阿莫西林与替硝唑治疗急性肠胃炎的效果观察

目的观察阿莫西林与替硝唑治疗急性肠胃炎的效果。方法以本院2018年4月—2019年4月收治的60例急性肠胃炎患者作为研究对象,借助双盲随机抽样法分为对照、试验组,每组列入30例,对照组给予阿莫西林治疗,试验组予以阿莫西林与替硝唑联合治疗,评定两组患者的临床效果、肠胃炎症状积分。结果治疗前,两组患者的肠胃炎症状积分无显著差异,P>0.05(t=0.0752,P=0.9403);治疗后,试验组相较于对照组患者的肠胃炎症状积分较低,P<0.05(t=14.5841,P=0.0000);试验组(96.67%)较对照组(76.67%)临床效果较高,P<0.05(χ²=5.1923,P=0.0226)。结论急性肠胃炎患者予以阿莫西林与替硝唑联合治疗具有积极意义,值得临床研究。     

Antibiotic resistance of subgingival species during and after antibiotic therapy

AIM: The purpose of the present investigation was to determine the percentage and identity of antibiotic-resistant species in subgingival plaque and saliva samples from chronic periodontitis patients treated by scaling and root planing followed by orally administered amoxicillin or metronidazole. METHOD: In all, 20 chronic periodontitis patients were selected for study. After clinical and microbiological monitoring, subjects were randomly assigned to receive either orally administered amoxicillin at the dosage of 500 mg, 3 times daily for 14 days or orally administered metronidazole at the dosage of 250 mg, 3 times daily for 14 days. For the antibiotic resistance determinations, subgingival plaque samples were taken from six posterior teeth at baseline, and 90 days; and from two randomly selected teeth at 3, 7 and 14 days during and after antibiotic administration. Samples were plated on enriched blood agar plates with or without either 2 micro g/mL metronidazole or 2 micro g/mL amoxicillin. Colonies were counted at 7 days. Significant differences in percentage of resistant organisms over time were determined by the Quade test. Microbial growth was washed from antibiotic-containing media and the identity of species determined using checkerboard DNA-DNA hybridization. Data were compared with those obtained in a previous study from subjects receiving SRP only or SRP followed by 14 days of orally administered doxycycline. The level of doxycycline used to determine antibiotic resistance in that study was 4 micro g/mL. RESULTS: The mean percentage of resistant isolates increased during antibiotic administration and returned to baseline levels by 90 days post therapy. The mean percentages (+/- SEM) of isolates resistant to 2 micro g/mL metronidazole were 53 +/- 9, 65 +/- 9, 79 +/- 4 and 69 +/- 7 at baseline, 3, 7 and 14 days during antibiotic administration, and 57 +/- 4, 64 +/- 5, 62 +/- 7 and 47 +/- 6 at 3, 7, 14 and 90 days after antibiotic administration. At the same time points, the percentage of resistant isolates to amoxicillin was 0.5 +/- 0.2, 22 +/- 12, 14 +/- 5 and 37 +/- 11 during, and 31 +/- 11, 8 +/- 3, 3 +/- 2 and 3 +/- 0.6 after, administration. Antibiotic-resistant isolates of resistant species detected during or after therapy were also detected prior to therapy. The most prevalent resistant species in the metronidazole-treated group were: A. naeslundii 1, S. constellatus, A. naeslundii 2, S. mitis, S. oralis, A. odontolyticus, S. sanguis, and in the amoxicillin-treated group: S. constellatus, P. nigrescens, E. saburreum, A. naeslundii 1, S. oralis, P. melaninogenica and P. intermedia. CONCLUSIONS: Systemic antibiotic administration transiently increased the percentage of resistant subgingival species, but a major component of subgingival plaque remained sensitive to the agents during their administration. Antibiotic-resistant isolates of resistant species could be detected in samples both prior to and after therapy. However, % antibiotic-resistant isolates returned to baseline levels 90 days after antibiotic administration.     

Amoxicillin plus metronidazole in the treatment of adult periodontitis patients. A double-blind placebo-controlled study

BACKGROUND, AIMS: The aim of this double-blind, parallel study was to evaluate the adjunctive effects of systemically administered amoxicillin and metronidazole in a group of adult periodontitis patients who also received supra- and subgingival debridement. METHODS: 49 patients with a diagnosis of generalised severe periodontitis participated in the study. Random assignment resulted in 26 patients in the placebo (P) group with a mean age of 40 years and 23 patients in the test (T) group which had a mean age of 45 years. Clinical measurements and microbiological assessments were taken at baseline and 3 months after completion of initial periodontal therapy with additional placebo or antibiotic treatment. Patients received coded study medication of either 375 mg amoxicillin in combination with 250 mg metronidazole or identical placebo tablets, every 8 hours for the following 7 days. RESULTS: At baseline, no statistically significant differences between groups were found for any of the clinical parameters. Except for the plaque, there was a significantly larger change in the bleeding, probing pocket depth (PPD) and clinical attachment level (CAL) in the T-group as compared to the P-group after therapy. The greatest reduction in PPD was found at sites with initial PPD of > or = 7 mm, 2.5 mm in the P-group and 3.2 mm in the T-group. The improvement in CAL was most pronounced in the PPD category > or = 7 mm and amounted to 1.5 mm and 2.0 mm in the P- and T-groups, respectively. No significant decrease was found in the number of patients positive for any of the test species in the P-group. The number of patients positive for Porphyromonas gingivalis, Bacteroides forsythus and Prevotella intermedia in the T-group showed a significant decrease. After therapy there was a significant difference between the P- and the T- group in the remaining number of patients positive for P. gingivalis, B. forsythus and Peptostreptococcus micros. 4 subgroups were created on the basis of the initial microbiological status for P. gingivalis positive (Pg-pos) and negative patients (Pg-neg) in the P- and the T-groups. The difference in reduction of PPD between Pg-pos and Pg-neg patients was particularly evident with respect to the changes in % of sites with a probing pocket depth > or = 5 mm. This % decreased from 45% at baseline to 23% after treatment in the Pg-pos placebo subgroup and decreased from 46% to 11% in the Pg-pos test subgroup (p < or = 0.005). In contrast, the changes in the proportions of sites with a probing pocket depth > or = 5 mm in the Pg-neg placebo and Pg-neg test subgroup were similar, from 43% at baseline to 18% after treatment versus 40% to 12% respectively. CONCLUSIONS: This study has shown that systemic usage of metronidazole and amoxicillin, when used in conjunction with initial periodontal treatment in adult periodontitis patients, achieves significantly better clinical and microbiological results than initial periodontal treatment alone. Moreover, this research suggests that especially patients diagnosed with P. gingivalis benefit from antibiotic treatment.     

联合用药对促进溃疡愈合作用交互影响的研究

目的观察阿莫西林(A)、甲硝唑(M)和胶体次枸橼酸铋(B)联合使用对促进大鼠胃溃疡愈合作用的交互影响,为临床合理选用药物治疗消化道溃疡提供参考。方法采用实验性乙酸致大鼠胃溃疡模型,将大鼠随机分为对照组、阳性药物组及实验药物组,实验药物组大鼠分别给予A(118 mg·kg-1)、M(82 mg·kg-1)、B(25 mg·kg-1)、M+B、A+B、A+M、A+M+B,对照组给予2%羧甲基纤维素钠(CMC-Na),阳性对照组给予西咪替丁(110 mg·kg-1),以溃疡愈合率为观察指标,用金氏概率相加法(q值)分析药物间的交互影响。结果通过各组溃疡面积均值计算溃疡愈合百分率,再由公式计算表示组分间交互影响的q值;当q>1时,表明组分有协同作用;q<1时表明组分有拮抗作用;q=1时表明组分间无相互作用;结果各组间的q值分别为:qM+B=1.40,qA+B=1.07,qA+M=1.24,q(A+M)B=1.23,q(A+B)M=1.07,q(B+M)A=1.32;各组q值均大于1。结论对促进溃疡愈合作用,就阿莫西林、甲硝唑和胶体次枸橼酸铋而言,任何两药间及三药间均有协同作用;三药间协同作用优于两药之间协同作用。三药组合与西咪替丁促进溃疡愈合作用相当,而两药组合作用明显低于西咪替丁。     

阿莫西林原料药中有关物质的UPLC-TOF-MS/MS鉴定

目的快速鉴定阿莫西林原料药中的有关物质。方法采用UPLC-TOF-MS/MS法测定。Waters Acquity UPLCTM BEH色谱柱(100 mm×2.1 mm,1.7μm);流动相为乙酸铵体系;体积流量0.5 m L/min;检测波长254 nm;柱温30℃;进样量10μL。电喷雾电离源;正离子检测;毛细管电压3.0 k V;离子源温度120℃;雾化气温度500℃;雾化气体积流量700 L/h;锥孔气体积流量50 L/h。结果推测了阿莫西林原料药中6个杂质的化学结构及其裂解规律,同时与欧洲药典中的杂质进行了比对归属。结论建立的UPLC-TOF-MS/MS的方法和实验数据可为阿莫西林原料药的质量控制提供了重要依据。     

红外分光光度法鉴别阿莫西林胶囊

【】 目的：建立阿莫西林胶囊的红外光谱鉴定法。方法：取胶囊内容物,以高纯度溴化钾压片,直接测定红外吸收光谱。结果：阿莫西林胶囊与阿莫西林对照品的红外光谱完全一致,并与《药品红外光谱集》中阿莫西林的标准光谱一致。结论：本方法专属性好,能快速、准确,可用于阿莫西林胶囊中阿莫西林成分的鉴别。     

HPLC法测定注射用阿莫西林钠含量的方法研究

目的:建立高效液相色谱法测定注射用阿莫西林钠含量的方法。方法:色谱条件:C18柱,流动相为0.05 mol/L磷酸二氢钾溶液-乙腈(97.5∶2.5),检测波长为254 nm,流速1.0 m L/min,柱温25℃。结果:阿莫西林在0.25 mg/m L~0.75 mg/m L范围内与峰面积呈良好线性关系,平均回收率为99.4%,RSD=0.12%(n=6)。结论:该方法操作简便、快捷,重现性好,可作为注射用阿莫西林钠的含量测定方法。     

Microbiological analysis of autologous bone particles obtained by low-speed drilling and treated with different decontamination agents

The aim of this study was to compare the effectiveness of three agents – two antibiotics (amoxicillin and clindamycin) and an antiseptic (chlorhexidine) – to decontaminate bone grafts obtained by low-speed drilling. The study included 248 bone tissue samples harvested from 62 patients by low-speed drilling before dental implant placement. Each of four samples obtained from every patient was dropped, using a sterile instrument, into a sterile tube containing a 500-μl solution of 400 μg/mL amoxicillin, 150 μg/mL clindamycin, 0.12% chlorhexidine, or physiological saline for 1 min. The number of colony-forming units (CFU) was determined at 48 h of culture. The use of clindamycin, amoxicillin, or chlorhexidine as decontaminant for 1 min significantly reduced the CFU count when compared to physiological saline (control agent). In both anaerobic and CO₂-rich atmospheres, significant differences in CFU/mL were found between the control and chlorhexidine groups (P < 0.001), control and amoxicillin groups (P < 0.001), control and clindamycin groups (P < 0.001), chlorhexidine and amoxicillin groups (P < 0.0001), and chlorhexidine and clindamycin groups (P < 0.0001). In conclusion, clindamycin had the highest decontaminating effect on bone particles obtained by low-speed drilling, followed by chlorhexidine and amoxicillin. Clindamycin may therefore be a valid alternative option for the routine decontamination of intraoral bone grafts.