ascorbic-acid and Streptococcal-Infections

Psoriasis is a chronic skin disease that affects approximately two per cent of the general population. Plaque psoriasis is the most common form: it usually appears as raised, red patches of inflamed skin, covered with silvery white scales. The patches often occur in a symmetrical pattern. Guttate psoriasis is a particular form of psoriasis with widespread, small erythematosquamous lesions. Streptococcal infection is suspected to be a triggering factor for the onset of guttate psoriasis, and flare-up of chronic plaque psoriasis. The previous Cochrane Review on this topic was published in 2000; it required an update because antistreptococcal treatment continues to be used to treat psoriasis, especially for the acute form of guttate psoriasis.. To assess the effects of antistreptococcal interventions for guttate and chronic plaque psoriasis.. We searched Cochrane Skin Specialised Register, Cochrane Register of Studies Online, CENTRAL, MEDLINE, Embase, LILACS, and five trials registers (January 2019). We checked the reference lists of included and excluded studies and searched conference proceedings from the American Academy of Dermatology, Society for Investigative Dermatology, and European Academy of Dermatology and Venereology.. We considered randomised controlled trials (RCTs) assessing antistreptococcal interventions (tonsillectomy or systemic antibiotic treatment) in people with clinically diagnosed acute guttate and chronic plaque psoriasis compared with placebo, no intervention, or each other.. We used standard methodological procedures expected by Cochrane. Primary outcome measures were: 1) time-to-resolution; achieving clear or almost clear skin (Physician Global Assessment (PGA) 0 or 1 or Psoriasis Area and Severity Index (PASI) 90 or 100); 2) proportion of participants with adverse effects and severe adverse effects. Secondary outcomes were: 1) proportion of participants achieving clear or almost clear skin; 2) proportion of participants achieving PASI 75 or PGA 1 to 2; 3) risk of having at least one relapse at long-term follow-up. Short-term assessment was defined as within eight weeks of the start of treatment; long-term was at least one year after the start of treatment.. We included five trials (162 randomised participants); three were conducted in a hospital dermatology department. One study declared funding by a pharmaceutical company. Participants' ages ranged from 12 to 77 years; only two participants were younger than 15 years. Mean PASI score at baseline varied from 5.7 (i.e. mild) to 23 (i.e. severe) in four studies. Twenty-three of 162 participants had streptococcus-positive throat swab culture. We did not perform a meta-analysis due to heterogeneity of participants' characteristics and interventions.None of the trials measured our efficacy primary outcome, time-to-resolution, or the secondary outcome, risk of having at least one relapse at long-term follow-up.We rated the quality of the results as very low-quality evidence, due to high risk of bias (absence of blinding of participants and caregivers, and high risk of outcome reporting bias) and imprecision (single study data with a low number of events). Hence, we are very uncertain about the results presented.Guttate psoriasisOne three-armed trial (N = 43) assessed penicillin (50,000 international units (IU)/kg/day in three doses) versus erythromycin (250 mg four times per day) versus no treatment (treatment for 14 days, with six-week follow-up from start of treatment). Adverse events and the proportion of participants achieving clear or almost clear skin were not measured.One trial (N = 20) assessed penicillin (1.6 MU (million units) intramuscularly once a day) versus no treatment (six weeks of treatment, with eight-week follow-up from start of treatment). At six-week (short-term) follow-up, no adverse events were observed in either group, and there was no statistically significant difference between the two groups in the proportion of participants with clear or almost clear skin (risk ratio (RR) 2.00, 95% confidence interval (CI) 0.68 to 5.85).One trial (N = 20) assessed rifampicin (300 mg twice daily) versus placebo (14-day treatment duration; six-week follow-up from start of treatment); none of the review outcomes were measured.These trials did not measure the proportion of participants achieving PASI 75 or PGA 1 to 2.Chronic plaque psoriasisOne trial (N = 50) assessed long-term azithromycin treatment (500 mg daily dose) versus vitamin C. Adverse events were reported in the azithromycin group (10 out of 30 had nausea and mild abdominal upset), but not in the vitamin C group. The proportion of participants who achieved clear or almost clear skin was not measu. We found only five trials (N = 162), which assessed the effects of five comparisons (systemic antibiotic treatment (penicillin, azithromycin) or tonsillectomy). Two comparisons (erythromycin compared to no treatment, and rifampicin compared to placebo) did not measure any of the outcomes of interest. There was very low-quality evidence for the outcomes that were measured, Therefore, we are uncertain of both the efficacy and safety of antistreptococcal interventions for guttate and chronic plaque psoriasis.The included trials were at unclear or high risk of bias and involved only a small number of unrepresentative participants, with limited measurement of our outcomes of interest. The studies did not allow investigation into the influence of Streptococcal infection, and a key intervention (amoxicillin) was not assessed.Further trials assessing the efficacy and tolerance of penicillin V or amoxicillin are needed in children and young adults with guttate psoriasis.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Ascorbic Acid; Azithromycin; Child; Erythromycin; Humans; Middle Aged; Penicillin V; Psoriasis; Randomized Controlled Trials as Topic; Rifampin; Streptococcal Infections; Tonsillectomy; Vitamins

Topics: Adult; Amantadine; Animals; Antiviral Agents; Ascorbic Acid; Child; Cytopathogenic Effect, Viral; DNA, Viral; Fusidic Acid; Guanidines; Humans; Infant; Interferons; Isoquinolines; Middle Aged; Respiratory Tract Infections; RNA, Viral; Streptococcal Infections; Virus Cultivation; Virus Diseases; Viruses

Group A beta haemolytic streptococcal (GABHS) infection induce an abnormal immune response in a susceptible host. Micronutrient deficiency may affect the immune response of an individual. The aim of this study was to determine whether antioxidant vitamins could improve the abnormal immune response in GABHS infected children in rural Bangladesh. A total of 516 GABHS infected school children aged 5 to 15 years were randomly assigned to two groups. Group 1 (N=258) was treated with phenoxymethyl penicillin V and group 2 (N=258) was treated with penicillin V plus antioxidant vitamins (beta carotene, alpha tocopherol and ascorbic acid). From each group two blood samples were drawn; the first sample at the beginning of the study and another one after eight weeks. Streptococcal antibodies and immunoglobulin levels were compared between the two samples. The mean age of the study population was 10.6 years. Equal number of boys and girls were included in both groups. After treatment, antistreptolysin O (ASO) and antideoxyribonuclease B (ADNase B) titres were decreased in both groups. Serum alpha tocopherol and beta-carotene levels were increased significantly in group 2. In group 1 immunoglobulin M and A levels decreased significantly (P =0.0001) whereas immunoglobulin G showed no change. To the contrary, concentration of three immunoglobulins decreased significantly (P=0.0001) in group 2. Least-square means of between-group differences showed highly significant results for ASO, ADNase B, immunoglobulins M, A and G (P=0.0001). Our data indicate that treatment by antioxidant vitamins plus penicillin is more effective in decreasing immunological abnormalities in GABHS infected children then penicillin alone.

Topics: Adolescent; alpha-Tocopherol; Anti-Bacterial Agents; Antibodies, Bacterial; Antioxidants; Ascorbic Acid; Bangladesh; beta Carotene; Child; Child, Preschool; Dietary Supplements; Drug Therapy, Combination; Female; Humans; Immunoglobulins; Male; Penicillin V; Streptococcal Infections; Streptococcus pyogenes; Treatment Outcome

A study was done on school children infected with group A beta hemolytic streptococci to examine whether antioxidant vitamins play a role in improving the hemoglobin level. A total of 606 primary school children aged 5 to 15 years were randomly divided into two intervention groups. Group 1 (n=299) was treated with pehnoxymethyl penicillin V and group 2 (n=307) was treated with phenoxymethyl penicillin V plus antioxidant vitamins for eight weeks. From each group two blood samples were drawn in acute and convalescent (after eight weeks) states. Before treatment, mean hemoglobin values were 11.0 and 10.8 mg/dL in groups 1 and 2 respectively. After treatment hemoglobin values were 10.5 and 11.6 mg/dL respectively. Values were significantly decreased in group 1 (P=0.0001), whereas increased in group 2 (P=0.001). Adjustment for age and sex by ANCOVA confirmed the difference in hemoglobin levels between group (LS means-0.5 vs 0.8 in groups 1 and 2 respectively (P=0.0001). Hemoglobin level increases after antioxidant vitamin supplementation in children suffering from group A beta hemolytic streptococcal infection.

Topics: Adolescent; alpha-Tocopherol; Anemia; Antioxidants; Ascorbic Acid; beta Carotene; Child; Child, Preschool; Female; Hemoglobins; Humans; Male; Penicillins; Streptococcal Infections; Streptococcus pyogenes; Vitamins

Plasma and erythrocyte samples from acute post-streptococcal glomerulonephritis (APSGN) children and control children were enrolled in this study. Lipid peroxidation (LPO), measured in terms of thiobarbituric acid-reactive substances (TBARS) was found to be significantly increased in plasma and RBCs of APSGN children (P<0.05) than in control children. Osmotic fragility of erythrocytes was examined. RBCs of APSGN patients were found to be osmotically more sensitive towards hypotonic saline (50% hemolysis at 7 g/l saline) when compared to control RBCs (50% hemolysis at 4 g/l saline). The activities of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione S-transferase (GST) were significantly lowered (P<0.05) in APSGN RBCs when compared to control RBCs. Plasma ascorbic acid, reduced glutathione (GSH), RBC ascorbic acid, GSH and RBC total sulphydryl content (TSH) were significantly depleted in APSGN children relative to controls. The susceptibility of RBCs of APSGN children to lipid peroxidation was confirmed in this study.

Topics: Antioxidants; Ascorbic Acid; Catalase; Child; Child, Preschool; Erythrocytes; Female; Glomerulonephritis; Glutathione; Glutathione Peroxidase; Glutathione Transferase; Humans; Lipid Peroxidation; Male; Osmotic Fragility; Oxidative Stress; Plasma; Reference Values; Streptococcaceae; Streptococcal Infections; Superoxide Dismutase

Topics: Ascorbic Acid; Bioethical Issues; Child; Child Health Services; Clinical Trials as Topic; Common Cold; Compensation and Redress; Control Groups; Coronary Care Units; Coronary Disease; Disclosure; Epidemiologic Methods; Ethics Committees, Clinical; Ethics Committees, Research; Ethics, Medical; Federal Government; Female; Glomerulonephritis; Government Regulation; Human Experimentation; Humans; Informed Consent; Insurance, Liability; Jurisprudence; Male; Maternal Health Services; Moral Obligations; Nontherapeutic Human Experimentation; Penicillin G Benzathine; Placebos; Professional Staff Committees; Respiratory Tract Infections; Rheumatic Fever; Risk Assessment; Streptococcal Infections; Therapeutic Human Experimentation; United States; Withholding Treatment

We report a patient with risk factors for both microbial keratitis and endophthalmitis, which were initially challenging to distinguish. Cultures of corneal scrapings yielded several organisms, including an uncultivable Gram-negative rod, eventually identified as

Topics: Administration, Ophthalmic; Adult; Anti-Inflammatory Agents; Antioxidants; Ascorbic Acid; Ceftazidime; Cocaine; Cocaine-Related Disorders; Coinfection; Dopamine Uptake Inhibitors; Doxycycline; Endophthalmitis; Female; Gram-Positive Bacterial Infections; Humans; Keratitis; Kingella; Linezolid; Moxifloxacin; Neisseriaceae Infections; Ophthalmic Solutions; Prednisone; Propionibacterium acnes; Streptococcal Infections; Streptococcus; Substance Abuse, Intravenous; Tobramycin; Vancomycin; Voriconazole

The loss of soluble brain antioxidants and protective effects of radical scavengers implicate reactive oxygen species in cortical neuronal injury caused by bacterial meningitis. However, the lack of significant oxidative damage in cortex [J. Neuropathol. Exp. Neurol. 61 (2002) 605-613] suggests that cortical neuronal injury may not be due to excessive parenchymal oxidant production. To see whether this tissue region exhibits a prooxidant state in bacterial meningitis, we examined the state of the major cortical antioxidant defenses in infant rats infected with Streptococcus pneumoniae. Adenine nucleotides were co-determined to assess possible changes in energy metabolism. Arguing against heightened parenchymal oxidant production, the high NADPH/NADP(+) ratio ( approximately 3:1) and activities of the major antioxidant defense and pentose phosphate pathway enzymes remained unchanged at the time of fulminant meningitis. In contrast, cortical ATP, ADP and total adenine nucleotides were on average decreased by approximately 25%. However, energy depletion did not lead to a significant decrease in adenylate energy charge (AEC). ATP depletion was likely a consequence of metabolic degradation, since it correlated with both the loss of total adenine nucleotides and accumulation of purine degradation products. Furthermore, the loss of ATP and decrease in AEC correlated significantly with the extent of neuronal injury. These results strongly suggest that energy depletion rather than parenchymal oxidative damage is involved in the observed cortical neuronal injury.

Topics: Adenosine Triphosphate; Animals; Antioxidants; Ascorbic Acid; Cerebral Cortex; Disease Models, Animal; Energy Metabolism; Free Radicals; Meningitis, Bacterial; NAD; NADP; Oxidative Stress; Pentose Phosphate Pathway; Rats; Rats, Wistar; Streptococcal Infections; Streptococcus pneumoniae

Topics: Adult; Ascorbic Acid; Chronic Disease; Escherichia coli Infections; Female; Humans; Infections; Lung Diseases; Male; Middle Aged; Osteomyelitis; Peritonitis; Pleural Diseases; Pneumonia; Staphylococcal Infections; Streptococcal Infections; Suppuration; Surgical Wound Infection; Tetracycline; Thiamine

Topics: Adolescent; Adult; Anti-Bacterial Agents; Ascorbic Acid; Child; Cloxacillin; Female; Humans; Kanamycin; Male; Methicillin; Oxacillin; Penicillin G; Penicillin Resistance; Penicillins; Ristocetin; Staphylococcal Infections; Streptococcal Infections; Vancomycin

Topics: Ascorbic Acid; Borrelia Infections; Dental Prophylaxis; Diet; Diet Therapy; Drug Therapy; Folic Acid; Fusobacterium; Gingivitis; Gingivitis, Necrotizing Ulcerative; Humans; Hydrogen Peroxide; Necrosis; Pathology; Penicillins; Staphylococcal Infections; Streptococcal Infections; Sulfadiazine; Sulfamerazine; Sulfamethazine; Vitamin B Complex

Topics: Absorption; Amino Acids; Animals; Ascorbic Acid; Aspirin; Barium; Dogs; Fats; Intestinal Absorption; Intestines; Monosaccharides; Penicillin V; Pharmacology; Rabbits; Rats; Research; Streptococcal Infections; Sulfisoxazole