PubMed · 17012491
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Allison Taylor. 2006. Sinusitis.. https://doi.org/10.1542/pir.27-10-395
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BACKGROUND AND OBJECTIVE: This study investigated whether treating acute exacerbations of COPD (AE-COPD) with levofloxacin modifies the long-term outcome of COPD patients in comparison with standard antibiotic regimens. METHODS: A 6-month open-label clinical trial of AE-COPD patients compared the outcomes of treating with levofloxacin versus standard therapy (clarithromycin, cefuroxime, or amoxicillin/clavulanate) at recommended doses for 10 days. Several variables were analysed: pulse oximetry, FEV1, health-related quality of life, infection-free interval, number of exacerbations, hospitalizations due to an exacerbation and mortality. RESULTS: Of the 116 patients initially enrolled, completion or withdrawal information was available for 50 patients in the levofloxacin arm and 52 in the standard therapy arm. At the end of the study, there were no differences in mortality (17.8% vs. 22.9%, P = 0.53), number of exacerbations (33 vs. 41, P = 0.40), pulse oximetry (median 91.71% vs. 92.46%, P = 0.18), FEV1 (median 51.31% vs. 47.14%, P = 0.30), health-related quality of life (median 8.63 vs. 10.75, P = 0.94) and infection-free interval (median 112 vs. 101 days, P = 0.72), for the levofloxacin and standard therapy, respectively. However, 12 out of 33 (33.6%) exacerbations treated with levofloxacin required in-hospital management versus 27 out of 41 (65.8%) treated with standard therapy (P = 0.02). CONCLUSION: This preliminary study suggests that 10-day treatment of AE-COPD with levofloxacin is associated with a reduction in hospitalizations compared with standard antibiotics despite there being no significant benefit in other outcome variables.
BACKGROUND: The authors examine the role of dental disease and nonsurgical dental procedures in the incidence and duration of bacteremia in children. METHODS: The authors randomized a group of children to receive amoxicillin or a placebo before dental rehabilitation in an operating room setting. They collected eight blood draws at the following times: two minutes after intubation (draw 1); after dental restorations, pulp therapy and cleaning (draw 2); 10 minutes later (draw 3); and five draws during and after dental extractions (draws 4-8). The authors compared dental disease parameters and the type of dental procedures performed with the incidence and duration of bacteremia. RESULTS: The authors enrolled 100 children (aged 1-8 years) in the study. The incidence of bacteremia from draw 2 was 20 percent in the placebo group and 6 percent in the amoxicillin group (P = .07), and the incidence from draw 3 was 16 percent in the placebo group and zero percent in the amoxicillin group (P = .03). Subjects with higher gingival scores were more likely to have a bacteremia for draw 2 (P = .01). The authors found that subjects in the group with bacteremia for draw 3 had undergone more pulpotomies than did subjects in the group without bacteremia for draw 3 (3 +/- 2.5 standard deviation [SD] versus 1.5 +/- 1.6 SD, P = .04), while they found almost no differences for draw 2. CONCLUSIONS: This study suggests that gingival disease has an impact on bacteremia after dental restorations and prophylaxis. Although antibiotics have an impact, they do not eliminate bacteremia altogether.
A technique based on multisyringe chromatography (MSC) was developed to determine three beta-lactamic antibiotics. Amoxicillin (AMOXI), ampicillin (AMPI) and cephalexin (CEPHA) were analyzed using a system with a very simple design and very low-cost equipment consisting of a multisyringe module, three low-pressure solenoid valves, a monolithic Chromolith Flash RP-18e column and a diode array spectrophotometric detector monitoring at 250 nm. Mobile phases containing methanol:acetic acid (0.1 M)-sodium acetate (0.1 M), pH 6.2, were tested for various ratios of methanol:acetic acid-sodium acetate, but a ratio of 10:90 gave optimum results with a flow rate of 2 ml min(-1). Validation parameters were evaluated for amoxicillin. The response to amoxicillin was linear over the range 0.04-0.4 mg/mL, with a correlation coefficient of 0.9996; precisions, evaluated as the repeatability for 0.04, 0.16 and 0.4 mg/mL amoxicillin, were 0.6%, 0.1% and 0.6%, respectively. Recovery from a generic formulation of amoxicillin was evaluated. The method showed selectivity in the presence of excipients commonly used in capsules, and satisfactory specificity was observed for amoxicillin and hydrolytic degradation products. The linearity was also evaluated for cephalexin and ampicillin. The conditions selected for MSC separation were compared with those for a HPLC system, and similar results were obtained in terms of chromatographic parameters but a difference in retention times was observed.