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Objectives: Although amoxicillin is the first‐line prophylactic drug for impacted mandibular third molar extraction, third‐generation cephalosporins are widely prescribed in Japan. The lack of real‐world evidence may be one reason for this inappropriate use. We evaluated differences in the incidence of surgical site infection between amoxicillin and third‐generation cephalosporins for impacted mandibular third molar extraction. Methods: Using the JMDC Claims Database, we identified dental visits with fully or horizontally impacted mandibular third molar extraction from April 2015 to March 2020. One‐to‐one propensity‐score matching was conducted between amoxicillin and third‐generation cephalosporin groups. The incidence of surgical site infection following extraction was compared in the matched pairs using McNemar's test. Results: We identified 109,266 dental visits, including 39,514 (36.2%) patients who received amoxicillin and 69,752 (63.8%) patients who received third‐generation cephalosporins. In the 39,514 matched pairs, the incidence of surgical site infection was 3.5% (n = 1399) for amoxicillin group and 3.7% (n = 1467) for third‐generation cephalosporin group (p = 0.003). Conclusions: Amoxicillin was associated with a lower incidence of surgical site infection after impacted mandibular third molar extraction compared with third‐generation cephalosporins. This result supports current guidelines and strengthens the importance of disseminating and implementing antimicrobial resistance control in dentistry. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) are the most common bacterial infections in children. This study aimed to review characteristics of causative bacteria and the effectiveness of antimicrobial therapy in children with febrile UTIs. Methods: Clinical records of 108 patients (130 episodes) with febrile UTIs admitted to the Kawasaki Medical School Hospital between July 2009 and October 2016 were retrospectively reviewed. The characteristics of the causative bacteria, antibacterial therapy, and therapeutic effect were verified. Results: Patients were aged between 0 and 183 months (median age: 3 months). Seventy‐three (67.6%) were males. Sixty‐three episodes (48.5%) were diagnosed with complicated UTIs. Forty‐seven episodes (36.2%) were observed in patients aged <3 months; 15 of them had complicated UTIs. Escherichia coli (E. coli) was the most common pathogen, followed by Enterococcus faecalis (E. faecalis). Blood cultures were positive in three episodes. Among the 130 episodes, 62 (47.7%) were treated with a combination of ampicillin and third‐generation cephalosporins, followed by third‐generation cephalosporins (31 episodes, 23.8%) and sulbactam sodium / ampicillin sodium (15 episodes, 11.5%). In case of patients with uncomplicated/complicated UTIs and patients aged <3 and ≥3 months, the most common pathogen was E. coli, followed by E. faecalis. There was no difference in therapeutic effects between "combination ampicillin and third‐generation cephalosporins" and "third‐generation cephalosporin monotherapy" administered for the treatment of UTIs caused by E. coli. Conclusions: Escherichia coli is the most common pathogen among pediatric UTIs. For antibacterial therapy, third‐generation cephalosporin monotherapy is effective and may not require combination therapy with ampicillin. [ABSTRACT FROM AUTHOR]

Staphylococcus pseudintermedius strains were isolated from healthy dogs and dogs with pyoderma in 2000-2002 and 2009. All the isolates from dogs with pyoderma in 1999-2000 and from healthy dogs in 2000-2002 and 2009 were susceptible to cefalexin and/or other cephalosporins and oxacillin. However, 7.1-12.5 and 11.4% of S. pseudintermedius isolates from dogs with pyoderma in 2009 were resistant to cephalosporins and oxacillin, respectively. All S. pseudintermedius isolates from dogs with pyoderma in 1999-2000 and those from healthy dogs in 2000-2002 were susceptible to fluoroquinolones; however, 50% of the S. pseudintermedius strains isolated from dogs with pyoderma in 2009 and 30% of the S. pseudintermedius strains isolated from healthy dogs in 2009 were resistant to fluoroquinolones. Of the 21 oxacillin-resistant S. pseudintermedius (MRSP) isolates, 11 carried SCC mec type V and 10 carried hybrid SCC mec types II-III. Staphylococcus pseudintermedius strains that were resistant to only one of three fluoroquinolones had a mutation in the quinolone resistance determination region of grlA, whereas S. pseudintermedius strains that were resistant to two or more fluoroquinolones had mutations in the quinolone resistance determination regions of both grlA and gyrA. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of prophylactic cefdinir (3 mg/kg given once daily) for the prevention of recurrent and complicated urinary tract infections (UTI) in pediatric patients. The study included 14 infants who were observed for at least 6 months following the first signs of infection (eight boys, six girls; mean age at admission [±SD]: 6.2 [±7.4] months). Twelve patients had vesico-ureteric reflux (grade I, two; grade II, three; grade III, six; grade IV, one), and two patients had ureteropelvic junction stenosis. No patients discontinued medication due to diarrhea or other adverse drug reactions. The patients had a 6-month recurrence-free rate of 93% (13/14); only one patient had recurrent UTI. The mean urinary cefdinir concentration was 16.3 [±11.7]µg/mL; there was considerable variability among individual measurements, even though the samples were collected at similar intervals after drug intake (mean 18.00 [±2.63] h after dose). However, the lowest measured urinary cefdinir concentration (1.16 µg/mL) was sufficient to eradicate Escherichia coli, one of the most significant causes of UTI. Fecal cultures, obtained at monthly clinic visits during the observation period, indicated that the patients' E. coli strains were very sensitive to cefdinir. No patients were infected with Pseudomonas aeruginosa or other non-fermenting Gram-negative bacilli or fungi. These results show that cefdinir given 3 mg/kg once daily is very effective and safe for preventing recurrent complicated UTI in infants. [ABSTRACT FROM AUTHOR]

The article focuses on occupational contact urticaria syndrome from cefotiam hydrochloride. Cefotiam hydrochloride (CTM) is a cephalosporin and one of the most common parenteral antibiotics in Japan in the last 10 years. Contact urticaria is classified as an immediate type of contact reaction and is further divided into 3 etiologic groups - non-immunologic, immunologic, and unknown. Contact urticaria related to antibiotics is usually accompanied by systemic symptoms, such as hypersensitivity reaction and is thus called contact urticaria syndrome.