Ciprofloxacin is not a better choice in the patients with diabetes suffering urinary tract infection

Objective: The aim of this study is to determine antibacterial susceptibilities of Gram-negative bacteria isolated from diabetic and non-diabetic patients as infectious agents of community-acquired urinary tract infections (UTI) and to compare their rates of resistance to the antibiotics frequently used in empirical treatment. Methods: Ninety-six diabetic and sixty-eight non-diabetic (total n=164) patients’ data were evaluated retrospectively who diagnosed as community-acquired urinary system infection and consulted to outpatient clinics of Department of Endocrinology and Infectious Diseases of Firat University School of Medicine between January 1st , 2014 and December 31st, 2014 whose urine cultures demonstrated Gram-negative bacteria were included in the study. Antibiotic susceptibilities of the isolated bacteria were determined using Vitek 2 automated system and the results were evaluated as sensitive and resistant. Results: In both diabetic and non-diabetic patient groups, most frequently Escherichia coli (88.5% in diabetic and 85.3% in non-diabetic groups) were isolated. In the diabetic group, microorganisms mostly demonstrated the highest rates of resistance against ampicillin, cephalosporins, ciprofloxacin, amoxicillin-clavulanic acid and in the non-diabetic group ampicillin, amoxicillin-clavulanic acid, cefuroxime and trimethoprim-sulfamethoxazole. Conclusion: Resistance to ciprofloxacin was at a significantly higher rate in the diabetic group. In diabetic patients, it will be more appropriate to give antibiotherapy in urinary system infections based on the antibacterial susceptibility test results

Efficacy of chemotherapeutics in classic and non-classic Kaposi sarcoma: A single-center retrospective real-world data

Kaposi sarcoma is a rare disease and there is a gap in the literature about which chemotherapeutics should be applied, especially for the classical type. We aimed to present our institutional data on the demographic characteristics, treatment, and treatment efficacy in 16 Kaposi sarcoma (KS) patients treated with chemotherapy. We retrospectively analyzed the demographic and clinical characteristics, and the chemotherapeutic agents administered to the 16 KS patients diagnosed in our center and treated with chemotherapy, based on the medical records obtained. The median age, gender, type of KS, site of involvement, cytotoxic agents administered, progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety profiles of the patients were evaluated. The median age at disease onset was 61.07 years (range, 39.4–85.8 years). Among the patients, 1 had immunosuppression-related KS, 4 had AIDS-related KS, and 11 had classical KS. In the first-line cytotoxic therapy, 7 patients received pegylated-liposomal doxorubicin (PLD), 6 patients received paclitaxel, 2 patients received oral etoposide, and 1 patient received the adriamycin, bleomycin, and vincristine regimen. In the Kaplan–Meier analysis, the PFS was 39.9 months (95% CI, 7.7–72.0). In the first-line setting, a significant difference in terms of PFS was observed between the PLD- and paclitaxel-treated groups (not reached vs. 12.8 months, p = 0.033). The OS was 66.1 months (95% CI, 30.2–102.0). The ORR of the 16 patients was 43.8%, and their DCR was 81.3%. No grade 3 or 4 toxicity was observed. This retrospective study showed that PLD seems better than paclitaxel in terms of PFS and response rates and it has shown to have a good safety profile in KS patients