Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The appropriateness of antimicrobial prescribing habits by resident physicians in a family practice center was evaluated. From a six-month period, 225 antibiotic prescriptions were reviewed retrospectively, in a three-phase study. In the first phase, two physicians determined the validity of the diagnosis and treatment for each case, based on criteria suggested by current literature. In the second phase, the pharmacist investigators compared the prescribed regimens with the established criteria for appropviateness of drug choice, daily dose, dosage interval, and duration of therapy. In the third phase, charts were reviewed to determine if microbial cultures had been ordered. The diagnosis was accepted in 89% of the cases; of those, drug therapy was indicated for 84%, an appropriate drug was prescribed in 89%, daily dose was appropriate in 72%, dosage interval was acceptable in 75%, and duration of therapy was appropriate in 59%. Microbial cultures were commonly ordered for pharyngitis, cystitis, pyelonephritis, and gonococcal urethritis. Cultures were not ordered for tonsillitis, nongonococcal urethritis, prostatis, and pelvic inflammatory disease. The prescribing patterns of a group of family practice residents were found to be in less than full compliance with standards in the literature. However, the importance of this finding is difficult to judge because there have been few such studies in ambulatory care settings and the validity of some of the criteria for appropriateness is not known.
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PMID:Antimicrobial use review in a family practice setting. 728 1

Combinations of beta-lactamase inhibitors with penicillins, especially aminopenicillins, have broad-spectrum antibacterial activity against most of the common pathogens of the respiratory and urinary tracts. This means that they are an ideal treatment for infections such as otitis media, sinusitis, special cases of pharyngeal tonsillitis (recurring forms, indirect pathogenic action, or after the failure of amoxicillin monotherapy), acute exacerbations of chronic bronchitis, cystitis, urethritis, etc. The amoxicillin-sulbactam combination is active against both beta-lactamase producer and nonproducer strains, and is effective against Gram-positive cocci (Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus of nonhospital origin), Gram-negative cocci (Neisseria gonorrhoeae, Moraxella catarrhalis and others), Gram-negative bacilli (nonhospital strains of Haemophilus influenzae, Escherichia coli and Klebsiella pneumoniae and others) and anaerobes. Its antimicrobial activity means that it is indicated in the treatment of respiratory, ear, nose and throat, urinary, dermatological and gynecological infections caused by susceptible germs, as well as in a variety of surgical situations (both as a treatment and as prophylaxis). It is absorbed very well orally, and its pharmacokinetic profile is very favorable, with very good tissue penetration. It is reasonably well tolerated: in a variable percentage of cases it may cause modification of intestinal transit and/or fecal consistency, which usually abates spontaneously. The new formulation for administration at intervals of 12 h is easier to use, is better tolerated and favors completion of therapy. In summary, the amoxicillin-sulbactam combination is effective and well tolerated in most infections of nonhospital origin in adults and children. (c) 2001 Prous Science. All rights reserved.
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PMID:Amoxicillin-sulbactam: A clinical and therapeutic review. 1278 93

Cefuroxime is the first commercially-available second-generation cephalosporine to be widely used in therapy; it is a semi-synthetic cephalosporin obtained from the 7-cephalosporanic acid nucleus of cephalosporin C. Cefuroxime axetil is the acetoxyethyl ester of cefuroxime. The majority of micro-organisms associated with respiratory infections are highly sensitive to cefuroxime. These include Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes and the other streptococci (excluding group D streptococci), and Moraxella catarrhalis. Bacteria sensitive to cefuroxime include the enterobacteria (Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Salmonella and Shigella and Straphylococcus aureus (methicillin-sensitive strains). The pharmacokinetic studies show that the maximum plasma concentration of cefuroxime after oral administration of 250 mg and 500 mg of cefuroxime axetil after a meal are respectively 4.6 and 7.9 mg/l. The absolute bioavailability of tablets is 68% (extremes 63-73%) after oral administration of 500 mg cefuroxime axetil. The protein binding is 33+/-5.7%. Tissue diffusion was studied in the interstitial fluid, the bronchial mucosa, the tonsils, and the bronchial secretions. Cefuroxime axetil is available as capsule-shaped tablets containing 125, 250 or 500 mg. An oral suspension dosage form for paediatric purposes is also available as granules in multidose bottles and sachets. Constitution gives a suspension containing 125 mg or 250 mg cefuroxime (as cefuroxime axetil). Cefuroxime axetil is indicated for the treatment of infections caused by susceptible bacteria. Indications include: lower respiratory tract infections (e.g., acute and chronic bronchitis and pneumonia); upper respiratory tract infections (e.g., ear, nose and throat infections such as otitis media, sinusitis tonsillitis and pharyngitis); genito-urinary tract infections (e.g., pyelonephritis, cystitis and urethritis, gonorrhoea, acute uncomplicated gonococcal urethritis and cervicitis); and skin and soft tissue infections (e.g., furunculosis, pyoderma and impetigo). For most infections, a dose of 250 mg twice daily is appropriate. In some urinary tract infections, 125 mg twice daily has been shown to be effective. If pneumonia is suspected or in more severe lower respiratory tract infection, doses of 500 mg bd should be used. Uncomplicated gonorrhoea has been shown to respond to a single 1-g dose of cefuroxime axetil. Adverse reactions to cefuroxime have generally been mild and transient in nature (gastrointestinal disturbances, including diarrhoea, nausea and vomiting).
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PMID:Cefuroxime axetil. 1861 87