tetracycline and Acquired-Immunodeficiency-Syndrome

During the last few years, acquired resistance of pneumococci to the main families of normally active antibiotics has appeared. This resistance is now worldwide but unevenly distributed: in Europe, for instance, it predominates in Spain and Hungary. In France, according to the national Registry, resistance to penicillins, which was less than 5 percent in 1988, rose to 16.9 percent in 1991. More than 80 percent of resistant strains are found among 4 stereotypes (6, 9, 19, 23) and more than 50 percent belong to stereotype 23F exclusively. The incidence of penicillin-resistant has been evaluated at 8.5 percent in the year 1991-92. The most significant risk factor is a previous treatment with beta-lactam antibiotics, but some authors also blame frequent pneumonias in the previous year, nosocomial pneumonia, or hospitalization during the previous 3 months. There are no specific clinico-radiological features. The incidence of resistant strains is said to be higher in HIV seropositive subjects. Amoxicillin administered in high doses remains the reference treatment for strains with intermediate susceptibility (minimal inhibitory concentration [MIC] between 0.1 and 1.0 microgram/ml). Strains with a more than 1 microgram/ml MIC require beta-lactam antibiotics such as ceftriaxone, cefotaxime of imipenem in high doses. Pristinamycin still has good in vitro activity on resistant strains. Prevention rests on isolation of infected patients, treatment of healthy carriers and wide prescription of anti-pneumococcus vaccine.

Topics: Acquired Immunodeficiency Syndrome; AIDS-Related Opportunistic Infections; Amoxicillin; Anti-Bacterial Agents; Drug Resistance, Microbial; Humans; Incidence; Penicillin G; Penicillin Resistance; Pneumonia, Pneumococcal; Streptococcus pneumoniae; Tetracycline; Tetracycline Resistance

Inappropriate antibiotics prescription in dental healthcare delivery that may result in the emergence of antibiotic-resistant bacteria, is a worldwide concern. The objective of the study was to determine the antibiotics knowledge and prescription patterns among dentists in Nigeria.. A total of 160 questionnaires were distributed to dentists attending continuing education courses organized by two organizations in Southern and Northern parts of Nigeria. Data analysis was done using SPSS version 17.0.. A total of 146 questionnaires were returned, properly filled, out of 160 questionnaires, giving an overall response rate 91.3%. The clinical factors predominantly influenced the choice of therapeutic antibiotics among the respondents. In this study, the most commonly prescribed antibiotics among the respondents was a combination of amoxicillin and metronidazole. Of the respondents, 136 (93.2%) of them considered antibiotic resistance as a major problem in Nigeria and 102 (69.9%) have experienced antibiotics resistance in dental practice. The major reported conditions for prophylactic antibiotics among the respondents were diabetic mellitus, HIV/AIDS, history of rheumatic fever, other heart anomalies presenting with heart murmur and presence of prosthetic hip. The knowledge of adverse effects of antibiotics was greatest for tooth discoloration which is related to tetracycline.. Data from this study revealed the most commonly prescribed antibiotics as a combination of amoxicillin and metronidazole. There existed gaps in prophylactic antibiotic prescription, consideration in the choice of therapeutic antibiotics and knowledge of adverse effects of antibiotics among the studied dentists.

Topics: Acquired Immunodeficiency Syndrome; Amoxicillin; Anaphylaxis; Anti-Bacterial Agents; Antibiotic Prophylaxis; Attitude of Health Personnel; Dental Care; Dentists; Diabetes Mellitus; Drug Combinations; Drug Prescriptions; Drug Resistance, Bacterial; Education, Dental; Female; Heart Diseases; Hip Prosthesis; HIV Infections; Humans; Male; Metronidazole; Nigeria; Practice Patterns, Dentists'; Rheumatic Fever; Tetracycline; Tooth Discoloration

The epidemiology and etiology of spontaneous pneumothorax (SP) are shifting away from the predominance of subpleural bleb disease as emphasized by most reports since that of Kjaergaard (Sweden, 1932). We conducted a retrospective review of all patients admitted to a large urban hospital with the diagnosis of SP over the past 8 years. Of 120 patients, 32 had the acquired immunodeficiency syndrome (AIDS) (group 1, 26.6%), 43 patients had classic subpleural bleb disease or chronic obstructive pulmonary disease with blebs (group 2, 35.8%), and 45 patients had nonbleb disease exclusive of AIDS (group 3, 37.5%). These three groups were studied with respect to primary success rates with differing modalities of therapy. Bilateral SP occurred in 34% of group 1 patients, 2% of group 2 patients, and 11% of group 3 patients. The in-hospital mortality was 34% in group 1 compared with 2% in group 2 and 4% in group 3. Thirty-four percent of group 1 patients had recurrent SP compared with 16% of group 2 patients and 8% of group 3 patients. This report describes the changing etiology and epidemiology of SP in a large urban hospital from 1983 to 1991 and represents the largest single-institution report of AIDS-related pneumothorax. Standardized therapy was shown to have predictably favorable results in patients with bleb disease and nonbleb disease exclusive of AIDS. SP in patients with AIDS was associated with a high mortality rate and primary treatment failure; small-bore catheters and nondrainage therapies have a very limited role in these patients.

Topics: Acquired Immunodeficiency Syndrome; Catheterization; Chest Tubes; Humans; Lung Diseases; Lung Diseases, Obstructive; Oxygen Inhalation Therapy; Pleural Diseases; Pneumothorax; Punctures; Retrospective Studies; Suction; Tetracycline; Texas; Time Factors; Tissue Adhesions

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Administration, Topical; Adult; Anti-Inflammatory Agents; Humans; Hydrocortisone; Levamisole; Male; Middle Aged; Mouthwashes; Nystatin; Pentamidine; Stomatitis, Aphthous; Tetracycline; Triamcinolone; Zidovudine

This report describes persistent, painful oral ulcers that occurred in nine patients with the acquired immunodeficiency syndrome (AIDS). These ulcers resembled major aphthous ulcers in clinical appearance and response to therapy. They occurred less frequently in patients with AIDS than those caused by herpes simplex and were found in 4 of 346 (1.1%) patients with AIDS at one medical center. Lesions were typically painful. Identification and treatment with topical tetracycline and steroids led to resolution with relief of symptoms. Further study is necessary to understand the etiology and pathogenesis of these ulcers.

Topics: Acquired Immunodeficiency Syndrome; Carboxymethylcellulose Sodium; Female; Humans; Male; Stomatitis, Aphthous; Tetracycline; Triamcinolone Acetonide

Spontaneous pneumothorax is occurring in patients with the acquired immunodeficiency syndrome and Pneumocystis carinii infection with increasing frequency. These patients are typically poor surgical candidates. Conservative management using tetracycline sclerosis was performed with good results in a patient with acquired immunodeficiency syndrome and recurrent pneumothorax.

Topics: Acquired Immunodeficiency Syndrome; Adult; Chest Tubes; Humans; Instillation, Drug; Male; Pleura; Pneumonia, Pneumocystis; Pneumothorax; Sclerotherapy; Tetracycline

Topics: Acquired Immunodeficiency Syndrome; Adult; Bleomycin; Female; Humans; Intubation; Pneumonia, Pneumocystis; Pneumothorax; Sclerotherapy; Tetracycline

Topics: Acquired Immunodeficiency Syndrome; Animals; Antiviral Agents; Chick Embryo; Encephalomyelitis, Venezuelan Equine; Humans; Infectious Mononucleosis; Mice; Mycoplasma Infections; Tetracycline; Virus Diseases

Topics: Acquired Immunodeficiency Syndrome; Hemophilia A; Humans; Male; Middle Aged; Skin Diseases; Telangiectasis; Tetracycline

We identified Campylobacter jejuni infections in four patients infected with the human immunodeficiency virus (HIV); three had persistent and severe C. jejuni infections. Multiple isolates obtained from each patient had the same biochemical and serotypic characteristics, indicating recurrent infection rather than reinfection with unrelated strains. Serum antibody responses to C. jejuni group antigens by enzyme-linked immunosorbent assay were markedly impaired in the three patients with persistent infection compared with forty-two immunocompetent C. jejuni-infected controls and with the HIV-infected patient who readily cleared the organism. One patient was bacteremic; his blood isolate was killed by normal serum but was resistant to his own serum, whereas a simultaneous stool isolate of a different serotype was sensitive. Failure of two patients to eradicate the organism and long-term administration of erythromycin therapy led to the in-vivo development of resistance to this antibiotic, which is most frequently used to treat C. jejuni infections.

Topics: Acquired Immunodeficiency Syndrome; Adult; Aged; Antibodies, Bacterial; Campylobacter fetus; Campylobacter Infections; Diarrhea; Drug Resistance, Microbial; Erythromycin; Humans; Immunoglobulin A; Male; Recurrence; Tetracycline

In the absence of a cure or vaccine for acquired immune deficiency syndrome (AIDS) educational and social marketing efforts to reduce the transmission of Human T-lymphotropic type III/lymphadenopathy-associated virus (HTLV-III/LAV) are currently our best hope for controlling the disease. Since 1983, the Centers for Disease Control (CDC) has funded a series of research studies to determine whether education efforts can successfully motivate the adoption of key behaviors relevant to the control of a variety of sexually transmitted diseases (STDs). Analysis of the first two studies which are now completed, and preliminary data from a third study, have documented dramatic changes in behavior, knowledge, and attitudes among clients in inner-city public health clinics. The authors describe the principles and underlying assumptions that have guided the design of their STD initiatives, drawing special attention to the implications for AIDS health education efforts.. The results of a series of 3 research studies to determine whether education efforts can successfully motivate the adoption of key behaviors relevant to the control of a variety of sexually transmitted diseases (STDs) are reported, and some of the similarities and differences are examined between prevention efforts such as those reported, which are aimed at the more traditional STDs, and possible acquired immune deficiency syndrome (AIDS) risk-reduction strategies. With the important exceptions of condom promotion and sex partner notification/referral, the behavioral objectives focused the the 3 studies are unrelated to objectives one would target in an AIDS risk-reduction program. The fact that AIDS is both incurable and fatal distinguishes it from the other STDs. The serious attention directed to AIDS which has resulted is in marked contrast to the often cavalier attitude that many segments of the public take toward gonorrhea, syphillis, and other STDs for which there are cures. Another difference between AIDS risk-reduction and other STD prevention efforts is their location, i.e., most STD prevention efforts have occurred in clinics. For AIDS prevention messageses, educators must reach high-risk groups in the general public who have not been exposed yet or who have been exposed but are asymptomatic. Yet, despite the problems, with creativity and the thoughtful use of multiple channels of communications, AIDS prevention messages will be heard. Recent social marketing campaigns illustrate the range of creativity that can be brought to a community effort. It is particularly well suited for promoting condoms, whose use is critical to reducing HTLV-III/LAV transmission among both homsexuals and heterosexuals. Drama-based methods are especially relevant to AIDS risk-reduction efforts. They offer an excellent means of modeling the communication and interpersonal skills that are fundamental to the behavior changes sought. Drama-based videotapes, for example, would be especially useful for seropositive men and women who face exceptional stress as a consequence of learning their diagnosis. Clinic-based videotapes would be good resources for counselors of seropositive men who face the prospect of telling their diagnosis to wives and women friends who may never have suspected they would be at risk. Drama-based videotapes are not the only ways to create identification or motivate behavior change. Peer education, individual counseling, and social marke

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Contraceptive Devices, Male; Female; Gonorrhea; Health Education; Homosexuality; Humans; Male; Risk; Sexually Transmitted Diseases; Tetracycline; Videotape Recording