International journal of antimicrobial agents
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Int. J. Antimicrob. Agents · May 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparative analysis of azithromycin and ciprofloxacin in the treatment of chronic prostatitis caused by Chlamydia trachomatis.
A total of 89 patients, (>18 years), with symptoms of chronic prostatitis and inflammatory findings as well as the presence of Chlamydia trachomatis confirmed by DNA/RNA DIGENE hybridization method and/or by isolation, McCoy culture and Lugol stain in expressed prostatic secretion or in voided bladder urine collected immediately after prostatic massage, were examined. The patients were randomized to receive a total of 4.5 g of azithromycin for 3 weeks, given as a 3-day therapy of 1 x 500 mg weekly or ciprofloxacin 500 mg b.i.d. for 20 days. ⋯ Clinical and bacteriological efficacy were evaluated 4-6 weeks after the end of therapy. Significantly higher eradication (36/45: 17/44; P=0.0002) and a significantly higher clinical cure (31/45: 15/44; P=0.0021) were achieved in the group of patients treated with azithromycin than in the ciprofloxacin group.
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Int. J. Antimicrob. Agents · Feb 2003
ReviewVenomous snakes of Saudi Arabia and the Middle East: a keynote for travellers.
Geographically Saudi Arabia and the Middle East include Asian Turkey, Syria, Lebanon, Jordan, Israel, Palestine, the Arabian Peninsula, Iraq, Iran and the previous Southern Asiatic Soviet Republics. The snake fauna contains species in common with northern Africa, Europe and central Asia and towards the east there is infiltration of species characteristic of tropical Asia. A classification of the venomous snakes of this area together with their distribution in the different countries is presented. ⋯ Management of snake bite victims including first aid, treatment at the hospital, clues from signs and symptoms that can help in the identification of the causative snake and antivenom treatment is stressed. Traditional manipulations like local incision and suction, use of caustics, oxidizing agents and cryotherapy and the injudicious use of tourniquets are evaluated and criticized. Finally the preventive control of snake bites for travellers in areas infested with venomous snakes is presented and discussed.
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Bacillus anthracis infection can occur in three forms: cutaneous, gastrointestinal and inhalation depending on the mode of infection. Anthrax is a zoonotic disease but the inhalation form can also be used as a biological warfare agent. The recent mail spread outbreak of bioterrorism-related infections in the USA prompted the introduction of specific guidelines by the USA Centers for Disease Control and Prevention. ⋯ The same agents are also advocated for the treatment of inhalation anthrax. However, therapy with two or more antimicrobial agents that are predicted to be effective are recommended. Other agents with in vitro activity are also suggested for be use in conjunction with ciprofloxacin or doxycycline include rifampciin, vancomycin, imipenem, chloramphenicol, penicillin and ampicillin, clindamycin, and clarithromycin.
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Int. J. Antimicrob. Agents · Nov 2002
ReviewThe place of probiotics in human intestinal infections.
A number of studies have been carried out on the effect of several probiotic species on treatment and prevention of intestinal infections. The most commonly used microorganisms are lactic-acid producing bacteria such as lactobacilli and bifidobacteria belonging to the human normal microflora. In vitro and animal studies have shown that probiotic microorganisms interfere with the colonisation of Helicobacter pylori and of enteropathogenic microorganisms. ⋯ Clinically significant benefits of probiotics have been demonstrated in the treatment of rotavirus induced diarrhoea and of Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea (AAD). In patients suffering from inflammatory bowel disease, several probiotic strains have been shown to be as effective as traditional medication in preventing relapses. Standardised and well performed studies are needed to elucidate further the mechanisms of action and the clinical significance of probiotics.
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Prompt diagnosis and treatment with appropriate antimicrobial chemotherapy is of paramount importance to reduce morbidity and mortality associated with sepsis. Inflammatory markers currently in use, such as C-reactive protein (CRP) do not reliably differentiate between the systemic inflammatory response and sepsis. ⋯ In particular, serial measurements are useful in order to monitor response to therapy. Together with good clinical judgement and judicious use of antimicrobial agents, PCT should serve as a valuable adjunct in the diagnosis and management of sepsis.