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Thesis (M Med (Otorhinolaryngology))-- University of Limpopo, 2011. / Aims: The purpose of this study was to assess if the use of post-operative antibiotics have any beneficial effects in reducing morbidity following elective tonsillectomy in children with age range of 1-13 years. . Objectives: To assess the degree of post-tonsillectomy pain, determine the incidence of secondary haemorrhage, establish the time period to the resumption of a normal diet, document adverse effects of the use of antibiotics (e.g. skin rash, anaphylaxis, diarrhoea and vomiting), determine the bacteriology in tonsil removed and make recommendations on post-tonsillectomy treatment protocol at DGMH. Methods: This prospective study was conducted at DGMH on 81 children with an age range of l-13years (mean 5.7years). At total of 40 children received paracetamol l5mg/kg/day (Group A) in three divided doses for seven days, and 41 received amoxicillin 40 mg/kg/day and paracetamol (Group B) for the same duration. The post operative morbidity and bacteriology of the two treatment groups were compared. Primary outcomes measured included the incidence and severity of pain, use of analgesia, resumption of normal diet, incidence ofheamorrhage, fever, vomiting and adverse reactions.

Microbial keratitis is a major cause of avoidable visual impairment worldwide with S. aureus a leading cause of this disease in humans. Recently S. aureus isolated from eye infections have exhibited resistance to many antibiotics with those isolates from more severe infections exhibiting higher rates of antibiotic resistance. New therapies are therefore needed to ensure adequate treatment for these infections. In microbial keratitis the hosts' immune response is responsible for significant disease pathology so development of a therapy which also targets the immune response would be beneficial. The fimbrolides produced by Delisea pulchra are potential candidates as they are both growth inhibitory and immunomodulatory in vitro. The antibiotic susceptibility of clinical S. aureus isolates from ocular infections was determined using the CDS method and similarity of these isolates determined by PFGE and PCR-ribotyping. In addition the effect of fimbrolides on bacterial growth alone or in combination with antibiotics and the immune response to bacterial stimulation in PMNs and HCE cells was determined. Fimbrolides were then topically applied to S. aureus corneal infections and the effect of these compounds on disease progression determined by assessing corneal pathology, bacterial numbers and PMNs recovered from infected corneas. A larger proportion of keratitis isolates exhibited resistance to antibiotics than conjunctivitis isolates. Keratitis isolates were also related within a geographical region. The fimbrolides inhibited bacterial growth and modulated the immune response to bacterial stimulation in vitro. These compounds also exhibited synergy with conventional antimicrobials. In combination with ciprofloxacin the fimbrolides reduced the clinical score and numbers of bacteria recovered from ciprofloxacin-resistant or ciprofloxacin-sensitive S. aureus corneal infections. This thesis has identified that S. aureus isolates which produce the worst disease pathology in the eye are related and also exhibit higher rates of resistance to antibiotics indicating novel therapies to treat these infections are needed. This thesis demonstrated that fimbrolides inhibit S. aureus growth, exhibit synergy with antibiotics and modulate the immune response in vitro. In combination with ciprofloxacin the fimbrolides also improved disease pathology in keratitis, illustrating the potential of fimbrolides to be used as an adjunct therapy in the treatment of S. aureus keratitis.

Thesis (Masters)--California Institute of Technology, 1983. / Advisor names found in the Acknowledgments pages of the thesis. Title from home page. Viewed 02/09/10. Includes bibliographical references.

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