Amoxicillin, a well-known antibiotic, has a broad spectrum against gram-negative and gram-positive bacteria. This experiment was conducted in order to investigate the effect of micronized and non-micronized amoxicillin prepared using different comminution techniques on change in blood concentration of rats. Forty adult male Sprague Dawley rats (6~7 weeks of age, body weight 128.3 +/- 10.7 g) were randomly allocated to two treatment groups: micronized amoxicillin (MA) group treated with micronized amoxicillin trihydrate powder (particle size, over 90% of 10 microm), non-micronized amoxicillin (NMA) group treated with non-micronized amoxicillin trihydrate powder (particle size, over 70% of 100 microm), given 480 mg/kg body weight once daily for four days. The results showed a significant increase in serum concentration in the MA group on days 3 and 4, compared to the NMA group (P<0.05). In particular, serum concentration of the MA group on day 4 was increased almost two times that of the NMA group. The results indicate that due to the increase of the drug's oral bioavailability, higher serum concentration would be achieved with the micronized amoxicillin trihydrate than with the non-micronized drug.
Administration, Oral ; Adult ; Amoxicillin ; Animals ; Biological Availability ; Body Weight ; Gram-Positive Bacteria ; Humans ; Male ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the efficacy of esomeprazole-based 1 week or 2 weeks triple therapy for Helicobactor pylori (H. pylori) infection in children.

METHODSOne hundred and five children with H. pylori infection identified by 13C-UBT were randomly assigned into Group A (n=60) and Group B (n=45). The patients of the two groups were administered with 1 week or 2 weeks triple therapy consisting of esomeprazole, clarithromycin and amoxillin, respectively. They were followed up four weeks after drug withdrawal.

RESULTSRecurrent abdominal pain was relieved in all of patients. Fifty-five patients (91.7%) showed 13C-UBT negative in Group A and 42 (93.3%) presented negative in Group B. There was no significant difference in the eradication rate of H. pylori.

CONCLUSIONSEsomeprazole-based triple therapy for H. pylori infection is effective in children. The efficacy of esomeprazole-based 1 week or 2 weeks triple therapy for this disorder does not appear to be different.

Adolescent ; Amoxicillin ; administration & dosage ; Anti-Bacterial Agents ; adverse effects ; Anti-Ulcer Agents ; administration & dosage ; Child ; Child, Preschool ; Clarithromycin ; administration & dosage ; Drug Therapy, Combination ; Esomeprazole ; administration & dosage ; Female ; Helicobacter Infections ; drug therapy ; Helicobacter pylori ; Humans ; Male

OBJECTIVETo evaluate the clinical effect of proton pump inhibitor-based triple therapy combined with Saccharomyces boulardii in the treatment of Helicobacter pylori (Hp) infection among children in terms of Hp eradication rate and incidence of adverse events.

METHODSA prospective randomised controlled study was conducted on 240 children with a confirmed diagnosis of Hp infection. These patients were randomized into triple therapy (n=120) and probiotics groups (n=120). The triple therapy group received amoxicillin [40 mg/(kg·d), Tid], clarithromycin [15 mg/(kg·d), Bid] and omeprazole [0.7-0.8 mg/(kg·d), Qd], while the probiotics group received Saccharomyces boulardii (250 mg, Bid) in addition to triple therapy. The course of treatment was 14 days in both groups. The adverse events in subjects were recorded by their parents during treatment. Hp eradiation was evaluated by (13)C breath test at 4 weeks after treatment, and the eradication rate and incidence of adverse events were compared between the two groups.

RESULTSThe Hp eradication rates were 75.8% (91/120) in the triple therapy group and 85% (102/120) in the probiotics group (P>0.05). Compared with the triple therapy group, the probiotics group had nonsignificantly lower incidence of nausea, vomiting, and abdominal pain (P>0.05) and significantly lower incidence of stomatitis, constipation and diarrhea (P<0.05).

CONCLUSIONSTriple therapy combined with Saccharomyces boulardii cannot significantly increase Hp eradication rate, but can significantly reduce the incidence of stomatitis, constipation, and diarrhea during treatment.

Amoxicillin ; administration & dosage ; Child ; Child, Preschool ; Clarithromycin ; administration & dosage ; Combined Modality Therapy ; Drug Therapy, Combination ; Female ; Helicobacter Infections ; therapy ; Helicobacter pylori ; Humans ; Male ; Omeprazole ; administration & dosage ; Probiotics ; administration & dosage ; Prospective Studies ; Saccharomyces

BACKGROUND/AIMS: Bismuth-containing quadruple and moxifloxacin-based triple regimens are recommended as second-line therapy for Helicobacter pylori infection. The aim of this study was to compare the efficacy of each regimen. METHODS: From August 2004 to October 2012, a total of 949 patients (mean age, 54.32+/-12.08 years; male, 49.4%) who failed H. pylori eradication with a standard triple regimen were included. Patients treated with a bismuth-containing quadruple regimen for 7 and 14 days were designated as 7-BMT and 14-BMT, respectively, and those treated with a moxifloxacin-based triple regimen for 7 and 14 days were designated as 7-MA and 14-MA, respectively. H. pylori eradication was confirmed using the 13C-urea breath test, rapid urease test or histology. RESULTS: The eradication rates by 7-BMT, 14-BMT, 7-MA, and 14-MA were 66.4% (290/437), 71.1% (113/159), 53.1% (51/96), and 73.5% (189/257), respectively, by intention-to-treat analysis (ITT) and 76.5% (284/371), 83.8% (109/130), 55.6% (50/90), and 80.6% (187/232), respectively, by per-protocol analysis (PP). The eradication rates were higher in 14-BMT than 7-BMT by the ITT and PP analyses (p=0.277 and p=0.082, respectively). The 14-BMT and 14-MA treatments showed similar efficacies by ITT and PP (p=0.583 and p=0.443, respectively). CONCLUSIONS: The 7-BMT, 14-BMT, and 14-MA treatments showed similar and suboptimal efficacies. In both regimens, extending the duration of treatment may be reasonable considering the high level of antibiotic resistance in Korea.
Adult ; Aged ; Amoxicillin/administration & dosage ; Antacids/*administration & dosage ; Anti-Infective Agents/*administration & dosage ; Bismuth/*administration & dosage ; Drug Administration Schedule ; Drug Therapy, Combination/methods ; Female ; Fluoroquinolones/*administration & dosage ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Humans ; Intention to Treat Analysis ; Male ; Metronidazole/administration & dosage ; Middle Aged ; Proton Pump Inhibitors/administration & dosage ; Retrospective Studies ; Tetracycline/administration & dosage ; Treatment Outcome

Triple therapy with bismuth subsalicylate, amoxicillin, metronidazole (BAM) or with omeprazole, amoxicillin, clarithromycin (OAC) has been commonly used for the eradication of Helicobacter pylori infection. We compared the efficacy of these triple therapies in children with H. pylori infection. We retrospectively analyzed results in 233 children with H. pylori infection and treated with OAC (n=141) or BAM (n=92). Overall eradication rates of triple therapy with OAC and BAM were 74% and 85%, respectively, which showed no statistical difference. Our study showed that the triple therapy with BAM was more effective for the first-line eradication of H. pylori infection in Korean children, but has no statistical difference with OAC regimen.
Treatment Outcome ; Salicylates/*administration & dosage ; Retrospective Studies ; Organometallic Compounds/*administration & dosage ; Omeprazole/*administration & dosage ; Metronidazole/*administration & dosage ; Male ; Humans ; Helicobacter pylori/*drug effects ; Helicobacter Infections/*drug therapy ; Female ; Drug Combinations ; Clarithromycin/*administration & dosage ; Child, Preschool ; Child ; Bismuth/*administration & dosage ; Anti-Bacterial Agents/administration & dosage ; Amoxicillin/*administration & dosage ; Adolescent

Triple therapy with bismuth subsalicylate, amoxicillin, metronidazole (BAM) or with omeprazole, amoxicillin, clarithromycin (OAC) has been commonly used for the eradication of Helicobacter pylori infection. We compared the efficacy of these triple therapies in children with H. pylori infection. We retrospectively analyzed results in 233 children with H. pylori infection and treated with OAC (n=141) or BAM (n=92). Overall eradication rates of triple therapy with OAC and BAM were 74% and 85%, respectively, which showed no statistical difference. Our study showed that the triple therapy with BAM was more effective for the first-line eradication of H. pylori infection in Korean children, but has no statistical difference with OAC regimen.
Treatment Outcome ; Salicylates/*administration & dosage ; Retrospective Studies ; Organometallic Compounds/*administration & dosage ; Omeprazole/*administration & dosage ; Metronidazole/*administration & dosage ; Male ; Humans ; Helicobacter pylori/*drug effects ; Helicobacter Infections/*drug therapy ; Female ; Drug Combinations ; Clarithromycin/*administration & dosage ; Child, Preschool ; Child ; Bismuth/*administration & dosage ; Anti-Bacterial Agents/administration & dosage ; Amoxicillin/*administration & dosage ; Adolescent

A urinary tract infection (UTI) is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. The incidence of UTIs in adult males aged under 50 years is low, with adult women being 30 times more likely than men to develop a UTI. Appropriate classification of UTI into simple or complicated forms guides its management and the ORENUC classification can be used. Diagnosis of a UTI is based on a focused history, with appropriate investigations depending on individual risk factors. Simple uncomplicated cystitis responds very well to oral antibiotics, but complicated UTIs may require early imaging, and referral to the emergency department or hospitalisation to prevent urosepsis may be warranted. Escherichia coli remains the predominant uropathogen in acute community-acquired uncomplicated UTIs and amoxicillin-clavulanate is useful as a first-line antibiotic. Family physicians are capable of managing most UTIs if guided by appropriate history, investigations and appropriate antibiotics to achieve good outcomes and minimise antibiotic resistance.
Adult ; Aged ; Amoxicillin ; administration & dosage ; Amoxicillin-Potassium Clavulanate Combination ; Anti-Bacterial Agents ; Clavulanic Acid ; administration & dosage ; Cystitis ; drug therapy ; Drug Resistance, Microbial ; Escherichia coli ; Escherichia coli Infections ; drug therapy ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Primary Health Care ; Risk Factors ; Urinary Tract Infections ; drug therapy ; epidemiology

The aim of this study was to evaluate the efficacy of levofloxacin and rifaximin based quadruple regimen as first-line treatment for Helicobacter pylori infection. A prospectively randomized, double-blinded, parallel group, comparative study was performed. Three hundred consecutive H. pylori positive patients were randomized to receive: omeprazole, amoxicillin, clarithromycin (OAC); omeprazole, amoxicillin, levofloxacin (OAL); and omeprazole, amoxicillin, levofloxacin, rifaximin (OAL-R). The eradication rates in the intention to treat (ITT) and per protocol (PP) analyses were: OAC, 77.8% and 85.6%; OAL, 65.3% and 73.6%; and OAL-R, 74.5% and 80.2%. The eradication rate achieved with OAC was higher than with OAL on the ITT (P = 0.05) and PP analysis (P = 0.04). OAL-R regimen was not inferior to OAC. The frequency of moderate to severe adverse effects was significantly higher in OAC treatment group. Especially, diarrhea was most common complaint, and there was a significantly low rate of moderate to severe diarrhea with the rifaximin containing regimen. In conclusion, the levofloxacin and rifaximin based regimen comes up to the standard triple therapy, but has a limited efficacy in a Korean cohort. The rifaximin containing regimen has a very high safety profile for H. pylori eradication therapy.
Adult ; Aged ; Amoxicillin/administration & dosage ; Anti-Bacterial Agents/*administration & dosage ; Clarithromycin/administration & dosage ; Diarrhea/chemically induced ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Helicobacter Infections/complications/*drug therapy ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Ofloxacin/*administration & dosage ; Omeprazole/administration & dosage ; Peptic Ulcer/complications/*drug therapy ; Prospective Studies ; Rifamycins/*administration & dosage

OBJECTIVEHelicobacter pylori (Hp) infection presents high prevalence in the world, but there are few pediatric assays evaluating antimicrobial treatment using a short regimen of triple therapy. To evaluate the eradication rate and long term therapeutic effect of a triple therapy consisted of omeperazole, clarithromycin (CLA) and amoxycillin (AMO) on Hp infection, the authors explored the alternative therapeutic programs and their effects after first therapeutic failure.

METHODSA total of 192 children with Hp infection were divided into two groups: 157 children were given the triple therapy for one week (CLA group); 35 children were given another triple therapy composed of omeperazole, metronidazole (MET) and AMO for two weeks (MET group). All of the children were followed up for 1 - 36 months after the therapies ended. Twenty-two children in whom Hp was eradicated with CLA triple therapy were followed up for 3 years. The children of the two groups who had therapeutic failure were given re-treatment as follows. CLA triple therapy was given for one week to the children who had failure after MET triple therapy; increased doses of CLA with longer treatment course was given to the children who had failure after CLA triple therapy. A tetra therapy consisted of omeperazole, colloidal bismuth subcitrate (CBS), furazolidone (FUR) and AMO was given to the children in whom the re-treatment failed.

RESULTSThe Hp eradication and ulcer recovery rate of CLA group was 90.4% (142/157) and 96.9% (32/33), respectively; the Hp eradication rate of MET group was 77% (27/35). There was significant difference between eradication rates of the two groups (chi(2) = 4.69, P < 0.05). The recurrence rate of 22 Hp eradicated children treated with CLA triple therapy was 4.5% (1/22) during the 3-year follow-up. The eradication rate of the three re-treatment programs for 29 children was 75% (6/8), 77% (11/15) and 100% (6/6), respectively.

CONCLUSION(1) Omeperazole, CLA and AMO triple therapy for one week was the best to eradicate Hp infection with high eradication rate, few side effects, short period of treatment, good compliance and low recurrence rate. (2) Proper increase of CLA dose and longer therapeutic course may increase the eradication rate. Omeperazole, CBA, FUR and AMO tetra therapeutic program may be used as an alternative treatment in patients who develop resistance to CLA triple therapy.

Adolescent ; Amoxicillin ; administration & dosage ; therapeutic use ; Anti-Ulcer Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Clarithromycin ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; administration & dosage ; therapeutic use ; Female ; Follow-Up Studies ; Helicobacter Infections ; drug therapy ; Helicobacter pylori ; drug effects ; Humans ; Male ; Metronidazole ; administration & dosage ; therapeutic use ; Omeprazole ; administration & dosage ; therapeutic use ; Recurrence ; Time Factors ; Treatment Outcome

Although it is debatable whether Helicobacter pylori may play a role in the pathogenesis of rosacea, some authors suggested that the treatment of H. pylori might have a beneficial effect. The aim of this investigation was to compare the prevalence of H. pylori between rosacea patients and controls, and to evaluate an effect of H. pylori eradication on rosecea by a 2-week triple therapy that was composed of amoxicillin, clarithromycin and omeprazole. H. pylori was detected by using gastroscopic biopsy with Warthin-Starry stain. Forty-two (84%) of 50 patients with rosacea and 39 (78%) of 50 controls had H. pylori, showing no significant difference in prevalence. The cure rates of H. pylori in rosacea patients and controls were 80% (16/20) and 85% (17/20), respectively. There was no significant decrease in the intensity of erythema in active treatment and placebo groups both during and after the treatment. Temporary improvement in papulopustules exclusively during the treatment (within 2 weeks) could be independent of H. pylori eradication. Overall, no significant reduction in the number of papulopustules was observed in active treatment and placebo groups after the treatment (in 2 months). Taken together, our study found no significant lessening of rosacea lesions by treating H. pylori infection, which conclusively does not concur with a view that H. pylori may be related to rosacea.
Acne Rosacea/microbiology* ; Acne Rosacea/epidemiology* ; Adult ; Amoxicillin/administration & dosage ; Anti-Ulcer Agents/administration & dosage ; Antibiotics, Macrolide/administration & dosage ; Biopsy ; Clarithromycin/administration & dosage ; Cohort Studies ; Erythema/microbiology ; Erythema/epidemiology ; Female ; Follow-Up Studies ; Helicobacter Infections/pathology ; Helicobacter Infections/epidemiology* ; Helicobacter Infections/drug therapy* ; Helicobacter pylori* ; Human ; Male ; Middle Age ; Omeprazole/administration & dosage ; Penicillins/administration & dosage ; Prevalence