zithromax and Skin-Diseases--Bacterial

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Azithromycin; Biological Availability; Child; Clarithromycin; Clinical Trials as Topic; Half-Life; Humans; Intestinal Absorption; Macrolides; Respiratory Tract Infections; Skin Diseases, Bacterial

Azithromycin (AZM) is a new macrolides antibiotic that has a 15-membered ring structure obtained by introducing methyl-substituted nitrogen into a 14-membered ring lactone of erythromycin(EM). This article reviewed and summarized the clinical studies in the treatment of skin and skin structure infections conducted in Japan and abroad of AZM.

Topics: Anti-Bacterial Agents; Azithromycin; Clinical Trials as Topic; Double-Blind Method; Humans; Multicenter Studies as Topic; Skin Diseases, Bacterial; Tissue Distribution; Treatment Outcome

We have recently completed a proof-of-concept trial showing that bacterial colonization decreased in women and newborns after the administration of azithromycin during labor. Here, we aim to assess the effect of the intervention on maternal and neonatal clinical infections.. This was a double-blind, placebo-controlled randomized trial. Gambian women in labor were given either an oral dose of azithromycin (2 g) or placebo. Follow-up was conducted for 8 weeks after delivery.. From April 2013 to April 2014, we recruited 829 mothers and their 830 newborns. Sixteen infants died during the follow-up period (8 per arm). No maternal deaths or serious adverse events related to the intervention were reported. Maternal infections were lower in the azithromycin group (3.6% vs 9.2%; relative risk [RR], 0.40; 95% confidence interval [CI], 0.22-0.71; P = .002), as was the prevalence of mastitis (1.4% vs 5.1%; RR, 0.29; 95% CI, 0.12-0.70; P = .005) and fever (1.9% vs 5.8%; RR, 0.33; 95% CI, 0.15-0.74; P = .006). Among newborns, the overall prevalence of infections was also lower in the azithromycin group (18.1% vs 23.8%; RR, 0.76; 95% CI, 0.58-0.99; P = .052) and there was a marked difference in prevalence of skin infections (3.1% vs 6.4%; RR, 0.49; 95% CI, 0.25-0.93; P = .034).. Azithromycin given to women in labor decreases infections in both women and newborns during the puerperal period. Larger studies designed to evaluate the effect of the intervention on severe morbidity and mortality are warranted.

Topics: Administration, Oral; Azithromycin; Bacterial Infections; Carrier State; Developing Countries; Double-Blind Method; Female; Fever of Unknown Origin; Gambia; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mastitis; Pneumococcal Infections; Pregnancy; Puerperal Infection; Skin Diseases, Bacterial; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus agalactiae

An open, randomized, multicentre study was undertaken to compare a three-day regimen of azithromycin with a seven-day course of dicloxacillin or flucloxacillin in the treatment of 118 children (aged 2-12 years) with clinically diagnosed acute skin and skin-structure infections. Sixty patients received a single daily dose of azithromycin of 10 mg/kg for three days, whilst 58 received a cloxacillin ester: either dicloxacillin (n = 49) at a daily dose of 12.5-25 mg/kg (depending on severity of infection); or flucloxacillin (n = 9) at 250-2000 mg/day (depending on age). Both cloxacillin esters were administered in four divided doses for seven days. Clinical, safety and, where possible, bacteriological assessments were made before therapy and after 3 to 5 and 7 to 10 days of treatment. A successful clinical response (cure and improvement) was recorded in 57 of 59 (97%) of evaluable azithromycin patients, and in 57 of 58 (98%) of cloxacillin ester patients. Eradication of the key pathogens was 31 of 34 (91%) and 34 of 35 (97%) for Staphylococcus aureus, and 5 of 5 and 4 of 4 for Streptococcus pyogenes in the azithromycin and cloxacillin ester groups, respectively. Both medications were well tolerated, with mild to moderate side-effects (abdominal pain and vomiting) occurring in two patients in each group, and laboratory abnormalities (elevated eosinophil count) in one patient in each group. There were no withdrawals from therapy. The results of this study suggest that azithromycin is as effective and as well tolerated as a cloxacillin ester antibiotic in the treatment of children with acute skin and skin-structure infections.

Topics: Azithromycin; Child; Child, Preschool; Dicloxacillin; Drug Administration Schedule; Erythromycin; Floxacillin; Humans; Skin Diseases, Bacterial; Staphylococcal Skin Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus pyogenes

The aim of this prospective, blinded, randomized study was to demonstrate the efficacy and safety of oral azithromycin and dicloxacillin in the treatment of adults with acute skin and skin-structure infections. Sixty-two patients were included in the intent-to-treat group and 60 were evaluable for analysis. Azithromycin was given as a 500 mg once-daily dose for three days and dicloxacillin as 250 mg qid for seven days. Isolated pathogens included primarily Staphylococcus aureus, Streptococcus spp., and coagulase-negative staphylococci. Clinical resolution was 83.3% in the azithromycin group and 83.9% in the dicloxacillin group, with bacteriological eradication of 90.0% in the azithromycin group and 87.1% in the dicloxacillin group. Persistence of infection was recorded in one patient in the dicloxacillin group and superinfection in one patient in the azithromycin group. Azithromycin appears to be a safe and effective antibiotic for the treatment of adult patients with acute skin and skin-structure infections.

Topics: Abscess; Acute Disease; Adolescent; Adult; Azithromycin; Dicloxacillin; Double-Blind Method; Drug Administration Schedule; Erythromycin; Female; Humans; Male; Middle Aged; Prospective Studies; Skin Diseases, Bacterial; Staphylococcal Skin Infections; Staphylococcus aureus; Streptococcus

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Ceftriaxone; Female; Gonorrhea; Humans; Immunocompromised Host; Neisseria gonorrhoeae; Skin Diseases, Bacterial; Systemic Inflammatory Response Syndrome

Topics: Adult; Azithromycin; Biopsy, Needle; Diagnosis, Differential; Diphtheria; Female; Humans; Immunohistochemistry; Leg Ulcer; Pyoderma Gangrenosum; Risk Assessment; Severity of Illness Index; Skin Diseases, Bacterial; Treatment Outcome

Topics: Abscess; Amikacin; Anti-Bacterial Agents; Arthroplasty, Replacement, Hip; Azithromycin; Drug Resistance, Multiple, Bacterial; Hip Joint; Humans; Male; Middle Aged; Minocycline; Mycobacterium chelonae; Mycobacterium Infections, Nontuberculous; Skin Diseases, Bacterial; Tigecycline

Antibiotic delivery via liposomal encapsulation represents a promising approach for the efficient topical treatment of skin infections. The present study aimed to investigate the potential of using different types of azithromycin (AZT)-loaded liposomes to locally treat skin infections caused by methicillin-resistant Staphylococcus aureus (MRSA) strains. Conventional liposomes (CLs), deformable liposomes (DLs), propylene glycol-containing liposomes (PGLs) and cationic liposomes (CATLs) encapsulating AZT were prepared, and their physical characteristics, drug release profiles, ex vivo skin penetration/deposition abilities, in vitro anti-MRSA activities (planktonic bacteria and biofilm) and cell biocompatibilities were assessed. The (phospho)lipid composition and presence of surfactant or propylene glycol affected the physical characteristics of the liposomes, the release profile of AZT, its deposition inside the skin, as well as in vitro antibacterial efficacy and tolerability with the skin cells. All the liposomes retained AZT inside the skin more efficiently than did the control and were biocompatible with keratinocytes and fibroblasts. CATLs, DLs and PGLs efficiently inhibited MRSA strain growth and were superior to free AZT in preventing biofilm formation, exhibiting minimal inhibitory concentrations and minimal biofilm inhibitory concentrations up to 32-fold lower than those of AZT solution, thus confirming their potential for improved topical treatment of MRSA-caused skin infections.

Topics: Administration, Cutaneous; Animals; Anti-Bacterial Agents; Azithromycin; Biofilms; Cell Line; Chemistry, Pharmaceutical; Drug Delivery Systems; Drug Liberation; Humans; Liposomes; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Propylene Glycol; Skin Absorption; Skin Diseases, Bacterial; Staphylococcal Infections; Swine

Topics: Abscess; Anti-Bacterial Agents; Azithromycin; Ethambutol; Female; Humans; Immunocompromised Host; Immunosuppressive Agents; Leg; Lung Diseases, Interstitial; Middle Aged; Mycobacterium avium-intracellulare Infection; Mycophenolic Acid; Polymyositis; Prednisone; Rifabutin; Skin Diseases, Bacterial

Virtually all pediatric cases of Neisseria gonorrhoeae originate from contact with an infected adult. A cutaneous abscess caused by N. gonorrhoeae in a child is extremely rare, especially outside the genital area. We report a case of a 22-month-old boy with a gonococcal cutaneous abscess on the abdominal wall and suggest that N. gonorrhoeae should be included in the differential diagnosis of skin and soft tissue infections in children.

Topics: Abdomen; Abscess; Anti-Bacterial Agents; Azithromycin; Burns; Ceftriaxone; Diagnostic Errors; Drug Therapy, Combination; Emergency Shelter; Environmental Exposure; Gonorrhea; Humans; Infant; Male; Neisseria gonorrhoeae; Skin Diseases, Bacterial; Spouse Abuse

Topics: Aged, 80 and over; Anti-Bacterial Agents; Arthritis, Rheumatoid; Azithromycin; Drug Therapy, Combination; Ethambutol; Female; Glucocorticoids; Humans; Immunocompromised Host; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Prednisone; Rifampin; Skin Diseases, Bacterial

Aboriginal children living in remote Australia experience high rates of bacterial infection such as trachoma, otitis media and streptococcal skin infection, which often progress to associated chronic diseases in later life.. In February, 1995, single dose azithromycin was given to 130 Aboriginal children with trachoma and their contacts. The impact of this program on respiratory and skin group A Streptococcus pyogenes carriage and infection was also monitored.. Immediately before treatment 90% of children had skin sores, 38% of sores had pus and 74% of sores with pus had group A Streptococcus (GAS). Overall 57% of children had GAS skin infections. At 2 to 3 weeks and 2 and 6 months after treatment, this proportion was 10, 32 and 51%, respectively. For the upper respiratory tract GAS recovery rates were 8% before treatment and 0, 11 and 15% at the 2- to 3-week, 2-month and 6-month posttreatment visits, respectively. Multiple types occurred concurrently in individuals, particularly after treatment. Identical types were sometimes recovered simultaneously from the upper respiratory tract and skin, suggesting that the high rates of acute rheumatic fever in this population in the absence of high rates of detectable throat GAS carriage could be related to high rates of skin GAS infection.. There is an urgent need for education, adequate housing, scabies eradication and improved hygiene to reduce skin trauma and subsequent GAS infection in this population. Clinical trials are needed to determine how these measures can best be integrated with the trachoma eradication program to maximize health outcomes.

Topics: Adolescent; Anti-Bacterial Agents; Australia; Azithromycin; Child; Child Welfare; Child, Preschool; Drug Administration Schedule; Female; Humans; Hygiene; Infant; Infant, Newborn; Male; Native Hawaiian or Other Pacific Islander; Respiratory Tract Infections; Skin Diseases, Bacterial; Streptococcal Infections; Streptococcus pyogenes; Treatment Outcome

The activities of HMR 3004 and HMR 3647 and comparator agents, especially macrolides, were determined by the agar dilution method against 262 aerobic and 120 anaerobic strains isolated from skin and soft tissue infections associated with human and animal bite wounds. HMR 3004 and HMR 3647 were active against almost all aerobic and fastidious facultative isolates (MIC at which 90% of the isolates are inhibited [MIC90], < or = 0.5 and 1 microg/ml, respectively) and against all anaerobes [Bacteroides tectum, Porphyromonas macacae (salivosa), Prevotella heparinolytica, Porphyromonas sp., Prevotella sp., and peptostreptococci] at < or = 0.25 and < or = 0.5 microg/ml, respectively, except Fusobacterium nucleatum (HMR 3004, MIC90 = 16 microg/ml; HMR 3647, MIC90 = 8 microg/ml) and other Fusobacterium species (MIC90, 1 and 2 microg/ml, respectively). In general, HMR 3004 and HMR 3647 were more active than any of the macrolides tested. Azithromycin was more active than clarithromycin against all Pasteurella species, including Pasteurella multocida subsp. multocida, Eikenella corrodens, and Fusobacterium species, while clarithromycin was more active than azithromycin against Corynebacterium species, Weeksella zoohelcum, B. tectum, and P. heparinolytica.

Topics: Animals; Anti-Bacterial Agents; Azithromycin; Bacteria, Aerobic; Bacteria, Anaerobic; Bites, Human; Clarithromycin; Erythromycin; Humans; Ketolides; Macrolides; Microbial Sensitivity Tests; Roxithromycin; Skin Diseases, Bacterial; Soft Tissue Infections; Wounds and Injuries

During the process of abscess formation, a myriad of changes are observed histologically that impede the penetration of antimicrobial agents into infection loci. A Staphylococcus aureus foreign body abscess, developed in rats, was employed to evaluate the penetration kinetics of azithromycin, roxithromycin and cephalexin at various stages of abscess development; the progressive patho-histological changes of abscess formation were also characterized in this model. In an early abscess (18 h post-challenge), azithromycin penetration into inflammatory fluid was enhanced (AUC of 351 vs 130 mg.h/kg) and residence prolonged relative to an inflammation control (half-life of 88 vs 27 h). In contrast, roxithromycin and cephalexin penetration into, and residence in, inflammatory fluid were unaltered in the early abscess. However, penetration into, and egress from, a mature abscess (ten days post-challenge) were impeded for all three antimicrobials (P < or = 0.03). The penetration kinetics of azithromycin into inflammatory fluid in an early abscess were independent of the dose regimen, but dependent on the total dose. The persistently high concentrations of azithromycin in inflammatory fluid within abscess were associated with the infiltration of phagocytic cells and encapsulation by fibrous tissue. These data are consistent with a phagocytic delivery mechanism for azithromycin, whereby the presence of high concentrations of azithromycin in inflammatory fluid are a consequence of augmented drug distribution via the release of accumulated intracellular drug from the infiltrating phagocytic cells and fibroblasts associated with abscess formation.

Topics: Abscess; Animals; Azithromycin; Cephalexin; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Administration Schedule; Erythromycin; Male; Mice; Mice, Inbred Strains; Rats; Roxithromycin; Skin Diseases, Bacterial; Staphylococcal Infections; Staphylococcus aureus; Time Factors