• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.522-529
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• 2005

Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.58.1-58.8
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• 2021

Objectives: This study addresses the effect of using nanoparticles (np) on the antimicrobial properties of bioactive glass (BAG) when used in intracanal medicaments against Enterococcus faecalis (E. faecalis) biofilms. Materials and Methods: E. faecalis biofilms, grown inside 90 root canals for 21 days, were randomly divided into 4 groups according to the antimicrobial regimen followed (n = 20; BAG-np, BAG, calcium hydroxide [CaOH], and saline). After 1 week, residual live bacteria were quantified in terms of colony-forming units (CFU), while dead bacteria were assessed with a confocal laser scanning microscope. Results: Although there was a statistically significant decrease in the mean CFU value among all groups, the nano-group performed the best. The highest percentage of dead bacteria was detected in the BAG-np group, with a significant difference from the BAG group. Conclusions: The reduction of particle size and use of a nano-form of BAG improved the antimicrobial properties of the intracanal treatment of E. faecalis biofilms

• Journal of Oral Medicine and Pain
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• v.21 no.1
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• pp.123-131
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• 1996

Bacteremia occurs in a wide variety of clinical procedures in oral cavity. Reduction of the number of causative microorganisms of infective endocarditis in oral cavity by local administration of antimicrobial agents decreases the magnitude of bacteremia and possibility of infective endocarditis. The effects of chlorhexidine on Streptococcus sanguis, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Staphylococcus aureus, and Staphylococcus epidermis were investigated by measurement of turbidity. The effects of 0.1% chlorhexidine gargling for 7 days on oral bacterial flora, total streptococci, S. mutans, S. aureus, and S. epidermis in whole saliv a of 7 healthy human subjects, were investigated by measurement of Colony Forming Units (CFU). The obtained results were as follows : 1. Chlorhexidine showed significant antimicrobial effects on Streptococcus snaguis, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Staphylococcus aureus, and Staphylococcus epidermis. However, the effects on S. sanguis and S. gordonii were not apparent compared with other microorganisms. 2. Oral gargling of 0.1% chlorhexidine decreased the CFU values of normal oral bacterial flora, total streptococci, S. mutans, S. aureus, and S. epidermis in whole saliva. The antimicrobial effects were significant after 4 days of chlorhexidine gargling. 3. Local antimicrobial administration in addition to systemic antibiotic prophylaxis can be highly recommended as an effective adjunct regimen for prevention of infective endocarditis.

• Journal of Periodontal and Implant Science
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• v.35 no.2
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• pp.401-411
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• 2005

The aim of this study was to determine the minimal inhibitory concentration(MIC) of cefixime, which is a 3rd generation of cefalosporin, against 6 species of putative periodontopathogens; Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Prevotella nigrescens, Tannerella forsythia and Porphyromonas gingivalis. The efficacy of cefixime was examined by comparing it with that of several antibiotics(amoxicillin, $Augmentin^{(R)}$ ciprofloxacin, metronidazole, and tetracycline), which were used as the control. The MIC was measured using a microdilution method. The MIC of cefixime against the putative periodotopathogens, as a single use regimen, was relatively lower than that of the other antibiotics. The MIC of cefixime/metronidazole against P. intermedia ChDC KB14, P. nigrescens ChDC KB50, F. nucleatum ChDC PV-F37, F. nucleatum ChDC F130, and F. nucleatum ChDC F175, as a simultaneous regimen, was lower than that of the other antibiotics. The concentration of cefixime in the crevicular fluid of volunteers who received 250mg every 12 hours for 3 days was $9{\mu}g/ml$ after 9 hours. In conclusion, cefixime showed good antimicrobial activity in a single treatment or as a combined therapy with amoxicillin, $Augmentin^{(R)}$ or metronidazole against 6 periodontopathogens.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.2
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• pp.405-421
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• 1997

The main purpose of this study was to evaluate the acid resistance and antimicrobial effect of fluoride-laser combined application. Recently extracted third molars were used. $5{\times}3mm$ of the buccal and lingual specimens were exposed and incipient artificial carious lesions were formed by keeping them in the artificial cariogenic solution for 5 days. They were divided into five groups and treated with fluoride and laser according to the predetermined regimen. The acid resistance was compared between groups by chemical quantitative analysis of the calcium and phosphorous released into the test solution after single or combined application of fluoride and laser. The antimicrobial effect of each group was analyzed by counting the number of colony forming units after microbial incubation. The results from the present study can be summarized as follows; 1. Experimental groups showed lower values in calcium and phosphorous contents as well as in $CFU/m{\ell}$(colony forming units) than control group. Combined application groups showed lower values than single application groups. 2. Acid resistance and antimicrobial effect by fluoride and laser treatment were confirmed in this study. 3. Based upon the above-mentioned results of this study, it can be assumed that the use of laser-fluoride combined application may provide the child and adolescent patient population with antimicrobial effect as well as acid resistance. Further studies using various materials and experimental conditions are being encouraged.

• Korean Journal of Clinical Pharmacy
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• v.20 no.1
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• pp.78-84
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• 2010

Background: Clostridium difficile is the primary reason of the nosocomial diarrhea. The antimicrobial therapy plays a central role in the pathogenesis of Clostridium difficile associated diarrhea (CDAD). Although nearly all classes of antimicrobial agents have been associated with CDAD, clindamycin and the third-generation cephalosporins have traditionally been considered to the greatest risk factor. Recent studies have also implicated fluoroquinolones as high-risk agents due to increasing use of the agents. This study was to determine the incidence and the risk factors of CDAD related to the administered antibiotics and to assess the therapeutic regimen of metronidazole or vancomycin based on the C. difficile toxin assay Methods: A retrospective study was performed in patients with Clostridium difficile toxin assay at I Hospital (Incheon, South Korea) during the period from January 2007 through December 2007. Administrative, laboratory, and pharmacy data were collected from Electronic Medical Databases. Results: The analysis included 129 reported C.difficile toxin assay results, with 42 positive cases and 87 negative cases. Significant antibiotic risk factors for CDAD included the use of the fourth-generation cephalosporinse (OR=5.97, 95% CI 1.37-25.98, P=0.017). Administration of metronidazole was protective against CDAD (OR=0.30, 95% CI 0.12-0.74, P=0.009). Prolonged antimicrobial therapy has been associated with an increased risk of CDAD. The third-generation cephalosporins (OR=3.81, 95% CI 1.08-13.41, P=0.037) and aminoglycoside (OR=5.50, 95% CI 1.43-21.10, P=0.013) demonstrated greater risk for CDAD over 15 days than 8days or less days of treatment duration. Conclusions: The fourth and third generation cephalosporin, aminglycoside were the significant risk factors compared with other antibiotics, whereas metronidazole appears to be protective. The longer duration of antiobiotic use increased CDAD.

• Korean Journal of Clinical Pharmacy
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• v.8 no.2
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• pp.83-88
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• 1998

Improved knowledge of the time course of antimicrobial activity should provide useful information for designing optimal dosage regimen. In contrast to $\beta$-lactam, aminoglycosides tend to induce a prolonged postantibiotic effect against aerobic or facultative gram negative rods and clinical outcome was significantly correlated with achieving peak serum concentrations. The objective of this study was to compare the efficacy, safety of e same total daily dose of amikacin and gentamicin given either twice or thrice daily in the treatment of patients. Consecutive patients over 20 years old with a suspected or confirmed infection for which an aminoglycosides was indicated were eligible. Exclusion criteria were known allergy to aminoglycosides, renal impairment, granulocytopenia and pregnancy. Patients were treated with intravenous amikacin 15 mg/kg/day or gentamicin 4.5 mg/kg/day either in two devided or in three devided. Seventy-four patients with infection were enrolled in this study of amikacin twice daily (A2, n=29), gentamicin twice daily (G2, n=8) vs amikacin thrice daily (A3, n=30), gentamicin thrice daily (G3, n=7). Baseline characteristics were comparable in G2 and G3. The clinical cure rate (including partial improve) were $89.0\%\;and\;86.0\%$ in A2 group and A3 group respectively. The bacteriologic cure rate were $99.0\%\;and\;85.7\%$ in A2 group and in A3 group respectively. The clinical and bacteriologic effects were difficult to compare G2 with G3, because of the small numbers of patients. The serum creatinin rose in $3.44\%$ (1 in 29) of patients in the A2 group compared to $13.3\%$ (4 in 30) in e A3 group. Although audiometry was not performed, there was no clinical evidence of ototoxicity in any of the patients. In our opinion, twice-daily regimen of aminoglycosides is more effective and less nephrotoxic than thrice-daily regimen.

• Archives of Pharmacal Research
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• v.12 no.2
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• pp.114-118
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• 1989

The effects of intraperitoneal injection of cephradine in a dose of 75 mg/kg and netilmicin in dose of 50 mg/kg and their combination on creatinine and urea serum levels of rabbits were studied as well as the antipseudomonal activity against three multiresistant clinicial isolates. The antibacterial activity was investigated by two methods: Checkerboard titration method and time-kill studies. Finally, the antibacterial activity of the sera obtained from the rabbits receiving the used drugs in the previous regimen was studied using time-kill study method against Pseudomonas aeruginosa isolates. Results obtained from this study indicated that both creatinine and urea serum levels of the rabbits receiving both drugs were not significantly different from those of the rabbits receiving either cephradine or netilmicin alone. At the same time the in vitro antibactrial activity (either of the prepared solutions of the used drugs and their combination or of the sera obtained from the rabbits receiving these drugs as mentioned before) showed a synergistic effect against the tested strains of Pseudomonas aeruginosa

• Journal of Veterinary Clinics
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• v.25 no.5
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• pp.346-354
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• 2008

The combined effects of EDTA-Tris and eighteen antimicrobial agents have been evaluated in eight clinically isolated methicillin-resistant bacteria (Staphylococcus aureus, Escherichia coli, Streptococcus uberis and Streptococcus agalactiae) from bovine mastitis. The antimicrobial activity was evaluated by measuring the minimal bactericidal concentration (MBC) for the antibiotics alone or in combination with EDTA-Tris in Mueller-Hilton broth and milk. Combined use of EDTA-Tris and antibiotics potentiated or antagonized activity of antibiotics against mastitic pathogens. Milk increased the antibiotic potency of erythromycin and spiramycin on S. aureus. Culture in milk changed patterns of EDTA-Tris combinational effects compared with that in standard Mueller-Hilton broth. Combined with EDTA-Tris in milk, synergic effects were observed in colistin, dihydrostreptomycin, kanamycin, erythromycin, gentamycin, oxytetracycline, streptomycin to E. coli, Str. uberis, and Str. agalactiae. However, significant antagonistic effects of milk on antibiotic susceptibility in combination with EDTA-Tris were noted in neomycin, streptomycin, penicillin, roxithromycin, and amoxicillin. This study indicates that combination therapy of EDTA-Tris with antibiotics in bovine mastitis should be used with caution because of the possible antagonistic effects of antibiotic combination with EDTA-Tris on mastitic pathogens. In addition, antibiotic susceptibility test in combination with EDTA-Tris in milk culture condition can be benefit in search of effective treatment regimen for some antibiotic-resistant bacteria of mastitis.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.52-58
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• 1997

Background : Tuberculous pleurisy has been treated With a combined regimen of corticosteroids- antimicrobial therapy. But whether such combination therapy add to benefits is unknown. We evaluate the effects of corticosteroid and its routine application in relief of clinical symptoms, absorption of pleural effusion, and pleural adhesions. Methods : A prospective, randomized study of the role of corticosteroid in the treatment of tuberculous pleurisy was performed in 83 patients(nonsteroid group: 50 patients, steroid group: 33 patients) from June, 1991 to September, 1994. Results : 1) The mean duration from symptoms(fever, chest pain, dyspnea) to relief was 3.8 days in the steroid group, and 7.4 days in the nonsteroid group(P<0.05). Clinical symptoms including fever, chest pain, sputum and weight loss were relieved more rapidly in the steroid group than other symptoms(weakness, night sweating and dyspnea). 2) Pleural effusion was taken an averge of 88 days in the steroid group and 101 days in the nonsteroid group 10 be absorbed completely(p>0.05) 3) The incidence of pleural adhesions was 17/33(5l.5%) in the steroid group and 32/50(64%) in the nonsteroid group(p>0.05) 4) Side effects of corticosteroids were observed in only one patient causing epigastric pain and discontinuation of drug. Conclusion : Corticosteroid exert benefitial role in the more rapid relief of clinical symptoms to patients with tuberculous pleurisy, but absortion of pleural effusion and occurrence of pleural adhesions was not influenced significantly Therefore, its routine application should be reevaluated.