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Biomedical subjects

A Strömberg

Publications and source records attributed to A Strömberg.

At least 37 records · Page 2Linked to original sources
PubMed1992

Empiric treatment of acute diarrheal disease with norfloxacin. A randomized, placebo-controlled study. Swedish Study Group.

OBJECTIVE: To evaluate the clinical and microbiologic efficacy and safety of norfloxacin for acute diarrhea. DESIGN: Double-blind, placebo-controlled, randomized clinical multicenter trial. SETTING: Six departments of infectious disease. PARTICIPANTS: Patients 12 years of age or older with a history of acute diarrhea lasting 5 or fewer days. Eighty-five percent of patients (511/598) were evaluable for efficacy. Of these evaluable patients, 70% had traveled abroad within the previous 6 weeks. INTERVENTIONS: Patients received either norfloxacin, 400 mg, or placebo twice daily for 5 days. MEASUREMENTS: Enteric pathogens were isolated in 51% of the evaluable patients: Campylobacter species in 29%, Salmonella species in 16%, Shigella species in 3.5%, and other pathogens in 2.6%. RESULTS: Norfloxacin had a favorable overall effect compared with placebo (cure rate, 63% compared with 51%; P = 0.003). There were statistically favorable effects in culture-positive patients, patients with salmonellosis, and severely ill patients but not in culture-negative patients or patients with campylobacteriosis or shigellosis. A significant difference was noted between norfloxacin and placebo in median time to cure among all evaluable patients (3 compared with 4 days, P = 0.02) and in patients with campylobacteriosis (3 compared with 5 days, P = 0.05) but not in patients. Culture-positive, but not culture-negative patients, in the norfloxacin group had significantly fewer loose stools per day compared with patients in the placebo group from day 2 onward (P less than or equal to 0.01). Norfloxacin was significantly less effective than placebo in eliminating Salmonella species on days 12 to 17 (18% compared with 49%, P = 0.006), whereas the opposite was true for Campylobacter species (70% compared with 50%, P = 0.03). In six of nine patients tested, norfloxacin-resistant Campylobacter species (MIC, greater than or equal to 32 micrograms/mL) appeared after norfloxacin treatment. CONCLUSION: Empiric treatment reduced the intensity and, to some extent, the duration of symptoms of acute diarrhea. The effect was restricted to patients who had bacterial enteropathogens or who were severely ill. The clinical usefulness of this treatment is limited by the fact that norfloxacin seems to delay the elimination of salmonella and to induce resistance in campylobacter.

Acute Disease↗
PubMed1992

Rapid emergence of quinolone resistance in Campylobacter jejuni in patients treated with norfloxacin.

15/60 subjects from one center, who all took part in a multicenter double-blind, placebo-controlled study to evaluate the effect of norfloxacin on acute enteritis, had norfloxacin sensitive strains of Campylobacter jejuni in pre-study stool specimens. Eight of the 15 subjects received active drug. In 3 of these 8, high-level quinolone resistant Campylobacter strains of the same serotype as in pre-treatment samples were isolated 4-90 days after the initiation of treatment.

Adult↗
PubMed1991

Outbreak of group A streptococcal bacteremia in Sweden: an epidemiologic and clinical study.

The nationwide incidence of group A streptococcal bacteremia in Sweden was 1.8 per 100,000 population in 1987. During the winter season 1988-1989, the reported cases rate doubled and then declined to the previous level. The peak was due to a type T1/M1 Streptococcus pyogenes strain associated with an increased case fatality rate (33% vs. 15% for other T types). The highest incidence rates were found in the age groups less than 12 months and greater than 70 years. Among a sample of 79 patients hospitalized in November or December 1988, a portal of entry, mainly cutaneous, was recognized in 89% of the patients and concomitant conditions in 67%. Among the clinical findings were signs of skin or soft tissue infection (41%), local or generalized pain (41%), vomiting or diarrhea (24%), cough (18%), and upper respiratory tract symptoms (12%). A fatal outcome was associated with high age, lower respiratory tract or unknown focus, leukopenia on admission, start of antibiotic therapy greater than 6 h after the patient's initial contact with a physician, and a rapid clinical course including multiple organ failure. Renewed awareness of the many facets of fulminant streptococcal infection represents one approach to minimize the case fatality rate.

Disease Outbreaks↗
PubMed1991

[Lung roentgen can be eliminated following uncomplicated pneumonia].

An overwhelming majority of the pulmonary X-rays carried out on patients five to six weeks after recovery from pneumonia reveal no changes. A retrospective study of a five year material shows that pulmonary X-ray after uncomplicated pneumonia is unnecessary if the patient is clinically recovered on his/her next visit to the doctor. This conclusion is independent of the result of possible SR examination.

Blood Sedimentation↗
PubMed1990

Ciprofloxacin treatment of murine typhus.

A 31-year-old woman developed fever, severe headache, myalgia and rash 3 weeks after a visit to Cyprus where she experienced insect bites in her bed. Treatment with ciprofloxacin resulted in a remarkable and rapid effect. Endemic typhus was proved by serology.

Adult↗
PubMed1988

Bacteriological and serological aspects of group A streptococcal pharyngotonsillitis caused by group A streptococci.

Several bacteriological and serological variables were studied in connection with a clinical treatment trial in 212 patients with group A streptococcal pharyngotonsillitis. Anaerobic incubation was not superior to incubation in 5% CO2 in air for the detection of group A streptococci. Saliva cultures were inferior to conventional throat cultures in detecting group A streptococci. No strains from patients with recurrences were found to be tolerant to penicillin. In several patients (all asymptomatic), group C and G streptococci were found in follow-up cultures. Group A streptococci serology was more often positive after two months than after one month, also in patients without recurrence.

Adolescent↗
PubMed1988

Human parvovirus B19 infection with severe anemia affecting mother and son.

Two patients, a 43-year-old mother and her 12-year-old son developed severe anemia after a disease with fever, myalgia, rash and gastrointestinal symptoms. The infectious proved to be caused by human parvovirus B19 (IgM antibody titer rises). Investigations revealed that both patients suffered from spherocytosis, apparently hereditary and not known before. This emphasizes the importance of thorough hematological investigations in patients showing symptoms resembling a viral disease when seen in connection with severe anemia in order to reveal underlying chronic hemolytic disease. In patients with these diseases transient aplastic crisis will give a much more pronounced anemia than in otherwise healthy individuals.

Adult↗
PubMed1988

Throat carrier rates of beta-hemolytic streptococci among healthy adults and children.

In order to investigate the carrier rate of beta-hemolytic streptococci throat cultures were obtained every third month from 382 asymptomatic adults and schoolchildren during a 2-year period, altogether 2226 samples. In addition, 300 asymptomatic 4-year-olds were sampled once. The carrier rate of beta-hemolytic streptococci was 19.4%; group A streptococci alone 5.0%. There was no season-dependent variation. In the 3 age groups the carrier rates of group A streptococci were 0.8%, 5.9%, and 11.3%, respectively, with the highest rate among the 4-year-olds. Some of the individuals that were sampled repeatedly seemed to be pharyngeal carriers of group A streptococci, while others never became carriers. Group A streptococci were found significantly more often among 4-year-olds not attending day-care centres compared to those attending such institutions. For group C and G streptococci the influence of age on carrier rates was not similar to that found for group A streptococci. Throat carriership of beta-hemolytic streptococci does not result in clinical infections.

Adolescent↗
PubMed1988

Five versus ten days treatment of group A streptococcal pharyngotonsillitis: a randomized controlled clinical trial with phenoxymethylpenicillin and cefadroxil.

216 patients aged greater than or equal to 7 years with febrile group A streptococcal pharyngotonsillitis were randomly assigned to 3 treatment groups receiving either phenoxymethylpenicillin for 5 days followed by placebo for 5 days, phenoxymethylpenicillin for 10 days, or cefadroxil for 10 days. 209 patients completed treatment, 70 subjects in each phenoxymethylpenicillin group and 69 in the cefadroxil group. Within 1 week after completion of the antibiotic treatment significantly more recurrences with the same T-type as the initial streptococcal strain occurred in the 5-day treatment group (27%) as compared with the two 10-day groups (6% and 3%, respectively). The cumulative rate of recurrences (irrespective of T-type) within 2 months from the start of therapy was 55% among patients treated with phenoxymethylpenicillin for 5 days, 24% among those treated for 10 days with this drug and 19% among patients receiving cefadroxil. Obviously, one important factor to avoid recurrence of group A streptococcal pharyngotonsillitis is the length of antibiotic treatment and, in our opinion, it is not advisable to change the current recommendation of 10 days treatment.

Adolescent↗
PubMed1987

Concentrations of phenoxymethylpenicillin and cefadroxil in tonsillar tissue and tonsillar surface fluid.

Thirty patients who underwent elective tonsillectomy were given phenoxymethylpenicillin (0.8 g) or cefadroxil (1 g) at different times before operation. The concentrations of the antibiotics were analysed in serum, tonsillar tissue, fluid from the surface of the tonsils, and mixed saliva. The concentrations in tonsillar tissue for both drugs were much lower than the corresponding serum concentrations. This apparently low tissue accessibility could be ascribed to the limited intracellular penetration of beta-lactam antibiotics. For both antibiotics the concentrations in the tonsillar surface fluid were higher than the levels in the tissue and well above the minimal inhibitory concentrations for streptococci. This was not due to antibiotics in saliva but probably a result of leakage from the interstitial fluid. Inability to reach active concentrations of phenoxymethylpenicillin or cefadroxil at the site of infection does not therefore seem to be a probable cause for relapse after treatment of streptococcal tonsillitis.

Adolescent↗