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The addition of combined oral and topical antimicrobial therapy for male partners to treatment of women for bacterial vaginosis resulted in a lower rate of recurrence within 12 weeks than treatment of the woman alone.

This study explores the therapeutic effects of combining clindamycin phosphate tablets (CPT) with medroxyprogesterone acetate tablets (MAT) in treating endometritis. A total of 80 patients with endometritis, admitted between March 2021 and March 2024, were randomly divided into two groups: the control group (n=40) received CPT alone at a dosage of 0.3g per administration, 3 times daily; the observation group (n=40) received CPT (same dosage as control group) plus MAT at 6mg per administration, 3 times daily. Both groups continued treatment for 14 days. The observation group demonstrated a significantly higher treatment efficacy (92.50% vs. 75.00%) and better menstrual recovery. Clinical symptoms, such as pelvic pain and abnormal vaginal secretions, resolved more quickly in the observation group. Additionally, inflammatory markers IL-4, TNF-α, MMP-2, and MMP-9 decreased significantly post-treatment, while TGF-β1 increased and VCAM-1 decreased, indicating improved endometrial repair. No severe adverse reactions were observed. These findings suggest that the combination of CPT and MAT is more effective than CPT alone in alleviating symptoms, reducing inflammation, and promoting menstrual normalization in patients with endometritis Cette étude explore les effets thérapeutiques de l’association de comprimés de phosphate de clindamycine (CPT) et de comprimés d’acétate de médroxyprogestérone (MAT) dans le traitement de l’endométrite. Au total, 80 patientes atteintes d’endométrite, admises entre mars 2021 et mars 2024, ont été réparties aléatoirement en deux groupes : le groupe témoin (n = 40) a reçu du CPT seul à la dose de 0,3 g par administration, 3 fois par jour ; le groupe d’observation (n = 40) a reçu du CPT (même dosage que le groupe témoin) plus MAT à la dose de 6 mg par administration, 3 fois par jour. Les deux groupes ont poursuivi le traitement pendant 14 jours. Le groupe d’observation a démontré une efficacité thérapeutique significativement supérieure (92,50 % contre 75,00 %) et une meilleure récupération menstruelle. Les symptômes cliniques, tels que les douleurs pelviennes et les sécrétions vaginales anormales, ont disparu plus rapidement dans le groupe d’observation. De plus, les marqueurs inflammatoires IL-4, TNF-α, MMP-2 et MMP-9 ont diminué significativement après le traitement, tandis que TGF-β1 a augmenté et VCAM-1 a diminué, indiquant une amélioration de la réparation endométriale. Aucun effet indésirable grave n’a été observé. Ces résultats suggèrent que l’association CPT et MAT est plus efficace que la CPT seule pour soulager les symptômes, réduire l’inflammation et favoriser la normalisation menstruelle chez les patientes atteintes d’endométrite.

There are limited data on the role of antimicrobials in the treatment of skin abscesses. In this trial, clindamycin or trimethoprim–sulfamethoxazole was found to facilitate more rapid resolution than placebo in the management of skin abscess under 5 cm in diameter. More than 4 in 100 people seek treatment for skin infections annually in the United States. 1 Abscesses are the most common of these infections, and the majority of patients are treated as outpatients. 1 Serious complications, such as bacteremia, occur in rare cases. 1 , 2 Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA) strains, causes most skin infections, 3 , 4 but the appropriate strategy for the treatment of these infections has not been defined. Clindamycin and trimethoprim–sulfamethoxazole (TMP-SMX) are recommended for outpatient treatment of abscesses because of their low cost and in vitro activity against community-associated MRSA and methicillin-susceptible strains, 5 but data on their . . .

Background A three-pronged approach to acne treatment—combining an antibiotic, antibacterial, and retinoid—could provide greater efficacy and tolerability than single or dyad treatments, while potentially improving patient compliance and reducing antibiotic resistance. Objectives We aimed to evaluate the efficacy and safety of triple-combination, fixed-dose topical clindamycin phosphate 1.2%/benzoyl peroxide (BPO) 3.1%/adapalene 0.15% (IDP-126) gel for the treatment of acne. Methods In a phase II, double-blind, multicenter, randomized, 12-week study, eligible participants aged ≥ 9 years with moderate-to-severe acne were equally randomized to once-daily IDP-126, vehicle, or one of three component dyad gels: BPO/adapalene; clindamycin phosphate/BPO; or clindamycin phosphate/adapalene. Coprimary endpoints were treatment success at week 12 (participants achieving a ≥ 2-grade reduction from baseline in Evaluator’s Global Severity Score and clear/almost clear skin) and least-squares mean absolute changes from baseline in inflammatory and noninflammatory lesion counts to week 12. Treatment-emergent adverse events and cutaneous safety/tolerability were also assessed. Results A total of 741 participants were enrolled. At week 12, 52.5% of participants achieved treatment success with IDP-126 vs vehicle (8.1%) and dyads (range 27.8–30.5%; P ≤ 0.001, all). IDP-126 also provided significantly greater absolute reductions in inflammatory (29.9) and noninflammatory (35.5) lesions compared with vehicle or dyads (range inflammatory, 19.6–26.8; noninflammatory, 21.8–30.0; P < 0.05, all), corresponding to > 70% reductions with IDP-126. IDP-126 was well tolerated, with most treatment-emergent adverse events of mild-to-moderate severity. Conclusions Once-daily treatment with the novel fixed-dose triple-combination clindamycin phosphate 1.2%/BPO 3.1%/adapalene 0.15% gel demonstrated superior efficacy to vehicle and all three dyad component gels, and was well tolerated over 12 weeks in pediatric, adolescent, and adult participants with moderate-to-severe acne. Clinical Trial Registration ClinicalTrials.gov identifier NCT03170388 (registered 31 May, 2017).

Uncomplicated skin infections are a common outpatient clinical problem. In this randomized, controlled trial, clindamycin and trimethoprim–sulfamethoxazole (TMP-SMX) were compared as outpatient therapy for uncomplicated cellulitis or abscess. Skin and skin-structure infections (hereafter referred to as skin infections) are common conditions among patients seeking medical care in the United States, 1 , 2 accounting for approximately 14.2 million outpatient visits in 2005 1 and more than 850,000 hospital admissions. 3 Skin infections are associated with considerable complications, including bacteremia, the need for hospitalization and surgical procedures, and death. 4 , 5 Results of cultures of skin-infection lesions in the United States have shown that most of the infections are caused by methicillin-resistant Staphylococcus aureus (MRSA), 6 , 7 but the efficacy of various antibiotic regimens in areas where community-associated MRSA is endemic has not been defined. . . .

Acne vulgaris is a common skin condition that significantly impacts both physical appearance and mental well-being. Acne, being a chronic skin condition, often requires continuous treatment. This study aims to evaluate the efficacy and safety of clindamycin phosphate 1.2%/benzoyl peroxide 3% compared to clindamycin phosphate 1.2%/adapalene 0.1% combinations for treating acne vulgaris. A systematic review and meta-analysis of randomized controlled trials were carried out following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and three databases were searched to identify RCTs comparing CLIN/BPO with CLIN/ADAP. Primary outcomes included treatment-emergent adverse events, inflammatory and non-inflammatory lesion counts, and application site side effects. Statistical analyses were conducted using RevMan 5.3. The study included a total of 800 participants across three RCTs. The meta-analysis of three RCTs demonstrated a significantly lower risk of TEAEs with CLIN/BPO (OR = 0.49, 95% CI: 0.35–0.86, p  < 0.001). CLIN/BPO also resulted in fewer application site side effects (OR = 0.33, 95% CI: 0.23–0.47, p  < 0.001). However, no significant differences were observed between the groups for reducing inflammatory (MD = 1.34, 𝑝 = 0.121) or non-inflammatory lesion counts (MD = 0.04, 𝑝 = 0.98). The study concluded that although CLIN/BPO was associated with fewer side effects, both treatments were equally effective in reducing acne lesions. The favorable safety profile of CLIN/BPO, particularly regarding treatment-emergent and application-site adverse events, suggests it may be the more tolerable option for patients. Future studies with larger, more diverse populations are recommended to confirm these findings and explore long-term efficacy.

To determine if oral metronidazole (MTZ-400 mg bid) with 2% vaginal clindamycin-cream (Clind) or a Lactobacillus acidophilus vaginal-probiotic containing oestriol (Prob) reduces 6-month bacterial vaginosis (BV) recurrence. Double-blind placebo-controlled parallel-group single-site study with balanced randomization (1:1:1) conducted at Melbourne Sexual Health Centre, Australia. Participants with symptomatic BV [Nugent Score (NS) = 7-10 or ≥3 Amsel's criteria and NS = 4-10], were randomly allocated to MTZ-Clind, MTZ-Prob or MTZ-Placebo and assessed at 1,2,3 and 6 months. MTZ and Clind were administered for 7 days and Prob and Placebo for 12 days. Primary outcome was BV recurrence (NS of 7-10) on self-collected vaginal-swabs over 6-months. Cumulative BV recurrence rates were compared between groups by Chi-squared statistics. Kaplan-Meier, log rank and Cox regression analyses were used to compare time until and risk of BV recurrence between groups. 450 18-50 year old females were randomized and 408 (91%), equally distributed between groups, provided ≥1 NS post-randomization and were included in analyses; 42 (9%) participants with no post-randomization data were excluded. Six-month retention rates were 78% (n = 351). One-month BV recurrence (NS 7-10) rates were 3.6% (5/140), 6.8% (9/133) and 9.6% (13/135) in the MTZ-Clind, MTZ-Prob and MTZ-Placebo groups respectively, p = 0.13. Hazard ratios (HR) for BV recurrence at one-month, adjusted for adherence to vaginal therapy, were 0.43 (95%CI 0.15-1.22) and 0.75 (95% CI 0.32-1.76) in the MTZ-Clind and MTZ-Prob groups compared to MTZ-Plac respectively. Cumulative 6-month BV recurrence was 28.2%; (95%CI 24.0-32.7%) with no difference between groups, p = 0.82; HRs for 6-month BV recurrence for MTZ-Clind and MTZ-Prob compared to MTZ-Plac, adjusted for adherence to vaginal therapy were 1.09(95% CI = 0.70-1.70) and 1.03(95% CI = 0.65-1.63), respectively. No serious adverse events occurred. Combining the recommended first line therapies of oral metronidazole and vaginal clindamycin, or oral metronidazole with an extended-course of a commercially available vaginal-L.acidophilus probiotic, does not reduce BV recurrence. ANZCTR.org.au ACTRN12607000350426.

The primary aim of the present randomised, double-blind, placebo-controlled trial was to investigate whether clindamycin and live Lactobacillus crispatus CTV-05 (LACTIN-V) would improve clinical pregnancy rates in IVF patients with abnormal vaginal microbiota (AVM) defined by high quantitative PCR loads of Fannyhessea vaginae and Gardnerella spp . IVF patients were randomised prior to embryo transfer into three parallel groups 1:1:1. Group one (CLLA) received clindamycin 300 mg ×2 daily for 7 days followed by vaginal LACTIN-V until the day of pregnancy scan. Group two (CLPL) received clindamycin and placebo LACTIN-V, and finally, group three (PLPL) received an identical placebo of both drugs. A total of 1533 patients were screened, and 338 patients were randomised. The clinical pregnancy rates per embryo transfer were 42% (95%CI 32–52%), 46% (95%CI 36–56%) and 45% (95%CI 35–56%) in the CLLA, CLPL, PLPL groups respectively. Thus, treatment of AVM did not improve reproductive outcome. The EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) clinical trial identifier is 2016-002385-31; first registration day 2016-07-11. Here, the authors present the results of a randomised, double-blind, placebo-controlled trial testing whether clindamycin and live Lactobacillus crispatus CTV-05 (LACTIN-V) improve clinical pregnancy rates in IVF patients with abnormal vaginal microbiota, showing that successful treatment of vaginal dysbiosis was independent and not related to the reproductive success.

The clinical and financial impact of surgical site infection after ventral hernia repair is significant. Here we investigate the impact of dual antibiotic irrigation on SSI after VHR. This was a multicenter, prospective randomized control trial of open retromuscular VHR with mesh. Patients were randomized to gentamicin ​+ ​clindamycin (G ​+ ​C) (n ​= ​125) vs saline (n ​= ​125) irrigation at time of mesh placement. Primary outcome was 30-day SSI. No significant difference was seen in SSI between control and antibiotic irrigation (9.91 vs 9.09 ​%; p ​= ​0.836). No differences were seen in secondary outcomes: SSO (11.71 vs 13.64 ​%; p ​= ​0.667); 90-day SSO (11.1 vs 13.9 ​%; p ​= ​0.603); 90-day SSI (6.9 vs 3.8 ​%; p ​= ​0.389); SSIPI (7.21 vs 7.27 ​%, p ​= ​0.985); SSOPI (3.6 vs 3.64 ​%; p ​= ​0.990); 30-day readmission (9.91 vs 6.36 ​%; p ​= ​0.335); reoperation (5.41 vs 0.91 ​%; p ​= ​0.056). Dual antibiotic irrigation with G ​+ ​C did not reduce the risk of surgical site infection during open retromuscular ventral hernia repair. •Prospective randomized study of antibiotic irrigation effect on infection.•Patients randomized to gentamicin ​+ ​clindamycin vs saline irrigation.•No difference seen in surgical site infection between groups.•Underpowered to demonstrate potential difference in non-clean cases.

The dearth of new medicines effective against antibiotic-resistant bacteria presents a growing global public health concern 1 . For more than five decades, the search for new antibiotics has relied heavily on the chemical modification of natural products (semisynthesis), a method ill-equipped to combat rapidly evolving resistance threats. Semisynthetic modifications are typically of limited scope within polyfunctional antibiotics, usually increase molecular weight, and seldom permit modifications of the underlying scaffold. When properly designed, fully synthetic routes can easily address these shortcomings 2 . Here we report the structure-guided design and component-based synthesis of a rigid oxepanoproline scaffold which, when linked to the aminooctose residue of clindamycin, produces an antibiotic of exceptional potency and spectrum of activity, which we name iboxamycin. Iboxamycin is effective against ESKAPE pathogens including strains expressing Erm and Cfr ribosomal RNA methyltransferase enzymes, products of genes that confer resistance to all clinically relevant antibiotics targeting the large ribosomal subunit, namely macrolides, lincosamides, phenicols, oxazolidinones, pleuromutilins and streptogramins. X-ray crystallographic studies of iboxamycin in complex with the native bacterial ribosome, as well as with the Erm-methylated ribosome, uncover the structural basis for this enhanced activity, including a displacement of the m 2 6 A 2058 nucleotide upon antibiotic binding. Iboxamycin is orally bioavailable, safe and effective in treating both Gram-positive and Gram-negative bacterial infections in mice, attesting to the capacity for chemical synthesis to provide new antibiotics in an era of increasing resistance. Structure-guided design and component-based synthesis are used to produce iboxamycin, a novel ribosome-binding antibiotic with potent activity against Gram-positive and Gram-negative bacteria.