment (culture of the urine, culture from the IUD and from the cervix, and swabs were taken laparoscopically). This made it possible to identify aerobic and anaerobic organisms. (The gonococcus was found more often in the group treated with triple antibiotics). On discharge, cures had been obtained in 12 women and 6 more were responding out of the Augmentin group. Out of the triple therapy group 8 were cured and 10 were responding. There was one failure in each group (persisting fever). Long-term assessment was carried out in the out-patients three weeks after discharge. 11 out of the 13 reviewed in the Augmentin group and 8 out of the 14 in the triple therapy group were considered as definitely cured. The clinical safety of both treatments was good. These results demonstrate that Augmentin is as effective as the combined therapy in treating acute salpingitis and with the added advantage of its easy use and lower cost.

Topics: Acute Disease; Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clavulanic Acids; Drug Therapy, Combination; Female; Gentamicins; Humans; Metronidazole; Penicillins; Salpingitis

Plesiomonas shigelloides are ubiquitous Gram-negative bacteria that are found in fresh or marine water, particularly in tropical or warm climates; they were recently implicated in diarrhoeal disease. Patients usually present with a history of recent travel to tropical regions or consumption of uncooked seafood. Extraintestinal disease has rarely been reported, occurring generally in neonates or immunocompromised patients, and is often fatal. We report a case of right pyosalpinx due to P. shigelloides acquired by swimming in contaminated water. Laparoscopic salpingectomy led to a good outcome.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Doxycycline; Drug Therapy, Combination; Female; Gram-Negative Bacterial Infections; Humans; Laparoscopy; Middle Aged; Plesiomonas; Salpingitis; Swimming; Water Microbiology

To test the efficacy and safety of amoxycillin/clavulanate (Augmentin), 102 hospital patients with laparoscopically confirmed acute salpingitis were treated with parenteral amoxycillin/clavulanate (1.2 g qid for three days) followed by oral amoxycillin/clavulanate (two tablets of 625 mg tid for a further six days). Bacteriological samples were obtained from the cervix uteri and the pouch of Douglas. One hundred patients were assessable for clinical outcome using several variables including pain scores. Amoxycillin/clavulanate alone was effective in 95 patients (95%). Three patients (3%) responded to amoxycillin/clavulanate with marked improvement but another antibiotic was subsequently added to their treatment regimen. Treatment failed in two patients. At follow-up two weeks after hospital discharge, three patients (3.8%) had relapsed or were re-infected. Adverse drug events included one case of drug fever, one case of rash and one case of severe diarrhoea. Treatment was stopped in all three cases. Gastrointestinal reactions, mainly mild diarrhoea, were seen in 31 patients. No clinically relevant changes in haematological or clinical chemical indices were attributable to the amoxycillin/clavulanate treatment. We conclude that amoxycillin/clavulanate is a clinically effective and safe treatment for acute salpingitis.

Topics: Acute Disease; Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Therapy, Combination; Erythrocyte Count; Female; Humans; Laparoscopy; Leukocyte Count; Middle Aged; Salpingitis

41 cases of acute salpingitis were treated: either with the combination Augmentin + Tetracycline (A + T) including 21 severe cases treated intravenously for 4 days, then per os and 10 moderate cases treated per os from the beginning-or by Augmentin alone (A) per os for 10 other moderate cases. An accurate bacteriological diagnosis was made before treatment and, in case of failure, most often by celioscopy. A Chlamydia serology was performed. Patients were seen again after 8 days (41 cases), one month (39 cases) and several months (32 cases).. A Chlamydia infection was found responsible, by culture or serology, in one out of 2 cases; only one germ was found in 14 cases, 2 germs in 21 cases and none in 7 cases. The association A + T was effective in all moderate cases at 8 and 30 days; in severe forms, there was a failure at 8 days and 4 others at 30 days or 17%. Augmentin alone per os caused 5 failures out of 10 cases at 8 days. No new failure was observed after several months in cases cured at 30 days. The association A + T may be recommended as very effective in moderate forms of acute salpingitis.

Topics: Acute Disease; Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Salpingitis; Tetracycline