virginiamycin and Pyoderma

This study was aimed to compare the clinical and antibacterial efficacy of fusidic acid 500 mg twice a day, per os, over 7.5 days) to pristinamycin 1 g twice a day, per os, over 10 days).. Patients aged over 18, suffering from a superficial pyoderma requiring antibiotherapy and having given their informed consent were enrolled in a controlled, multicentre, double blind double dummy, parallel groups study. From day 0 to day 10, the patients received the randomised treatment. Those who were cured at day 11 had a visit at day 25 without any treatment between day 11 and day 25. A swab was performed on days 0, 11 and 25. The two treatment groups were compared in terms of efficacy, safety and global cost.. 334 patients seen in dermatologic consultation were included in the study. 313 patients were analysed on an intent-to-treat basis. 158 received fusidic acid (FA) and 155 were treated with pristinamycin (P). At D11, 126 patients were cured in the FA group (79.7%) and 118 in the P group (76.1%) (p = 0.44). The bacteriological success rate was 85.2% in the FA group and 82.7 in the P group (p = 0.67). The recovery was confirmed in 92.6% of the FA patients and 90.4% of the P patients at D25 (p = 0.56). Digestive tolerance was better with fusidic acid than with pristinamycin. In economic terms, fusidic acid was cheaper than pristinamycin: 443 French francs in the FA group versus 545 FF in the P group.. Therefore we conclude that an oral course of 7.5 days with fusidic acid is an efficient and cheaper alternative to a treatment with pristinamycin over 10 days.

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Costs and Cost Analysis; Data Interpretation, Statistical; Double-Blind Method; Female; Fusidic Acid; Humans; Male; Middle Aged; Placebos; Pyoderma; Skin Diseases, Bacterial; Staphylococcal Skin Infections; Streptococcal Infections; Time Factors; Virginiamycin

Superficial pyoderma occurs frequently. Generally, the benign infection is caused by Staphylococcus aureus and/or a group A streptococci. The subject is controversial, but treatment usually is based on narrow-spectrum antibiotics active against both germs.. A multicentric, randomized, double-blind, double-placebo study was conducted to compare pristinamycin (1 g b.i.d.) with a reference antibiotic, oxacillin (1 g b.i.d.) for 10 days. Inclusion criteria were: both sexes, age 15-80 years, clinical diagnosis of superficial pyoderma (impetigo, wound infection within the last 15 days, furunculosis, carbuncle, perionyxis), informed consent. The general practitioner investigators (n = 52) were assisted by 9 dermatologist-coordinators. Clinical diagnosis was validated by a committee of experts at the end of the study after analyzes of the photos and bacteriological results obtained on samples taken at the practitioner's office on visit 1 (D0), visit 3 (D14 +/- 3) and visit 4 (D25 +/- 3). Successful treatment was defined by clinical, bacteriological and photographic efficacy at visit 3 (equivalence analysis: one-way 95 p. 100 confidence interval).. There were 293 included patients given pristinamycin (n = 151) or oxacillin (n = 142). Mean age of analyzed patients was 40 +/- 17 years. Diagnosis was confirmed in 255 patients in accordance with the protocol: furunculosis or carbuncle (n = 100), recently superinfected wound (n = 97), impetigo (n = 41), acute perionyxis (n = 17). Thirty-five patients (12 p. 100) were considered to have been wrongly included. The germs most often isolated were: Staphylococcus aureus (n = 126), group A streptococci (n = 13), group B streptococci (n = 5) and P. multocida (n = 3). At visit 3, the two treatments were found to be equivalent with a success rate of 86.7 p. 100 for pristinamycin and 89.8 p. 100 for oxacillin (CI [*9.97]). Tolerance was statistically comparable between the two treatments (27 to 32 percent minor side effects).. This study is the first performed in outpatients attended by general practitioners with diagnostic confirmation on both bacteriological and photographic evidence of superficial pyoderma. The results obtained demonstrate the good reliability of such studies although 12 p. 100 of the patients were wrongly included, a factor which should be taken into account for future studies. The efficacy and tolerance of pristinamycin were statistically equivalent to those of oxacillin for all the patients with superficial pyoderma. Nevertheless, the subgroup of patients with folliculitis gave rather heterogeneous bacteriology and therapeutic results.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Double-Blind Method; Drug Tolerance; Female; Humans; Male; Middle Aged; Oxacillin; Penicillins; Pyoderma; Virginiamycin

Topics: Anti-Bacterial Agents; Dexamethasone; Folliculitis; Furunculosis; Humans; Leg Ulcer; Ointments; Pyoderma; Skin Diseases, Infectious; Staphylococcal Infections; Virginiamycin

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Child; Child, Preschool; Dexamethasone; Drug Eruptions; Drug Synergism; Female; Humans; Intertrigo; Leg Ulcer; Lupus Erythematosus, Systemic; Male; Middle Aged; Nails, Ingrown; Polymyxins; Psoriasis; Pyoderma; Skin Diseases, Infectious; Virginiamycin; Vulvovaginitis

Topics: Anti-Bacterial Agents; Drug Resistance, Microbial; Drug Tolerance; Humans; Male; Middle Aged; Pyoderma; Staphylococcal Infections; Streptococcal Infections; Virginiamycin

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Child; Dexamethasone; Eczema; Eczema, Dyshidrotic; Erythema; Female; Humans; Keratosis; Male; Middle Aged; Ointments; Polymyxins; Pyoderma; Skin Diseases; Staphylococcal Infections; Virginiamycin

Topics: Anti-Bacterial Agents; Dermatitis; Drug Resistance, Microbial; Genetics, Microbial; Humans; In Vitro Techniques; Pyoderma; Staphylococcal Infections; Staphylococcus; Virginiamycin