Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Clavulanic Acids”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 631 records · Page 35Linked to original sources

In vitro activity of ampicillin, amoxicillin, ampicillin-sulbactam, and amoxicillin-clavulanic acid against consecutive clinical isolates of Enterobacteriaceae.

Ampicillin was generally twice as active as amoxicillin against 2440 consecutive isolates of Enterobacteriaceae from five medical centers. When beta-lactamase inhibitors were added to the penicillins, there was a significant increase in susceptibility. The magnitude of the increased susceptibility to ampicillin-sulbactam (A-S) and amoxicillin-clavulanic (A-C) acid varied with the species and types of beta-lactamases elaborated. Although cross-susceptibility and cross-resistance between ampicillin and amoxicillin was nearly complete, major differences were documented between A-S and A-C with 6.7% of our consecutive isolates of Enterobacteriaceae. The clinical significance of these findings remains uncertain, but they may help explain some of the discrepancies occasionally observed by clinical microbiologists with the combination drugs.

Amoxicillin↗

[Cholestatic acute hepatitis induced by amoxycillin-clavulanic acid combination. Role of ursodeoxycholic acid in drug-induced cholestasis].

We report two cases of acute hepatotoxicity after treatment with amoxicillin-clavulanic. Viral hepatitis serology and autoantibodies were negative. Biliary tree obstruction and other etiologies were excluded. After discontinuation of the drug the evolution was favorable with clinical improvement and normalization of liver tests. Liver biopsy made in one patient showed cholestasic hepatitis with hepatocellular necrosis and other patient was treated with ursodeoxycholic. Also, we analyse potential utility of ursodeoxycholic acid administration in toxic cholestasis.

Aged↗

Treatment of urinary tract infections with a combination of amoxicillin and clavulanic acid.

A 10-day course of amoxicillin (250 mg)-potassium clavulanate (125 mg) was administered three times daily to 116 female college students with urinary tract infections. All of the bacterial isolates from these patients were susceptible to amoxicillin-potassium clavulanate in vitro; only 81.0% were susceptible to amoxicillin alone. Evaluations at 1 week after completion of this course showed that clinical and bacteriological cures had been achieved in 96.9% of those who completed therapy. Cures were sustained in 85.6% of the patients examined at 4 weeks after the end of therapy. Therapeutic responses were comparable, irrespective of the results of antibody-coated bacteria tests. All strains of Enterobacteriaceae isolated from the rectal and urogenital sites at 1 week after therapy were susceptible to amoxicillin-potassium clavulanate. The proportion of fecal Escherichia coli resistant to amoxicillin alone increased from 13.3% before therapy to 35.6% at 1 week after therapy. Adverse drug reactions consisted of gastrointestinal symptoms (9.8%) and rashes (4.1%). Sixteen patients (14.2%) developed symptomatic candida vaginitis by 1 week after therapy.

Amoxicillin↗

Characteristics of murine model of genital infection with Chlamydia trachomatis and effects of therapy with tetracyclines, amoxicillin-clavulanic acid, or azithromycin.

Following intravaginal inoculation of progesterone-treated outbred mice with Chlamydia trachomatis MoPn, 4 to 6 log10 inclusion-forming units were recovered in vaginal swabs for 21 days but all animals were culture negative after 28 days. Serum antibody titers were elevated and remained high for at least 70 days. Between 28 and 70 days, upper tract infection (inflammation and distension of the uterine horns, occlusion of oviducts with inflammatory exudate, pyosalpinx, and hydrosalpinx) was seen in > 80% of the animals. Mice were dosed orally, commencing at 7 days after infection, with minocycline, doxycycline, or amoxicillin-clavulanate. Further groups received azithromycin either as a single high dose or as lower once-daily doses. In addition, minocycline and amoxicillin-clavulanate were administered at 24 h after infection, and this early treatment prevented elevation of antibody titers whereas delayed therapy did not. Vaginal swabs from mice in all treatment regimens were culture negative except for 25% of mice receiving either early amoxicillin-clavulanate or low-dose azithromycin, which yielded low numbers (20 to 70 inclusion-forming units) of chlamydiae. Numbers of fertile mice in the early treatment regimens and their litter sizes were similar to those of noninfected controls, although 25% of amoxicillin-clavulanate-treated mice had unilateral hydrosalpinges. In comparison, 88% of untreated mice developed hydrosalpinges and only 25% conceived. Delayed dosing did not affect the outcome of amoxicillin-clavulanate therapy but did diminish the protective efficacy of minocycline such that 50% of treated mice had either unilateral hydrosalpinges or ovarian abscesses. Doxycycline and azithromycin were highly effective in restoring fertility. This model makes possible the study of both short- and long-term outcomes of chlamydial infection.

Amoxicillin↗

[Ambulatory treatment with cefuroxime-axetil of infectious bronchitis in patients sixty years of age or older: comparative study of the combination of amoxicillin and clavulanic acid].

The aim of this multicenter, prospective randomized trial was to compare the efficacy and safety of cefuroxime-axetil and amoxycillin/clavulanic acid for the treatment of infectious bronchitis in the elderly patient. Between January and April 1989, 157 out patients aged 60 years or more and presenting with infectious bronchitis were treated with either cefuroxime-axetil (250 mg bid), or the association amoxycillin/clavulanic acid (500 mg/125 mg bid). The two treatment groups were comparable at the time of inclusion; the mean age was 70 years, 82% of the patients were febrile, 75% presented purulent expectoration, 24% had a history of chronic bronchitis and 19% received symptomatic treatment was NSAIDs. The mean duration of treatment was 9 days. Clinical efficacy was assessed by the investigators. While fever and cough resolved similarly in the two groups, statistically fewer patients presented persistent purulent expectoration in the cefuroxime-axetil treatment group than in the group receiving amoxycillin/clavulanic acid (2% and 13%, respectively, p = 0.03). The proportion of patients who reported at least one side-effect was 3.6% in the cefuroxime-axetil treatment group against 21.6% of those who received the association (p = 0.006).

Acute Disease↗

Antibacterial characteristics of YTR 830, a sulfone beta-lactamase inhibitor, compared with those of clavulanic acid and sulbactam.

The antibacterial activity, binding to penicillin-binding proteins, and morphological changes effected by YTR 830, a sulfone beta-lactamase inhibitor, were studied in comparison with those of other beta-lactamase inhibitors. YTR 830 had very poor antibacterial activity, bound to PBP 2 of gram-negative organisms, and at the MIC caused rapid lysis of spheroplasts formed.

Bacteria↗

[Results of a multicenter study of an amoxicillin-clavulanic acid combination in sinusitis in children and adults].

Efficacy and safety of Augmentin were evaluated in 79 patients, 64 adults and 15 children, treated for sinusitis during a multicentric hospital trial. Pre-treatment meatal pus samples were examined for bacteriology: 37 of 39 strains (95%) isolated from adults were sensitive to Augmentin, and two beta-lactamase producing Haemophilus strains sensitive to Augmentin were isolated from the children. Adult dosage was usually 2 g per day as two divided doses over 8 to 10 days. Recovery was obtained at end of treatment in 92% of cases, side effects being reported in 56 patients, including 8 with benign digestive disorders. Usual dosage in children was 25 to 50 mg/kg/d over 8 to 10 days and treatment was effective in 13 cases. One child developed a skin rash, and there was no report of digestive disturbance.

Adolescent↗

Comparative activities of cefuroxime, amoxicillin-clavulanic acid, ciprofloxacin, enoxacin, and ofloxacin against aerobic and anaerobic bacteria isolated from bite wounds.

We studied the comparative in vitro activities of 10 oral antimicrobial agents against 147 aerobic and 61 anaerobic bacteria making up species in 13 genera (Staphylococcus aureus, streptococci, Eikenella corrodens, Pasteurella multocida, Haemophilus-Actinobacillus spp., M-5, EF-4, Moraxella spp., Flavobacterium IIb, Bacteroides melaninogenicus, Bacteroides spp., Fusobacterium spp., and Peptostreptococcus spp.) that were isolated from bite wounds. Cefuroxime was generally greater than fourfold more active than cephalexin and cefadroxil against all aerobic isolates, including Pasteurella multocida. The fluoroquinolones were highly active against most aerobic isolates but were less active against anaerobic isolates. Ciprofloxacin was generally more active than either enoxacin or ofloxacin. Discrepancies of greater than 30% in the interpretation of susceptibilities between break points suggested by the National Committee for Clinical Laboratory Standards and those related to oral dose peak levels (one-half to one-quarter of maximum achievable concentrations) were noted in 14% (18 of 130) of the instances.

Amoxicillin↗

[Amoxicillin in association with clavulanic acid in the treatment of urinary infection in children].

Fifty-eight paediatric patients aged one month to 14 years, who met the inclusion criteria for urinary infection, were studied. They were administered amox/clav at a dose of 21.9 +/- 2.96 (mean +/- SD) mg/kg/day for ten days. E. coli was isolated in 53 cases, P. mirabilis in two, K. pneumoniae in two and E. cloacae in one. Of the E. coli, 94.34% were sensitive to amox/clav, 67.92% were resistant to ampicillin, three cases showed intermediate sensitivity and the case of E. cloacae was resistant. These four patients were withdrawn from the study, and four more who did not come for follow-up. Of the 50 assessable patients, 94% were cured. Three days after completing the treatment, three patients (6%) still had a positive uroculture, although only one showed symptoms. Of the remaining 47, five cases (11%) presented bacteriological relapse in the culture made seven days later. Only 10% of the patients showed any type of gastrointestinal disturbances, and interruption of treatment was not necessary. The amox/clav combination, in view of its broad spectrum, easy administration by oral route and good tolerance, should be taken into account as a first choice treatment in urinary infections in paediatric patients of any age.

Amoxicillin↗

[Treatment of acute otitis media in infants using an amoxicillin-clavulanic acid formulation (in the form of an oral suspension for pediatric use)].

In a multicenter study, Augmentin pediatric suspension was given to 1,227 young children (3 months - 3 years) with otitis media seen in private practice. Patterns of otitis included first episodes, recurrences, and forms that had failed to respond to previous antimicrobial therapy. The study medication was given as a first-line treatment, on the basis of epidemiologic data, in a daily dose of 40 mg/kg for 7 to 10 days. In the 3 months to 3 years age group, two micro-organisms are prevalent, ie. Haemophilus influenzae, which is the most common agent and may produce beta-lactamases (10 to 18% of strains), and Streptococcus pneumoniae. Among our patients, the otitis-conjunctivitis syndrome caused by Haemophilus influenzae was fairly frequent (8.7% of cases). Clinical effectiveness as evaluated between D8 and D11 was good or very good in 91.2% of cases. Tolerance was satisfactory in 83% of patients. Side effects were uncommon and consisted primarily in gastrointestinal symptoms. We point out the potentially deleterious effect of concurrent anti-inflammatory treatment. Acceptability of the suspension was judged satisfactory by the parents in 91.6% of cases. Augmentin proved well-suited to epidemiologic data, outstandingly effective, well tolerated, and easy to use because of its presentation as a pediatric suspension; it is therefore an appropriate first-line drug in the common indication addressed in our study.

Acute Disease↗

[Antibiotic therapy of perforated appendicitis in children: comparison between the amoxicillin-clavulanic acid and the benzylpenicillin-netilmicin-metronidazole combinations].

In a multicentre trial we compared the clinical efficacy of amoxicillin/clavulanate used as a single-agent therapy with that of the three-agent combination usually prescribed in the post-operative period for appendicular peritonitis in children. Only bacteriologically documented peritoneal infections were included. Sixty-four patients were randomly distributed between two groups: Group A (29 cases) treated with amoxicillin/clavulanate, first administered iv (100 mg/kg/d), followed by conversion to the oral route (50 mg/kg/d) once the patient had been afebrile for 48 hours; Group B (35 cases) first treated by the iv route with benzylpenicillin (100,000 IU/kg/d) plus netilmicin (5 mg/kg/d) plus metronidazole (30 mg/kg/d), followed by conversion to the oral route for metronidazole (30 mg/kg/d). In both groups, the total duration of parenteral and oral treatment was not less than 5 days. One hundred and seventy nine bacterial strains were recovered from peritoneal fluid samples obtained during surgery; 86% of these were sensitive to amoxicillin/clavulanate. Clinical efficacy, assessed on the basis of time until return to normal temperature and gut transit and duration of hospitalization, was identical in both groups, with follow-up monitoring on day 30 showing recovery in all cases. Cure was obtained without any problems of infection in 25/29 patients in group A and in 34/35 patients in group B (non significant difference). Tolerance was excellent and identical in the two groups with the exception of three cases of thrombophlebitis which occurred in group B. The results of this study suggest that amoxicillin/clavulanate may be useful as single-agent therapy as a first-line curative treatment for appendicular peritonitis in children.

Adolescent↗

Impact of amoxicillin, associated or not with clavulanic acid, on pharyngeal colonization and selection of Streptococcus pneumoniae resistance in children under 5 years of age.

Among young children, pneumococcal nasopharyngeal colonization (NPC) rates of >90% have been described. The aim of our study was to assess the effect of amoxicillin exposure on the NPC. From Dec 2001 to Feb 2004, less than 5 years old children with respiratory symptoms and fever who were prescribed amoxicillin were eligible. Three nasopharyngeal swabs were taken: at the time of the initial visit (IV), 60 hours after amoxicillin discontinuation (end of treatment visit, ETV), and 4 weeks later (follow-up visit, FUV). One hundred and thirty four children were included. NPC was detected in 58.5%, 42.9% and 51% of <1, 1-2 and >2 years-old children respectively (NS). Vaccine serotypes (VS) or vaccine-related serotypes (VRS) were identified in 80%, 40% and 55% of <1-year-old, 1-2 year-old and >2-year-old children respectively (NS). The proportion of PNSSP was 60% in <1-year-old children, 43% in 1-2 year-old children and 40% in >2-year-old children (NS). 49 out of 134 (36.5%) children completed the three study visits. 51%, 22.4% and 46.9% of those were colonized at IV, ETV and FUV, respectively (p=0.007). The percentage of resistant SP was 28%, 45.5% and 8.7% (p=0.05) for penicillin. In children <1 year of age, a higher proportion of SP colonization, presence of VS and PNSSP was found. A downfall of NPC at the end of therapy was observed. NPC returned to baseline levels thanks to "de novo" colonization in half of the cases, a few weeks after.

Amoxicillin↗