The Quality and <i>in Vitro</i>Efficacy of Amoxicillin/Clavulanic Acid Formulations in the Central Region of Ghana

Aim: To assess the quality and in vitro efficacy of five brands of amoxicillin/clavulanic acid tablet, suspension and injectable preparations selected from pharmacies in the Central Region of Ghana. Method: Using a Stratified Representation Sampling method, forty preparations (tablets, suspensions and injectable powders) containing amoxicillin and clavulanic acid were sampled from nine different locations within the Central Region of Ghana. To determine drug quality, several procedures, namely, content assay, disintegration and dissolution testing were employed. In vitro drug efficacy was determined by comparing the Minimum Inhibitory Concentrations (MIC’s) obtained with published values. Results: All tablets passed the disintegration test, with disintegration time ranging between six (6) and fifteen (15) minutes. Analyses of all the tablets for drug content showed 100% failure (14 out of 14) for amoxicillin and 14% failure (2 out of 14) for clavulanic acid. Injectable formulations showed similar results. All four (4) samples analyzed for content failed the amoxicillin content assay (0 out of 4) but all passed clavulanic acid assay (4 out of 4). For tablet dissolution tests, there was a 93% (13 out of 14) pass rate for both amoxicillin and clavulanic acid. Content analysis of all suspension formulations involved twenty-two (22) samples from five (5) brands. Only 41% (9 out of 22) passed for both amoxicillin and clavulanic acid. All the other samples failed for either amoxicillin, clavulanic acid or both. Results obtained from drug quality tests were confirmed by in vitro efficacy tests against selected microorganisms. Conclusion: The samples were therefore not of good quality, since content assay is the most crucial test. It is hypothesized that this is due to poor storage conditions, and recommendations, such as air conditioning and more structured procedures along the supply chain, are put forward to counteract this.

Amoxicillin–clavulanic acid induced sperm abnormalities and histopathological changes in mice

Objective: To explore the genotoxic potential and histopathological changes induced in liver, kidney, testis, brain and heart after using the antibiotic drug amoxicillin/clavulanic acid(4:1).Methods: The study included chromosomal aberration analysis in bone-marrow and mouse spermatocytes, induction of sperm morphological abnormalities and histopathological changes in different body organs. The drug was administrated orally at a dose of81 mg/kg body weight twice daily(Total = 162 mg/kg/day) for various periods of time equivalent to 625 mg/men(twice daily).Results: The results revealed non-significant chromosomal aberrations induced after treatment with amoxicillin/clavulanic acid(AC) in both bone marrow and mouse spermatocytes after 7 and 10 days treatment. On the other hand, statistically significant percentages of sperm morphological abnormalities were recorded. Such percentage reached 8.10 ± 0.55, 9.86 ± 0.63 and 12.12 ± 0.58 at the three time intervals tested(7, 14 and 35 days after the 1 st treatment respectively)(treatment performed for 5 successive days) compared with 2.78 ± 0.48 for the control. The results also revealed histopathological changes in different body organs after AC treatment which increased with the prolongation of the period of therapy. Congestion of central vain, liver hemorrhage and hydropic changes in hepatocytes were noticed in the liver. Degenerative changes were found in kidney glomerulus and tubules while testis showed atrophy of seminiferous tubules, and reduction of spermatogenesis. AC also induced neurotoxicity and altered brain neurotransmitter levels. Hemorrhage in the myocardium, disruption of cardiac muscle fibers and pyknotic nuclei in cardiomyocytes were recorded as side effects of AC in heart tissue.Conclusions: The results concluded that AC treatment induced sperm morphological abnormalities and histopathological changes in different body organs. Clinicians must be aware of such results while describing the drug.

Development and Validation of Stability Indicating HPLC Method for Simultaneous Estimation of Amoxicillin and Clavulanic Acid in Injection

A simple, fast, precise, accurate and rugged stability indicating high performance liquid chromatography (HPLC) method has been developed for simultaneous estimation of Amoxicillin and Clavulanic acid from injectable dosage form. The stability indicating capability of the method was proven by subjecting the drugs to stress conditions as per ICH recommended test conditions such as alkaline and acid hydrolysis, oxidation, photolysis, thermal degradation and resolution of the degradation products formed therein. The separation was obtained using a mobile phase composition at a ratio of 95:5 (v/v) of pH 5.0 buffer and methanol on Inertsil C18 column (250 × 4.0 mm, 4 μm) with UV detection at 220 nm at a flow rate of 1 ml/minute. The photodiode array detector was used for stress studies. The order of elution of peaks was Clavulanic acid followed by Amoxicillin. The linear calibration range was found to be 79.51 to 315.32 μg/ml for Amoxicillin and 17.82 to 67.90 μg/ml for Clavulanic acid. The Amoxicillin and Clavulanic acid were found to be stable in solution up to 24 hours. The method validation data showed excellent results for precision, linearity, specificity, limit of detection, limit of quantification and robustness. The present method can be successfully used for routine quality control and stability studies.

Treatment of Helicobacter pylori with potassium competitive acid blockers:A systematic review and meta-analysis

BACKGROUND Helicobacter pylori(H.pylori)infects over half the global population,causing gastrointestinal diseases like dyspepsia,gastritis,duodenitis,peptic ulcers,GMALT lymphoma,and gastric adenocarcinoma.Eradicating H.pylori is crucial for treating and preventing these conditions.While conventional proton pump inhibitor(PPI)-based triple therapy is effective,there’s growing interest in longer acid suppression therapies.Potassium competitive acid blocker(P-CAB)triple and dual therapy are new regimens for H.pylori eradication.Initially used in Asian populations,vonoprazan(VPZ)has been recently Food and Drug Administration-approved for H.pylori eradication.AIM To assess the efficacy of regimens containing P-CABs in eradicating H.pylori infection.METHODS This study,following PRISMA 2020 guidelines,conducted a systematic review and meta-analysis by searching MEDLINE and Scopus libraries for randomized clinical trials(RCTs)or observational studies with the following command:[("Helicobacter pylori"OR"H pylori")AND("Treatment"OR"Therapy"OR"Eradication")AND("Vonaprazan"OR"Potassium-Competitive Acid Blocker"OR"P-CAB"OR"PCAB"OR"Revaprazan"OR"Linaprazan"OR"Soraprazan"OR"Tegoprazan")].Studies comparing the efficacy of P-CABs-based treatment to classical PPIs in eradicating H.pylori were included.Exclusion criteria included case reports,case series,unpublished trials,or conference abstracts.Data variables encompassed age,diagnosis method,sample sizes,study duration,intervention and control,and H.pylori eradication method were gathered by two independent reviewers.Meta-analysis was performed in R software,and forest plots were generated.RESULTS A total of 256 references were initially retrieved through the search command.Ultimately,fifteen studies(7 RCTs,7 retrospective observational studies,and 1 comparative unique study)were included,comparing P-CAB triple therapy to PPI triple therapy.The intention-to-treat analysis involved 8049 patients,with 4471 in the P-CAB intervention group and 3578 in the PPI control group across these studies.The analysis revealed a significant difference in H.pylori eradication between VPZ triple therapy and PPI triple therapy in both RCTs and observational studies[risk ratio(RR)=1.17,95%confidence interval(CI):1.11-1.22,P<0.0001]and(RR=1.13,95%CI:1.09-1.17,P<0.0001],respectively.However,no significant difference was found between tegoprazan(TPZ)triple therapy and PPI triple therapy in both RCTs and observational studies(RR=1.04,95%CI:0.93-1.16,P=0.5)and(RR=1.03,95%CI:0.97-1.10,P=0.3),respectively.CONCLUSION VPZ-based triple therapy outperformed conventional PPI-based triple therapy in eradicating H.pylori,positioning it as a highly effective first-line regimen.Additionally,TPZ-based triple therapy was non-inferior to classical PPI triple therapy.

Simultaneous pharmacokinetic assessment of cefadroxil and clavulanic acid in human plasma by LC-MS and its application to bioequivalence studies

A simple, rapid and selective liquid chromatography-atmospheric pressure chemical ionization-mass spectrometry （LC-APCI-MS） assay method has been developed and fully validated for the simultaneous quantification of cefadroxil （CF） and clavulanic acid （CA） in human plasma. Analytes and internal standard （IS） were extracted from human plasma by solid- phase extraction （SPE） technique using Sam prep （3 mL, 100 mg） extraction cartridge. The extracted samples were chromatographed on a reverse phase Cls column using a mixture of methanol： acetonitrile： 2 mM ammonium acetate （pH 3.5） （25：25：50, v/v/v） as the mobile phase at a flow rate of 0.8 mL/min. Quantification of the analytes and IS were carried out using single quadrupole LC-APCI-MS through selected-ion monitoring （SIM） at m/z 362 and m/z 198, for CF and CA, respectively. Method validation was performed as per the FDA guidelines and the results met the acceptance criteria. Plasma concentration of CF and CA followed by the oral administration of CF/CA （500/125 mg） pill to healthy male volunteers （n= 12） was measured. Area under plasma concentration-time curve from 0 to 12 h （AUC0-12 h） and 0 h extrapolated to infinity （AUC0-∞） were calculated. The ratio of AUC0-12 h/AUC0-∞ was found to be 〉 85% for all the subjects, as recommended by the FDA guidelines.

Acute cholestatic hepatitis caused by amoxicillin/ clavulanate

Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used,especially for the treatment of respiratory and cutaneous infections.In general,it is a well-tolerated oral antibiotic.However,amoxicillin/clavulanate can cause adverse effects,mainly cutaneous,gastrointestinal,hepatic and hematologic,in some cases.Presented here is a case report of a 63-yearold male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate.After 6 wk of prolonged use of the drug,he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia(total bilirubin>300 mg/L).Diagnostic investigation was conducted by ultrasonography of the upper abdomen,serum tests for infection history,laboratory screening of autoimmune diseases,nuclear magnetic resonance(NMR)of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound.The duration of disease was approximately 4 mo,with complete resolution of symptoms and laboratory changes at the end of that time period.Specific treatment was not instituted,only a combination of anti-emetic(metoclopramide)and cholestyramine for pruritus.

Bioequiwalence of clavulanate Potassium and Amoxicillin(1:7) dispersible tablets in healthy volunteers

To study the bioequivalence of Clavulanate Potassium and Amoxicillin (1:7) dispersible tablets, a randomized cross over study was conducted in 18 healthy volunteers. A single oral dose of 1000 mg Clav ulanate Potassium and Amoxicillin (1:7) dispersible tablets (Tested formulation, T) or Augmentin syrup (Reference formulation, R). Concentrations in plasma were determined with high performance liquid chromatography. The main paramaters of T were: for Clavulanate Potassium and Amoxicillin, C max : 2.46±1.11 μg/m l and 18.81±7.26 μg/ml, T max : 1.12±0.23h and 1.30±0.34h, AUC (0 - 6 h) : 5.18±2.24 μg·h/ml and 45.09±14.53 μg·h/ml, t 1/2 : 1.43±0.44 h and 1.09±0.22 h., respectively. The relative bioavailability of T to R were 9 6.5±19.2 % and 98.4±26.1 % , respectively. Statistical analysis showed that th e two formulations were bioequivalent.

Cefprozil versus Amoxicillin/Clavulanate for the Treatment of Acute Otitis Media in Children: Meta-Analysis of Efficacy and Safety

Introduction: The efficacy of amoxicillin combined with clavulanic acid in Acute Otitis Media (AOM) is not debatable, but studies report a high frequency of gastrointestinal adverse effects related to this intervention. In this scenario, several studies about the antibiotic cefprozil report that it has the same efficacy as amoxicillin/clavulanate for the treatment of AOM with significantly fewer side effects. The aim of our study was to compare the efficacy and safety of both treatments in AOM. Methodology: We searched for clinical trials and systematic reviews with or without meta-analyses in the Cochrane Group Register and the MEDLINE database up to November 2013, comparing the two interventions mentioned. Results were expressed as a rate of treatment failures or favorable response rates (clinical and microbiological in both cases), and as the rate of adverse events. The analysis was carried out considering the fixed and random effects models. The significance level used in the test for heterogeneity was 0.05. Funnel plot was used to search for publication bias. Results: 7 clinical trials were included in the analysis and no significant difference was found for both interventions regarding clinical and bacteriological response (RR = 1.02, 95% CI, 0.97-1.06, p = 0.780 and RR = 1.02, 95% CI, 0.99-1.07, p = 0.228, respectively). However, a significant difference was found in the comparison of adverse effects, showing that amoxicillin/clavulanate has a significantly higher risk of developing side effects than cefprozil (RR = 0.52, 95% CI, 0.45-0.59, p = 0.000). Conclusion: Both treatments demonstrated equal clinical and microbiological efficacy. However, the use of cefprozil is significantly associated with a lower risk of adverse effects.

阿莫西林克拉维酸钾联合第三代头孢类抗菌药治疗新生儿肺炎的临床效果及其对肠道菌群的影响

目的分析阿莫西林克拉维酸钾与第三代头孢类抗菌药联合应用于新生儿肺炎患儿的应用效果及其对患儿肠道菌群的影响。方法选择在2021年2月—2022年11月期间于我院新生儿科接受相关治疗的100例新生儿肺炎患儿,依照简单随机化法将患儿分为研究组(n=50)及参照组(n=50)。给予参照组常规新生儿肺炎治疗,在此基础上给予研究组患者阿莫西林克拉维酸钾与第三代头孢类抗菌药的联合治疗。治疗结束后对比两组患儿的血清因子水平、肠道菌落情况、临床疗效以及不良反应发生情况。结果治疗前,两组患儿的血清因子水平、肠道内菌群数量比较差异无统计学意义(P>0.05),治疗后两组患儿的降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)、白细胞计数(white blood cell count,WBC)、肠球菌、肠杆菌、双歧杆菌以及乳酸杆菌水平均有改善(P<0.05),其中研究组的PCT、CRP、WBC、肠球菌、双歧杆菌以及乳酸杆菌数量低于参照组,而研究组的肠杆菌数量高于参照组;同时研究组的临床有效率(94.00%)与参照组的临床有效率(86.00%)比较差异无统计学意义(P>0.05);两组患儿的不良反应发生率比较差异无统计学意义(P>0.05),但其中研究组腹泻的发生率高于参照组(P<0.05)。结论在对新生儿肺炎患儿进行治疗时采取阿莫西林克拉维酸钾单纯治疗与阿莫西林克拉维酸钾+第三代头孢类抗菌药(头孢他啶)的临床疗效相当,联合用药虽能更为显著地减少患儿机体的细菌数量,改善血清因子水平,但更易发生腹泻的并发症,且为了减少耐药性,应适当采用单独用药。

阿莫西林-克拉维酸钾序贯治疗反复下呼吸道感染患儿的疗效

目的观察阿莫西林-克拉维酸钾序贯治疗反复下呼吸道感染(recurrent lower respiratory tract infection,RLRTI)患儿的疗效及对潮气肺功能,血清白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)、白细胞介素-10(interleukin-10,IL-10)水平的影响。方法纳入近92例RLRTI患儿作为研究对象,用随机数字表法分为观察组和对照组,各46例,应用阿莫西林-克拉维酸钾治疗。对照组静脉滴注7~10 d,观察组序贯治疗(静脉滴注3~5 d,口服混悬剂4~5 d)。比较2组临床疗效、主要症状(发热、咳嗽、喘息和肺啰音)消失时间、白细胞计数(white blood cell count,WBC)恢复时间、住院时间;治疗前后潮气肺功能指标(潮气量、呼吸频率、吸气时间、呼气时间、吸呼比、达峰时间比和达峰容积比)、血清炎症因子(IL-6、IL-8和IL-10)水平,及治疗期间不良反应。结果观察组的治疗总有效率高于对照组(P<0.05);观察组发热、咳嗽、喘息、肺啰音消失时间,WBC恢复时间及住院时间均短于对照组(P<0.05);2组呼吸频率均较治疗前下降(P<0.05),吸气时间、呼气时间、达峰时间比、达峰容积比均较治疗前升高(P<0.05),且观察组达峰时间比、达峰容积比均高于对照组(P<0.05);2组血清IL-6、IL-8水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);IL-10水平均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05);2组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论阿莫西林-克拉维酸钾序贯治疗小儿RLRTI可促进症状恢复,改善潮气肺功能,提高疗效,机制可能与其调节IL-6、IL-8、IL-10等炎症细胞因子的表达水平有关。

注射用阿莫西林钠/克拉维酸钾中两组分成盐率的分析

目的建立离子色谱法同时测定注射用阿莫西林钠/克拉维酸钾中钠离子与钾离子的含量,通过计算其成盐率,对不同企业样品的成盐工艺进行评价。方法采用IonPacCS12A阳离子交换色谱柱(4mm×250mm)和IonPac CG12A保护柱(4mm×50m m),检测器为电导检测器,抑制器电流为20mA,以6.7mmol/L甲烷磺酸溶液为淋洗液,流速为1.0 mL/min。结果钠离子浓度在6.01~18.04μg/mL范围内与峰面积呈良好的线性关系(r=0.9999,n=5);平均回收率为100.4%(RSD=0.4%,n=9);钾离子浓度在3.33~9.98μg/mL范围内与峰面积呈良好的线性关系(r=0.9998,n=5);平均回收率为100.2%(RSD=0.5%,n=9)。测定了37批注射用阿莫西林钠/克拉维酸钾中钠和钾的含量,其成盐率分别为1.00~1.13和0.94~1.05。结论本方法可用于注射用阿莫西林钠/克拉维酸钾中钠离子与钾离子的含量测定,各企业样品成盐情况较好,但需关注成盐剂的残留。

阿莫西林克拉维酸钾及替硝唑综合疗法对胃炎患儿的疗效及对hs-CRP、TNF-α、IL-10水平的影响

目的 研究阿莫西林克拉维酸钾及替硝唑综合疗法对胃炎患儿的疗效及对超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)水平的影响。方法 选择2019年7月至2021年7月收治的84例胃炎患儿,随机双盲对照法将其分为二药联合组及单药治疗组,每组42例。单药治疗组予以阿莫西林克拉维酸钾治疗,二药联合组则于单药治疗组的基础上增用替硝唑治疗。比较2组临床疗效,血清炎症指标及免疫功能指标水平,不良反应发生情况。结果 二药联合组治疗总有效率高于单药治疗组(P<0.05)。治疗前2组hs-CRP、TNF-α以及IL-10水平差异无统计学意义(P>0.05);治疗后,二药联合组血清hs-CRP、TNF-α水平均低于单药治疗组,而血清IL-10水平,高于单药治疗组(P<0.05)。治疗前,2组CD3^(+)、CD4^(+)以及CD8^(+)水平差异无统计学意义(P>0.05);治疗后,二药联合组CD3^(+)、CD4^(+)以及CD8^(+)水平均高于单药治疗组(均P<0.05)。二药联合组不良反应总发生率低于单药治疗组(P<0.05)。结论 阿莫西林克拉维酸钾及替硝唑综合疗法可提高胃炎患儿疗效,尤其是在减轻炎性反应及提高免疫功能方面优势明显,且有效降低不良反应发生风险。

痰热清注射液联合注射用阿莫西林钠克拉维酸钾治疗小儿支气管肺炎的效果及安全性

目的 观察痰热清注射液联合注射用阿莫西林钠克拉维酸钾治疗小儿支气管肺炎的临床效果及安全性。方法 回顾性选取2020年1月—2022年12月鹰潭市中医院收治的支气管肺炎患儿70例,根据用药方法分为西药组与中药联合组,各35例。西药组患儿予注射用阿莫西林钠克拉维酸钾,中药联合组患儿在西药组基础上予痰热清注射液,2组均持续用药1周。比较2组临床疗效,症状及体征消失时间,用药前后肺功能指标、免疫指标、血清炎性因子及不良反应。结果 中药联合组总有效率高于西药组(97.14%vs. 77.14%,χ^(2)=4.590,P=0.032)。中药联合组体温恢复正常时间、呼吸功能改善时间及咳嗽、肺部啰音、肺部病灶消失时间均短于西药组(P<0.05)。用药1周后,2组第1秒用力呼气容积、用力肺活量、呼气流量峰值及免疫球蛋白A、免疫球蛋白G、免疫球蛋白M、血清白介素-2、白介素-10水平高于用药前,血清肿瘤坏死因子-α水平低于用药前,且中药联合组高/低于西药组(P<0.01)。中药联合组与西药组不良反应总发生率比较,差异无统计学意义(5.71%vs. 8.57%,P=1.000)。结论 小儿支气管肺炎采用痰热清注射液联合注射用阿莫西林钠克拉维酸钾治疗的临床效果显著,能够明显改善患儿的肺功能,提高免疫功能,减轻炎性反应,进而促进症状及体征快速消失,且安全性较高。

阿莫西林克拉维酸钾对防治前列腺增生TURP术后感染的影响

目的观察阿莫西林克拉维酸钾对前列腺增生患者经尿道前列腺切除术(TURP)术后感染的防治效果。方法选取112例前列腺增生患者,按照随机数字表法分为对照组和观察组,每组56例。患者均接受TURP治疗,对照组术后实施常规抗感染治疗,观察组术后采用阿莫西林克拉维酸钾辅助治疗,比较两组的炎症指标、免疫指标改善情况,术后感染发生情况及用药安全性。结果治疗后,观察组的CRP、IL-10均低于对照组,T淋巴细胞CD4^(+)/CD3^(+)、CD4^(+)/CD8^(+)均高于对照组,CD8^(+)/CD3^(+)以及术后感染发生率均低于对照组,差异均具有统计学意义(P<0.05)。两组药物不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿莫西林克拉维酸钾辅助TURP治疗,能有效改善前列腺增生患者的炎症指标并增强免疫功能,有利于降低术后感染发生风险,且联合应用此药未明显增加不良反应发生风险,用药安全性较高。

阿莫西林克拉维酸钾联合中药溻渍外敷治疗丹毒的临床效果观察

目的:探究阿莫西林克拉维酸钾联合中药溻渍外敷治疗丹毒的临床效果观察.方法:选取2020年2月至2022年12月期间本院收治的82例下肢丹毒患者作为研究对象.将患者随机分为对照组和研究组,各41例.对照组使用阿莫西林克拉维酸钾治疗,研究组在对照组的基础上联合中药溻渍外敷治疗.分析比较两组的炎症反应指标、症状缓解指标及临床疗效.结果:治疗前,两组C-反应蛋白(C-reactive protein,CRP)、白细胞计数(White blood cell,WBC)、中性粒细胞计数(Neutrophil count,NEUT)指标无明显差异(P>0.05).治疗后,两组CRP、WBC、NEUT指标值均明显下降,且研究组明显低于对照组(P<0.05);研究组肿痛持续时间、皮温升高时间均明显低于对照组(P<0.05);研究组的治疗有效率显著高于对照组(P=0.001).结论:采用阿莫西林克拉维酸钾联合中药溻渍外敷治疗下肢丹毒,能提高临床疗效,降低患者CRP、WBC、NEUT炎症反应指标,缓解临床症状.

细菌溶解产物辅助治疗小儿迁延性细菌性支气管炎的临床观察

目的:探究细菌溶解产物辅助阿莫西林克拉维酸钾+氨溴特罗用于小儿迁延性细菌性支气管炎的治疗效果.方法:选取我院2021年1月至2022年12月收治88例迁延性细菌性支气管炎患儿作为研究对象,采用单双号法随机分组为观察组和对照组,每组各44例.对照组患儿给予阿莫西林克拉维酸钾+氨溴特罗的治疗方案,观察组患儿在对照组患儿治疗基础上联合细菌溶解产物治疗.观察并比较两组患儿治疗7 d后治疗效果(治疗期间发热、咳嗽、肺部湿啰音消失时间);治疗前及治疗7 d后免疫检测物水平(血清免疫球蛋白A(ImmunoglobulinA,IgA)、血清免疫球蛋白G(ImmunoglobulinG,IgG)、CD4^(+)T淋巴细胞群、CD8^(+)T淋巴细胞群);治疗前及治疗7 d后炎症因子水平(C-反应蛋白(C-reactive protein,CRP)、前降钙素);随访2 m内细菌性支气管炎复发率.结果:治疗后,两组患儿IgA、IgG、CD4^(+)、CD8^(+)水平较治疗前显著提升(P<0.05);且观察组患儿IgA、IgG、CD4^(+)、CD8^(+)水平明显高于对照组,临床症状消失时间、抗生素使用时间、CRP、前降钙素水平和复发率明显低于对照组(P<0.05).结论:细菌溶解产物辅助阿莫西林克拉维酸钾+氨溴特罗可加快迁延性细菌性支气管炎患儿症状消失,减轻炎症反应,提升其免疫水平以降低复发风险,且安全性高,建议临床推广使用.

氨溴索联合注射用阿莫西林克拉维酸钾治疗小儿支气管肺炎的临床效果

目的探究氨溴索联合注射用阿莫西林克拉维酸钾治疗小儿支气管肺炎的临床效果。方法选取2021年5月至2023年5月蒲城县医院收治的120例支气管肺炎患儿作为研究对象,按照随机数字表法分为对照组(60例)与观察组(60例)。对照组采用氨溴索治疗,观察组在对照组基础上联合注射用阿莫西林克拉维酸钾治疗。比较两组临床疗效、炎症因子水平、临床症状消退时间及不良反应发生情况。结果治疗后,观察组临床总有效率高于对照组(P<0.05);观察组白介素-6、肿瘤坏死因子-α、超敏C反应蛋白水平低于对照组(P<0.05);观察组发热、肺部啰音、扁桃体充血、咳嗽消退时间短于对照组(P<0.05);观察组不良反应总发生率低于对照组(P<0.05)。结论氨溴索联合注射用阿莫西林克拉维酸钾治疗小儿支气管肺炎可提高临床疗效,值得推广使用。

辛岑通窍颗粒联合布地奈德鼻喷雾剂与阿莫西林克拉维酸钾片治疗慢性鼻窦炎患儿的效果

目的:观察辛岑通窍颗粒联合布地奈德鼻喷雾剂与阿莫西林克拉维酸钾片治疗慢性鼻窦炎患儿的效果。方法:选取2020年9月至2021年10月该院收治的80例慢性鼻窦炎患儿进行前瞻性研究,按照随机数字表法分为对照组和观察组各40例。对照组给予布地奈德鼻喷雾剂联合阿莫西林克拉维酸钾片治疗,观察组在对照组基础上加用辛岑通窍颗粒治疗,比较两组临床疗效、治疗前后症状评分、炎性因子[白细胞介素(IL)-2、IL-4、IL-10]水平、鼻黏膜纤毛功能指标[鼻黏膜纤毛输送率(MTR)、鼻黏膜纤毛清除率(MCC)]水平和生命质量[鼻腔鼻窦结局测试-20(SNOT-20)]评分。结果:观察组治疗总有效率为97.50%,高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,两组鼻塞、流涕、头痛、嗅觉减退等症状评分和SNOT-20评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组IL-2、IL-4水平均低于治疗前,且观察组低于对照组,两组IL-10、MTR、MCC水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:辛岑通窍颗粒联合布地奈德鼻喷雾剂与阿莫西林克拉维酸钾片治疗慢性鼻窦炎患儿可提高治疗总有效率和鼻黏膜纤毛功能指标水平,改善炎性因子水平,降低症状评分和SNOT-20评分,优于布地奈德鼻喷雾剂联合阿莫西林克拉维酸钾片治疗效果。

阿莫西林克拉维酸钾联合水杨酸乙醇耳浴对化脓性中耳炎的疗效及免疫功能的影响

目的 探讨阿莫西林克拉维酸钾联合水杨酸乙醇耳浴对化脓性中耳炎的疗效及免疫功能的影响。方法 选取2019年5月-2022年6月贵州省人民医院收治的86例化脓性中耳炎患者。随机数表法分为对照组、研究组,每组43例。对照组给予水杨酸乙醇耳浴治疗,研究组在对照组基础上给予阿莫西林克拉维酸钾,两组均持续治疗2周后观察疗效。对比两组听力功能、致病菌清除率及临床疗效;比较两组的外周血炎症因子、免疫功能情况;记录治疗期间药物不良反应发生情况。结果 研究组治疗前后的气导阈值、骨导阈值的差值均高于对照组(P <0.05)。研究组致病菌率清除率、总有效率均高于对照组(P <0.05)。研究组治疗前后IL-4、TGF-β、IL-17和Th1/Th2、Th17/Treg、CD4^(+)/CD8^(+)的差值均高于对照组(P <0.05)。两组患者治疗期间未出现不良反应,心电图及肝肾功能亦无异常。结论 阿莫西林克拉维酸钾联合水杨酸乙醇耳浴治疗化脓性中耳炎可提高患者听力功能,清除致病菌,增强治疗疗效,进一步抑制炎症因子合成,改善患者免疫功能,安全可靠。

热炎宁合剂联合阿莫西林克拉维酸钾治疗猩红热患儿有效性和安全性研究

目的研讨猩红热患儿接受热炎宁合剂以及阿莫西林克拉维酸钾配合治疗的临床价值。方法选取2018年8月-2020年10月我院收诊的猩红热患儿70例,以随机数字表法完成分组,对照组35例接受阿莫西林克拉维酸钾单药治疗,观察组35例基于对照组用药条件施加热炎宁合剂口服,比较两组方案的临床药效、白细胞计数(WBC)、C反应蛋白(CRP)水平以及用药安全情况。结果观察组治疗后总有效率较对照组(94.3%vs71.4%)更高,比较有统计学意义(P<0.05)。观察组治疗后的WBC、CRP指标水平均低于对照组,比较有统计学意义(P<0.05)。两组发生不良反应的患儿总占比相当,无统计学意义(P>0.05)。结论热炎宁合剂与阿莫西林克拉维酸钾联合用药对猩红热患儿的治疗效果较好,能够有效抑制机体炎症反应,并保证用药安全。