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Summary A systematic review approach was used to evaluate the association between sub-therapeutic antibiotics in feed and Salmonella Typhimurium isolation in market-weight finisher swine raised in modern swine production systems. Fourteen challenge trials described the efficacy of different antibiotics after challenge with S. Typhimurium. The studies identified were of limited evidentiary value for the review question because they were not relevant to the review question, i.e. conducted in artificial settings on small numbers of young pigs. None of the studies reported using blinding during outcome assessment. No antibiotic regimen was evaluated more than once. The association between sub-therapeutic antibiotics and Salmonella outcomes in market-weight swine raised in modern production systems cannot be summarized using the currently available literature. Many available studies fail to report critical study design features such as blinding and/or to take into account the data generated from longitudinal studies.

The routine use of antibiotics in oral implant treatment seems to be widespread. The pre- or postoperative use of antibiotics in conjunction with implant surgery and its correlation with failure and success rates are poorly documented in the literature. The debate regarding overprescription of antibiotics raises the need for a critical evaluation of proper antibiotic coverage in association with implant treatment.The purpose of this study was to compare the implant survival rate following a 1-day single-dose preoperative antibiotic regimen with that following a 1-week postoperative antibiotic protocol.The study included 868 consecutively treated patients. A total of 3,021 implants were placed. The population was split into two categories, either receiving a 1-day single-dose administration only, or a 1-week postoperative administration of antibiotics. Healing was evaluated at second-stage surgery (6 months for the upper jaw, 3 months for the lower jaw). Failure was defined as removal of implants because of non-osseointegration. Statistical analyses were performed with analysis of variance and the Scheffé test, with a significance level of 5% for comparison of data.No significant differences with regard to complications and implant survival were found in the study.Based on the present data, a more restrictive regimen consisting of a 1-day dose of prophylactic antibiotic in conjunction with routine implant procedures is recommended.

Intrauterine fetal death and maternal shock occurred as a result of a type-1 hypersensitivity reaction following antibiotic prophylaxis in a cesarean section. Amniotic fluid embolism may mimic the condition. The ability to diagnose and treat such an event as early as possible is necessary in all maternity centers. The selection of antibiotic regimen and the type of anesthesia should be individualized depending upon the existing facilities and the patient's profile, especially in a resource-scarce developing country.

Local delivery of antimicrobials has been investigated as a possible method for controlling and treating periodontal disease. A number of antimicrobial agents have been studied both as adjunctive therapies with scaling and root planing and as stand-alone chemotherapies. More recent investigations have focussed on the delivery of antimicrobials in sustained-release formulations designed to maintain effective concentrations of drug within the periodontal pocket. This article provides an overview of the development of the use of locally-delivered metronidazole in periodontal therapy and the current state-of-the-art of the technique. It is concluded that treatment with local delivery of metronidazole seems to be as effective as scaling and root planing in untreated as well as in recall subjects. However, there are reasons to suggest that local delivery of metronidazole should not be used as a substitute for conventional treatment of periodontal disease, since side-effects of long-term use and repeated use are not known. The antibiotic regimen should preferably be used as an adjunct to surgical and non-surgical therapy.

Antibiotics are frequently prescribed in everyday practice for the management of acute microbial infections. The present study was designed to assess the relationship between the prescriber's instructions and the patient's adherence to a prescribed schedule of twice-daily doses of antibiotic for at least 5 days to treat an infectious disease. The trial was conducted by ten practicing physicians on ambulatory patients. Compliance with the antibiotic regimen was evaluated using a microelectronic device, the Medication Event Monitoring System (MEMS). Seventy patients were prescribed an antibiotic in twice-daily doses for 5 to 14 days (mean = 8). Data were available for analysis from 68 of them, aged 18 to 84 years (mean = 44). The "taking compliance" for the whole story group, which corresponded to the ratio of the number of times the bottle was opened and the total number of doses prescribed during the monitoring period, was nearly perfect at 99.6%. However, only 32.6% of the medications was taken within 1 hour before or after the 12-hour interval expected to be optimal for a twice-daily regimen. It therefore seems highly desirable that physicians give more detailed recommendations to their patients regarding the drug regimens they prescribe.

Because other known pathogens are frequently isolated with AXX, its clinical significance may be overlooked. AXX should not be considered a colonizer or contaminant, particularly in the presence of clinical signs and symptoms of infection. For a pediatric patient with AXX in the ear fluid, the choice of an antibiotic regimen should be based on in vitro activity of both AXX and other concurrent pathogens. Although the sensitivity of AXX may be highly variable, a number of antibiotics appear to be clinically useful.

Eleven cases of septic pelvic thrombophlebitis and persistant fever following cesarean section and cesarean hysterectomy are presented. Addition of heparin to the antibiotic regimen of these patients produced a clinical response within 1--5 days, except in two patients who developed septic pulmonary emboli, which finally resolved with continued heparin therapy. An incidental finding was a high incidence of pelvic thrombophlebitis following hypogastric artery ligation. The results justify a trial of heparin therapy, before resorting to exploratory laparotomy, in postpelvic surgery patients who have unexplained fever.

Seventy-eight pediatric cancer patients were treated for gram-positive bacterial septicemia during a 10-year period (1968-1977). Sixty-one (78%) of the patients were granulocytopenic (PMNs less than 500/mm3) at the onset of the septic episode. All the patients whose granulocytopenia resolved (PMNs greater than 500/mm3) within one week of therapy recovered without sequelae. However, 7 of 15 patients (47%) who remained granulocytopenic for more than 7 days and who were treated with a single antibiotic developed a second sepsis with a gram-negative organism. In contrast, second infections were not observed in 24 patients with PMNs less than 500/mm3 for more than 7 days who were treated with broad spectrum antibiotics (p less than 0.002), suggesting that a broad-spectrum antibiotic regimen may be preferable when a cancer patient has prolonged granulocytopenia.

The authors have evaluated the efficacy of a medical regimen, consisting of systemic antibiotics and steroids, in the management of acute iatrogenic subglottic stenosis. The study consisted of the infliction of a standardized subglottic injury to three groups of five dogs: Group I animals were placed on prednisone 1 mg/kg/24 hours and potassium phenoxymethyl penicillin 50 mg/kg/24 hours from the day of the trauma. Group II were placed on a similar regimen from the eighth day after subglottic trauma. Group III received no medical therapy at all. Therapy was continued in treated Groups I and II for five weeks. At the end of the study the dogs were sacrificed and the final degree of subglottic stenosis evaluated, at which time the laryngotracheal complexes were submitted for pathological evaluation. A significant difference was found between the degree of stenosis attained in the three groups. The study suggests that the introduction of a steroid/antibiotic regimen has a beneficial effect in developing subglottic stenosis and that the timing of such therapy is of importance.