trimethoprim--sulfamethoxazole-drug-combination and Pharyngitis

Seven-day courses of either 200 mg pivmecillinam plus 250 mg pivampicillin or co-trimoxazole (800 mg sulphamethoxazole plus 160 mg trimethoprim) given twice daily were compared in a multi-centre general practice study in 318 patients with signs and symptoms of upper or lower respiratory tract infection. Patients were stratified into four diagnostic groups (sinusitis, otitis media, throat infections, and acute bronchitis) and randomly allocated to treatment within these groups. Assessments at Day 7 showed that both treatments were equally effective clinically, 154 (91%) patients in the pivmecillinam plus pivampicillin group showing clinical cure or improvement and 142 (88%) patients in the co-trimoxazole group. Side-effects were reported by 19 (11.9%) patients in the pivmecillinam plus pivampicillin group and by 24 (15.8%) patients in the co-trimoxazole group. Two patients in the pivmecillinam plus pivampicillin group and 4 patients in the co-trimoxazole group stopped treatment.

Topics: Adolescent; Adult; Aged; Amdinocillin; Amdinocillin Pivoxil; Ampicillin; Anti-Infective Agents; Bronchitis; Child; Clinical Trials as Topic; Drug Combinations; Family Practice; Female; Humans; Male; Middle Aged; Otitis Media; Pharyngitis; Pivampicillin; Random Allocation; Respiratory Tract Infections; Sinusitis; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

We present a case of late acute myopia syndrome following discontinuation of treatment with a combination of sulphonamide drugs. To the best of our knowledge, this is the first reported case with such a presentation, and suggests that the pathophysiological basis for the acute myopia syndrome is a rapid decrease in serum carbonic anhydrase inhibitors levels which may lead to a rebound increase in the production of aqueous humor and accumulation of suprachoroidal fluid. It is further postulated that there may be a cumulative effect of sulphonamide drug use on carbonic anhydrase activity in the ciliary body epithelium of susceptible individuals.

Topics: Acute Disease; Adult; Anti-Infective Agents; Anticonvulsants; Drug Therapy, Combination; Female; Fructose; Humans; Intraocular Pressure; Migraine Disorders; Myopia; Pharyngitis; Topiramate; Trimethoprim, Sulfamethoxazole Drug Combination

A 24-year-old active duty soldier was evacuated from Afghanistan to the United States after persistent upper respiratory tract infection. His course was complicated by an exfoliative rash, diffuse muscle aches, and elevated creatine kinase following trimethoprim-sulfamethoxazole exposure that persisted despite withdrawal of the medication. Dermatomyositis was strongly considered, but the patient had a negative muscle biopsy and had positive serologies for acute Epstein-Barr virus infection. We present a case of acute Epstein-Barr virus infection and possible trimethoprim-sulfamethoxazole reaction mimicking dermatomyositis.

Topics: Afghan Campaign 2001-; Anti-Infective Agents; Creatine Kinase; Dermatomyositis; Diagnosis, Differential; Drug Eruptions; Exanthema; Humans; Infectious Mononucleosis; Male; Military Personnel; Myalgia; Pharyngitis; Rhabdomyolysis; Trimethoprim, Sulfamethoxazole Drug Combination; United States; Young Adult

Pharyngotonsillitis by β-hemolytic Streptococcus mostly affects children and immunocompromised, being Streptococcus pyogenes (Group A) the most common agent in bacterial pharyngotonsillitis.. This work targeted the research of β-hemolytic Streptococcus Group-A (SBHGA) and No-A (SBHGNA) in the oropharynx of individuals with special health needs from the APAE (Maceió-AL).. A prospective study with oropharynx samples from patients with Down syndrome and other mental disorders (test) and students from a private school (control) aged 5-15 years. Cultures in blood agar (5%) were identified through Gram/catalase tests and bacitracin/trimethoprim-sulfamethoxazole disk diffusion method, applying the chi-squared statistical analysis.. A total of 222 bacterial colonies were isolated in 74 individuals from APAE and 65 in the control group. In the test group, previous episodes of pharyngotonsillitis were reported by 36.49% (27/74) and 9.46% (7/74) were diagnosed with symptoms and/or signs suggestive of oropharynx infection. No positive sample of S. pyogenes was confirmed at APAE, being all samples classified as SBHGNA, with 5 SBHGA in the control group.. The early identification of β-hemolytic Streptococcus is important for the fast treatment of pharyngotonsillitis and the absence of S. pyogenes avoid future suppurative or not-suppurative sequels in the group from APAE.

Topics: Anti-Bacterial Agents; Case-Control Studies; Child; Disk Diffusion Antimicrobial Tests; Female; Humans; Intellectual Disability; Male; Pharyngitis; Prevalence; Prospective Studies; Streptococcal Infections; Streptococcus pyogenes; Tonsillitis; Trimethoprim, Sulfamethoxazole Drug Combination

It is aimed to detect the sensitivity and specificity of rapid antigen detection of group A beta hemolytic streptococci from throat specimen compared with throat culture. The other goal of the study is to help in giving clinical decisions in upper respiratory tract infections according to the age group, by detection of sensitivity and positive predictive values of the rapid tests and throat cultures.. Rapid antigen detection and throat culture results for group A beta hemolytic streptococci from outpatients attending to our university hospital between the first of November 2005 and 31st of December 2008 were evaluated retrospectively. Throat samples were obtained by swabs from the throat and transported in the Stuart medium and Quickvue Strep A [Quidel, San Diego, USA] cassette test was applied and for culture, specimen was inoculated on 5% blood sheep agar and identified according to bacitracin and trimethoprim-sulphametaxazole susceptibility from beta hemolytic colonies.. During the dates between the first of November 2005 and 31st of December 2008, from 453 patients both rapid antigen detection and throat culture were evaluated. Rapid antigen detection sensitivity and specificity were found to be 64.6% and 96.79%, respectively. The positive predictive value was 80.95% whereas negative predictive value was 92.82%. Kappa index was 0.91. When the results were evaluated according to the age groups, the sensitivity and the positive predictive value of rapid antigen detection in children were 70%, 90.3% and in adults 59.4%, 70.4%.. When bacterial infection is concerned to prevent unnecessary antibiotic use, rapid streptococcal antigen test (RSAT) is a reliable method to begin immediate treatment. To get the maximum sensitivity of RSAT, the specimen collection technique used and education of the health care workers is important. While giving clinical decision, it must be taken into consideration that the sensitivity and the positive predictive value of the RSAT is quite lower in adult age group than in pediatric age group.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antigens, Bacterial; Bacitracin; Bacteriological Techniques; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Middle Aged; Pharyngitis; Respiratory Tract Infections; Retrospective Studies; Sensitivity and Specificity; Streptococcal Infections; Streptococcus pyogenes; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Not only is Group A beta-hemolytic Streptococcus (GAS) the most frequent cause of bacterial pharyngitis, it is also the culprit in various skin and systemic infections, acute rheumatic fever, post streptococcal glomerulonephritis, and other disorders and complications. A new, ready-to-use media, Dio-Bacit, in a two section plate containing 5% sheep blood agar on one side and sheep blood agar with bacitracin (2 microg/ml) on the other was compared for its efficiency in identifying GAS with bacitracin and bacitracin + sulphamethaxazole / trimethoprim disk tests applied after isolation of beta-hemolytic colonies. We also used the latex-agglutination test as the gold standard method for differentiating GAS from streptococci belonging to other groups. Compared with the latex-agglutination test, we found the sensitivity and specificity of the Dio-Bacit method to be 92.0% and 96.9%, respectively. Dio-Bacit plates provide an easy and very useful way to identify GAS within one day, saving time, labor, and money for routine diagnostic microbiology laboratories.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents; Bacitracin; Bacteriological Techniques; Child; Culture Media; Female; Humans; Latex Fixation Tests; Male; Microbial Sensitivity Tests; Pharyngitis; Sensitivity and Specificity; Streptococcal Infections; Streptococcus pyogenes; Trimethoprim, Sulfamethoxazole Drug Combination

160 children with an average age of 9 years (range 6-15) affected by acute bacterial tonsillitis, were selected and assigned, following an open, parallel group design to: a) brodimoprim at the dose of 10 mg/kg on the first day, in single administration, and of 5 mg/kg on the following days; b) cotrimoxazole suspension, at the dosage of 6 mg of trimethoprim/kg/day, in two daily administrations; c) amoxicillin with clavulanic acid suspension (amoxi-clavulanate) 50 mg/kg every 12 hours. Quantity of pharynx and tonsillar exudate, pharynx pain, dysphonia and dysphagia were checked at the basal time, 3rd, 7th and at the last day of therapy. These symptoms were evaluated using a four-step rating scale. The evolution of body temperature was measured at two different times (1 and 5 o'clock p.m.), until the end of treatment, foreseen five days after disappearance of fever. Microbiological evaluation through a pharynx swab was performed at the beginning and at the end of therapy. Side-effects were registered during all the observation period. Lab-tests were carried out at the enrollment and at the end of treatment. The frequency and intensity of symptoms decreased significantly in all treatment groups. In comparison with amoxi-clavulanate, the brodimoprim group showed an earlier improvement (3rd day) of the clinical situation and a significantly better regression of pharynx exudate (p < 0.01), pharynx pain (p < 0.05) and dysphonia (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Child; Child, Preschool; Clavulanic Acids; Drug Therapy, Combination; Humans; Pharyngitis; Suspensions; Tonsillitis; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Blood Glucose; Bronchitis; Cough; Humans; Hypoglycemia; Pharyngitis; Trimethoprim, Sulfamethoxazole Drug Combination

The computerized outpatient records of the Harvard Community Health Plan, a 230,000-member health maintenance organization, were used to determine the frequency with which serum sickness is recognized in the practice setting after exposure to antibiotics. The medical records of 3,487 children who had been prescribed cefaclor or amoxicillin were searched in December 1986 for coded diagnoses of serum sickness and related conditions. Diagnoses were validated by blinded review of dictated and written office notes. There were 12 cases of serum sickness in 11,523 child-years. During this time, these children were prescribed 13,487 courses of amoxicillin, 5,597 courses of trimethoprim-sulfamethoxazole (TMP-SMZ), 3,553 courses of cefaclor, and 2,325 courses of penicillin V. Serum sickness was considered to be antibiotic-related if it occurred within 20 days of initiation of antibiotic therapy. Five cases were temporally associated with cefaclor, one with both amoxicillin and TMP-SMZ, four with TMP-SMZ alone, and one with penicillin V alone. One case was not associated with any antibiotic exposure. All antibiotic-related cases occurred in children under age 6 years who were treated for otitis media or streptococcal pharyngitis, and most cases began 7-11 days after initiation of antibiotic. All but one of the antibiotic-related cases occurred in children who had relatively heavy lifetime antibiotic exposure. The risk of serum sickness was significantly elevated after cefaclor compared with amoxicillin, even among the most heavily exposed children (relative risk = 14.8, p = 0.01, 95% confidence interval 2.0-352.0). Most cases prompted several physician visits, but none required hospitalization.

Topics: Adolescent; Amoxicillin; Cefaclor; Cephalexin; Child; Child, Preschool; Female; Health Maintenance Organizations; Humans; Incidence; Infant; Infant, Newborn; Information Systems; Male; Massachusetts; Otitis Media; Penicillin V; Pharyngitis; Seasons; Serum Sickness; Streptococcal Infections; Trimethoprim, Sulfamethoxazole Drug Combination

In January, February and March 1987, the frequency of Group A beta hemolytic streptococcus among 468 patients with acute tonsillopharyngitis who admitted to Dr. Sami Ulus Children's Hospital was % 41. Ten day procaine penicillin therapy was not successful in the % 29.5 patients. Cefadroxil (Duricef), clavulanic acid-amoxicillin combination (Augmentin) and erythromycin were tried in these patients. While the success rate of Duricef therapy was % 55, the results of other drug therapies were not been successful.

Topics: Acute Disease; Adolescent; Anti-Bacterial Agents; Cefadroxil; Child; Child, Preschool; Drug Combinations; Erythromycin; Female; Humans; Male; Penicillin G Procaine; Penicillin Resistance; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes; Sulfamethoxazole; Tonsillitis; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The relative frequency of pharyngeal gonococcal infection may be increased in certain prenatal populations. Therapy of penicillin-sensitive strains of Neisseria gonorrhoeae is associated with acceptable cure rates using aqueous procaine penicillin with probenecid. Infection of the oropharynx of pregnant women with penicillinase-producing strains is more problematic. The antibiotics normally used for the therapy of uncomplicated penicillinase-producing N gonorrhoeae infections, spectinomycin or cefoxitin, are not effective in the therapy of pharyngeal infection. Reported is the first case of penicillinase-producing N gonorrhoeae oropharyngeal infection during pregnancy. The patient was successfully treated with trimethoprim/sulfamethoxazole, and no maternal or neonatal morbidity was noted.

Topics: Adult; Anti-Bacterial Agents; Drug Combinations; Female; Gonorrhea; Humans; Infant, Newborn; Neisseria gonorrhoeae; Penicillinase; Pharyngitis; Pregnancy; Pregnancy Complications, Infectious; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

The bacteriologic detection of group A Streptococcus in pharyngitis is vital in everyday practice to prevent serious potential sequelae. The purposes of this study were to determine whether throat cultures should be incubated in anaerobic atmosphere and whether an increased recovery rate could be obtained by stabbing of the plates (partial anaerobiosis) and by using a sulfamethoxazole-trimethoprim disk to enhance growth and identification. We examined 243 throat cultures, in duplicate, which were incubated in room air and in anaerobiosis (carbon dioxide, 10%). We found that, in aerobic incubation, the recovery rate of group A streptococci was 5.7%; in anaerobic incubation it was 19.8%. Stabbing of the agar to create a partial anaerobiosis was useless. When directly placed on the plate, the sulfamethoxazole-trimethoprim disk facilitated the identification of beta-hemolysis areas. To achieve maximum detection of group A streptococci in specimens obtained from the throats of infected children, we found that anaerobic incubation should be used.

Topics: Anaerobiosis; Bacteriological Techniques; Child; Child, Preschool; Culture Media; Drug Combinations; Humans; Pharyngitis; Pharynx; Streptococcal Infections; Streptococcus pyogenes; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination