zithromax and Hemorrhage

Topics: Azithromycin; Campylobacter Infections; Campylobacter jejuni; Enteritis; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Infant, Newborn; Rectal Diseases; Risk Assessment; Treatment Outcome

The purpose of the study was to compare the clinical response to two regimes of azithromycin use in the complex of non-surgical periodontal therapy. After initial periodontal therapy of chronic generalized periodontitis (CGP), 60 patients were randomly assigned to three groups. In group I patients underwent standard medical care; In group II - patients underwent standard medical care and azithromycin: 500 mg once per day, during 3 days; In group III: 500 mg once per day, during 7 days, followed by 500 mg once per week during 12 weeks. Clinical periodontal indices were recorded before treatment and after 1, 3, 6, and 12 months. In group I after 3 months of treatment the clinical effect was lost in 65% of patients. In group III after 12 months clinical effect persisted in 80% of cases. CGP exacerbations frequency was significantly lower in group III compared with group I (χ2=8,03; р=0,0046). The long-term azithromycin at the CGP results in significantly clinical benefit of 80% patients for at least one year and satisfactorily tolerated.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Chronic Periodontitis; Female; Hemorrhage; Humans; Male; Middle Aged; Periodontal Index; Periodontal Pocket; Treatment Outcome

COVID-19 became a widespread infectious disease in late 2019. Indonesia currently has the highest COVID-19 mortality rate in Asia, between 4-5 percent. Interestingly, COVID-19-associated coagulopathy characterized by an increase of several procoagulant factor levels, including fibrinogen and D-dimer, that has been associated with higher mortality and unfavorable outcomes. We report a case of a 30-year-old male admitted to the hospital with a profuse vomiting and worsening fever, cough and shortness of breath, and was diagnosed with COVID-19-associated coagulopathy. Seven days after admission, he became deteriorated with significant reduction of oxygen saturation and his coagulation parameter levels were increased with highly suspicion of pulmonary embolism. He was treated with azithromycin, isoprinosine, lopinavir, and fondaparinux with thromboprophylaxis dosage since admission. The role of increased fondaparinux dosage at the time of clinical deterioration was then followed by clinical improvement and reduced D-dimer level. Anticoagulant therapy, mainly with fondaparinux, showed a better prognosis in patients with markedly elevated D-Dimer. Fondaparinux needs to be monitored appropriately to prevent bleeding and adverse. The patient was discharged from the hospital in an improved condition and normal D-Dimer levels. There was no bleeding event nor other major side effects had been found in this case. The decision for increasing dose of anticoagulant may be determined on individual basis, considering risks, benefits, and also the most important is clinical findings.

Topics: Adult; Antiviral Agents; Azithromycin; Clinical Deterioration; COVID-19; COVID-19 Drug Treatment; Dose-Response Relationship, Drug; Drug Monitoring; Factor Xa Inhibitors; Fibrin Fibrinogen Degradation Products; Fondaparinux; Hemorrhage; Humans; Inosine Pranobex; Lopinavir; Male; Pulmonary Embolism; SARS-CoV-2; Thrombophilia; Treatment Outcome

Clarithromycin is a commonly prescribed antibiotic associated with higher levels of direct oral anticoagulants (DOACs) in the blood, with the potential to increase the risk of hemorrhage.. To assess the 30-day risk of a hospital admission with hemorrhage after coprescription of clarithromycin compared with azithromycin among older adults taking a DOAC.. This population-based, retrospective cohort study was conducted among adults of advanced age (mean [SD] age, 77.6 [7.2] years) who were newly coprescribed clarithromycin (n = 6592) vs azithromycin (n = 18 351) while taking a DOAC (dabigatran, apixaban, or rivaroxaban) in Ontario, Canada, from June 23, 2009, to December 31, 2016. Cox proportional hazards regression was used to examine the association between hemorrhage and antibiotic use (clarithromycin vs azithromycin). Statistical analysis was performed from December 23, 2019, to March 25, 2020.. Hospital admission with major hemorrhage (upper or lower gastrointestinal tract or intracranial). Outcomes were assessed within 30 days of a coprescription.. Among the 24 943 patients (12 493 women; mean [SD] age, 77.6 [7.2] years) in the study, rivaroxaban was the most commonly prescribed DOAC (9972 patients [40.0%]), followed by apixaban (7953 [31.9%]) and dabigatran (7018 [28.1%]). Coprescribing clarithromycin vs azithromycin with a DOAC was associated with a higher risk of a hospital admission with major hemorrhage (51 of 6592 patients [0.77%] taking clarithromycin vs 79 of 18 351 patients [0.43%] taking azithromycin; adjusted hazard ratio, 1.71 [95% CI, 1.20-2.45]; absolute risk difference, 0.34%). Results were consistent in multiple additional analyses.. This study suggests that, among adults of advanced age taking a DOAC, concurrent use of clarithromycin compared with azithromycin was associated with a small but statistically significantly greater 30-day risk of hospital admission with major hemorrhage.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Azithromycin; Clarithromycin; Dabigatran; Drug Interactions; Factor Xa Inhibitors; Female; Hemorrhage; Hospitalization; Humans; Male; Pyrazoles; Pyridones; Retrospective Studies; Risk Factors; Rivaroxaban

Ocular and parenteral application potentials of azithromycin-containing, non-phospholipid-based cationic nanosized emulsion in comparison to the phospholipid-based anionic and neutral-charged nanosized emulsions were investigated. Various physical, chemical, nonclinical toxicity and antimicrobial activity studies (mean droplet diameter, surface charge, creaming index, entrapment efficiency, accelerated, long-term and freeze-thaw cycling stabilities, TLC study, modified hen's egg chorioallantoic membrane (HET-CAM) test, in vitro hemolysis test, in vitro and in vivo myotoxicity, and in vitro antimicrobial activity) were conducted for assessing the potentials of these three types of emulsions. Following autoclave sterilization, all of these emulsions exhibited a nanometer range mean particle diameter (200 ± 29 to 434 ± 13 nm). While the anionic and cationic emulsions did show high negative (-34.2 ± 1.23 mV) and positive zeta potential (42.6 ± 1.45 mV) values, the neutral-charged emulsion did not. Even with 5 freeze-thaw cycles, the cationic emulsion remained stable whereas other two emulsions underwent phase-separation. The hen's egg chorioallantoic membrane test revealed an irritation score value that was higher for the anionic emulsion than for cationic or neutral-charged emulsion. A significantly higher % hemolysis value was also noticed for the anionic emulsion when compared to the % hemolysis value of cationic emulsion (ANOVA, P ‹ 0.05). However, all of the emulsions showed a lesser intracellular creatine kinase (CK) release/plasma CK level in comparison to the positive control (phenytoin) indicating their lesser myotoxicity at the injection site . When compared to anionic and neutral-charged emulsions, the possible controlled drug release from cationic emulsion delayed the in vitro antimicrobial action against H.influenzae and S.pneumoniae.

Topics: Administration, Ophthalmic; Animals; Anti-Bacterial Agents; Azithromycin; Chickens; Chorioallantoic Membrane; Creatine Kinase; Drug Stability; Emulsions; Erythrocytes; Haemophilus influenzae; Hemolysis; Hemorrhage; Infusions, Parenteral; Lipids; Male; Muscle, Skeletal; Poloxamer; Rats; Rats, Sprague-Dawley; Sheep; Streptococcus pneumoniae; Surface Properties

Topics: Adolescent; Anti-Bacterial Agents; Anti-Infective Agents; Azithromycin; Blister; Ciprofloxacin; Dexamethasone; Diagnosis, Differential; Drug Therapy, Combination; Glucocorticoids; Hemorrhage; Humans; Male; Otitis; Tympanic Membrane

Topics: Adolescent; Anti-Infective Agents; Azithromycin; Bronchoscopy; Ceftriaxone; Factor VIII; Hemophilia A; Hemorrhage; Humans; Lung Diseases; Male; Pulmonary Alveoli; Radiography; Sulfamethoxazole; Treatment Outcome; Trimethoprim

Azithromycin (AZM) is widely used for the treatment of respiratory infection. Macrolides are generally well tolerated and adverse reactions are extremely rare. A 78-year-old man was treated with AZM for upper respiratory infection in November 2007. He developed bloody sputum at 5 days after AZM administration. Chest X-ray and CT images revealed diffuse ground glass opacities in the bilateral lung fields. Bronchoalveolar lavage demonstrated bloody fluid. The clinical symptoms and CT image improved after the corticosteroid therapy. His past history revealed that he also developed similar clinical symptoms and radiological features after treatment with AZM for upper respiratory infection at another hospital in October 2006. At that time, his condition improved after the administration of corticosteroid under a diagnosis of interstitial lung disease of unknown etiology. Finally, we diagnosed recurrent alveolar hemorrhage caused by re-administration of AZM. This is apparently the first reported case of AZM-induced diffuse alveolar hemorrhage.

Topics: Aged; Anti-Bacterial Agents; Azithromycin; Hemorrhage; Humans; Lung Diseases; Male

Topics: Adult; Anti-Bacterial Agents; Antibodies, Bacterial; Azithromycin; Bronchoscopy; Ceftriaxone; Drug Therapy, Combination; Floxacillin; Hemorrhage; Humans; Leptospira; Leptospirosis; Lung Diseases; Male; Pneumonia, Bacterial; Radiography, Thoracic

A patient with mechanical heart valves developed bleeding, after the introduction of amiodarone and azithromycin. Though the anticoagulant effect could be neutralized, the patient succumbed to heart failure. Any new drug prescribed to patients on anticoagulant must be assessed for its potential for interaction and warrants frequent prothrombin time testing.

Topics: Amiodarone; Anticoagulants; Atrial Fibrillation; Azithromycin; Coumarins; Drug Interactions; Fatal Outcome; Female; Heart Valve Prosthesis Implantation; Hemorrhage; Humans; Middle Aged; Postoperative Complications; Respiratory Tract Infections