[A microbiological evaluation of the use of roxithromycin in oral odontogenic infections]

Odontogenic infections are the primary infections caused by indigenous oral bacteria, when a factor changes their perfect equilibrium. We studied 30 samples from patients with odontogenic infections that were submitted to therapy with roxithromycin. Our results showed that 79% of aerobic and 71% of anaerobic bacteria, responsible for odontogenic infections, were sensitive to roxithromycin.

Efficacy of azithromycin compared with spiramycin in the treatment of odontogenic infections

Sixty patients with acute odontogenic infections were randomly allocated to oral treatment with azithromycin 500 mg/day once-daily for three days (n = 30) or spiramycin 3,000,000 units three-times daily for seven days (n = 30). Baseline and post-treatment oral specimens were collected from patients to test for pathogenic bacteria. Aerobic bacteria were tested using the Kirby-Bauer disc diffusion method, and anaerobic bacteria with a broth microdilution method, for their susceptibility to azithromycin and spiramycin. A greater incidence of resistance was found in the spiramycin group than in the azithromycin group. The bacteriological assessment showed that the normal balance of microflora was re-established in 67% of patients treated with azithromycin vs 53% in the group treated with spiramycin. Clinical cure was higher in the azithromycin treatment group (97%) compared with the spiramycin group (73%). These results indicate that three-day azithromycin, possibly because of its unusual pharmacokinetics, is more effective than seven-day spiramycin in the treatment of odontogenic infections.

[Roxithromycin in dental infections]

Roxithromicin is a semisynthetic macrolide antibiotic, with similar antibacterial activity to erythromycin. It is characterized by an excellent pharmacokinetic profile and a good tissue penetration. Particularly at the dose of 300 mg per day the dental tissue diffusion is extremely good, and this is important to oppose the oral cavity infections. Oral cavity infections can be either odontogenic or non odontogenic. Odontogenic infections are typically primary and are caused by commensal bacteria (oral Streptococci, Bacteroides sp., Veillonella sp. and Fusobacterium sp.). The antibacterial spectrum of roxithromycin is very large and includes many of the most frequent strains responsible for oral cavity infections. A very interesting characteristic of roxithromycin is its penetration in macrophages (uptake) that allow a more rapid inhibition of bacterial activity. To evaluate the clinical efficacy and tolerance of roxithromycin in the treatment of odontogenic infections, an open study was performed. This study evaluated both the microbiological and clinical aspects. Thirty patients (21 females and 9 males) who had not been previously treated with antibiotic or antibacterial drugs, affected by infective dysodontiasis, gingivitis and periodontal diseases, received 300 mg per day (once a day) of roxithromycin for an average period of 6 days. The symptomatology considered was: intumescence, redness, pain, lymphangitis and presence of trismus. Clinical symptomatology was assessed at the start and at the end of the treatment. The symptomatological improvement due to roxithromycin was rapid and very effective. After 6 days of therapy, the improvement was statistically significant (p < 0.01) compared to basal conditions. No adverse reactions or side-effects were complained during the study. No changement were detected in laboratory parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

[The effect of Lactobacillus acidophilus and Bifidobacterium bifidum on the intestinal ecosystem of the elderly patient]

The authors have tested the therapeutic efficacy of a multibacterial combination consisting of Lactobacillus acidophilus (10(9)) and Bifidobacterium bifidum (10(9)) in elderly patients with bowel disorders. Bacteriological and histopathologic investigation showed this combination to yield excellent biologic results with restoration of duodenal bacterial flora and subsidence of clinical symptoms. The function of the muciparous glands was restored and the duodenal mucosa was normalized.

[Adhesion capacity of Enterococcus faecium (SF 68) and Enterococcus faecalis to various substrates]

The author's studied the adherence ability of Enterococcus faecium SF 68 compared to that of Enterococcus faecalis IM 11f, on various substrates: vascular catheters and cardiac valves of rabbit, immunodepressed rats and diabetic rats. The bacterial adherence test was calculated by the number of bacteria adhered for microscopic field enlarged to 2000. The data obtained by scanning electron microscope SEM (Cambridge Stereoscan 150 MK2) revealed a different adherence action of the two germs on the various substrates. All the adherence tests showed a higher and uniform adherence activity of E. faecalis compared to that of E. faecium.

[Study on the activity of a therapeutic bacterial combination in intestinal motility disorders in the aged]

The possible beneficial effects and changes in the histology of the duodenojejunal and colonic mucosa brought about by oral bacterial therapy were studied in 60 elderly patients (mean age +/- SD: 76.6 +/- 5.3 years) with bowel disorders mainly represented by diarrhea accompanied by abdominal pain and meteorism. All patients were submitted to a 7-day washout followed by treatment with 6 capsules daily, each capsule containing live, lyophilized Lactobacillus acidophilus (10(9) CFU/ml). The clinical course was observed in 50 patients while the remaining 10 were hospitalized and submitted to esophago-gastro-duodenoscopy and colonoscopy both before and after treatment for withdrawal of duodenal secretion and fragments of duodenojejunal and colonic mucosa biopsies. Duodenal secretion was examined bacteriologically, and after treatment an increase of the anaerobic flora at the expense of the aerobic one was found together with improved quality of the former. Histologic examination showed reduction of the inflammatory infiltration by lymphocytes and plasma cells and increased muciparous activity of the glands. Clinically, a marked improvement of the symptoms was observed in all 60 patients.

[The interference of miocamycin on the adhesiveness and coaggregation of the bacteria responsible for periodontopathies]

The authors studied the effect miocamycin has on the adherence and coaggregation of pathogenic bacteria in periodontopathy. The data obtained by optic microscopy, after treatment of the strains with doses of miocamycin equal to 1/4 and 1/8 of the MIC after 3 and 6 hours, shows the interference effect on the coaggregation and adhesivity of the antibiotic. These results have been confirmed by the observations obtained by scanning electron microscope (SEM).

Microbiological study of Enterococcus faecium SF68: post-antibiotic effect and growth curves

We studied the microbiological characteristics of Enterococcus faecium SF 68 (an oral vaccine) assessing post-antibiotic effect of ampicillin and growth curves in different media. Results showed a good resistance of the microorganism tested which has important implications in clinical practice. The growth ability of Enterococcus faecium SF 68 was similar on all media tested.

[Competitive activity of a bacterial preparation on colonization and pathogenicity of C. pylori. A clinical study]

The authors studied the ability of a live polymicrobial formulation containing Lactobacillus acidophilus 10(9) and Bifidobacterium bifidum 10(9) to act as an "ecological" therapy for gastritis and duodenitis. The study was carried out in volunteers suffering from these disorders which nowadays are attributed to C. pylori. The results obtained confirm previous findings in experimental animals. The polymicrobial formulation was found to be able to compete effectively with the microorganism responsible for the disorders and to improve the results obtained by traditional therapy.

[Interference of clindamycin in skin infection in rabbits caused by suture threads infected with slime-producing S. epidermidis]

The authors have carried out an experimental study to evaluate the interference of sub-inhibitory concentrations of clindamycin on the adherence of slime producing S. epidermidis to surgical nets and its ability to infect rabbits. 80 rabbits divided into 4 groups, (A, B, C, and D), underwent sham operation of the abdominal zone and were sewn up with sterile nets, infected nets and sub MIC of clindamycin equal to 1/8 MIC, respectively. The results obtained stressed a different survival rate 12 days after operation: 95% in group A, 35% in group B; 100% in group C and 95% in group D. This data were confirmed by the results obtained using MES (Cambridge Stereosecan 150 KM2). From our research an excellent clindamycin inhibitory activity on the pathogenicity of slime producing staphylococci emerged.

Effect of clindamycin on adherence of coagulase-negative Staphylococcus to surgical nets

The authors studied the effect that a subinhibitory concentration of Clindamycin has on adherence of coagulase negative S. epidermidis to surgical nets. Clindamycin, as expected, interferes with the adhesivity to the nets of coagulase-negative S. epidermidis slime producing when sub-MICs are used. The documentation obtained by scanning electron microscope, after treatment of the strains with doses of Clindamycin equal to 1/6 of the MIC after 3 and 6 hours, confirms the anti-adherent effect of the antibiotic.

[Immunogenic activity of a polyvalent oral vaccine]

The AA. studied the effects of a polyvalent oral vaccine on the cellular immunity, and on IgA level in animal. They also studied its ability to reactivate the response to the Clostridium tetani toxin in human volunteers. The results show a very good ability of the vaccine as specific and aspecific stimulator.

[Mixed culture of Enterococcus faecium SF 68 with pathogenic intestinal bacterial strains]

An antagonistic activity of Enterococcus faecium SF 68 towards Plesiomonas shigelloides, Aeromonas sp., enteropathogenic Escherichia coli and Yersinia enterocolitica has been studied and demonstrated.

[Protection of an oral vaccine against experimental infection of mice and its role combined with the administration of penicillin]

The AA. studied the immunologic profile of an oral vaccine to prevent the experimental infection in mice and its effect when it was administered with antibiotic. The mice were infected with Staphylococcus aureus and protected by the vaccine administration. Our results confirmed the higher survival in the group that used this combination. The observed mortality was lower in group of mice treated with vaccine and penicillin combination, than in the untreated group.

[Role of Enterococcus faecium SF 68 in experimental infection in mice]

The normal intestinal flora is an important defence against various infectious agents. It also allows important metabolic stages in the host. The Authors studied the ability of Enterococcus faecium SF 68 to protect the mice (Swiss strain) from infection by Salmonella typhi and its role when used with penicillin in infection by Staphylococcus aureus. Our results showed that SF 68, determined a good protection against infection. Moreover the association E. faecium SF 68-antibiotic lowers the mortality rate in the infected mice compared with the control group.

Action of clindamycin-phosphate in foreign body infections due to Staphylococcus epidermidis in mice

The virulence of Staphylococcus epidermidis strain slime producer was examined in an experimental model of foreign body infection in mice. In the course of this experimental infection the mice were injected with two antibiotics (clindamycin and cefazolin) active in vitro toward the Staphylococcus strain used. The results obtained after a week of antibiotic therapy show that clindamycin alone has a therapeutic action against the infection caused by S. epidermidis. Cefazolin showed a very poor therapeutic effect. The results are discussed on the basis of inflammatory reaction elicited from the foreign body and the characteristics of clindamycin in connection with the host's defense mechanisms.

[Immunologic characteristics of a polyvalent vaccine]

A lot of bacterial vaccines show a very interesting immunostimulating profile. The AA. studied the effects of a polyvalent vaccine on the phagocytosis, on the cellular immunity and on the IgA production. They also investigated its capacity to reactivate the response to the C tetani toxin (Booster effect), both "in vitro" and in human volunteers. The results show a significant improvement in the immunity response to specific and aspecific stimuli.

Evaluation of antinfective activity of an association bifidobacterium/lactobacillus in mouse intestine

The present research aimed at studying the action of an association of Bifidobacterium bifidum and Lactobacillus acidophilus, in controlling an experimental severe infection by Salmonella enteritidis administered in mouse per os. The behaviour of some parameters was undertaken, checking for the pH of intestinal content; the condition of the colonization in the intestinal wall by means of scanning electron microscopy and plates cultures; the presence of antibodies IgA in intestinal content; the index of mortality in the diversely treated animal's groups. The reported data show a string incidence of the administration of Bifidobacterium and Lactobacillus in increasing the animal's resistance against the lethal infection.

[The intestinal ecosystem of mice after administration of a polyvalent oral vaccine]

Bacterial antigens orally administered, have been showed by many Authors capable to stimulate immunity system, hinding thus the pathogen flora from gut-colonization. Founding on these findings, AA. of the present paper intend to point out by collected microbial data and M.E.S. photos, the activity of an oral polyvalent vaccine made by lysates strains of E.coli, enterococci, staphylococci and P.vulgaris, on normal intestinal flora of mice contemporaneously administered with a pathogenic strain of Salmonella enteritidis. Vaccine showed himself to be able enough to limit alterations of intestinal flora due to infection by the pathogens.

Studies on lincosamide antibiotic resistance in methicillin-susceptible and -resistant staphylococci

Lincomycin and clindamycin are still effective against anaerobic bacteria, and their antibacterial activity has also been indicated against gram-positive aerobic cocci, chiefly Staphylococcus aureus. The present emergency due to epidemiological circulation of Staphylococci, especially coagulase-negative, methicillin-resistant, and the question of the current validity of the lincosamides, induced us to study the activity of lincomycin and clindamycin against staphylococci belonging to different lyogroups in comparison to erythromycin. Clindamycin showed good antibacterial activity while methicillan-resistant strains showed an increase in resistance to erythromycin and lincomycin.

Microbiological basis for the use of fosfomycin trometamol as single-dose therapy for simple cystitis

Fosfomycin trometamol (FOT), a new soluble salt of fosfomycin, was developed especially for single-dose treatment in uncomplicated urinary tract infections. In this study, the minimum inhibitory concentrations (MICs) of FOT were measured both in nutrient broth and human urine and compared with calcium fosfomycin, pipemidic acid and cotrimoxazole. A total of 300 bacterial strains of different species from recent urinary infections were studied. Staphylococcus aureus showed the lowest MIC (0.38 micrograms/ml) and Pseudomonas spp. the highest (50 micrograms/ml) with fosfomycin salts in nutrient broth. The MIC of fosfomycin resulted in being higher than those for pipemidic acid and cotrimoxazole against Escherichia coli and Proteus rettgeri and lower for all the other species considered. The MIC values increased about ten times when urine was used as medium. No differences were observed between the two fosfomycin salts. The fosfomycin concentrations of 137-1500 micrograms/ml, easily obtained in urine of healthy adult subjects after a single dose of FOT (3g of fosfomycin), were able to kill all the strains, with the exception of Streptococcus faecalis. The bacterial adhesion of a resistant microorganism (P. aeruginosa) to the cells of the urinary tract, showed a 50% reduction after FOT treatment.

Coaggregation between Actinomyces viscosus with Streptococcus pyogenes and Streptococcus agalactiae

Interbacterial coaggregation between Actinomyces viscosus indigenous to the human mouth and Streptococcus pyogenes and Streptococcus agalactiae was studied. Fifteen of twenty-six strains of Streptococcus pyogenes and thirteen of thirty-one Streptococcus agalactiae showed a coaggregation with Actinomyces viscosus strain. The results show that the coaggregation mechanism required calcium and was dependent on pH. Some coaggregations were inhibited by 0.06 M. lactose and by 1 M. NaCl.

[Bactericidal and potent antiadhesive activity of sulbenicillin]

Sulbenicillin, a wide broad spectrum penicillin, is active against a lot of gram positive and gram negative bacteria. The AA. studied the activity of this molecule against urinary infections causing germs, by evaluating two parameters: his antiadhesive capability and the Killing curves, in comparison with mezlocillin and piperacillin. An inhibition in adhesive capability of test-germs, due to sulbenicillin was obtained. Furthermore, resulting Killing curves showed more rapidity in action for sulbenicillin than for the two others molecules, versus resistant germs, like P. aeruginosa and S. faecalis.

In vitro comparative study of RU 28965 against organisms from oral and vaginal flora

The Authors studied the activity of RU 28965, a new macrolide antibiotic, in comparison whith erytromycin, josamycin, miocamycin, ampicillin and rifampicin against oral streptococci (45 strains), coryneform bacteria (23 strains) and G. vaginalis (15 strains). Minimum inhibitory concentrations (MIC), minimum bactericidal concentrations (MBC) and the effect of inoculum size on MICs were determined. RU 28965 showed better activity than the other macrolides. The MICs of RU 28965 were eightfold higher than the corresponding MICs. The MICs of RU 28965 showed up to 10 fold increase by increasing the inoculum density from 10(3) to 10(7) CFU/ml.

[Interference of the intestinal ecosystem of mice in the oral administration of lyophilized live bacteria]

Oral vaccines mode by living or killed bacteria are commonly used to restore normal intestinal flora; it's not well know, however, which bacteria play the leading part in this ecosystem. In the present paper Authors have intended to compare the effectiveness of an oral vaccine, made by Bifidobacterium bifidus and Lactobacillus acidofilus, with another of similar use, made by Enterococci, to increase the mouse resistance to lethal Salmonella enteritidis infections. According to collected microbiological data and M.E.S. photos, the association Bifidob./Lactobac. is more effective than Enterococci to enhance resistance to the experimental infection.

Synergic activity of beta-lactamines and aminoglycosides vs. bacterial strains treated with sub-MIC concentrations

The aim of the present paper was to evaluate the interaction between beta-lactamines and aminoglycosides against Gram-positive and Gram-negative bacteria previously treated with sub-inhibitory doses of each antibiotic in the combination. Bacterial strains were: S. aureus ATTC 25923, S. mitis NCTC 3165, E. coli ATTC 25922, P. vulgaris ATTC 13315. Antibiotics used were penicillin G and gentamicin. The most synergistic combination was the ratio of 4 (penicillin G) to 1 (gentamicin) before and after sub-MIC treatment with penicillin.

Effect of oral administration of a variety of bacteria on depressed macrophage functions in tumour-bearing rats

In consideration of the well documented influence of normal microbial flora on the level of activation of macrophages, we evaluated the effects of oral administration of bacteria on rats with depressed macrophage functions. An oral, killed polyvalent vaccine (Diplococcus pneumoniae types I, II and III, Streptococcus haemolyticus, Staphylococcus aureus and Haemophilus influenzae), the live lyophilized Streptococcus faecium and spores of Bacillus subtilis, respectively, were administered orally to immuno-depressed rats. Results demonstrate the restoration of phagocytosis, intracellular killing and the chemotactic activity of macrophages. These experimental observations suggest that bacterial flora associated with mucosae can influence the level of activation of peritoneal macrophages.

Incidence and antibiotic susceptibility of Haemophilus influenzae in clinical specimens

Recent data report increasing Haemophilus influenzae ampicillin- and chloramphenicol-resistant strains. Authors report the results of one year investigation in Sicily. In 281 clinical specimens tested, Haemophilus influenzae has been isolated in 60 cases. From antibiotic susceptibility tests it can be observed that 58 strains show ampicillin-resistance.

Comparative susceptibilities of organisms isolated in Sicily to cefotetan and other antibiotics

In recent years there has been a gradual increase in the number of infections caused by Klebsiella, Enterobacter and Serratia and non-fermentative bacilli such as Pseudomonas, Alcaligenes and Acinetobacter. The object of this investigation was to evaluate the antibacterial properties of the cephalosporins cefoxitin, cefoperazone, cefotaxime and of gentamicin, in comparison with cefotetan, a new cephamycin with a high degree of stability to beta-lactamases. The cefotetan MIC was not affected either by size of the bacterial inoculum, or the culture medium and the serum protein binding of cefotetan was 85%. Cefotetan showed only moderate antibacterial activity, similar to that of the other cephalosporins tested, against the Gram-positive cocci, whereas it was very active against fermentative and non-fermentative Gram-negative bacilli, except for Pseudomonas aeruginosa. The remarkable activity of cefotetan against Klebsiella, Enterobacter and Serratia is of particular interest.

[Changes in aerobic bacterial flora in the oral cavity of subjects with neoplasms of the head and neck area undergoing antiblastic therapy]

The AA. refer their experience about the oral bacterial flora change in patients with malignant diseases regarding to cervic - cefalic district . An increase of Lactobacilli and cariogenic Streptococci was showed in telecobaltotherapy patients, but not in patients chemotherapy treated. Therefore the AA. conclude that the radiotherapy is the most important treatment in these subjects .

[Synergic action of the combination of fosfomycin and kanendomycin against gram-positive and gram-negative bacteria]

Association between kanendomycin, an aminoglycoside antibiotic with a high antibacterial activity, non susceptible to inactivating action of acetylating enzymes and fosfomycin, an antimicrobial drug active only on bacterial cells, and without toxicity in man, was studied by Authors. An evidence synergism of two examined drugs was found particularly against Proteus spp. and Pseudomonas aeruginosa. A discussion about mechanisms of action of fosfomycin and kanendomycin is referred by Authors to explain this synergism.

[Antibacterial activity of amikacin towards gentamicin-resistant, Gram-negative bacilli]

Antibacterial activity of amikacin with regards to gentamicin resistant, Gram-negative bacteria was evaluated. Probable systems of enzymatic inactivation of antibiotic were postulated for amikacin and other aminoglycosides.

[Identification and antibiotic resistance of non-fermenting gram-negative bacteria (author's transl)]

Occurrence of non-fermenting Gram-negative bacteria was investigated by the Authors in various clinical specimens expecially of compromised hosts. 15 non-fermenting Gram-negative bacterial strains were isolated and identificated by two routine diagnostic systems. Isolates, were resistant to tetracycline, ampicillin, chloramphenicol and carbenicillin, while were shown to have different pattern of susceptibility to the aminoglycoside antibiotics examined.