amoxicillin-potassium-clavulanate-combination and Skin-Diseases

This study tested whether levofloxacin, at a new high dose of 750 mg, was effective for the treatment of complicated skin and skin-structure infections (SSSIs). Patients with complicated SSSIs (n=399) were randomly assigned in a ratio of 1:1 to 2 treatment arms: levofloxacin (750 mg given once per day intravenously [iv], orally, or iv/orally) or ticarcillin-clavulanate (TC; 3.1 g given iv every 4-6 hours) followed, at the investigator's discretion, by amoxicillin-clavulanate (AC; 875 mg given orally every 12 hours). In the clinically evaluable population, therapeutic equivalence was demonstrated between the levofloxacin and TC/AC regimens (success rates of 84.1% and 80.3%, respectively). In the microbiologically evaluable population, the overall rate of eradication was 83.7% in the levofloxacin treatment group and 71.4% in the TC/AC treatment group (95% confidence interval, -24.3 to -0.2). Both levofloxacin and TC/AC were well tolerated. These data demonstrate that levofloxacin (750 mg once per day) is safe and at least as effective as TC/AC for complicated SSSIs.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Infective Agents; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Levofloxacin; Male; Middle Aged; Ofloxacin; Skin Diseases; Ticarcillin; Treatment Outcome

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Fusidic Acid; Humans; Male; Middle Aged; Skin Diseases; Spider Bites; Spiders

Septic-embolic diseases are life threatening; survival critically depends on rapid diagnosis. Clinically, cutaneous manifestations like Janeway lesions are infrequently occurring but highly characteristic. In contrast, histological features are not clearly defined. We report the case of a 59-year-old male patient in deteriorating general condition and fever of unknown origin with lesions suggestive for Janeway lesions. Histology showed dilated blood vessels and extravasated erythrocytes throughout the dermis. Only serial sections revealed single, deep dermal vessels occluded by fibrin thrombi. Computed tomography scan identified multiple pulmonary round masses. Blood cultures showed growth of Staphylococcus aureus and Enterococcus faecalis. The knowledge of the described subtle histological features and a clinical-pathological correlation is essential for the diagnosis of certain cases of septic-embolic conditions.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Blood Vessels; Embolism; Enterococcus faecalis; Gram-Negative Bacterial Infections; Humans; Male; Middle Aged; Sepsis; Skin; Skin Diseases; Staphylococcal Infections