zithromax and Endophthalmitis

The purpose of this study was to assess presumptive sexually transmitted disease treatment on pregnancy outcome and HIV transmission.. In a randomized trial in Rakai District, Uganda, 2070 pregnant women received presumptive sexually transmitted disease treatment 1 time during pregnancy at varying gestations, and 1963 control mothers received iron/folate and referral for syphilis. Maternal-infant sexually transmitted disease/HIV and infant outcomes were assessed. Intent-to-treat analyses estimated adjusted rate ratios and 95% confidence intervals.. Sexually transmitted diseases were reduced: Trichomonas vaginalis (rate ratio, 0.28; 95% CI, 0.18%-0.49%), bacterial vaginosis (rate ratio, 0.78; 95% CI, 0.69-0.87), Neisseria gonorrhoeae /Chlamydia trachomatis (rate ratio, 0.43; 95% CI, 0.27-0.68), and infant ophthalmia (rate ratio, 0.37; 95% CI, 0.20-0.70). There were reduced rates of neonatal death (rate ratio, 0.83; 95% CI, 0.71-0.97), low birth weight (rate ratio, 0.68; 95% CI, 0.53-0.86), and preterm delivery (rate ratio, 0.77; 95% CI, 0.56-1.05); but there were no effects on maternal HIV acquisition or perinatal HIV transmission.. Reductions of maternal sexually transmitted disease improved pregnancy outcome but not maternal HIV acquisition or perinatal HIV transmission.

Topics: Azithromycin; Birth Weight; Cefixime; Drug Therapy, Combination; Endophthalmitis; Female; Folic Acid; HIV Infections; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Iron; Metronidazole; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications, Infectious; Sexually Transmitted Diseases; Uganda

We evaluated antibiotic resistance among intraocular isolates obtained from presumed endophthalmitis cases collected from 2009 through 2020 in the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study, the only ongoing nationwide surveillance study tracking in vitro resistance in ocular pathogens.. Presumed endophthalmitis isolates obtained from the aqueous humour and vitreous humour were collected from participating centres, and minimum inhibitory concentrations were determined and interpreted per Clinical and Laboratory Standards Institute methods and available breakpoints.. A total of 307 presumed endophthalmitis isolates (aqueous humour, n = 88; vitreous humour, n = 219) were obtained from 43 clinical sites, including 188 coagulase-negative staphylococci (CoNS), 61 Staphylococcus aureus, 31 Streptococcus pneumoniae, 14 Pseudomonas aeruginosa, and 13 Haemophilus influenzae isolates. Of the CoNS isolates, 47.9% (90/188) were methicillin resistant, 58.0% (109/188) were azithromycin resistant, and 46.3% (87/188) were ciprofloxacin resistant. Of the S. aureus isolates, 45.9% (28/61) were methicillin resistant, 57.4% (35/61) were azithromycin resistant, and 44.3% (27/61) were ciprofloxacin resistant. Multidrug resistance (MDR; i.e., resistance to ≥3 antibiotic classes) was prevalent among staphylococci, particularly methicillin-resistant strains, of which >70% exhibited MDR. Resistance among S. pneumoniae isolates was notable for azithromycin and penicillin, each 38.7% (12/31), and for polymyxin B among P. aeruginosa 100.0% (14/14), whereas no resistance was observed for H. influenzae isolates to the antibiotics tested.. In vitro antibiotic resistance was common among presumed endophthalmitis isolates collected in the ARMOR surveillance study. These data could inform antibiotic selection for infection prophylaxis and/or treatment of intraocular infections.

Topics: Anti-Bacterial Agents; Azithromycin; Bacteria; Ciprofloxacin; Drug Resistance, Microbial; Endophthalmitis; Haemophilus influenzae; Humans; Pseudomonas aeruginosa; Staphylococcus aureus; Streptococcus pneumoniae; Vitreous Body

Francolins ophthalmia is often caused by resistant conditional pathogenic bacteria. Conditional pathogenic Staphylococcus saprophyticus is a potential reservoir of macrolides antibiotics resistance gene. Baicalin has been reported as a potential agent to synergistically inhibit the replication of Staphylococcus. The objective of this study was to isolate the pathogen of the francolins ophthalmia, identify the antibiotic resistance profile of isolated S. saprophyticus, and investigate the effect of baicalin combined with azithromycin (Azm) against azithromycin resistant S. saprophyticus (ARSS). The ARSS was isolated and identified from francolins suffered from ophthalmia by phenotypic and molecular biology methods. The antibiotic resistance profile was identified by Kirby-Bauer method. Then the minimal inhibitory concentration (MIC) of Azm in absence and presence of a sub-inhibitory concentration baicalin/verapamil was determined to assess the effect that baicalin combined with Azm against ARSS. ARSS was isolated and identified from francolins experienced ophthalmia. The isolated ARSS was resistant to 11 among the 13 antibiotics that were tested. The synergistic effect of baicalin and Azm was noticed with a reduction rate varied from 2 to 128-fold. It appears from this study that S. saprophyticus can cause francolins ophthalmia and baicalin may be used as a natural agent resistance inhibitor for ARSS.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Drug Resistance, Microbial; Drug Synergism; Endophthalmitis; Flavonoids; Galliformes; Poultry Diseases; Staphylococcus saprophyticus

Although topical antibiotics have been used as antimicrobial prophylaxis after ocular surgery, recent studies have determined that intracameral cefuroxime at the end of surgery significantly reduce the risk to suffer an infection and suggest that the use of topical antibiotics in the prophylaxis of infectious postoperative endophthalmitis (IPOE) is controversial. Moreover, there is no evidence to confirm the higher effectiveness of topical ciprofloxacin, considered the standard of care, or topical azithromycin in preventing IPOE of cataract surgeries.. IPOE topical prophylaxis was performed with two different strategies: with azithromycin from January 1st, 2010 to December 31st, 2014 (group I) and with ciprofloxacin from January 1st, 2015 to January 31st, 2017 (group II). Patient characteristics and clinical signs and symptoms of IPOE from all consecutive cataract surgeries performed over a 7-year period were collected.. A total of 15,146 cataract surgeries were conducted; 10,756 in group I and 4,390 in group II. Two cases of IPOE in each group were diagnosed, showing a 0.019% and 0.046% rate respectively, with no statistically significance. IPOE cases were related with aging, systemic and ocular comorbidities or with a complicated cataract surgery.. The benefit of the application of topical antibiotics after cataract surgery is questionable when intracameral cefuroxime prophylaxis is performed and no better effectiveness with ciprofloxacin or azithromycin was observed.

Topics: Administration, Topical; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antibiotic Prophylaxis; Azithromycin; Cataract Extraction; Cefuroxime; Ciprofloxacin; Endophthalmitis; Eye Infections, Bacterial; Female; Humans; Male; Ophthalmic Solutions; Postoperative Complications

Topics: Administration, Intravenous; Anti-Bacterial Agents; Azithromycin; Bacteremia; Drug Therapy, Combination; Endophthalmitis; Female; Humans; Hypercholesterolemia; Hypertension; Middle Aged; Patient Transfer; Penicillin G; Risk Factors; Streptococcal Infections; Streptococcus pneumoniae; Treatment Outcome; Vancomycin; Vitrectomy

To describe the clinical and laboratory features of infectious crystalline keratopathy and endophthalmitis secondary to Mycobacterium abscessus in a patient with Stevens-Johnson syndrome.. Case report. A 19-year-old man with a history of Stevens-Johnson syndrome and multiple corneal transplants developed white crystalline corneal infiltrates.. Anterior chamber aspirate disclosed acid-fast bacilli. A repeat corneal transplant was performed and antibiotic therapy begun. Histopathology showed focal acute inflammation surrounding collections of acid-fast bacilli, which were speciated as M. abscessus.. M. abscessus is a cause of infectious crystalline keratopathy and endophthalmitis. Risk factors include ocular surface disease, corneal transplantation, and immunosuppressive therapy.

Topics: Adult; Amikacin; Anterior Chamber; Azithromycin; Corneal Diseases; Drug Therapy, Combination; Endophthalmitis; Eye Infections, Bacterial; Humans; Keratoplasty, Penetrating; Male; Mycobacterium; Mycobacterium Infections; Stevens-Johnson Syndrome; Vision, Monocular

A low nutrient culture medium was used to identify the pathogens in four cases of persisting ocular infection. Bacto R2A agar was used in addition to conventional liquid- and solid-phase media to culture pathogenic bacteria from one case of recurrent keratitis, one case of suture-related keratitis with endophthalmitis and two eyes (two patients) with post-operative endophthalmitis. In each case, a pathogen was identified solely with R2A agar after culture for 6 days. Species isolated were Pseudomonas aeruginosa (one), Propionibacterium acnes (two) and Staphylococcus aureus (one). Antibiotic therapy was tailored to conform to the sensitivity of the cultured organism in each case. The use of Bacto R2A low nutrient agar should be considered in culture negative eyes not showing clinical improvement, or for chronic cases where bacteria may have become adapted to more stringent ocular environments.

Topics: Aged; Amikacin; Anti-Bacterial Agents; Anti-Infective Agents; Azithromycin; Ciprofloxacin; Clarithromycin; Culture Media; Endophthalmitis; Eye Infections, Bacterial; Female; Humans; Keratitis; Male; Middle Aged; Propionibacterium acnes; Pseudomonas aeruginosa; Staphylococcus aureus; Vancomycin