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Abstract
Telavancin was discovered by modifying the chemical structure of vancomycin and belongs to the group of lipoglycopeptides. It employs its antimicrobial potential through two distinct mechanisms of action: inhibition of bacterial cell wall synthesis and induction of bacterial membrane depolarization and permeabilization. In this article we review the clinically relevant pharmacokinetic and pharmacodynamic data of telavancin. For comparison, the pharmacokinetic and pharmacodynamic data of the other glycopeptides are presented. Although, in contrast to the newer lipoglycopeptides, telavancin demonstrates a relatively short half-life and rapid total clearance, its apparent volume of distribution (Vd) is almost identical to that of dalbavancin. The accumulation of telavancin after repeated dosing is only marginal, whereas the pharmacokinetic values of the other glycopeptides show much greater differences after administration of multiple doses. Despite its high plasma-protein binding of 90% and relatively low Vd of approximately 11 L, telavancin shows near complete equilibration of the free fraction in plasma with soft tissue. The ratio of the area under the plasma concentration-time curve from time zero to 24 h (AUC24) of unbound plasma concentrations to the minimal inhibitory concentration (MIC) required to inhibit growth of 90% of organisms (MIC90) of Staphylococcus aureus and S. epidermidis of telavancin are sufficiently high to achieve pharmacokinetic/pharmacodynamic targets indicative for optimal bacterial killing. Considering both the AUC24/MIC ratios of telavancin and the near complete equilibration of the free fraction in plasma with soft tissue, telavancin is an appropriate antimicrobial agent to treat soft tissue infections caused by Gram-positive pathogens. Although the penetration of telavancin into epithelial lining fluid (ELF) requires further investigations, the AUC24/MIC ratio for S. aureus indicates that bactericidal activity in the ELF could be expected.
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202
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Abstract
A series of novel coumarin-1,2,3-triazole derivatives were synthesized in good yield via click chemistry using Cu(I) catalyzed intermolecular Huisgen [3+2] cycloaddition reaction. All the synthesized compounds were characterized spectroscopically. This piece of work could be helpful to develop biologically relevant coumarin analogs.
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Affiliation(s)
- Ritu Mamgain
- Department of Chemistry, Modern College of Arts, Science and Commerce, Ganeshkhind, Pune-411007, India
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203
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Sadigursky D, Sousa MD, Cajaíba YGL, Martins RR, Lobão DMV. Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis. Rev Bras Ortop 2019; 54:617-26. [PMID: 31875059 DOI: 10.1016/j.rbo.2017.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/07/2017] [Indexed: 01/11/2023] Open
Abstract
Despite many existing strategies used to reduce the rates of surgical site infection (SSI), these are still fairly frequent complications that pose a challenge for orthopedic surgeons. Therefore, the search for more effective methods of perioperative infection prophylaxis became a main subject of research, with the goal of decreasing postoperative morbidity, mortality, and costs. Thus, the present study sought to assess the effectiveness of intra-wound vancomycin powder in orthopedic surgery SSI prophylaxis. A systematic review and meta-analysis study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). A comprehensive literature search was performed to identify controlled studies on the rates of SSI with or without the local use of vancomycin powder. Exclusion and inclusion criteria were applied. A meta-analysis with random effects was performed. Out of 412 titles that met the criteria, 7 studies regarding spine surgery were included: 4 prospective and 3 retrospective studies. A total of 6,944 cases were identified, and they were divided into 2 groups: the control group (3,814 patients), to whom intrawound vancomycin was not administered, and the intervention group (3,130 patients), to who vancomycin was administered locally. We observed that 64 (2.04%) patients in the intervention group developed SSI, in contrast to 144 (3.75%) patients in the control group. The results of the meta-analysis showed that the local use of vancomycin powder had an statistically significant protective effect against SSI in cases of spine surgery, with a relative risk (RR) of 0.59 and a 95% confidence interval (95%CI) of 0.35-0.98. The use of prophylactic intrawound vancomycin powder has a protective effect against SSI in spine surgeries; however, further prospective trials are needed to endorse its use in orthopedic surgeries.
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204
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Antonoplis A, Zang X, Wegner T, Wender PA, Cegelski L. Vancomycin-Arginine Conjugate Inhibits Growth of Carbapenem-Resistant E. coli and Targets Cell-Wall Synthesis. ACS Chem Biol 2019; 14:2065-2070. [PMID: 31479234 DOI: 10.1021/acschembio.9b00565] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The emergence of multi-drug-resistant Gram-negative bacteria, including carbapenem-resistant Enterobacteriaceae, is a major health problem that necessitates the development of new antibiotics. Vancomycin inhibits cell-wall synthesis in Gram-positive bacteria but is generally ineffective against Gram-negative bacteria and is unable to penetrate the outer membrane barrier. In an effort to determine whether vancomycin and other antibiotics effective against Gram-positive bacteria could, through modification, be rendered effective against Gram-negative bacteria, we discovered that the covalent attachment of a single arginine to vancomycin yielded conjugates with order-of-magnitude improvements in activity against Gram-negative bacteria, including pathogenic E. coli. The vancomycin-arginine conjugate (V-R) exhibited efficacy against actively growing bacteria, induced the loss of rod cellular morphology, and resulted in the intracellular accumulation of peptidoglycan precursors, all consistent with cell-wall synthesis disruption as its mechanism of action. Membrane permeabilization studies demonstrated an enhanced outer membrane permeability of V-R as compared with vancomycin. The conjugate exhibited no mammalian cell toxicity or hemolytic activity in MTT and hemolysis assays. Our study introduces a new vancomycin derivative effective against Gram-negative bacteria and underscores the broader potential of generating new antibiotics through combined mode-of-action and synthesis-informed design studies.
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Affiliation(s)
- Alexandra Antonoplis
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
| | - Xiaoyu Zang
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
| | - Tristan Wegner
- Organisch-Chemisches Institut, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany
| | - Paul A. Wender
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
- Department of Chemical and Systems Biology, Stanford University, Stanford, California 94305, United States
| | - Lynette Cegelski
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
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205
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Li S, Rong H, Zhang X, Zhang Z, Wang C, Tan R, Wang Y, Zheng T, Zhu T. Meta-analysis of topical vancomycin powder for microbial profile in spinal surgical site infections. Eur Spine J 2019; 28:2972-2980. [PMID: 31522274 DOI: 10.1007/s00586-019-06143-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/05/2019] [Accepted: 09/07/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To systematically evaluate the impact of topical vancomycin powder for microbial profile in spinal surgical site infections. METHODS All available literature regarding the topical use of vancomycin powder to prevent postoperative spinal infections was retrieved from the MEDLINE, EMBASE, and Cochrane databases starting from the creation date and up until September 30, 2018. RESULTS A total of 21 studies involving 15,548 patients were reviewed. The combined odds ratio showed that topical use of vancomycin powder was effective for reducing the incidence of gram-positive bacterial infections in spinal surgical sites (OR 0.41, P < 0.00001) without affecting its efficacy in the prevention of polymicrobial infections (OR 0.30, P = 0.03). Additionally, it could significantly reduce the infection rate of methicillin-resistant staphylococcus (OR 0.34, P < 0.0001). However, topical vancomycin powder showed no advantage for preventing gram-negative bacterial infections (OR 0.94, P = 0.75). CONCLUSIONS Topical administration of vancomycin powder may not increase the rates of gram-negative bacterial or polymicrobial infections in spinal surgical sites. On the contrary, it can significantly reduce the infection rates of gram-positive bacteria, methicillin-resistant staphylococcus (MRS) and microorganism. Of course, the topical vancomycin powder cannot change the rates of gram-negative bacterial infections, which may be related to the antimicrobial spectrum of vancomycin. Due to the limited number of articles included in this study, additional large-scale and high-quality studies are needed to provide more reliable clinical evidence.
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Affiliation(s)
- Sipeng Li
- Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Hongtao Rong
- Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Xueqin Zhang
- Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Zhengshan Zhang
- Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Chao Wang
- Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Rui Tan
- Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Yi Wang
- Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Ting Zheng
- Tianjin Medical University General Hospital, Tianjin, China
| | - Tao Zhu
- Department of Neurosurgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.
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206
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Šíma M, Hartinger J, Grus T, Slanař O. Initial dosing of intermittent vancomycin in adults: estimation of dosing interval in relation to dose and renal function. Eur J Hosp Pharm 2019; 28:276-279. [PMID: 34426481 DOI: 10.1136/ejhpharm-2019-002013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/24/2019] [Accepted: 07/30/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Due to the high interindividual variability in vancomycin pharmacokinetics, optimisation of its dosing is still challenging. This study aimed to explore vancomycin pharmacokinetics in adult patients and to propose an easy applicable dosing nomogram for initial treatment. METHODS Vancomycin pharmacokinetics was calculated in a two-compartmental model based on therapeutic drug monitoring data. A linear regression model was used to explore the relationship between vancomycin elimination half-life and glomerular filtration rate estimated according the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. RESULTS In the whole study population (n=66), vancomycin volume of distribution, clearance and half-life median (IQR) values were 0.69 (0.58-0.87) L/kg, 0.031 (0.022-0.050) L/h/kg and 14.4 (9.5-25.2) hours, respectively. Vancomycin half-life was associated with glomerular filtration rate (r2=0.4126, p<0.0001) according to the formula: t1/2 (h) = -0.247×eGFRCKD-EPI (mL/min/1.73 m2)+32.89. This relationship was used to construct a dosing nomogram. CONCLUSIONS We propose an easy-to-use dosing nomogram for vancomycin therapy initiation that allows individualisation of the dosing interval with respect to the administered dose size and functional renal status.
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Affiliation(s)
- Martin Šíma
- Department of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jan Hartinger
- Department of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Tomáš Grus
- 2nd Department of Surgery - Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Ondřej Slanař
- Department of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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207
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Piepenbreier H, Diehl A, Fritz G. Minimal exposure of lipid II cycle intermediates triggers cell wall antibiotic resistance. Nat Commun 2019; 10:2733. [PMID: 31227716 DOI: 10.1038/s41467-019-10673-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/23/2019] [Indexed: 01/08/2023] Open
Abstract
Cell wall antibiotics are crucial for combatting the emerging wave of resistant bacteria. Yet, our understanding of antibiotic action is limited, as many strains devoid of all resistance determinants display far higher antibiotic tolerance in vivo than suggested by the antibiotic-target binding affinity in vitro. To resolve this conflict, here we develop a comprehensive theory for the bacterial cell wall biosynthetic pathway and study its perturbation by antibiotics. We find that the closed-loop architecture of the lipid II cycle of wall biosynthesis features a highly asymmetric distribution of pathway intermediates, and show that antibiotic tolerance scales inversely with the abundance of the targeted pathway intermediate. We formalize this principle of minimal target exposure as intrinsic resistance mechanism and predict how cooperative drug-target interactions can mitigate resistance. The theory accurately predicts the in vivo efficacy for various cell wall antibiotics in different Gram-positive bacteria and contributes to a systems-level understanding of antibiotic action.
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208
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Affiliation(s)
- Kim T. Mortensen
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, U.K
| | - Thomas J. Osberger
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, U.K
| | - Thomas A. King
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, U.K
| | - Hannah F. Sore
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, U.K
| | - David R. Spring
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, U.K
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209
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Abstract
BACKGROUND AND OBJECTIVE The effect of cancer cachexia on the pharmacokinetics of vancomycin remains unclear. We investigated whether the pharmacokinetics of vancomycin and the risk of kidney injury are altered with the development of cancer cachexia. METHODS A retrospective analysis was conducted using therapeutic drug monitoring data obtained from 86 cancer patients who received vancomycin intravenously for infection. The patients were classified into four groups according to the stage of cachexia defined by international consensus-non-cachexia (n = 26), pre-cachexia (n = 10), cachexia (n = 21) and refractory cachexia (n = 29). Vancomycin pharmacokinetics were analyzed by a traditional one-compartment model and Bayesian method using plasma concentrations measured in these patients. Renal function and pharmacokinetic parameters were compared between the non-cachexia patients (n = 26) and total cancer cachexia patients (n = 60). RESULT No significant difference in estimated glomerular filtration rate was observed between the non-cachexia and the total cancer cachexia patients. In contrast, systemic clearance of vancomycin was significantly lower in the total cancer cachexia patients compared with the non-cachexia patients when analyzed by the traditional one-compartment model [median (range)-49.7 (9.8‒98.7) vs 70.2 (12.5‒211.8) mL/min, p < 0.01] and by the Bayesian method [45.6 (12.5-84.7) vs 63.3 (12.2-102.5) mL/min, p < 0.05]. None of the non-cachexia patients developed kidney injury, whereas 15% (9 of 60 patients) of the total cancer cachexia patients developed kidney injuries (p = 0.052). CONCLUSIONS The present study revealed that cancer patients with cachexia may have reduced vancomycin clearance compared with those without cachexia. Cancer cachexia may be a risk factor of vancomycin-associated kidney injury, independent of renal function.
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Affiliation(s)
- Hirokazu Nakayama
- Department of Pharmacy, NTT Medical Center Tokyo, 5-9-22 Higashi-gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.
| | - Masahiro Suzuki
- Department of Palliative Care, NTT Medical Center Tokyo, 5-9-22 Higashi-gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Toshiaki Kato
- Department of Pharmacy, NTT Medical Center Tokyo, 5-9-22 Higashi-gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Hirotoshi Echizen
- Department of Pharmacotherapy, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
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210
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Basco MDS, Kothari A, McKinzie PB, Revollo JR, Agnihothram S, Azevedo MP, Saccente M, Hart ME. Reduced vancomycin susceptibility and increased macrophage survival in Staphylococcus aureus strains sequentially isolated from a bacteraemic patient during a short course of antibiotic therapy. J Med Microbiol 2019; 68:848-859. [DOI: 10.1099/jmm.0.000988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- M. D. S. Basco
- 1 Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, USA
| | - A. Kothari
- 2 Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Page B. McKinzie
- 3 Division of Molecular and Genetic Toxicology, NCTR, Food and Drug Administration, Jefferson, Arkansas, USA
| | - J. R. Revollo
- 3 Division of Molecular and Genetic Toxicology, NCTR, Food and Drug Administration, Jefferson, Arkansas, USA
| | - S. Agnihothram
- 1 Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, USA
| | - M. P. Azevedo
- 1 Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, USA
| | - M. Saccente
- 2 Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - M. E. Hart
- 1 Division of Microbiology, National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, USA
- 4 Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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211
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Bidu NS, Fernandes BJ, Dias EJ, Filho JN, Bastos RE, Godoy AL, Azeredo FJ, Pedreira JN, Couto RD. Vancomycin Therapeutic Regime Adjustment in Newborns and Infants with Bacterial Infection: Case Series. Curr Pharm Biotechnol 2019; 20:346-351. [DOI: 10.2174/1389201020666190319161511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/29/2018] [Accepted: 03/12/2019] [Indexed: 11/22/2022]
Abstract
Background:
Vancomycin is used mostly to overcome infections caused by methicillinresistant
microorganisms. There are no well-established administration protocols for neonates and infants,
so the leak of a specific administration regime in that population may lead to serum concentrations
beyond the specified range.
Objective:
This case series evaluated the pharmacokinetics adjustment from a vancomycin therapeutic
regimen prescribed to neonates and infants with bacterial infection at a neonatal public hospital intensive-
care-unit, with the primary purpose to verify cases of nephrotoxicity.
Methods:
Three neonates and four infants taking vancomycin therapy, hospitalized in a public hospital
from November 2014 to March 2015, were included in the study. Vancomycin serum concentrations
were determined by particle-enhanced-turbidimetric inhibition-immunoassay. The vancomycin concentrations
were used for dose adjustment by USC*Pack-PC-Collection®, a non-parametric maximization
program. The trough serum concentration range of 10 to 20mg.L-1 was considered therapeutic.
Results:
Three patients had serum concentration outside the reference-range, one with subtherapeutic,
and two with supratherapeutic concentrations. All patients had concomitant use of drugs which interfered
with vancomycin distribution and excretion pharmacokinetics parameters, including drugs that
may enhance nephrotoxicity. One patient showed signs of acute renal damage, by low vancomycin and
creatinine estimated clearances.
Conclusion:
The pharmacokinetic adjustment has been proven to be a useful and necessary tool to
increase therapeutic efficacy and treatment benefits. The standard dose of vancomycin can be used to
initiate therapy in neonates and infants admitted to the ICU, but after reaching the drug steady state,
the dosing regimen should be individualized and guided by pharmacokinetic parameters.
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Affiliation(s)
- Nadielle S. Bidu
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | - Bruno J.D. Fernandes
- Clinical Biochemistry Laboratory, Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | | | | | - Regina E.A. Bastos
- Department of Pediatrics, Hospital Roberto Santos, Salvador, Bahia, Brazil
| | - Ana L.P.C. Godoy
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | - Francine J. Azeredo
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | - Joice N.R. Pedreira
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
| | - Ricardo D. Couto
- Pharmacy Postgraduate Program, Faculty of Pharmacy, Federal University of Bahia/UFBA, Salvador, Bahia, Brazil
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212
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Hashimoto M, Iketani O, Ichinose N, Enoki Y, Taguchi K, Uno S, Uwamino Y, Hasegawa N, Matsumoto K. Evaluation for optimal dosing of vancomycin in patients with different physical types. J Infect Chemother 2019; 25:735-737. [PMID: 31126752 DOI: 10.1016/j.jiac.2019.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/13/2019] [Accepted: 04/20/2019] [Indexed: 10/26/2022]
Abstract
The sufficient dose to obtain an optimal trough concentration of vancomycin (VCM) in patients with non-standard physical types remains controversial. In this study, we examined the relationship between the dose and physical type in patients in whom an optimal trough concentration was obtained among VCM-treated patients. We retrospectively investigated the dose of VCM and physical type in patients treated with VCM between January 2012 and January 2017 at two medical institutions (n = 272). The physical type was classified using the body mass index (BMI). Patients with a BMI of <18.5 kg/m2 were assigned to the lean group, those with a BMI of 18.5-24.9 kg/m2 were assigned to the standard group, and those with a BMI of ≥25 kg/m2 were assigned to the obesity group. The mean doses of VCM per time (mg/kg) to achieve the target trough concentration of VCM, 15-20 μg/mL, were 19.8 ± 4.3, 16.5 ± 3.7, and 13.7 ± 2.7 mg/kg in the lean, standard, and obesity groups, respectively. The dose per time to achieve the target trough concentration decreased significantly in association with an increase of BMI. The upper limit of the recommended dose (15-20 mg/kg) or higher in lean patients, and the lower dose in obese patients than the recommended dose might be appropriate to achieve the target trough concentration when we calculated the dose per time based on actual body weight.
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Affiliation(s)
- Mari Hashimoto
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan; Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Osamu Iketani
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naoki Ichinose
- Showa General Hospital Pharmaceutical Department, 8-1-1 Hanakoganei, Kodaira-shi, Tokyo, 187-8510, Japan
| | - Yuki Enoki
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan.
| | - Kazuaki Taguchi
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan
| | - Shunsuke Uno
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yoshifumi Uwamino
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naoki Hasegawa
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuaki Matsumoto
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan
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213
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Kufel WD, Seabury RW, Mogle BT, Beccari MV, Probst LA, Steele JM. Readiness to implement vancomycin monitoring based on area under the concentration–time curve: A cross-sectional survey of a national health consortium. Am J Health Syst Pharm 2019; 76:889-94. [DOI: 10.1093/ajhp/zxz070] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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214
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Bezar IF, Mashruwala AA, Boyd JM, Stock AM. Drug-like Fragments Inhibit agr-Mediated Virulence Expression in Staphylococcus aureus. Sci Rep 2019; 9:6786. [PMID: 31043623 PMCID: PMC6494831 DOI: 10.1038/s41598-019-42853-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 04/01/2019] [Indexed: 11/23/2022] Open
Abstract
In response to the increasingly problematic emergence of antibiotic resistance, novel strategies for combating pathogenic bacteria are being investigated. Targeting the agr quorum sensing system, which regulates expression of virulence in Staphylococcus aureus, is one potentially useful approach for combating drug-resistant pathogens that has not yet been fully explored. A previously published study of a fragment screen resulted in the identification of five compound fragments that interact with the DNA-binding domain of the response regulator AgrA from S. aureus. We have analyzed the ability of these compounds to affect agr-mediated virulence gene expression in cultured S. aureus cells. Three of the compounds demonstrated the ability to reduce agr-driven transcription at the P2 and P3 promoters of the agr operon and increase biofilm formation, and two of these compounds also showed the ability to reduce levels of secreted toxins. The finding that the compounds tested were able to reduce agr activity suggests that they could be useful tools for probing the effects of agr inhibition. Furthermore, the characteristics of compound fragments make them good starting materials for the development of compound libraries to iteratively improve the inhibitors.
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Affiliation(s)
- Ian F Bezar
- Department of Biochemistry and Molecular Biology, Center for Advanced Biotechnology and Medicine, Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, 08854, USA
- Graduate School of Biomedical Sciences at Robert Wood Johnson Medical School, Piscataway, New Jersey, 08854, USA
| | - Ameya A Mashruwala
- Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, New Jersey, 08901, USA
- Graduate School-New Brunswick, Rutgers University, New Brunswick, New Jersey, 08901, USA
- Department of Molecular Biology, Princeton University, Princeton, 08544, New Jersey, USA
| | - Jeffrey M Boyd
- Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, New Jersey, 08901, USA
| | - Ann M Stock
- Department of Biochemistry and Molecular Biology, Center for Advanced Biotechnology and Medicine, Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey, 08854, USA.
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215
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Abstract
Staphylococcus aureus is capable of becoming resistant to all classes of antibiotics clinically available and resistance can develop through de novo mutations in chromosomal genes or through acquisition of horizontally transferred resistance determinants. This review covers the most important antibiotics available for treatment of S. aureus infections and a special emphasis is dedicated to the current knowledge of the wide variety of resistance mechanisms that S. aureus employ to withstand antibiotics. Since resistance development has been inevitable for all currently available antibiotics, new therapies are continuously under development. Besides development of new small molecules affecting cell viability, alternative approaches including anti-virulence and bacteriophage therapeutics are being investigated and may become important tools to combat staphylococcal infections in the future.
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Guo T, van Hest RM, Roggeveen LF, Fleuren LM, Thoral PJ, Bosman RJ, van der Voort PHJ, Girbes ARJ, Mathot RAA, Elbers PWG. External Evaluation of Population Pharmacokinetic Models of Vancomycin in Large Cohorts of Intensive Care Unit Patients. Antimicrob Agents Chemother 2019; 63:e02543-18. [PMID: 30833424 DOI: 10.1128/AAC.02543-18] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/22/2019] [Indexed: 01/01/2023] Open
Abstract
Dosing of vancomycin is often guided by therapeutic drug monitoring and population pharmacokinetic models in the intensive care unit (ICU). The validity of these models is crucial, as ICU patients have marked pharmacokinetic variability. Therefore, we set out to evaluate the predictive performance of published population pharmacokinetic models of vancomycin in ICU patients. The PubMed database was used to search for population pharmacokinetic models of vancomycin in adult ICU patients. The identified models were evaluated in two independent data sets which were collected from two large hospitals in the Netherlands (Amsterdam UMC, Location VUmc, and OLVG Oost). We also tested a one-compartment model with fixed values for clearance and volume of distribution, in which a clinical standard dosage regimen (SDR) was mimicked to assess its predictive performance. Prediction error was calculated to assess the predictive performance of the models. Six models plus the SDR model were evaluated. The model of Roberts et al. (J. A. Roberts, F. S. Taccone, A. A. Udy, J.-L. Vincent, F. Jacobs, and J. Lipman, Antimicrob Agents Chemother 55:2704-2709, 2011, https://doi.org/10.1128/AAC.01708-10) performed satisfactorily, with mean and median values of prediction error of 5.1% and -7.5%, respectively, for Amsterdam UMC, Location VUmc, patients, and -12.6% and -17.2% respectively, for OLVG Oost patients. The other models, including the SDR model, yielded high mean values (-49.7% to 87.7%) and median values (-56.1% to 66.1%) for both populations. In conclusion, only the model of Roberts et al. was able to validly predict the concentrations of vancomycin for our data, whereas other models and standard dosing were largely inadequate. Extensive evaluation should precede the adoption of any model in clinical practice for ICU patients.
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217
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Affiliation(s)
- David W Nelson
- Plant Pathology, AgriFood & Biosciences Institute (AFBI), Belfast
| | - John E Moore
- School of Biomedical Sciences, Ulster University, Coleraine
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, UK
- Centre for Experimental Medicine, Queen’s University, Belfast, UK
| | - Juluri R Rao
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, UK
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218
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Itoh H, Inoue M. Comprehensive Structure–Activity Relationship Studies of Macrocyclic Natural Products Enabled by Their Total Syntheses. Chem Rev 2019; 119:10002-10031. [DOI: 10.1021/acs.chemrev.9b00063] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Hiroaki Itoh
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Masayuki Inoue
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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219
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Szűcs Z, Ostorházi E, Kicsák M, Nagy L, Borbás A, Herczegh P. New semisynthetic teicoplanin derivatives have comparable in vitro activity to that of oritavancin against clinical isolates of VRE. J Antibiot (Tokyo) 2019; 72:524-34. [PMID: 30874609 DOI: 10.1038/s41429-019-0164-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/11/2019] [Accepted: 02/24/2019] [Indexed: 11/08/2022]
Abstract
Ten analogues of a teicoplanin pseudoaglycon derivative have been synthesized with the aim of optimizing the in vitro activity of the compound against VanA type vancomycin resistant enterococci (VRE) isolated from hospitalized patients. Teicoplanin, vancomycin, and oritavancin were used as reference antibiotics for the antibacterial evaluations. One of the new derivatives exhibited far superior activity than the original compound. The in vitro MICs measured were comparable to that of oritavancin against the investigated VRE strains.
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220
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Abstract
Natural cyclic peptides are conformationally constrained notable biomolecules and reveal several drug-like properties such as high binding affinity, metabolic stability, target selectivity, bioavailability, low toxicity and flexibility. They have attracted a lot of attention as alternative sources of new drugs to traditional small molecules in drug discovery. Compared to classical medicines, cyclic peptides with a novel mechanism of action are attractive for their potential therapeutic applications particularly for cancer therapy and several diseases caused by resistant and non-resistant bacteria, virus, and fungi. Herein, we provide an overview of the naturally occurring biologically active cyclic peptide therapeutic landscape, including promising candidates, which are under trial in different stages for future and/or clinically used drugs against different diseases. This will certainly be an essential resource for upcoming and existing researchers and scientists within industry and academia in medicinal, bioorganic, and natural product chemistry.
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Affiliation(s)
- Smritilekha Bera
- School of Chemical Sciences, Central University of Gujarat, Gandhinagar - 382030, India
| | - Dhananjoy Mondal
- School of Chemical Sciences, Central University of Gujarat, Gandhinagar - 382030, India
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221
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Monserrat-Martinez A, Gambin Y, Sierecki E. Thinking Outside the Bug: Molecular Targets and Strategies to Overcome Antibiotic Resistance. Int J Mol Sci 2019; 20:ijms20061255. [PMID: 30871132 PMCID: PMC6470534 DOI: 10.3390/ijms20061255] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/04/2019] [Accepted: 03/04/2019] [Indexed: 12/25/2022] Open
Abstract
Since their discovery in the early 20th century, antibiotics have been used as the primary weapon against bacterial infections. Due to their prophylactic effect, they are also used as part of the cocktail of drugs given to treat complex diseases such as cancer or during surgery, in order to prevent infection. This has resulted in a decrease of mortality from infectious diseases and an increase in life expectancy in the last 100 years. However, as a consequence of administering antibiotics broadly to the population and sometimes misusing them, antibiotic-resistant bacteria have appeared. The emergence of resistant strains is a global health threat to humanity. Highly-resistant bacteria like Staphylococcus aureus (methicillin-resistant) or Enterococcus faecium (vancomycin-resistant) have led to complications in intensive care units, increasing medical costs and putting patient lives at risk. The appearance of these resistant strains together with the difficulty in finding new antimicrobials has alarmed the scientific community. Most of the strategies currently employed to develop new antibiotics point towards novel approaches for drug design based on prodrugs or rational design of new molecules. However, targeting crucial bacterial processes by these means will keep creating evolutionary pressure towards drug resistance. In this review, we discuss antibiotic resistance and new options for antibiotic discovery, focusing in particular on new alternatives aiming to disarm the bacteria or empower the host to avoid disease onset.
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Affiliation(s)
- Ana Monserrat-Martinez
- European Molecular Biology Laboratory Australia (EMBL Australia) Node in Single Molecule Science, Sydney, NSW 2031, Australia.
- School of Medical Sciences, The University of New South Wales, Sydney, NSW 2031, Australia.
| | - Yann Gambin
- European Molecular Biology Laboratory Australia (EMBL Australia) Node in Single Molecule Science, Sydney, NSW 2031, Australia.
- School of Medical Sciences, The University of New South Wales, Sydney, NSW 2031, Australia.
| | - Emma Sierecki
- European Molecular Biology Laboratory Australia (EMBL Australia) Node in Single Molecule Science, Sydney, NSW 2031, Australia.
- School of Medical Sciences, The University of New South Wales, Sydney, NSW 2031, Australia.
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222
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Wang L, Yuan Q, Tan M, Xie S, Wu J, Song X, Wang C. Evaluation of efficacy and nephrotoxicity during vancomycin therapy: A retrospective study in China. Exp Ther Med 2019; 17:2389-2396. [PMID: 30867724 DOI: 10.3892/etm.2019.7188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/23/2018] [Indexed: 12/13/2022] Open
Abstract
The aim of the present study was to investigate the predictive value of vancomycin serum concentrations regarding its efficacy and nephrotoxicity in a Chinese population and to determine a relatively safe optimal target concentration during vancomycin therapy. A total of 65 patients that received vancomycin between March 2013 and March 2018 at Shanghai 10th People's Hospital (Shanghai, China) were enrolled and their vancomycin trough and peak concentrations were monitored. Factor analysis was performed in order to exclude interaction between variables. Univariate and multivariate analyses were used to identify predictors of drug efficacy and nephrotoxicity. Receiver operating characteristic curve analysis was performed to determine the thresholds of the vancomycin trough and peak concentrations for optimal efficacy and acceptable nephrotoxicity, respectively. Among the 65 cases, treatment was deemed to be effective for 43 patients and ineffective for 22 patients. Furthermore, 20 patients fulfilled the criteria for nephrotoxicity. A total of 15 continuous variables loaded the first five factors by factor analysis (which converts large numbers of highly inter-correlated variables into a small number of comprehensive indicators that reflect a dimensionality reduction) and the factors were as follows: Inflammation, renal function, liver function, vancomycin trough and peak concentrations, and nutritional status. Univariate and multivariate analyses identified the trough concentration and peak concentration as independent variables associated with efficacy and nephrotoxicity of vancomycin, and the nutritional status was a risk factor associated with efficacy. Regarding efficacy, the critical values for the trough concentration and peak concentration were determined to be 9.02 mg/l (95.3% sensitivity and 68.2% specificity) and 23.62 mg/l (83.7% sensitivity and 59.1% specificity), respectively. The thresholds of vancomycin trough and peak concentrations for the development of nephrotoxicity were 16.08 mg/l (80.0% sensitivity and 84.4% specificity) and 30.42 mg/l (75.0% sensitivity and 73.3% specificity), respectively. In conclusion, during vancomycin therapy, the trough and peak concentrations are associated with efficacy and nephrotoxicity. Furthermore, a trough concentration between 9.02 and 16.08 mg/l and a peak concentration of 23.62-30.42 mg/l were determined to be relatively safe (the clinical trial registry no. ChiCTR-OPC-16007920).
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Affiliation(s)
- Liping Wang
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Qing Yuan
- Department of Emergency Medicine, Shanghai 10th People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Min Tan
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Shuanshuan Xie
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Jufang Wu
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Xiaolian Song
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University, Shanghai 200072, P.R. China
| | - Changhui Wang
- Department of Respiratory Medicine, Shanghai 10th People's Hospital, Tongji University, Shanghai 200072, P.R. China
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223
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Abstract
Drugs are discovered through the biological screening of collections of compounds, followed by optimization toward functional end points. The properties of screening collections are often balanced between diversity, physicochemical favorability, intrinsic complexity, and synthetic tractability (Huggins, D. J.; et al. ACS Chem. Biol. 2011, 6, 208; DOI: 10.1021/cb100420r ). Whereas natural product (NP) collections excel in the first three attributes, NPs suffer a disadvantage on the last point. Academic total synthesis research has worked to solve this problem by devising syntheses of NP leads, diversifying late-stage intermediates, or derivatizing the NP target. This work has led to the discovery of reaction mechanisms, the invention of new methods, and the development of FDA-approved drugs. Few drugs, however, are themselves NPs; instead, NP analogues predominate. Here we highlight past examples of NP analogue development and successful NP-derived drugs. More recently, chemists have explored how NP analogues alter the retrosynthetic analysis of complex scaffolds, merging structural design and synthetic design. This strategy maintains the intrinsic complexity of the NP but can alter the physicochemical properties of the scaffold, like core instability that renders the NP a poor chemotype. Focused libraries based on these syntheses may exclude the NP but maintain the molecular properties that distinguish NP space from synthetic space (Stratton, C. F.; et al. Bioorg. Med. Chem. Lett. 2015, 25, 4802; DOI: 10.1016/j.bmcl.2015.07.014 ), properties that have statistical advantages in clinical progression (Luker, T.; et al. Bioorg. Med. Chem. Lett. 2011, 21, 5673, DOI: 10.1016/j.bmcl.2011.07.074 ; Ritchie, T. J.; Macdonald, S. J. F. Drug Discovery Today 2009, 14, 1011, DOI: 10.1016/j.drudis.2009.07.014 ). Research that expedites synthetic access to NP motifs can prevent homogeneity of chemical matter available for lead discovery. Easily accessed, focused libraries of NP scaffolds can fill empty but active gaps in screening sets and expand the molecular diversity of synthetic collections.
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Affiliation(s)
- Benjamin J. Huffman
- Department of Chemistry, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, United States
| | - Ryan A. Shenvi
- Department of Chemistry, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, United States
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224
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Abstract
BACKGROUND Risk factors for the development of vancomycin-associated acute kidney injury (AKI) have been evaluated in both pediatric and adult populations; however, no previous studies exist evaluating this in the critically ill adolescent and young adult patients. OBJECTIVE Identify the incidence of AKI and examine risk factors for the development of AKI in critically ill adolescents and young adults on vancomycin. METHODS This retrospective review evaluated the incidence of AKI in patients 15 to 25 years of age who received vancomycin, while admitted to an intensive care unit. Acute kidney injury in this population was defined as an increase in serum creatinine by 0.5 mg/dL or 50% from baseline. Patients who developed AKI were evaluated for specific risk factors compared to those who did not develop AKI. RESULTS A total of 50 patients (20 developed AKI) were included in the study. There was no difference in vancomycin daily dose or duration of vancomycin therapy. Maximum vancomycin trough (31.15 mg/dL vs 12.5 mg/dL, P = .006), percentage of patients with concurrent nephrotoxic medication (95% vs 60%, P = .012) and concurrent vasopressor (55% vs 23%, P = .029) were higher in those who developed AKI. Percentage of patients who underwent a procedure while on vancomycin (35% vs 6.7%, P = .021) was also higher within the AKI group. CONCLUSIONS Vancomycin-associated AKI occurred in 40% of critically ill adolescent and young adult patients. These patients may be more likely to develop vancomycin-associated AKI if they had undergone a procedure, as well as in the presence of high vancomycin trough levels, concurrent nephrotoxic agents, and concurrent vasopressor therapy.
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Affiliation(s)
- William B Hays
- Department of Pharmacy, 22535Indiana University Health Methodist Hospital, Indianapolis, IN, USA
| | - Emma Tillman
- Department of Pharmacy, 22536Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
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225
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Secco G, Sachetti C, Rossato-Grando LG, Regina Hahn S, Pagnussat LR, da Cruz Fresco PMF, Dallazem Bertol C. Quality of Vancomycin for Injection Formulations in Brazil. CURR PHARM ANAL 2019. [DOI: 10.2174/1573412914666180116143232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The presence of impurities in vancomycin compromised the safety and contributed
to decrease of its use for years. In Brazil, vancomycin generic drug represents an option to reduce
hospital costs. However, the controversy over the quality of these formulations and their relationship
to effectiveness and safety raised concerns.
Objective and Methods:
To assess in vitro quality of vancomycin injections through uniformity of
weight, pH, clarity of solution, microbiological assay and impurities determination by High Performance
Liquid Chromatography (HPLC).
Results:
The samples were approved in the tests.
Conclusion:
The injectable formulations of vancomycin proved to be safe for use in hospital environment.
This work contributes to increase health professionals’ confidence on generic vancomycin.
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Affiliation(s)
- Gabriela Secco
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | - Cristiane Sachetti
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Siomara Regina Hahn
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | - Lidiane Riva Pagnussat
- Servico de Controle de Infeccao Hospitalar, Hospital Sao Vicente de Paulo, Passo Fundo, RS, Brazil
| | | | - Charise Dallazem Bertol
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
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226
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Collignon PJ, McEwen SA. One Health-Its Importance in Helping to Better Control Antimicrobial Resistance. Trop Med Infect Dis 2019; 4:E22. [PMID: 30700019 PMCID: PMC6473376 DOI: 10.3390/tropicalmed4010022] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/18/2019] [Accepted: 01/23/2019] [Indexed: 01/21/2023] Open
Abstract
Approaching any issue from a One Health perspective necessitates looking at the interactions of people, domestic animals, wildlife, plants, and our environment. For antimicrobial resistance this includes antimicrobial use (and abuse) in the human, animal and environmental sectors. More importantly, the spread of resistant bacteria and resistance determinants within and between these sectors and globally must be addressed. Better managing this problem includes taking steps to preserve the continued effectiveness of existing antimicrobials such as trying to eliminate their inappropriate use, particularly where they are used in high volumes. Examples are the mass medication of animals with critically important antimicrobials for humans, such as third generation cephalosporins and fluoroquinolones, and the long term, in-feed use of antimicrobials, such colistin, tetracyclines and macrolides, for growth promotion. In people it is essential to better prevent infections, reduce over-prescribing and over-use of antimicrobials and stop resistant bacteria from spreading by improving hygiene and infection control, drinking water and sanitation. Pollution from inadequate treatment of industrial, residential and farm waste is expanding the resistome in the environment. Numerous countries and several international agencies have now included a One Health Approach within their action plans to address antimicrobial resistance. Necessary actions include improvements in antimicrobial use, better regulation and policy, as well as improved surveillance, stewardship, infection control, sanitation, animal husbandry, and finding alternatives to antimicrobials.
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Affiliation(s)
- Peter J Collignon
- Infectious Diseases and Microbiology, Canberra Hospital, Garran, ACT 2605, Australia.
- Medical School, Australian National University, Acton ACT 2601, Australia.
| | - Scott A McEwen
- Department of Population Medicine, University of Guelph, Guelph N1G 2W1, Canada.
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227
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Gyamlani G, Potukuchi PK, Thomas F, Akbilgic O, Soohoo M, Streja E, Naseer A, Sumida K, Molnar MZ, Kalantar-Zadeh K, Kovesdy CP. Vancomycin-Associated Acute Kidney Injury in a Large Veteran Population. Am J Nephrol 2019; 49:133-142. [PMID: 30677750 DOI: 10.1159/000496484] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/21/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND To determine the association of vancomycin with acute kidney injury (AKI) in relation to its serum concentration value and to examine the risk of AKI in patients treated with vancomycin when compared with a matched cohort of patients receiving non-glycopeptide antibiotics (linezolid/daptomycin). METHODS From a cohort of > 3 million US veterans with baseline estimated glomerular filtration rate ≥60 mL/min/1.73 m2, we identified 33,527 patients who received either intravenous vancomycin (n = 22,057) or non-glycopeptide antibiotics (linezolid/daptomycin, n = 11,470). We examined the association of the serum trough vancomycin level recorded within the first 48 h of administration with subsequent AKI in all patients treated with vancomycin and association of vancomycin vs. non-glycopeptide antibiotics use with the risk of incident AKI. RESULTS The overall multivariable adjusted ORs of AKI stages 1, 2, and 3 in patients on vancomycin vs. non-glycopeptides were 1.1 (1.1-1.2), 1.2 (1-1.4), and 1.4 (1.1-1.7), respectively. When examined in strata divided by vancomycin trough level, the odds of AKI were similar or lower in patients receiving vancomycin compared to non-glycopeptide antibiotics as long as serum vancomycin levels were ≤20 mg/L. However, in patients with serum vancomycin levels > 20 mg/L, the ORs of AKI stages 1, 2, and 3 in patients on vancomycin vs. non-glycopeptide antibiotics were 1.5 (1.4-1.7), 1.9 (1.5-2.3), and 2.7 (2-3.5), respectively. CONCLUSIONS Vancomycin use is associated with a higher risk of AKI when serum levels exceed > 20 mg/L.
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Affiliation(s)
- Geeta Gyamlani
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA
| | - Praveen K Potukuchi
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- IHOP, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Fridtjof Thomas
- Division of Biostatistics, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Oguz Akbilgic
- Center for Biomedical Informatics, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Melissa Soohoo
- Division of Nephrology, University of California, Irvine, California, USA
| | - Elani Streja
- Division of Nephrology, University of California, Irvine, California, USA
| | - Adnan Naseer
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA
| | - Keiichi Sumida
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Miklos Z Molnar
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Division of Transplant Surgery, Methodist University Hospital Transplant Institute, Memphis, Tennessee, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | | - Csaba P Kovesdy
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA,
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA,
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228
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229
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Abstract
Metalloenzymes are central to a wide range of essential biological activities, including nucleic acid modification, protein degradation, and many others. The role of metalloenzymes in these processes also makes them central for the progression of many diseases and, as such, makes metalloenzymes attractive targets for therapeutic intervention. Increasing awareness of the role metalloenzymes play in disease and their importance as a class of targets has amplified interest in the development of new strategies to develop inhibitors and ultimately useful drugs. In this Review, we provide a broad overview of several drug discovery efforts focused on metalloenzymes and attempt to map out the current landscape of high-value metalloenzyme targets.
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Affiliation(s)
- Allie Y Chen
- Department of Chemistry and Biochemistry , University of California, San Diego , La Jolla , California 92093 , United States
| | - Rebecca N Adamek
- Department of Chemistry and Biochemistry , University of California, San Diego , La Jolla , California 92093 , United States
| | - Benjamin L Dick
- Department of Chemistry and Biochemistry , University of California, San Diego , La Jolla , California 92093 , United States
| | - Cy V Credille
- Department of Chemistry and Biochemistry , University of California, San Diego , La Jolla , California 92093 , United States
| | - Christine N Morrison
- Department of Chemistry and Biochemistry , University of California, San Diego , La Jolla , California 92093 , United States
| | - Seth M Cohen
- Department of Chemistry and Biochemistry , University of California, San Diego , La Jolla , California 92093 , United States
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230
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Sen F, Ganim MA, Baloglu MC, Aygun A, Sayiner HS, Altunoglu YC, Kandemirli F, Demirkan B, Kuyuldar E, Bulut E. Synergistic and Antagonistic Effects of Phenylalanine and Various Antibiotics on the Growth of Pathogenic Bacteria. BioNanoSci 2019; 9:446-52. [DOI: 10.1007/s12668-019-0597-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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231
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Atashgahi S, Liebensteiner MG, Janssen DB, Smidt H, Stams AJM, Sipkema D. Microbial Synthesis and Transformation of Inorganic and Organic Chlorine Compounds. Front Microbiol 2018; 9:3079. [PMID: 30619161 PMCID: PMC6299022 DOI: 10.3389/fmicb.2018.03079] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/29/2018] [Indexed: 12/26/2022] Open
Abstract
Organic and inorganic chlorine compounds are formed by a broad range of natural geochemical, photochemical and biological processes. In addition, chlorine compounds are produced in large quantities for industrial, agricultural and pharmaceutical purposes, which has led to widespread environmental pollution. Abiotic transformations and microbial metabolism of inorganic and organic chlorine compounds combined with human activities constitute the chlorine cycle on Earth. Naturally occurring organochlorines compounds are synthesized and transformed by diverse groups of (micro)organisms in the presence or absence of oxygen. In turn, anthropogenic chlorine contaminants may be degraded under natural or stimulated conditions. Here, we review phylogeny, biochemistry and ecology of microorganisms mediating chlorination and dechlorination processes. In addition, the co-occurrence and potential interdependency of catabolic and anabolic transformations of natural and synthetic chlorine compounds are discussed for selected microorganisms and particular ecosystems.
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Affiliation(s)
- Siavash Atashgahi
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, Netherlands
| | | | - Dick B. Janssen
- Department of Biochemistry, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen, Groningen, Netherlands
| | - Hauke Smidt
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, Netherlands
| | - Alfons J. M. Stams
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, Netherlands
- Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Detmer Sipkema
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, Netherlands
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232
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Abstract
One Health is the collaborative effort of multiple health science professions to attain optimal health for people, domestic animals, wildlife, plants, and our environment. The drivers of antimicrobial resistance include antimicrobial use and abuse in human, animal, and environmental sectors and the spread of resistant bacteria and resistance determinants within and between these sectors and around the globe. Most of the classes of antimicrobials used to treat bacterial infections in humans are also used in animals. Given the important and interdependent human, animal, and environmental dimensions of antimicrobial resistance, it is logical to take a One Health approach when addressing this problem. This includes taking steps to preserve the continued effectiveness of existing antimicrobials by eliminating their inappropriate use and by limiting the spread of infection. Major concerns in the animal health and agriculture sectors are mass medication of animals with antimicrobials that are critically important for humans, such as third-generation cephalosporins and fluoroquinolones, and the long-term, in-feed use of medically important antimicrobials, such as colistin, tetracyclines, and macrolides, for growth promotion. In the human sector it is essential to prevent infections, reduce over-prescribing of antimicrobials, improve sanitation, and improve hygiene and infection control. Pollution from inadequate treatment of industrial, residential, and farm waste is expanding the resistome in the environment. Numerous countries and several international agencies have included a One Health approach within their action plans to address antimicrobial resistance. Necessary actions include improvements in antimicrobial use regulation and policy, surveillance, stewardship, infection control, sanitation, animal husbandry, and alternatives to antimicrobials. WHO recently has launched new guidelines on the use of medically important antimicrobials in food-producing animals, recommending that farmers and the food industry stop using antimicrobials routinely to promote growth and prevent disease in healthy animals. These guidelines aim to help preserve the effectiveness of antimicrobials that are important for human medicine by reducing their use in animals.
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233
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Takigawa M, Masutomi H, Shimazaki Y, Arai T, Lee J, Ishii T, Mori Y, Ishigami A. Age-dependent changes in vancomycin-induced nephrotoxicity in mice. J Toxicol Pathol 2018; 32:57-66. [PMID: 30739996 PMCID: PMC6361666 DOI: 10.1293/tox.2018-0036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 10/01/2018] [Indexed: 11/19/2022] Open
Abstract
Vancomycin hydrochloride (VCM) is a glycopeptide antibiotic that is commonly used to eradicate methicillin-resistant gram-positive cocci, despite its nephrotoxic side effects. Elderly people are particularly susceptible to developing VCM-induced nephrotoxicity. However, the precise mechanism by which VCM induces nephrotoxicity in elderly people is not completely understood. Therefore, we investigated VCM-induced nephrotoxicity in mice of different ages. VCM was injected intraperitoneally into mice at 1, 3, 6, 12, and 24 months of age at a dosage of 400 mg/kg body weight for 3 and 14 days. Twenty-four hours after the last injection, we examined plasma creatinine levels and histopathological alterations in the kidneys. VCM administration increased plasma creatinine levels, and these values gradually increased to higher levels with aging. The histological examination revealed renal tubular degeneration, such as brush-border atrophy, apoptosis/necrosis of the tubular epithelium, and epithelial desquamation, that gradually became more severe with aging. Furthermore, immunohistochemical staining with anti-CD10 and anti-single-stranded DNA antibodies revealed damaged renal proximal tubules with marked dilatation, as well as numerous apoptotic cells, and these features increased in severity in 12- and 24-month-old mice receiving VCM. Based on these results, aged mice were highly susceptible to kidney damage induced by VCM administration. In addition, proximal tubular epithelial cells likely underwent apoptosis after the administration of VCM. This report is the first to document VCM-induced nephrotoxicity in mice of different ages. Thus, this mouse model could be useful for understanding the mechanisms of VCM-induced nephrotoxicity in the elderly.
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Affiliation(s)
- Masaki Takigawa
- Molecular Regulation of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.,Department of Pharmacy, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Hirofumi Masutomi
- Molecular Regulation of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yoshitomo Shimazaki
- Molecular Regulation of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.,Department of Pharmacy, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Tomio Arai
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Jaewon Lee
- College of Pharmacy, Pusan National University, 2, Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan 46241, Korea
| | - Toshihiro Ishii
- Department of Practical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, 2-2-1 Miyama, Funabashi, Chiba 274-8510, Japan
| | - Yoshiko Mori
- Molecular Regulation of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.,Department of Pharmacy, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Akihito Ishigami
- Molecular Regulation of Aging, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
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234
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Zhou Y, Gao F, Chen C, Ma L, Yang T, Liu X, Liu Y, Wang X, Zhao X, Que C, Li S, Lv J, Cui Y, Yang L. Development of a Population Pharmacokinetic Model of Vancomycin and its Application in Chinese Geriatric Patients with Pulmonary Infections. Eur J Drug Metab Pharmacokinet 2018; 44:361-370. [PMID: 30506225 PMCID: PMC6520475 DOI: 10.1007/s13318-018-0534-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The optimal use of vancomycin in the elderly requires information about the drug’s pharmacokinetics and the influence of various factors on the drug’s disposition. However, because of sampling restrictions, it is often difficult to perform traditional pharmacokinetic studies in elderly patients. Objective This study was conducted to estimate the population pharmacokinetics of vancomycin in Chinese geriatric patients (age ≥ 65 years) with pulmonary infections and to explore the clinical application of this information for vancomycin dose individualization. Methods The steady-state trough concentrations were retrospectively collected from January 2011 to December 2016 and were analyzed using the nonlinear mixed-effect model software. The final model was evaluated using the bootstrap method, goodness-of-fit plots and the normalized prediction distribution error method. Main Outcome Measure Model parameters and prediction error. Results A total of 125 steady-state trough concentrations from 70 patients were retrospectively collected. A one-compartment model was established. The final model was depicted as clearance (CL) [L/h] = 2.45 × (CLCR/56.28) × 0.542; volume of distribution (Vd) [L] = 154. The creatinine clearance (CLCR) was identified as the most significant covariate in the final model. The typical values of CL and Vd in the final model were 2.45 L/h and 154 L, respectively. Model validation outcomes showed that the final model was stable and had satisfactory prediction performance. Conclusion A population pharmacokinetic model was established to estimate the pharmacokinetics characteristics of Chinese geriatric patients with pulmonary infections, and this model can be used to develop an initial vancomycin dosing regimen for geriatric patients.
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Affiliation(s)
- Ying Zhou
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China.,Department of Pharmacy, Peking University First Hospital, No.6 Dahongluochang Street, Xicheng District, Beijing, China
| | - Feifei Gao
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China.,Department of Pharmacy, Peking University First Hospital, No.6 Dahongluochang Street, Xicheng District, Beijing, China
| | - Chaoyang Chen
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China
| | - Lingyun Ma
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China
| | - Ting Yang
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China
| | - Xiao Liu
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China
| | - Yaou Liu
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China
| | - Xiaoqing Wang
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China.,Department of Pharmacy, Peking University First Hospital, No.6 Dahongluochang Street, Xicheng District, Beijing, China
| | - Xia Zhao
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China
| | - Chengli Que
- Department of Respiratory Medicine, Peking University First Hospital, No.1 Dahongluochang Street, Xicheng District, Beijing, China
| | - Shuangling Li
- Intensive-Care Unit, Peking University First Hospital, No.1 Dahongluochang Street, Xicheng District, Beijing, China
| | - JiCheng Lv
- Department of Nephrology, Peking University First Hospital, No.1 Dahongluochang Street, Xicheng District, Beijing, China
| | - Yimin Cui
- College of Pharmacy, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing, China. .,Department of Pharmacy, Peking University First Hospital, No.6 Dahongluochang Street, Xicheng District, Beijing, China.
| | - Li Yang
- Department of Nephrology, Peking University First Hospital, No.1 Dahongluochang Street, Xicheng District, Beijing, China.
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235
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Lopes A, Pereira C, Almeida A. Sequential Combined Effect of Phages and Antibiotics on the Inactivation of Escherichia coli. Microorganisms 2018; 6:E125. [PMID: 30563133 PMCID: PMC6313441 DOI: 10.3390/microorganisms6040125] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 11/28/2018] [Accepted: 12/03/2018] [Indexed: 12/17/2022] Open
Abstract
The emergence of antibiotic resistance in bacteria is a global concern. The use of bacteriophages (or phages) alone or combined with antibiotics is consolidating itself as an alternative approach to inactivate antibiotic-resistant bacteria. However, phage-resistant mutants have been considered as a major threat when phage treatment is employed. Escherichia coli is one of the main responsible pathogens for moderate and serious infections in hospital and community environments, being involved in the rapid evolution of fluoroquinolones and third-generation cephalosporin resistance. The aim of this study was to evaluate the effect of combined treatments of phages and antibiotics in the inactivation of E. coli. For this, ciprofloxacin at lethal and sublethal concentrations was added at different times (0, 6, 12 and 18 h) and was tested in combination with the phage ELY-1 to inactivate E. coli. The efficacy of the combined treatment varied with the antibiotic concentration and with the time of antibiotic addition. The combined treatment prevented bacterial regrowth when the antibiotic was used at minimum inhibitory concentration (MIC) and added after 6 h of phage addition, causing less bacterial resistance than phage and antibiotic applied alone (4.0 × 10-7 for the combined treatment, 3.9 × 10-6 and 3.4 × 10-5 for the antibiotics and the phages alone, respectively). Combined treatment with phage and antibiotic can be effective in reducing the bacterial density and it can also prevent the emergence of resistant variants. However, the antibiotic concentration and the time of antibiotic application are essential factors that need to be considered in the combined treatment.
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Affiliation(s)
- Ana Lopes
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
| | - Carla Pereira
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
| | - Adelaide Almeida
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
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236
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Antonoplis A, Zang X, Huttner MA, Chong KKL, Lee YB, Co JY, Amieva MR, Kline KA, Wender PA, Cegelski L. A Dual-Function Antibiotic-Transporter Conjugate Exhibits Superior Activity in Sterilizing MRSA Biofilms and Killing Persister Cells. J Am Chem Soc 2018; 140:16140-16151. [PMID: 30388366 PMCID: PMC6430714 DOI: 10.1021/jacs.8b08711] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
New strategies are urgently needed to target MRSA, a major global health problem and the leading cause of mortality from antibiotic-resistant infections in many countries. Here, we report a general approach to this problem exemplified by the design and synthesis of a vancomycin-d-octaarginine conjugate (V-r8) and investigation of its efficacy in addressing antibiotic-insensitive bacterial populations. V-r8 eradicated MRSA biofilm and persister cells in vitro, outperforming vancomycin by orders of magnitude. It also eliminated 97% of biofilm-associated MRSA in a murine wound infection model and displayed no acute dermal toxicity. This new dual-function conjugate displays enhanced cellular accumulation and membrane perturbation as compared to vancomycin. Based on its rapid and potent activity against biofilm and persister cells, V-r8 is a promising agent against clinical MRSA infections.
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Affiliation(s)
- Alexandra Antonoplis
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
| | - Xiaoyu Zang
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
| | - Melanie A. Huttner
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
| | - Kelvin K. L. Chong
- Singapore Centre for Environmental Life Science Engineering (SCELSE), School of Biological Sciences, Nanyang Technological University, Singapore 637551
- Nanyang Technological University Institute for Health Technologies, Interdisciplinary Graduate School, Nanyang Technological University, Singapore 637553
| | - Yu B. Lee
- Singapore Centre for Environmental Life Science Engineering (SCELSE), School of Biological Sciences, Nanyang Technological University, Singapore 637551
| | - Julia Y. Co
- Department of Pediatrics, Division of Infectious Diseases, Stanford University, Stanford, California 94305, United States
| | - Manuel R. Amieva
- Department of Pediatrics, Division of Infectious Diseases, Stanford University, Stanford, California 94305, United States
- Department of Microbiology & Immunology, Stanford University, Stanford, California 94305, United States
| | - Kimberly A. Kline
- Singapore Centre for Environmental Life Science Engineering (SCELSE), School of Biological Sciences, Nanyang Technological University, Singapore 637551
| | - Paul A. Wender
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
- Department of Chemical and Systems Biology, Stanford University, Stanford, California 94305, United States
| | - Lynette Cegelski
- Department of Chemistry, Stanford University, Stanford, California 94305, United States
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237
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Vieira C, Gomes ATPC, Mesquita MQ, Moura NMM, Neves MGPMS, Faustino MAF, Almeida A. An Insight Into the Potentiation Effect of Potassium Iodide on aPDT Efficacy. Front Microbiol 2018; 9:2665. [PMID: 30510542 PMCID: PMC6252324 DOI: 10.3389/fmicb.2018.02665] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/18/2018] [Indexed: 12/15/2022] Open
Abstract
Antimicrobial photodynamic therapy (aPDT) is gaining a special importance as an effective approach against multidrug-resistant strains responsible of fatal infections. The addition of potassium iodide (KI), a non-toxic salt, is recognized to increase the aPDT efficiency of some photosensitizers (PSs) on a broad-spectrum of microorganisms. As the reported cases only refer positive aPDT potentiation results, in this work we selected a broad range of porphyrinic and non-porphyrinic PSs in order to gain a more comprehensive knowledge about this aPDT potentiation by KI. For this evaluation were selected a series of meso-tetraarylporphyrins positively charged at meso positions or at β-pyrrolic positions and the non-porphyrinic dyes Methylene blue, Rose Bengal, Toluidine Blue O, Malachite Green and Crystal Violet; the assays were performed using a bioluminescent E. coli strain as a model. The results indicate that KI has also the ability to potentiate the aPDT process mediated by some of the cationic PSs [Tri-Py(+)-Me, Tetra-Py(+)-Me, Form, RB, MB, Mono-Py(+)-Me, β-ImiPhTPP, β-ImiPyTPP, and β-BrImiPyTPP] allowing a drastic reduction of the treatment time as well as of the PS concentration. However, the efficacy of some porphyrinic and non-porphyrinic PSs [Di-Py(+)-Me opp , Di-Py(+)-Me adj , Tetra-Py, TBO, CV, and MG] was not improved by the presence of the coadjuvant. For the PSs tested in this study, the ones capable to decompose the peroxyiodide into iodine (easily detectable by spectroscopy or by the visual appearance of a blue color in the presence of amylose) were the most promising ones to be used in combination with KI. Although these studies confirmed that the generation of 1O2 is an important fact in this process, the PS structure (charge number and charge position), aggregation behavior and affinity for the cell membrane are also important features to be taken in account.
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Affiliation(s)
- Cátia Vieira
- Department of Biology and CESAM, University of Aveiro, Aveiro, Portugal
| | | | | | - Nuno M. M. Moura
- Department of Chemistry and QOPNA, University of Aveiro, Aveiro, Portugal
| | | | | | - Adelaide Almeida
- Department of Biology and CESAM, University of Aveiro, Aveiro, Portugal
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238
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Abstract
The employment outlook for NPs is expected to continue its growth trend in the coming years. This article summarizes graduation and employment trends for nursing students and provides a synopsis of data from the Bureau of Labor Statistics about the growing demand for NPs and nurses. A brief overview of the history of recent workforce trends is also provided.
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Affiliation(s)
- Margaret Fitzgerald
- Adapted from Fitzgerald, M. Trends in NP and RN Enrollment, Graduation, and Practice. 2018(6):1-8, with permission from Fitzgerald Health Education Associates (fhea.com)
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239
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Stajić A, Maksić J, Maksić Đ, Forsdahl G, Medenica M, Jančić-stojanović B. Analytical Quality by Design-based development and validation of ultra pressure liquid chromatography/MS/MS method for glycopeptide antibiotics determination in human plasma. Bioanalysis 2018; 10:1861-76. [DOI: 10.4155/bio-2018-0181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim: An ultra pressure liquid chromatography (UPLC)/MS/MS method for vancomycin and teicoplanin determination in human plasma was developed in accordance with analytical quality by design (AQbD) concept and fully validated. Materials & methods: Chromatographic separation was performed on ACQUITY UPLC C18 charge surface hybrid (CSH) column (2.1 mm × 50 mm, 1.7 μm particle size) in gradient mode and the mobile phase consisted of 0.1% formic acid in water and pure acetonitrile. The experimental design methodology was used for the definition of optimal chromatographic and protein precipitation conditions. Results: The linearity ranges were 0.05–10 μg ml-1 for vancomycin and 0.5–200 μg ml-1 for total teicoplanin. The relative standard deviations for precision estimation were below 15% and the accuracy was within 85–115% for all quality control levels. Conclusion: The method was utilized for glycopeptide antibiotics bioanalysis.
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240
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Hyslop JF, Lovelock SL, Sutton PW, Brown KK, Watson AJB, Roiban G. Biocatalytic Synthesis of Chiral N‐Functionalized Amino Acids. Angew Chem Int Ed Engl 2018; 57:13821-13824. [DOI: 10.1002/anie.201806893] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Julia F. Hyslop
- Department of Pure and Applied ChemistryUniversity of Strathclyde 295 Cathedral Street Glasgow G1 1XL UK
- Advanced Manufacturing TechnologiesGlaxoSmithKlineMedicines Research Centre Gunnels Wood Road Stevenage SG1 2NY UK
| | - Sarah L. Lovelock
- Advanced Manufacturing TechnologiesGlaxoSmithKlineMedicines Research Centre Gunnels Wood Road Stevenage SG1 2NY UK
- Current address: Manchester Institute of BiotechnologySchool of ChemistryUniversity of Manchester 131 Princess Street Manchester M1 7DN UK
| | - Peter W. Sutton
- API ChemistryGlaxoSmithKlineMedicines Research Centre Gunnels Wood Road Stevenage SG1 2NY UK
- Current address: Department of Chemical EngineeringUniversitat Autònoma de Barcelona 08193 Bellaterra (Cerdanyola del Vallès), Catalunya Spain
| | - Kristin K. Brown
- Molecular Design, Computational and Modeling SciencesGlaxoSmithKline 1250 S. Collegeville Road Collegeville PA 19426 USA
| | - Allan J. B. Watson
- EaStCHEMSchool of ChemistryUniversity of St Andrews North Haugh St Andrews Fife KY16 9ST UK
| | - Gheorghe‐Doru Roiban
- Advanced Manufacturing TechnologiesGlaxoSmithKlineMedicines Research Centre Gunnels Wood Road Stevenage SG1 2NY UK
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241
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Yim G, Wang W, Pawlowski AC, Wright GD. Trichlorination of a Teicoplanin-Type Glycopeptide Antibiotic by the Halogenase StaI Evades Resistance. Antimicrob Agents Chemother 2018; 62:e01540-18. [PMID: 30275088 DOI: 10.1128/AAC.01540-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/22/2018] [Indexed: 01/31/2023] Open
Abstract
Glycopeptide antibiotics (GPAs) include clinically important drugs used for the treatment of infections caused by Gram-positive pathogens. These antibiotics are specialized metabolites produced by several genera of actinomycete bacteria. While many GPAs are highly chemically modified, A47934 is a relatively unadorned GPA lacking sugar or acyl modifications, common to other members of the class, but which is chlorinated at three distinct sites. The biosynthesis of A47934 is encoded by a 68-kb gene cluster in Streptomyces toyocaensis NRRL 15009. The cluster includes all necessary genes for the synthesis of A47934, including two predicted halogenase genes, staI and staK In this study, we report that only one of the halogenase genes, staI, is necessary and essential for A47934 biosynthesis. Chlorination of the A47934 scaffold is important for antibiotic activity, as assessed by binding affinity for the target N-acyl-d-Ala-d-Ala. Surprisingly, chlorination is also vital to avoid activation of enterococcal and Streptomyces VanB-type GPA resistance through induction of resistance genes. Phenotypic assays showed stronger induction of GPA resistance by the dechlorinated compared to the chlorinated GPA. Correspondingly, the relative expression of the enterococcal vanA resistance gene was shown to be increased by the dechlorinated compared to the chlorinated compound. These results provide insight into the biosynthesis of GPAs and the biological function of GPA chlorination for this medically important class of antibiotic.
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242
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Wang J, Wen K, Liu X, Weng CX, Wang R, Cai Y. Multiple Low Frequency Ultrasound Enhances Bactericidal Activity of Vancomycin against Methicillin-Resistant Staphylococcus aureus Biofilms. Biomed Res Int 2018; 2018:6023101. [PMID: 30364019 DOI: 10.1155/2018/6023101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/16/2018] [Indexed: 11/17/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) biofilm infections are difficult to treat due to the high antimicrobial resistance of biofilm. Therefore, new treatments are needed for more effective bacteria clearance. This study was to investigate whether low frequency ultrasound (LFU) can enhance the activity of antimicrobial agents against MRSA biofilm infection. Broth microdilution method was used to determine the minimum inhibitory concentration (MIC) of vancomycin (VAN), linezolid (LIN), and levofloxacin (LEV) against three clinical isolated strains, including one methicillin-susceptible Staphylococcus aureus (MSSA) strain and two MRSA strains. Effects of various influencing factors, such as antimicrobial agents, drug concentrations, ultrasonic intensity, and single (S-LFU, 5 or 15 min) or multiple ultrasound (M-LFU, 5 min every 8 h), on the inhibition of biofilms were investigated. The bactericidal effects of S-LFU or M-LFU on MRSA or MSSA biofilms were determined by colony counts. Right after ultrasound, synergistic effects were observed in groups of S-LFU combined with three antimicrobial agents against MSSA biofilm, but for MRSA biofilm, only S-LFU plus VAN had synergistic effect. At the time point of 24 h, M-LFU plus VAN treatment had synergistic bactericidal effect against MRSA and MSSA biofilms, and the synergy showed that VAN is concentration-dependent, but no synergistic effects were observed in all S-LFU combination groups. In conclusion, combination of M-LFU and antimicrobial agents had a better synergistic effect than S-LFU against MRSA or MSSA biofilm. LFU may be useful in treating biofilm infection in the future.
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243
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Affiliation(s)
- Julia F. Hyslop
- Department of Pure and Applied ChemistryUniversity of Strathclyde 295 Cathedral Street Glasgow G1 1XL UK
- Advanced Manufacturing TechnologiesGlaxoSmithKlineMedicines Research Centre Gunnels Wood Road Stevenage SG1 2NY UK
| | - Sarah L. Lovelock
- Advanced Manufacturing TechnologiesGlaxoSmithKlineMedicines Research Centre Gunnels Wood Road Stevenage SG1 2NY UK
- Current address: Manchester Institute of BiotechnologySchool of ChemistryUniversity of Manchester 131 Princess Street Manchester M1 7DN UK
| | - Peter W. Sutton
- API ChemistryGlaxoSmithKlineMedicines Research Centre Gunnels Wood Road Stevenage SG1 2NY UK
- Current address: Department of Chemical EngineeringUniversitat Autònoma de Barcelona 08193 Bellaterra (Cerdanyola del Vallès), Catalunya Spain
| | - Kristin K. Brown
- Molecular Design, Computational and Modeling SciencesGlaxoSmithKline 1250 S. Collegeville Road Collegeville PA 19426 USA
| | - Allan J. B. Watson
- EaStCHEMSchool of ChemistryUniversity of St Andrews North Haugh St Andrews Fife KY16 9ST UK
| | - Gheorghe‐Doru Roiban
- Advanced Manufacturing TechnologiesGlaxoSmithKlineMedicines Research Centre Gunnels Wood Road Stevenage SG1 2NY UK
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244
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di Fonzo H, Villegas Gutsch M, Castroagudin A, Cabrera MV, Mazzei ME, Rueda D. Agranulocytosis Induced by Vancomycin. Case Report and Literature Review. Am J Case Rep 2018; 19:1053-1056. [PMID: 30174327 PMCID: PMC6135043 DOI: 10.12659/ajcr.909956] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patient: Male, 38 Final Diagnosis: Agranulocytosis induced by Vancomycin Symptoms: Fever • pain Medication: Vancomycin Clinical Procedure: Antibiotic treatment Specialty: Hematology
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Affiliation(s)
- Horacio di Fonzo
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - Melina Villegas Gutsch
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - Augusto Castroagudin
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - María Victoria Cabrera
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - Mariano E Mazzei
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - Darío Rueda
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
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245
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Miller LG. Another New Antibiotic for Skin Infections and Why Infectious Disease Specialists Are Hypocrites. Clin Infect Dis 2018; 68:1223-1224. [DOI: 10.1093/cid/ciy720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 08/20/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Loren G Miller
- Division of Infectious Diseases and Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance
- David Geffen School of Medicine at the University of California, Los Angeles
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246
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Abdalla MA, McGaw LJ. Natural Cyclic Peptides as an Attractive Modality for Therapeutics: A Mini Review. Molecules 2018; 23:molecules23082080. [PMID: 30127265 PMCID: PMC6222632 DOI: 10.3390/molecules23082080] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/14/2018] [Accepted: 08/19/2018] [Indexed: 01/04/2023] Open
Abstract
Peptides are important biomolecules which facilitate the understanding of complex biological processes, which in turn could be serendipitous biological targets for future drugs. They are classified as a unique therapeutic niche and will play an important role as fascinating agents in the pharmaceutical landscape. Until now, more than 40 cyclic peptide drugs are currently in the market, and approximately one new cyclopeptide drug enters the market annually on average. Interestingly, the majority of clinically approved cyclic peptides are derived from natural sources, such as peptide antibiotics and human peptide hormones. In this report, the importance of cyclic peptides is discussed, and their role in drug discovery as interesting therapeutic biomolecules will be highlighted. Recently isolated naturally occurring cyclic peptides from microorganisms, sponges, and other sources with a wide range of pharmacological properties are reviewed herein.
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Affiliation(s)
- Muna Ali Abdalla
- Phytomedicine Programme, Department of Paraclinical Sciences, University of Pretoria, Private Bag X04, Onderstepoort 0110, South Africa.
- Department of Food Science and Technology, Faculty of Agriculture, University of Khartoum, Khartoum North 13314, Sudan.
| | - Lyndy J McGaw
- Phytomedicine Programme, Department of Paraclinical Sciences, University of Pretoria, Private Bag X04, Onderstepoort 0110, South Africa.
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Wan M, Walker SAN, Martin E, Elligsen M, Palmay L, Leis JA. The impact of vancomycin trough concentrations on outcomes in non-deep seated infections: a retrospective cohort study. BMC Pharmacol Toxicol 2018; 19:47. [PMID: 30064515 PMCID: PMC6069851 DOI: 10.1186/s40360-018-0236-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/11/2018] [Indexed: 11/20/2022] Open
Abstract
Background Guidelines recommending vancomycin trough concentrations > 10 mg/L in non-deep seated infections are based on expert opinion. The objective of this study was to evaluate patients with non-deep seated infections treated with short-course vancomycin to determine whether there were differences in outcomes with trough concentrations of ≤10 mg/L (low) versus > 10 mg/L (high). Methods A retrospective cohort study of patients hospitalized between March 10, 2010 and December 31, 2015 who received ≤14 days of vancomycin to treat a non-deep seated infection and had at least one steady state trough concentration was completed. Patient data for the low versus high trough cohorts were compared using appropriate statistical tests and binary logistic regression was used to identify factors associated with clinical outcome. Results Of 2098 patients screened, 103 (5%) met inclusion criteria. Baseline characteristics between cohorts were not different. Clinical cure was not different between the low (42/48 [88%]) and high trough (48/55 [87%]) cohorts (p > 0.99) and vancomycin trough concentration was not associated with clinical outcome (p = 0.973). More patients in the high trough group had dosing changes (7/48 [15%] vs. 22/55 [40%], p = 0.0046), with approximately three times more dose adjustments per patient (0.17 vs. 0.55, p = 0.0193). No signal for increased vancomycin resistance associated with vancomycin troughs was identified. Conclusions: No difference in clinical or microbiological outcomes based on vancomycin trough concentrations were observed in patients with non-deep seated infections treated with vancomycin for ≤14 days. Targeting higher vancomycin trough concentrations of > 10 mg/L may be associated with increased workload with no corresponding benefit in clinical or microbiological outcomes in these patients.
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Affiliation(s)
- Michael Wan
- Department of Pharmacy, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Sandra A N Walker
- Department of Pharmacy, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. .,Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON, M5S 3M2, Canada. .,Division of Infectious Diseases, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada. .,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
| | - Elaine Martin
- Present address: Elaine Martin, Trillium Health Partners, 100 Queensway W, Mississauga, ON, L5B 1B8, Canada
| | - Marion Elligsen
- Department of Pharmacy, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Lesley Palmay
- Department of Pharmacy, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Jerome A Leis
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
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248
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Fabri FV, Lolis MA, Gimenes M, Tognim MCB, Caparroz-Assef SM. Different formulations of vancomycin: In vitro antimicrobial activity against clinical isolates of methicillin-resistant Staphylococcus aureus. Diagn Microbiol Infect Dis 2018; 92:332-337. [PMID: 30033164 DOI: 10.1016/j.diagmicrobio.2018.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 02/18/2018] [Accepted: 06/21/2018] [Indexed: 11/16/2022]
Abstract
We compared in vitro antimicrobial activity of four vancomycin formulations used clinically against clinical isolates of Staphylococcus aureus, including methicillin-resistant and -susceptible (MRSA and MSSA, respectively), using different susceptibility assays. The minimal inhibitory concentrations (MICs) against MRSA clinical isolates were significantly different for some vancomycin formulations by the broth microdilution and agar dilution methods. However, these variations would not compromise their clinical use, since the MICs were within the range recommended by the Clinical and Laboratory Standards Institute. Furthermore, 26.9% of MRSA clinical isolates showed a vancomycin MIC ≥1.5 μg/mL according to the Etest® method but none by broth microdilution. Regarding quality, all formulations were in accordance with United States Pharmacopeia criteria. Our results showed that all vancomycin formulations tested showed similar in vitro antimicrobial activity, making them suitable for clinical use, and that the evaluation method chosen to determine sensitivity to this antimicrobial should be carefully performed, particularly for MRSA.
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Affiliation(s)
- Franciele Viana Fabri
- Post Graduate Program in Biociências e Fisiopatologia, Universidade Estadual de Maringá, Maringá, PR, Brazil.
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Forneris CC, Seyedsayamdost MR. In Vitro Reconstitution of OxyC Activity Enables Total Chemoenzymatic Syntheses of Vancomycin Aglycone Variants. Angew Chem Int Ed Engl 2018; 57:8048-8052. [DOI: 10.1002/anie.201802856] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/13/2018] [Indexed: 11/10/2022]
Affiliation(s)
| | - Mohammad R. Seyedsayamdost
- Department of ChemistryPrinceton University Princeton NJ 08544 USA
- Department of Molecular BiologyPrinceton University Princeton NJ 08544 USA
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250
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Forneris CC, Seyedsayamdost MR. In Vitro Reconstitution of OxyC Activity Enables Total Chemoenzymatic Syntheses of Vancomycin Aglycone Variants. Angew Chem Int Ed Engl 2018. [DOI: 10.1002/ange.201802856] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | - Mohammad R. Seyedsayamdost
- Department of ChemistryPrinceton University Princeton NJ 08544 USA
- Department of Molecular BiologyPrinceton University Princeton NJ 08544 USA
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