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Br Dent J. 2000 Jul 8;189(1):43-6.
A study of prophylactic antibiotic prescribing in National Health Service general dental practice in England.

Palmer NA, Pealing R, Ireland RS, Martin MV.

Department of Clinical Dental Sciences, University of Liverpool.

OBJECTIVE: To study the use of prophylactic antibiotics by general dental practitioners. DESIGN: A postal questionnaire of National Health Service (NHS) general dental practitioners in ten English Health Authorities. SUBJECTS: General dental practitioners (GDPs) (1544) contracted to provide NHS treatment in the Health Authorities of Liverpool, Wirral, Oxfordshire, Buckinghamshire, Nottingham, North Nottinghamshire, Sheffield, Newcastle, Northumberland and North Tyneside. MAIN OUTCOME MEASURES: The questionnaires were analysed and the responses to each question expressed as absolute frequencies. RESULTS: Responses to the questionnaires were received from 929 (60.1%) practitioners. Over 40% of general dental practitioners would prescribe prophylactic antibiotics for patients with no relevant medical history for minor oral surgery to prevent postoperative infection. Amoxicillin was the predominant choice of antibiotic in this situation. Between 15-67% of GDPs failed to prescribe prophylactic antibiotics for at risk medically compromised patients. GDPs also prescribed for patients with a medical history not known to be at risk from dental procedures. Over 50% of GDPs however, would seek specialist advice about prophylaxis if they were unsure of the indications and over 90% of GDPs indicated they would use the current recommended regime for antibiotic prophylaxis for patients at risk of infective endocarditis. CONCLUSIONS: The evidence from this study suggests that a significant number of the practitioners surveyed prescribe prophylactic antibiotics inappropriately, both for surgical procedures and for patients at risk from endocarditis. There is also evidence that practitioners prescribe antibiotic prophylaxis for clinical procedures and medical conditions for which there is little evidence. The results suggest that there is a need for the development of guidelines for practitioners on the appropriate prophylactic use of antibiotics.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10967824&dopt=Abstract




Rev Esp Quimioter. 1999 Dec;12(4):340-5.
[Relationship between antimicrobial susceptibility and virulence factors in Helicobacter pylori clinical isolates]

[Article in Spanish]

Damaso D, Alarcon T, Prieto N, Lopez-Brea M.

Servicio de Microbiologia, Hospital Universitario de la Princesa, Diego de Leon n(o) 62, 28006 Madrid.

The aim of this study was to determine the relationship between the antibiotic susceptibility and different virulence factors among Helicobacter pylori clinical isolates. One hundred and forty-five strains were isolated from biopsy cultures obtained from adult patients. Antimicrobial susceptibility to amoxicillin, clarithromycin, metronidazole and tetracycline were tested using an agar dilution method. cagA and iceA genes and s1 and s2 alleles of vacA were studied by polymerase chain reaction. A group of patients had been previously treated for H. pylori infection. We found a resistance rate of 28.7% and 16.5% to metronidazole and clarithromycin, respectively. We did not find any resistance to amoxicillin or tetracycline. The cagA gene and s1 allele were detected in 86.3% and 65.2% of the strains. One hundred and two (71.3%) strains were iceA+. cagA+ strains showed lower percentages of resistance to antibiotics, as did vacA s1 and iceA+ strains. The role of lower rates of resistance to clarithromycin and metronidazole in more virulent H. pylori strains may have favorable effects in their eradication in patients infected with these strains.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10855013&dopt=Abstract




Braz J Infect Dis. 1998 Feb;2(1):18-24.
Evaluation of the Antimicrobial Activity of Sparfloxacin, Relative to Other Oral Antibiotics Against 1,125 Bacterial Isolates from 10 Medical Centers in Brazil.

Mendes C, Sader H, Dainesi SM, Dias CG, Coscina A, Zoccoli C, da Silva JF, Magalhaes M, Teixeira LM, Souza HH, Oplustil CP, Andrade MG, Mimica L, Mimica I I.

University of Sao Paulo-FMUSP.

A multicenter study was carried out in order to compare the in vitro activity of sparfloxacin to ciprofloxacin, amoxicillin/clavulanic acid, cephalexin, cefuroxine and azithromycin, against 1,125 microorganisms recently isolated from clinical specimens, most of them representative of respiratory tract infections. Sparfloxacin demonstrated potent action and was more active than the beta-lactam agents and azithromycin against most of the bacterial strains tested. Sparfloxacin was more potent (96% and 95% sensitivity, with MIC(90) of 0.19microg/mL and 0.5microg/mL, respectively)than the other antimicrobial agents tested against the Enterobacteriaceae family (Escherichia coli and Elebsiella pneumoniae). It was found to be equivalent in activity to ciprofloxacin (96% and 91% sensitivity and MIC(90) of 0.25 and 0.75microg/mL, respectively). Sparfloxacin was also found to be very active against the most fastidious microorganisms commonly associated to respiratory tract infections such as the penicillin-susceptible and resistant Streptococcus pneumoniae (MIC(90) 0.5microg/mL and 0.38microg/mL, respectively), ampicillin-susceptible and -resistant Haemophilus influenzae (MIC(90) 0.016microg/mL and 0.38microg/mL, respectively), beta-lactamase producing Moraxella catarrhalis (MIC(90) 0.032microg/mL) and non beta-lactamase producing M.catarrhalis (MIC(90) 0.5microg/mL).

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11101907&dopt=Abstract [PubMed - as supplied by publisher]





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