1
|
Alzahrani DA, Alsulami KA, Alsulaihem FM, Bakr AA, Booq RY, Alfahad AJ, Aodah AH, Alsudir SA, Fathaddin AA, Alyamani EJ, Almomen AA, Tawfik EA. Dual Drug-Loaded Coaxial Nanofiber Dressings for the Treatment of Diabetic Foot Ulcer. Int J Nanomedicine 2024; 19:5681-5703. [PMID: 38882541 PMCID: PMC11179665 DOI: 10.2147/ijn.s460467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Diabetes mellitus is frequently associated with foot ulcers, which pose significant health risks and complications. Impaired wound healing in diabetic patients is attributed to multiple factors, including hyperglycemia, neuropathy, chronic inflammation, oxidative damage, and decreased vascularization. Rationale To address these challenges, this project aims to develop bioactive, fast-dissolving nanofiber dressings composed of polyvinylpyrrolidone loaded with a combination of an antibiotic (moxifloxacin or fusidic acid) and anti-inflammatory drug (pirfenidone) using electrospinning technique to prevent the bacterial growth, reduce inflammation, and expedite wound healing in diabetic wounds. Results The fabricated drug-loaded fibers exhibited diameters of 443 ± 67 nm for moxifloxacin/pirfenidone nanofibers and 488 ± 92 nm for fusidic acid/pirfenidone nanofibers. The encapsulation efficiency, drug loading and drug release studies for the moxifloxacin/pirfenidone nanofibers were found to be 70 ± 3% and 20 ± 1 µg/mg, respectively, for moxifloxacin, and 96 ± 6% and 28 ± 2 µg/mg, respectively, for pirfenidone, with a complete release of both drugs within 24 hours, whereas the fusidic acid/pirfenidone nanofibers were found to be 95 ± 6% and 28 ± 2 µg/mg, respectively, for fusidic acid and 102 ± 5% and 30 ± 2 µg/mg, respectively, for pirfenidone, with a release rate of 66% for fusidic acid and 80%, for pirfenidone after 24 hours. The efficacy of the prepared nanofiber formulations in accelerating wound healing was evaluated using an induced diabetic rat model. All tested formulations showed an earlier complete closure of the wound compared to the controls, which was also supported by the histopathological assessment. Notably, the combination of fusidic acid and pirfenidone nanofibers demonstrated wound healing acceleration on day 8, earlier than all tested groups. Conclusion These findings highlight the potential of the drug-loaded nanofibrous system as a promising medicated wound dressing for diabetic foot applications.
Collapse
Affiliation(s)
- Dunia A Alzahrani
- Advanced Diagnostics and Therapeutics Technologies Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Khulud A Alsulami
- Advanced Diagnostics and Therapeutics Technologies Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Fatemah M Alsulaihem
- Advanced Diagnostics and Therapeutics Technologies Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Abrar A Bakr
- Advanced Diagnostics and Therapeutics Technologies Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Rayan Y Booq
- Wellness and Preventative Medicine Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Ahmed J Alfahad
- Waste Management and Recycling Technologies Institute, Sustainability and Environment Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Alhassan H Aodah
- Advanced Diagnostics and Therapeutics Technologies Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Samar A Alsudir
- Bioengineering Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Amany A Fathaddin
- Department of Pathology, College of Medicine, King Saud University, Riyadh, 12372, Saudi Arabia
- King Saud University Medical City, Riyadh, 12372, Saudi Arabia
| | - Essam J Alyamani
- Wellness and Preventative Medicine Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| | - Aliyah A Almomen
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Essam A Tawfik
- Advanced Diagnostics and Therapeutics Technologies Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, 11442, Saudi Arabia
| |
Collapse
|
2
|
Yuan L, Chen Q, Zhu XY, Lai LM, Zhao R, Liu Y. Evaluation of clinical characteristics and risk factors associated with Chlamydia psittaci infection based on metagenomic next-generation sequencing. BMC Microbiol 2024; 24:86. [PMID: 38481150 PMCID: PMC10935969 DOI: 10.1186/s12866-024-03236-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Psittacosis is a zoonosis caused by Chlamydia psittaci, the clinical manifestations of Psittacosis range from mild illness to fulminant severe pneumonia with multiple organ failure. This study aimed to evaluate the clinical characteristics of Chlamydia psittaci infection diagnosed based on metagenomic next-generation sequencing(mNGS), as well as the risk factors affecting the progress of Chlamydia psittaci infection, in order to improve the effect of therapeutics. METHODS We retrospectively analyzed the clinical data of patients infected with chlamydia psittaci in the First Affiliated Hospital of Nanchang University from January 2021 to December 2021. The patient's past medical history, clinical manifestations, laboratory examinations, chest CT results, treatment status, and prognosis data were collected. we also investigated both the pathogenic profile characteristics and the lower respiratory tract microbiota of patients with Chlamydia psittaci pneumonia using mNGS. RESULTS All cases of Chlamydia psittaci in our research have been confirmed by mNGS. Among 46 cases of Chlamydia psittaci pneumonia, Poultry exposure was reported in 35 cases. In severe cases of Chlamydia psittaci pneumonia, Neutrophils, Procalcitonin (PCT), Lactate Dehydrogenase (LDH), Hydroxybutyrate Dehydrogenase (HBDH), Creatine Kinase Isoenzymes-B (CK-MB) and D-Dimer levels were remarkably higher than that of non-severe cases, except for lymphocytes (all P < 0.05). Chest CT scans showed Bilateral (77.8%), multiple lobar lungs (85.2%), pleural effusions (44.4%) involvement in those suffering from severe Chlamydia psittaci pneumonia, whereas its incidence was 0%, 21.1% and 10.5% in non-severe patients, respectively (P < 0.05). Multivariate analysis revealed that higher lymphocyte concentrations (OR 0.836, 95% CI 0.714-0.962, P = 0.041) were the only protective factor for survival. mNGS results indicated that 41.3% of patients (19/46) had suspected coinfections with a coinfection rate of 84.2% (16/19) in the severe group, much higher than that in the non severe group (p < 0.05). No significantly different profiles of lower respiratory tract microbiota diversity were found between non severe group and severe group. CONCLUSION A history of poultry exposure in patients can serve as an important basis for diagnosing Chlamydia psittaci pneumonia, and patients with severe Chlamydia psittaci pneumonia are more likely to develop elevated inflammatory biomarkers as well as elevated cardiac markers. Higher lymphocyte concentrations are protective factors associated with severe C. psittaci pneumonia. The higher proportion of patients with coinfections in our study supports the use of mNGS for comprehensive early detection of respiratory infections in patients with C. psittaci pneumonia.
Collapse
Affiliation(s)
- Lei Yuan
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China
| | - Qiang Chen
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China
| | - Xin Yu Zhu
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China
| | - Lan Min Lai
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China
| | - Rui Zhao
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China.
| | - Yang Liu
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China.
| |
Collapse
|
3
|
Rahmani F, Larbi Bouamrane O, Ben Bouabdallah A, Atanase LI, Hellal A, Apintiliesei AN. Biomimetic Hydroxyapatite Crystals Growth on Phosphorylated Chitosan Films by In Vitro Mineralization Used as Dental Substitute Materials. Polymers (Basel) 2023; 15:polym15112470. [PMID: 37299269 DOI: 10.3390/polym15112470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Chitosan (CS) films exhibit great potential as a substrate for the in vitro mineralization process. In this study, to mimic the formation of nanohydroxyapatite (HAP) as natural tissue, CS films coated with a porous calcium phosphate were investigated using scanning electron microscopy (SEM), Energy dispersive X-ray spectroscopy (EDX), Fourier transforms infrared spectroscopy (FTIR), X-ray diffractometry (XRD) and X-ray photoelectron spectroscopy (XPS). Calcium phosphate coating deposited on phosphorylated derivatives of CS was obtained by a process based on phosphorylation, Ca(OH)2 treatment and artificial saliva solution (ASS) immersion. The phosphorylated CS films (PCS) were obtained by partial hydrolysis of the PO4 functionalities. It was demonstrated that this precursor phase could induce the growth and the nucleation of the porous calcium phosphate coating when immersed in ASS. Moreover, oriented crystals and qualitative control of calcium phosphate phases on CS matrices are obtained in a biomimetic mode. Furthermore, in vitro antimicrobial activity of PCS was evaluated against three species of oral bacteria and fungi. It revealed an increase in antimicrobial activity with minimum inhibition concentration (MIC) values of 0.10% (Candida albicans), 0.05% (Staphylococcus aureus) and 0.025% (Escherichia coli) which proves their possible use as dental substitute materials.
Collapse
Affiliation(s)
- Fathia Rahmani
- Department of Technology, Faculty of Science and Technology, University of Djillali Bounaama, Theniet El Had Street, Khemis-Miliana, Ain Defla 44225, Algeria
- Laboratory for the Processing and Shaping of Fibrous Polymers (LTMFP), M'Hamed Bougara University, Boumerdes 35000, Algeria
| | - Omar Larbi Bouamrane
- Institute of Science, University Center of Tipaza Morseli Abdallah, Oued Merzoug, Tipaza 42022, Algeria
- Laboratory of Natural Substances Valorization (LVSN), Faculty of Science and Technology, University of Djillali Bounaama, Theniet El Had Street, Khemis-Miliana, Ain Defla 44225, Algeria
| | - Amina Ben Bouabdallah
- Laboratory for the Processing and Shaping of Fibrous Polymers (LTMFP), M'Hamed Bougara University, Boumerdes 35000, Algeria
- Department of Process Engineering, Faculty of Technology, University of M'hamed Bougara, Boumerdes 35000, Algeria
- Food Technology Laboratory, University of M'hamed Bougara, Boumerdes 35000, Algeria
| | - Leonard I Atanase
- Faculty of Medical Dentistry, "Apollonia" University of Iasi, 700511 Iasi, Romania
- Academy of Romanian Scientists, 050045 Bucharest, Romania
| | - Abdelkader Hellal
- Laboratory of Natural Substances Valorization (LVSN), Faculty of Science and Technology, University of Djillali Bounaama, Theniet El Had Street, Khemis-Miliana, Ain Defla 44225, Algeria
- Chemistry Department, Faculty of Sciences, University of Ferhat Abbas-Sétif-1, Sétif 19137, Algeria
| | | |
Collapse
|
4
|
Ullah A, Ahmad S, Ali N, Hussain H, Allahyani M, Almehmadi M, Alsaiari AA, Abdulaziz O, Almarshad F, Bukhari SH. The Effects of Moxifloxacin and Gemifloxacin on the ECG Morphology in Healthy Volunteers: A Phase 1 Randomized Clinical Trial. Diagnostics (Basel) 2023; 13:diagnostics13071234. [PMID: 37046452 PMCID: PMC10092949 DOI: 10.3390/diagnostics13071234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/14/2023] Open
Abstract
Moxifloxacin and gemifloxacin are the two newer broad-spectrum 8-methoxy-quinolone derivatives that are used to treat various bacterial infections in cardiac patients. In this research study, we assessed the impact of moxifloxacin and gemifloxacin on the QT intervals of electrocardiograms in normal adult doses and draw a comparison, in a controlled environment, on healthy volunteers. Additionally, the effect of both test drugs on the QRS complex was checked. Sixty healthy volunteers were randomly assigned to two groups via R-software, and each respectively received moxifloxacin and gemifloxacin for five days. The research ethics committee approved the research, and it was registered for clinical trial under NCT04692623. The participants' electrocardiograms were obtained before the start of the dose (baseline) and on the fifth day. Significant prolongation of QT interval was noted in moxifloxacin (p < 0.0001) as compared to gemifloxacin treated groups. There were no cases of QTc prolongation over the usual limits (450-470 ms) in the gemifloxacin-treated group, however, QTc prolongations at the rate of 30 and 60 ms from the baseline were noted, interpreted as per the EMEA guidelines. These findings indicate that moxifloxacin caused significant (p < 0.0001) QT interval prolongation (QTIP) as compared to gemifloxacin. In contrast to the previously reported literature, the prominent effect of moxifloxacin on the widening of the QRS-complex was noted with no such effect on QRS-widening in the gemifloxacin-treated group. It is concluded that both drugs have the potential for considerable QT interval prolongation (QTIP) effects, which is one of the risk factors for developing torsade de pointes (TdPs) in cardiac patients. Thus, clinicians should exercise caution when prescribing moxifloxacin and gemifloxacin to cardiac patients and should consider alternate treatment options.
Collapse
Affiliation(s)
- Abid Ullah
- Department of Pharmacy, Shaheed Benazir Bhutto University Sheringal, Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan
| | - Shujaat Ahmad
- Department of Pharmacy, Shaheed Benazir Bhutto University Sheringal, Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan
| | - Niaz Ali
- Department of Pharmacology, College of Medicine, Shaqra University, Shaqra 11961, Saudi Arabia
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar 25100, Khyber Pakhtunkhwa, Pakistan
| | - Haya Hussain
- Department of Pharmacy, Shaheed Benazir Bhutto University Sheringal, Dir Upper 18000, Khyber Pakhtunkhwa, Pakistan
| | - Mamdouh Allahyani
- Department of Clinical Laboratory, Sciences Saudi Arabia Department, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Mazen Almehmadi
- Department of Clinical Laboratory, Sciences Saudi Arabia Department, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Ahad Amer Alsaiari
- Department of Clinical Laboratory, Sciences Saudi Arabia Department, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Osama Abdulaziz
- Department of Clinical Laboratory, Sciences Saudi Arabia Department, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Feras Almarshad
- Department of Medicine, College of Medicine, Shaqra University, Shaqra 11961, Saudi Arabia
| | - Syeda Hajira Bukhari
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar 25100, Khyber Pakhtunkhwa, Pakistan
| |
Collapse
|
5
|
Regeneration Approach to Enhance the Antimicrobial and Antioxidant Activities of Chitosan for Biomedical Applications. Polymers (Basel) 2022; 15:polym15010132. [PMID: 36616481 PMCID: PMC9824206 DOI: 10.3390/polym15010132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022] Open
Abstract
Owing to its biodegradability, non-toxicity, and biocompatibility, chitosan (Cs) is a ubiquitous biopolymer. However, applications of Cs are limited owing to the existence of strong inter- and intra-molecular hydrogen bonds within its network. To address this issue, we regenerated medium-molecular-weight Cs to enhance the physico-chemical and functional properties using a cationic approach. Accordingly, alkaline modification was employed to introduce an additional positive charge to the amine functional groups of Cs and moderately disintegrate the inter- and intra-hydrogen bonds. The chemical structure of Cs and regenerated chitosan (RCs) was confirmed through Fourier transform infrared and 1H-NMR spectroscopy. RCs showed higher zeta potential value compared to Cs. Additionally, using X-ray diffraction, RCs exhibited low crystallinity, which can be attributed to the repulsive force caused by the positive surface charge and the destruction of hydrogen bonds. The RCs exhibited stronger antioxidant activity than Cs. Furthermore, the minimum inhibition concentrations (MICs) of RCs against Escherichia coli and Staphylococcus aureus were reduced by almost four times compared with those of Cs. The superior functional properties of RCs can be attributed to the formation of a polycationic structure after alkaline modification. Thus, RCs can be introduced as potent agents for various biomedical purposes.
Collapse
|
6
|
Yang M, Yang DH, Yang H, Ding SZ, Liu CH, Yin HM, Liu D, Chen P, Luo H. Clinical Characteristics of Chlamydia psittaci Pneumonia Infection in Central South China. Infect Dis Ther 2022; 11:1631-1647. [PMID: 35723864 PMCID: PMC9207437 DOI: 10.1007/s40121-022-00662-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/23/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Chlamydia psittaci pneumonia has been a global public health hotspot in recent years. Although some scattered cases of C. psittaci pneumonia have been reported, there is a lack of large case studies worldwide. Methods In this multicenter, observational study, we recruited all consecutive patients with confirmed C. psittaci pneumonia from October 4, 2018, to October 23, 2020, in nine tertiary general hospitals in Central-South China. Epidemiologic and clinical data from patients’ electronic medical records were collected and analyzed. Results One hundred and sixteen patients with C. psittaci pneumonia were included in the study. The mean age was 59.7 years. Fever (96.6%) and cough (65.5%) were the most common clinical symptoms. Most patients presented with an increase in the proportion of neutrophils, neutrophil to lymphocyte ratio, LDH, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and a significant decrease in lymphocytes. The main CT lung findings were consolidation (81%) and pleural effusion (35.3%), and bilateral lung consolidation was mainly found in severe patients. Chlamydia psittaci DNA was detected in BALF (bronchoalveolar lavage fluid) or blood samples by metagenomic next-generation sequencing (mNGS) in all patients. Use of quinolone was associated with shorter length of hospital stay and fever duration after antibiotic use. Multivariate logistic regression analysis indicated that respiratory support was associated with both severe pneumonia and in-hospital death. Conclusions The clinical phenotype of C. psittaci pneumonia is complex and variable. mNGS is helpful in the diagnosis and treatment of C. psittaci pneumonia, and early treatment with quinolone may benefit patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00662-4.
Collapse
Affiliation(s)
- Min Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Dan-Hui Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Huan Yang
- Department of Respiratory Medicine, Hunan Provincial People's Hospital (the First Affiliated Hospital of Normal University), Changsha, 410011, Hunan, China
| | - Shui-Zi Ding
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Cai-Hong Liu
- Department of Respiratory Medicine, The Third Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Hui-Ming Yin
- Department of Respiratory Medicine, The First Affiliated Hospital of Hunan Medical College (Huaihua Third People's Hospital), Huaihua, 418001, Hunan, China
| | - Dan Liu
- Department of Respiratory Medicine, Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital), Changsha, 410100, China
| | - Ping Chen
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China.
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China.
| | - Hong Luo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China.
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China.
| |
Collapse
|
7
|
Nair AB, Shah J, Jacob S, Al-Dhubiab BE, Sreeharsha N, Morsy MA, Gupta S, Attimarad M, Shinu P, Venugopala KN. Experimental design, formulation and in vivo evaluation of a novel topical in situ gel system to treat ocular infections. PLoS One 2021; 16:e0248857. [PMID: 33739996 PMCID: PMC7978349 DOI: 10.1371/journal.pone.0248857] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/06/2021] [Indexed: 12/30/2022] Open
Abstract
In situ gels have been extensively explored as ocular drug delivery system to enhance bioavailability and efficacy. The objective of present study was to design, formulate and evaluate ion-activated in situ gel to enhance the ocular penetration and therapeutic performance of moxifloxacin in ophthalmic delivery. A simplex lattice design was utilized to examine the effect of various factors on experimental outcomes of the in situ gel system. The influence of polymers (independent variables) such as gellan gum (X1), sodium alginate (X2), and HPMC (X3) on gel strength, adhesive force, viscosity and drug release after 10 h (Q10) were assessed. Selected formulation (MH7) was studied for ex vivo permeation, in vivo irritation and pharmacokinetics in rabbits. Data revealed that increase in concentration of polymers led to higher gel strength, adhesive force and viscosity, however, decreases the drug release. MH7 exhibited all physicochemical properties within acceptable limits and was stable for 6 months. Release profile of moxifloxacin from MH7 was comparable to the check point batches and followed Korsmeyer-Peppas matrix diffusion-controlled mechanism. Ocular irritation study signifies that selected formulation is safe and non-irritant for ophthalmic administration. In vivo pharmacokinetics data indicates significant improvement of moxifloxacin bioavailability (p < 0.0001) from MH7, as evidenced by higher Cmax (727 ± 56 ng/ml) and greater AUC (2881 ± 108 ng h/ml), when compared with commercial eye drops (Cmax; 503 ± 85 ng/ml and AUC; 978 ± 86 ng h/ml). In conclusion, developed in situ gel system (MH7) could offers a more effective and extended ophthalmic therapy of moxifloxacin in ocular infections when compared to conventional eye drops.
Collapse
Affiliation(s)
- Anroop B. Nair
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- * E-mail:
| | - Jigar Shah
- Department of Pharmaceutics, Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, India
| | - Shery Jacob
- Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Bandar E. Al-Dhubiab
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Nagaraja Sreeharsha
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Pharmaceutics, Vidya Siri College of Pharmacy, Bangalore, India
| | - Mohamed A. Morsy
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- Faculty of Medicine, Department of Pharmacology, Minia University, El-Minia, Egypt
| | - Sumeet Gupta
- Department of Pharmacology, M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, India
| | - Mahesh Attimarad
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Pottathil Shinu
- Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Katharigatta N. Venugopala
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Biotechnology and Food Technology, Durban University of Technology, Durban, South Africa
| |
Collapse
|
8
|
Haq S, Rehman W, Waseem M, Meynen V, Awan SU, Saeed S, Iqbal N. Fabrication of pure and moxifloxacin functionalized silver oxide nanoparticles for photocatalytic and antimicrobial activity. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2018; 186:116-124. [DOI: 10.1016/j.jphotobiol.2018.07.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/03/2018] [Accepted: 07/11/2018] [Indexed: 01/19/2023]
|
9
|
Makkar H, Patri G. Fabrication and Appraisal of Poly (Lactic-Co-Glycolic Acid) - Moxifloxacin Nanoparticles using Vitamin E-TPGS: A Potential Intracanal Drug Delivery Agent. J Clin Diagn Res 2017; 11:ZC05-ZC08. [PMID: 28764283 DOI: 10.7860/jcdr/2017/27633.9957] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/20/2017] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Nanotechnology is gaining momentum in the search for ideal biomaterials by dental researchers. The expansible nature of Endodontology deems exploration, learning and scrutinizing newer avenues which have the potential to be applied and investigated. The popularity of polymers as drug delivery vehicles has opened avenues for their application in the root canal system. This study utilized application of biodegradable polymers as potential drug delivery vehicles against Enterococcus faecalis, one of the main reasons for post treatment disease. AIM This study aimed at fabricating Poly (Lactic-co-Glycolic Acid) (PLGA)-moxifloxacin nanoparticles and assessing its sustained antimicrobial efficacy with calcium hydroxide and chitosan-moxifloxacin hydrogel against Enterococcus faecalis. MATERIALS AND METHODS PLGA (50:50) in a quantity of 100 mg was dissolved in 1 ml ethyl acetate and 45 ml of 0.3% w/v Vitamin-E Polyethylene Glycol 1000 Succinate (vitamin E-TPGS) was kept for magnetic stirring in separate beaker. Moxifloxacin (50 μl) was added to polymer PLGA following which vitamin E-TPGS was added to the polymer. Nanoparticles were fabricated using ultrasonication and collected by centrifugation. Surface characterization was assessed using scanning electron microscope. Results were obtained in the form of zone of inhibition by the nanoparticles against Enterococcus faecalis and comparisons were made with chitosan-moxifloxacin hydrogel and calcium hydroxide using Analysis of Variance (ANOVA) followed by Student t-test. RESULTS Upon statistical analysis, the zone of inhibition against E. faecalis remained constant with PLGA-moxifloxacin nanoparticles for 14 days while it decreased with chitosan-moxifloxacin hydrogel and remained nil for calcium hydroxide (p<0.01). CONCLUSION The study posits that PLGA encapsulated moxifloxacin nanoparticles showcased sustained antibacterial effect in low doses against the test pathogen. Its sustained and programmed release makes them unique contenders for further evaluation in Endodontics as potential intracanal medicaments.
Collapse
Affiliation(s)
- Hardik Makkar
- Postgraduate student, Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Gaurav Patri
- Professor, Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Bhubaneswar, Odisha, India
| |
Collapse
|
10
|
Wang C, Han C, Geng N, Fan A, Wang Y, Yue Y, Zhang H, Xue F. Efficacy of oral moxifloxacin for aerobic vaginitis. Eur J Clin Microbiol Infect Dis 2015; 35:95-101. [DOI: 10.1007/s10096-015-2513-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 10/19/2015] [Indexed: 12/01/2022]
|
11
|
Bílikova K, Huang SC, Lin IP, Šimuth J, Peng CC. Structure and antimicrobial activity relationship of royalisin, an antimicrobial peptide from royal jelly of Apis mellifera. Peptides 2015; 68:190-6. [PMID: 25784287 DOI: 10.1016/j.peptides.2015.03.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 01/24/2023]
Abstract
Royalisin is a 5.5-kDa antibacterial peptide isolated from the royal jelly of the honeybee (Apis mellifera). The antimicrobial activity of royalisin against fungi, Gram-positive and Gram-negative bacteria has been revealed. Compared with another insect antibacterial peptide, there is an extra stretch of 11 amino acid residues at the C-terminus of royalisin. In this study, a recombinant shortened form of royalisin named as royalisin-D, was constructed without the 11 amino acid residues at the C-terminal of royalisin and linked to the C-terminal of oleosin by an inteinS fragment. The recombinant protein was overexpressed in Escherichia coli, purified by artificial oil body system and subsequently released through self-splicing of inteinS induced by the changes of temperature. The antibacterial activity of royalisin-D was compared with royalisin via minimal inhibitory concentration (MIC) assay, minimal bactericidal concentration (MBC) assay, microbial adhesion to solvents (MATS) methods, and cell membrane permeability. Furthermore, the recombinant royalisin and royalisin-D have also been treated with the reducing agent of disulfide bonds, dithiothreitol (DTT), to investigate the importance of the intra-disulfide bond in royalisin. In our results, royalisin-D exhibited similar antimicrobial activity to royalisin. Royalisin and royalisin D lost their antimicrobial activities when the intra-disulfide bonds were reduced by DDT. The intra-disulfide bond plays a more important role than the extra stretch of 11 amino acid residues at the C-terminus of royalisin in terms of the antimicrobial properties of the native royalisin.
Collapse
Affiliation(s)
- Katarina Bílikova
- Institute of Forest Ecology, Slovak Academy of Sciences, Zvolen, Detasched workplace Department of Molecular Apidology, Bratislava, Slovakia
| | - Sheng-Chang Huang
- Department of Biotechnology, National Formosa University, Yunlin, Taiwan
| | - I-Ping Lin
- Department of Biotechnology, National Formosa University, Yunlin, Taiwan; Department of Research and Development, Challenge Bioproducts Co., Ltd., Yunlin, Taiwan
| | - Jozef Šimuth
- Institute of Forest Ecology, Slovak Academy of Sciences, Zvolen, Detasched workplace Department of Molecular Apidology, Bratislava, Slovakia
| | - Chi-Chung Peng
- Department of Biotechnology, National Formosa University, Yunlin, Taiwan.
| |
Collapse
|
12
|
Shrivastava R, Rai VK, Kumar A, Sinha S, Tripathi P, Gupta K, Sabharwal S. An in vitro Comparison of Endodontic Medicaments Propolis and Calcium Hydroxide alone and in Combination with Ciprofloxacin and Moxifloxacin against Enterococcus Faecalis. J Contemp Dent Pract 2015; 16:394-9. [PMID: 26162260 DOI: 10.5005/jp-journals-10024-1696] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To evaluate and compare the antimicrobial properties of propolis and calcium hydroxide alone and in combination with ciprofloxacin and moxifloxacin against Enterococcus faecalis (E. Faecalis). MATERIALS AND METHODS The laboratory study was carried out to test the effectiveness of propolis and calcium hydroxidealone as well as in combination with the established endodontic medicaments (moxifloxacin and ciprofloxacin). The various combinations were-group 1: propolis, group 2: calcium hydroxide, group 3: moxifloxacin, group 4: ciprofoxacin, group 5: propolis + moxifloxacin, group 6: propolis + Ciprofloxacin, group 7: calcium hydroxide + ciprofloxacin, group 8: calcium hydroxide + moxifloxacin. The efficacy of these medicaments was tested by checking for the zone of inhibition for the specific strain (ATCC 29212) of E. faecalis at different time intervals, i.e. 24, 48 and 72 hours. RESULTS Mean zone of inhibition was maximum in group V (21.94 ± 4.26) followed by group VI (18.80 ± 1.93), group I (18.71 ± 4.26), group VIII (15.88 ± 2.59), group III (14.91 ± 1.00), group VII (14.57 ± 2.17), group IV (13.91 ± 1.00) and minimum in group II (12.89 ± 2.14). Mean zone of inhibition was found to be maximum at 72 hours and minimum at 24 hours. At all time intervals, the combination of Propalis with Moxifocacin showed the maximum antimicrobial efficacy. CONCLUSION On the basis of the results of the present study, it can be concluded that propolis and calcium hydroxide show synergistic effect with moxifloxacin and ciprofloxacin against E. Faecalis. Propolis in combination with antibiotics and alone is more effective than calcium hydroxide. CLINICAL SIGNIFICANCE Since propolis alone and in combination with antibiotics was observed to be more effective than calcium hydroxide, propolis can be considered as an intracanal medicament when compared to traditional calcium hydroxide.
Collapse
Affiliation(s)
- Rahul Shrivastava
- Department of Conservative Dentistry and Endodontics Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Vivek Kumar Rai
- Department of Conservative Dentistry and Endodontics Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Aina Kumar
- Department of Conservative Dentistry and Endodontics Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Sonal Sinha
- Department of Conservative Dentistry and Endodontics Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Prerna Tripathi
- Department of Conservative Dentistry and Endodontics Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Khushboo Gupta
- Department of Conservative Dentistry and Endodontics Saraswati Dental College, Lucknow, Uttar Pradesh, India
| | - Sumit Sabharwal
- Postgraduate Student, Department of Conservative Dentistry and Endodontics Saraswati Dental College, Lucknow, Uttar Pradesh, India Phone:01452425650, e-mail:
| |
Collapse
|
13
|
Kaskoos RA. Investigation of moxifloxacin loaded chitosan-dextran nanoparticles for topical instillation into eye: In-vitro and ex-vivo evaluation. Int J Pharm Investig 2014; 4:164-73. [PMID: 25426437 PMCID: PMC4241621 DOI: 10.4103/2230-973x.143114] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction: Management of ocular surface disease by conventional formulation is limited by poor residence of drug at cul-de-sac of eye. To overcome this limitation, prolonged released mucoadhesive chitosan (CS)–dextran sulfate (DS) nanoparticles (NPs) were investigated for the prolonged topical ophthalmic delivery of moxifloxacin (Mox). Methods: Formulation was optimized by 3-factors (CS, DS, and Mox concentration), 3-levels (−1, 0, +1) Box-Behnken design. Optimized formulation was characterized for various in-vitro attributes, including particles size, zeta potential, shape and morphology, in-vitro release profile, corneal permeation, corneal retention, ocular tolerance test as well as antimicrobial activity. Results: Average hydrodynamic particle size of statistically optimized formulation was found to be 279.18 ± 15.63 nm with good polydispersity index, 0.367 ± 0.016 and positive zeta potential, +31.23 ± 1.32. NPs showed entrapment efficiency, 72.82 ± 3.6% and transmission electron microscopic analysis revealed a spherical shape of particles. Formulation exhibited biphasic release profile with an initial fast release (≈25% in 1st h) followed by sustained release (≈95% in next 24 h) following Korsmeyer–Peppas model with a nonFickian diffusion process. Mox loaded CS-DS NPs exhibited a significantly higher (P < 0.01), approximately 1.8-fold transcorneal permeation as well as significantly higher corneal retention (P < 0.01), around 4-5-fold when compared to free solution. Developed formulation exhibited safety profile comparable to normal saline, which was revealed by ocular tolerance test (Hen's egg test-chorioallantoic membrane). Mox-CS-DS NPs exhibited significantly high (P < 0.01) antimicrobial activity against Staphylococcus aureus and Pseudomonas aeruginosa. Conclusion: In-vitro and ex-vivo studies revealed that developed formulation could be a potential substitute for prolonged topical ocular delivery.
Collapse
Affiliation(s)
- Raad A Kaskoos
- Department of Pharmaceutics, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| |
Collapse
|
14
|
Lü H, Gao Y, Shan H, Lin Y. Preparation and antibacterial activity studies of degraded polysaccharide selenide from Enteromorpha prolifera. Carbohydr Polym 2014; 107:98-102. [DOI: 10.1016/j.carbpol.2014.02.045] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 01/28/2014] [Accepted: 02/14/2014] [Indexed: 10/25/2022]
|
15
|
Tsaousoglou P, Nietzsche S, Cachovan G, Sculean A, Eick S. Antibacterial activity of moxifloxacin on bacteria associated with periodontitis within a biofilm. J Med Microbiol 2013; 63:284-292. [PMID: 24217128 DOI: 10.1099/jmm.0.065441-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The activity of moxifloxacin was compared with ofloxacin and doxycycline against bacteria associated with periodontitis within a biofilm (single strain and mixed population) in vitro. MICs and minimal bactericidal concentrations (MBCs) of moxifloxacin, ofloxacin and doxycyline were determined against single strains and mixed populations in a planktonic state. Single-species biofilms of two Porphyromonas gingivalis and two Aggregatibacter actinomycetemcomitans strains and a multispecies biofilm consisting of 12 species were formed for 3 days. The minimal biofilm eradication concentrations (MBECs) were determined after exposing the biofilms to the antibacterials (0.002-512 µg ml(-1)) for 18 h, addition of nutrient broth for 3 days and subsequent subcultivation. Photographs were taken using confocal laser-scanning microscopy and scanning electron microscopy. The MICs and MBCs did not differ between ofloxacin and moxifloxacin against A. actinomycetemcomitans, whilst moxifloxacin was more active than the other tested antibacterials against anaerobes and the mixed population. The single-species biofilms were eradicated by moderate concentrations of the antibacterials, and the lowest MBECs were always found for moxifloxacin (2-8 µg ml(-1)). MBECs against the multispecies biofilms were 128, >512 and >512 µg ml(-1) for moxifloxacin, ofloxacin and doxycycline, respectively. In summary, moxifloxacin in a topical formulation may have potential as an adjunct to mechanical removal of the biofilms.
Collapse
Affiliation(s)
- Phoebus Tsaousoglou
- School of Dental Medicine, Department of Periodontology, University of Bern, Bern, Switzerland
| | - Sandor Nietzsche
- Department of Electron Microscopy, University Hospital of Jena, Jena, Germany
| | - Georg Cachovan
- Department of Restorative and Preventive Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anton Sculean
- School of Dental Medicine, Department of Periodontology, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- School of Dental Medicine, Department of Periodontology, University of Bern, Bern, Switzerland
| |
Collapse
|
16
|
Guo Q, Aly A, Schein O, Trexler MM, Elisseeff JH. Moxifloxacin in situ gelling microparticles-bioadhesive delivery system. RESULTS IN PHARMA SCIENCES 2012; 2:66-71. [PMID: 25755996 PMCID: PMC4167180 DOI: 10.1016/j.rinphs.2012.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 09/06/2012] [Accepted: 09/12/2012] [Indexed: 01/28/2023]
Abstract
Antibiotic use for ocular treatments has been largely limited by poor local bioavailability with conventional eyedrops formulations. Here, we developed a controlled delivery system composed of moxifloxacin-loaded poly(lactic-co-glycolic acid) (PLGA) microparticles encapsulated in a chondroitin sulfate-based, two-component bioadhesive hydrogel. Using a simple and fast electrohydrodynamic spray drying (electrospraying) technique, surfactant-free moxifloxacin-loaded microparticles were fabricated with diameters on the order of 1 μm. A mixed solvent system of methanol/dichloromethane (MeOH/DCM) was employed to prepare the microparticles for the electrospraying processing. Extended release of moxifloxacin using a series of MeOH/DCM mixed solvents was accomplished over 10 days with release concentrations higher than the minimum inhibitory concentration (MIC). In contrast, moxifloxacin loaded directly in hydrogels was released rapidly within 24 h. We observed a decrease of the drug release rate from the microparticles when using an increased percentage of methanol in the mixed solvent from 10% to 30% (v/v), which can be explained by the mixed solvent system providing a driving force to form a gradient of the drug concentrations inside the microparticles. In addition, the delivery system developed in this study, which incorporates a bioadhesive to localize drug release by in situ gelling, may potentially integrate antibiotic prophylaxis and wound healing in the eye.
Collapse
Affiliation(s)
- Qiongyu Guo
- Translational Tissue Engineering Center, Wilmer Eye Institute, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, MD 21231, USA
| | - Ahmed Aly
- Translational Tissue Engineering Center, Wilmer Eye Institute, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, MD 21231, USA
| | - Oliver Schein
- Department of Ophthalmology, Johns Hopkins University, Baltimore, Maryland, MD 21231, USA
| | - Morgana M Trexler
- Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland, MD 20723, USA
| | - Jennifer H Elisseeff
- Translational Tissue Engineering Center, Wilmer Eye Institute, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, MD 21231, USA ; Department of Ophthalmology, Johns Hopkins University, Baltimore, Maryland, MD 21231, USA
| |
Collapse
|
17
|
Manhart LE, Broad JM, Golden MR. Mycoplasma genitalium: should we treat and how? Clin Infect Dis 2011; 53 Suppl 3:S129-42. [PMID: 22080266 PMCID: PMC3213402 DOI: 10.1093/cid/cir702] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Mycoplasma genitalium is associated with acute and chronic urethritis in men. Existing data on infection in women are limited and inconsistent but suggest that M. genitalium is associated with urethritis, cervicitis, pelvic inflammatory disease, and possibly female infertility. Data are inconclusive regarding the role of M. genitalium in adverse pregnancy outcomes and ectopic pregnancy. Available data suggest that azithromycin is superior to doxycycline in treating M. genitalium infection. However, azithromycin-resistant infections have been reported in 3 continents, and the proportion of azithromycin-resistant M. genitalium infection is unknown. Moxifloxacin is the only drug that currently seems to uniformly eradicate M. genitalium. Detection of M. genitalium is hampered by the absence of a commercially available diagnostic test. Persons with persistent pelvic inflammatory disease or clinically significant persistent urethritis or cervicitis should be tested for M. genitalium, if possible. Infected persons who have not previously received azithromycin should receive that drug. Persons in whom azithromycin therapy fails should be treated with moxifloxicin.
Collapse
Affiliation(s)
- Lisa E Manhart
- Departments of Epidemiology, University of Washington, Center for AIDS and STD, 325 9th Ave, Box 359931, Seattle, WA 98104, USA.
| | | | | |
Collapse
|
18
|
Dutta J, Tripathi S, Dutta P. Progress in antimicrobial activities of chitin, chitosan and its oligosaccharides: a systematic study needs for food applications. FOOD SCI TECHNOL INT 2011; 18:3-34. [DOI: 10.1177/1082013211399195] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In recent years, active biomolecules such as chitosan and its derivatives are undergoing a significant and very fast development in food application area. Due to recent outbreaks of contaminations associated with food products, there have been growing concerns regarding the negative environmental impact of packaging materials of antimicrobial biofilms, which have been studied. Chitosan has a great potential for a wide range of applications due to its biodegradability, biocompatibility, antimicrobial activity, nontoxicity and versatile chemical and physical properties. It can be formed into fibers, films, gels, sponges, beads or nanoparticles. Chitosan films have been used as a packaging material for the quality preservation of a variety of foods. Chitosan has high antimicrobial activities against a wide variety of pathogenic and spoilage microorganisms, including fungi, and Gram-positive and Gram-negative bacteria. A tremendous effort has been made over the past decade to develop and test films with antimicrobial properties to improve food safety and shelf-life. This review highlights the preparation, mechanism, antimicrobial activity, optimization of biocide properties of chitosan films and applications including biocatalysts for the improvement of quality and shelf-life of foods.
Collapse
Affiliation(s)
- J. Dutta
- Department of Chemistry, Disha Institute of Management and Technology, Raipur 400701, India
| | - S. Tripathi
- Department of Chemistry, Motilal Nehru National Institute of Technology, Allahabad 211004, India
| | - P.K. Dutta
- Department of Chemistry, Motilal Nehru National Institute of Technology, Allahabad 211004, India
| |
Collapse
|
19
|
Abstract
Moxifloxacin is a recent addition to the fluoroquinolone class, differing from ciprofloxacin and other older agents in having much better in vitro activity against Gram-positive aerobes while retaining potent activity against Gram-negative aerobes. It is also active against the pathogens of human and animal bite wounds and those species of atypical mycobacteria associated with dermatologic infections. Its activity against anaerobes is quite variable. Moxifloxacin penetrates well into inflammatory blister fluid and muscle and subcutaneous adipose tissues. Moxifloxacin should thus be a reasonable option for the treatment of skin and skin structure infections (SSSIs). In 3 randomized controlled trials (RCTs), oral moxifloxacin was as effective as cephalexin in the treatment of uncomplicated SSSIs in adults while in 2 RCTs, intravenous/oral moxifloxacin was as effective as intravenous/oral β-lactam/β-lactamase inhibitor therapy in the treatment of complicated SSSIs in adults. Moxifloxacin does not inhibit cytochrome P450 enzymes and thus interact with warfarin or methylxanthines. However, multivalent cations can reduce its oral bioavailability substantially. Dosage adjustment is not required in the presence of renal or hepatic impairment. The clinical relevance of its electrophysiologic effects (QTc prolongation) remains unresolved.
Collapse
Affiliation(s)
- David Rp Guay
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota Minneapolis, MN, USA
| |
Collapse
|
20
|
Puglisi S, Privitera S, Maiolino L, Serra A, Garotta M, Blandino G, Speciale A. Bacteriological findings and antimicrobial resistance in odontogenic and non-odontogenic chronic maxillary sinusitis. J Med Microbiol 2011; 60:1353-1359. [PMID: 21498651 DOI: 10.1099/jmm.0.031476-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The main objectives of this study were to estimate the frequency of chronic maxillary sinusitis of dental origin, and to evaluate the microbiology of odontogenic and non-odontogenic chronic maxillary sinusitis. Aspirates from 59 patients with chronic maxillary sinusitis (47 non-odontogenic, 12 odontogenic), collected during a 3-year period, were microbiologically processed for aerobic and anaerobic bacteria. Moreover, antimicrobial susceptibility was evaluated in the isolated bacteria. In this study, 20 % of chronic maxillary sinusitis cases were associated with a dental origin, and sinus lift procedures were the main aetiological factor. Our microbiological findings showed that all specimens from chronic maxillary sinusitis were polymicrobial. Sixty aerobes and 75 anaerobes were recovered from the 47 cases of non-odontogenic sinusitis (2.9 bacteria per specimen); 15 aerobes and 25 anaerobes were isolated from the 12 patients with odontogenic sinusitis (3.3 bacteria per specimen). The predominant aerobes were Staphylococcus aureus (27) and Streptococcus pneumoniae (16), while the more frequent anaerobes were Peptostreptococcus species (31) and Prevotella species (30). Haemophilus influenzae and Moraxella catarrhalis were absent in sinusitis associated with a dental origin. Overall, 22 % of Staphylococcus aureus isolates were oxacillin-resistant, and 75 % of Streptococcus pneumoniae isolates were penicillin-resistant and/or erythromycin-resistant; 21 % of anaerobic Gram-positive bacteria were penicillin-resistant, and 44 % of anaerobic Gram-negative bacteria were β-lactamase-positive. Vancomycin and quinopristin-dalfopristin had the highest in vitro activity against Staphylococcus aureus and Streptococcus species, respectively; amoxicillin-clavulanate and cefotaxime showed the highest in vitro activity against aerobic Gram-negative bacteria; and moxifloxacin, metronidazole and clindamycin were the most active against anaerobic bacteria.
Collapse
Affiliation(s)
- Salvatore Puglisi
- Department of Bio-medical Sciences, Section of Microbiology, University of Catania, Catania, Italy
| | - Salvatore Privitera
- Department of Bio-medical Sciences, Section of Microbiology, University of Catania, Catania, Italy
| | - Luigi Maiolino
- Department of Medicine and Surgery, Section of Otolaryngology, University of Catania, Catania, Italy
| | - Agostino Serra
- Department of Medicine and Surgery, Section of Otolaryngology, University of Catania, Catania, Italy
| | - Matteo Garotta
- Department of Otorhinolaryngology, Foundation IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Giovanna Blandino
- Department of Bio-medical Sciences, Section of Microbiology, University of Catania, Catania, Italy
| | - Annamaria Speciale
- Department of Bio-medical Sciences, Section of Microbiology, University of Catania, Catania, Italy
| |
Collapse
|
21
|
An J, Luo Q, Yuan X, Wang D, Li X. Preparation and characterization of silver-chitosan nanocomposite particles with antimicrobial activity. J Appl Polym Sci 2011. [DOI: 10.1002/app.33532] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
22
|
Assessment of antibacterial activity of fractions from burdock leaf against food-related bacteria. Food Control 2010. [DOI: 10.1016/j.foodcont.2010.02.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
23
|
Ardila CM, Fernández N, Guzmán IC. Antimicrobial susceptibility of moxifloxacin against gram-negative enteric rods from colombian patients with chronic periodontitis. J Periodontol 2010; 81:292-299. [PMID: 20151809 DOI: 10.1902/jop.2009.090464] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Gram-negative enteric rods were associated with periodontal diseases in several populations. The association between enteric and putative periodontal pathogens has received little attention in the literature. The present investigation determined the occurrence and in vitro antimicrobial susceptibility of isolates of Gram-negative enteric rods from Colombian patients with chronic periodontitis. METHODS Clinical parameters and the in vitro antimicrobial sensitivity of isolates of Gram-negative enteric rods were examined in 76 patients with chronic periodontitis in Medellin, Colombia. Subgingival samples were processed using culture and biochemical tests for the detection of periodontal and superinfecting pathogens. Selected colonies of Gram-negative enteric rods from pure cultures were used to test the susceptibility to amoxicillin/clavulanic acid, ciprofloxacin, and moxifloxacin. Chi-square and Mann-Whitney tests were used to determine differences in clinical variables versus the presence or absence of Gram-negative enteric rods. RESULTS Klebsiella pneumoniae was found in 12 patients, Pseudomonas aeruginosa was found in four patients, and three other species were recovered with a lower prevalence. Men (38.75%) tended to harbor more of the studied organisms than women (17.7%) (P = 0.04). Gram-negative enteric rods in periodontal pockets correlated positively with the presence of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Prevotella intermedia/nigrescens (respectively, r = 0.66, 0.31, and 0.32; P <0.001). All superinfecting organisms demonstrated a high susceptibility to moxifloxacin and ciprofloxacin but exhibited a variable susceptibility to amoxicillin/clavulanic acid. CONCLUSIONS This study found high levels of Gram-negative enteric rods in patients with chronic periodontitis. Moxifloxacin and ciprofloxacin appeared capable of eradicating these organisms from periodontal pockets. Its good activity against Gram-negative enteric rods and periodontopathogens suggests the potential use of moxifloxacin as an adjunctive antibiotic in the treatment of mixed periodontal infections.
Collapse
Affiliation(s)
- Carlos M Ardila
- Epidemiology Group, University of Antioquia, Medellín, Colombia.
| | | | | |
Collapse
|
24
|
An J, Yuan X, Luo Q, Wang D. Preparation of chitosan-graft-(methyl methacrylate)/Ag nanocomposite with antimicrobial activity. POLYM INT 2010. [DOI: 10.1002/pi.2689] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
25
|
Liu H, Wang S, Xi Y, Liu P. Preparation, characterization, and antibacterial activity evaluation of collagen–Zn complex. Polym Bull (Berl) 2009. [DOI: 10.1007/s00289-009-0228-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
26
|
Chitosan-Copper (II) complex as antibacterial agent: synthesis, characterization and coordinating bond- activity correlation study. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.phpro.2009.11.061] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
27
|
Cai ZS, Song ZQ, Yang CS, Shang SB, Yin YB. Synthesis of 2-hydroxypropyl dimethylbenzylammoniumN,O-(2-carboxyethyl) chitosan chloride and its antibacterial activity. J Appl Polym Sci 2009. [DOI: 10.1002/app.29314] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
28
|
Synthesis, characterization and antibacterial activity of quaternized N,O-(2-carboxyethyl) chitosan. Polym Bull (Berl) 2009. [DOI: 10.1007/s00289-008-0004-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
29
|
Guentsch A, Jentsch H, Pfister W, Hoffmann T, Eick S. Moxifloxacin as an Adjunctive Antibiotic in the Treatment of Severe Chronic Periodontitis. J Periodontol 2008; 79:1894-903. [DOI: 10.1902/jop.2008.070493] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
30
|
LeCorn DW, Vertucci FJ, Rojas MF, Progulske-Fox A, Bélanger M. In vitro activity of amoxicillin, clindamycin, doxycycline, metronidazole, and moxifloxacin against oral Actinomyces. J Endod 2007; 33:557-60. [PMID: 17437871 DOI: 10.1016/j.joen.2007.02.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Actinomyces spp have been increasingly associated with endodontic infections. However, the antimicrobial susceptibility of this genus has not been studied extensively. The objective of this study was to determine the susceptibility of oral isolates of Actinomyces naeslundii, Actinomyces gerencseriae, Actinomyces israelii, Actinomyces viscosus, and Actinomyces odontolyticus to amoxicillin, clindamycin, doxycycline, metronidazole, and moxifloxacin using in vitro assays. The minimum inhibitory concentration (MIC) of each bacterial isolate was determined by using E-test strips (AB Biodisk, Solna, Sweden). The MIC(90) was 0.19 microg/mL for amoxicillin, 0.25 microg/mL for doxycycline, 0.50 microg/mL for moxifloxacin, and 1.00 microg/mL for clindamycin. However, metronidazole was not active against any of the Actinomyces spp tested (MIC(90)>256 microg/mL).
Collapse
Affiliation(s)
- Demetrick W LeCorn
- Department of Endodontics, College of Dentistry, and Center for Molecular Microbiology, University of Florida, Gainesville, FL 32610-0424, USA
| | | | | | | | | |
Collapse
|
31
|
Chen S, Wu G, Long D, Liu Y. Preparation, characterization and antibacterial activity of chitosan–Ca3V10O28 complex membrane. Carbohydr Polym 2006. [DOI: 10.1016/j.carbpol.2005.10.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
32
|
Malincarne L, Ghebregzabher M, Moretti MV, Egidi AM, Canovari B, Tavolieri G, Francisci D, Cerulli G, Baldelli F. Penetration of moxifloxacin into bone in patients undergoing total knee arthroplasty. J Antimicrob Chemother 2006; 57:950-4. [PMID: 16551691 DOI: 10.1093/jac/dkl091] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To investigate plasma and bone moxifloxacin concentrations following oral administration of a single or double dose of the drug, in order to consider its potential role in the treatment of osteomyelitis. PATIENTS AND METHODS Thirty consecutive patients undergoing total knee arthroplasty were recruited. Three groups, of ten patients each, were formed: group A received moxifloxacin 400 mg orally 2 h (range 1.5-2.5) preoperatively, group B received moxifloxacin 400 mg orally 4 h (range 3.5-4.5) preoperatively and group C received moxifloxacin 400 mg orally 14 h preoperatively, followed by a second dose 2 h (range 1.5-2.5) preoperatively. During surgery, at the time of bone removal, a blood sample and aliquots of cortical and cancellous bone were collected and moxifloxacin concentrations were measured by HPLC. RESULTS Mean plasma, cancellous bone and cortical bone concentrations were, respectively: 3.45, 1.89 and 1.43 mg/L for group A; 3.73, 1.81 and 1.56 mg/L for group B; and 6.26, 2.97 and 2.54 mg/L for group C. CONCLUSIONS These data show a good penetration of moxifloxacin into both cancellous and cortical bone, with concentrations, after double dosing, exceeding the MIC90 for most pathogens involved in osteomyelitis and the clinic susceptibility breakpoint for Mycobacterium tuberculosis.
Collapse
Affiliation(s)
- L Malincarne
- Department of Experimental Medicine and Biochemical Science, Section of Infectious Diseases, University of Perugia, Perugia, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Preparation, characterization and antimicrobial activity of quaternized carboxymethyl chitosan and application as pulp-cap. POLYMER 2006. [DOI: 10.1016/j.polymer.2006.01.073] [Citation(s) in RCA: 162] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
34
|
Smelov V, Perekalina T, Artemenko N, Smelova N, Ukleeva G, Gorelov A. Chlamydia trachomatis survival in the presence of two fluoroquinolones (lomefloxacin versus levofloxacin) in patients with chronic prostatitis syndrome. Andrologia 2005; 37:61-4. [PMID: 16026425 DOI: 10.1111/j.1439-0272.2005.00654.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Fluoroquinolones are recommended in the therapy of chronic prostatitis. Chlamydia trachomatis is one of the possible aetiological agents of chronic prostatitis. However, little is known about chlamydia survival in the presence of fluoroquinolones in patients with chronic prostatitis syndrome. For the first time, chlamydia survival in vitro in the presence of lomefloxacin (LOMX) (mostly recommended in the treatment of chronic prostatitis) versus levofloxacin (LVFX) (recommended in the therapy against chlamydia infection) is examined and analysed in the 33 chlamydia-infected patients with chronic prostatitis syndrome in this study. Antichlamydial activity in vitro of LOMX in patients with C. trachomatis and prostatitis was found to be more effective than LVFX. However, further clinical trials for these agents are recommended.
Collapse
Affiliation(s)
- V Smelov
- Medical Department, St Petersburg State University, St. Petersburg, Russia.
| | | | | | | | | | | |
Collapse
|
35
|
Chitosan- metal complexes as antimicrobial agent: Synthesis, characterization and Structure-activity study. Polym Bull (Berl) 2005. [DOI: 10.1007/s00289-005-0414-1] [Citation(s) in RCA: 180] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
36
|
|
37
|
Weyenberg W, Vermeire A, D'Haese E, Vanhaelewyn G, Kestelyn P, Callens F, Nelis HJ, Remon JP, Ludwig A. Effect of different sterilisation methods on the properties of bioadhesive powders and ocular minitablets, and clinical evaluation. Eur J Pharm Sci 2005; 23:77-87. [PMID: 15324925 DOI: 10.1016/j.ejps.2004.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2003] [Revised: 05/11/2004] [Accepted: 05/25/2004] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to evaluate the influence of gamma-irradiation and dry heat sterilisation on the properties of a bioadhesive powder mixture containing ciprofloxacin and its corresponding ocular minitablets. The molecular weight characteristics of drum dried waxy maize starch (DDWM), employed as major component of the bioadhesive formulation, the decay kinetics of radicals, the rheological properties of the bioadhesive polymers and the microbial activity of ciprofloxacin were studied. The influence of the different sterilisation methods on the characteristics of the ocular minitablets was investigated by measuring the crushing strength, the friability, and the in vitro release of ciprofloxacin from the minitablets. Finally, the clinical value of the selected sterilised minitablets was evaluated in seven healthy volunteers. Both sterilisation methods similarly affected the properties of the bioadhesive formulation by inducing stable radicals and decreasing the molecular weight of DDWM, although no changes in the microbiological activity of ciprofloxacin were measured. An obvious influence of both sterilisation methods was observed in the in vitro release study. The crushing strength and friability of the minitablets were not significantly influenced by gamma-irradiation. Based on these data, gamma-irradiation was more adequate as sterilisation method for the bioadhesive ocular minitablets than dry heat sterilisation, because it affected the least the physical properties of the minitablets. Therefore, the gamma-sterilised minitablets were selected for an in vivo evaluation in seven volunteers. The concentration of ciprofloxacin in the tear film remained above its MIC value for the most common ocular pathogens for at least 8 h. Consequently, the gamma-irradiated minitablets containing ciprofloxacin can be considered as a promising formulation to treat bacterial keratitis and conjunctivitis.
Collapse
Affiliation(s)
- W Weyenberg
- Laboratory of Pharmaceutical Technology and Biopharmacy, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
Moxifloxacin (Avelox) is a fluoroquinolone antibacterial with a methoxy group in the C-8 position and a bulky C-7 side chain. Moxifloxacin is approved for use in the treatment of acute exacerbations of chronic bronchitis (AECB), community-acquired pneumonia (CAP), acute bacterial sinusitis and uncomplicated skin and skin structure infections (approved indications may differ between countries). Moxifloxacin has a broad spectrum of antibacterial activity, including activity against penicillin-resistant Streptococcus pneumoniae. It achieves good tissue penetration and has a convenient once-daily administration schedule, as well as being available in both intravenous and oral formulations in some markets. Moxifloxacin has good efficacy in the treatment of patients with AECB, CAP, acute bacterial sinusitis and uncomplicated skin and skin structure infections, and is generally well tolerated. Thus, moxifloxacin is an important option in the treatment of bacterial infections.
Collapse
|
39
|
Pinheiro ET, Gomes BPFA, Drucker DB, Zaia AA, Ferraz CCR, Souza-Filho FJ. Antimicrobial susceptibility of Enterococcus faecalis isolated from canals of root filled teeth with periapical lesions. Int Endod J 2004; 37:756-63. [PMID: 15479258 DOI: 10.1111/j.1365-2591.2004.00865.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To test, in vitro, the susceptibility to different antibiotics of Enterococcus faecalis isolates from canals of root filled teeth with periapical lesions. METHODOLOGY Twenty-one E. faecalis isolates, from canals of root filled teeth with persisting periapical lesions, were tested for their antibiotic susceptibilities. The following antibiotics were used: benzylpenicillin, amoxicillin, amoxicillin-clavulanic acid, erythromycin, azithromycin, vancomycin, chloramphenicol, tetracycline, doxycycline, ciprofloxacin and moxifloxacin. Minimal inhibitory concentrations (MICs) for the antimicrobial agents were determined using the E-test System (AB BIODISK, Solna, Sweden), and the E. faecalis strains classified as susceptible or resistant according to the guidelines of National Committee for Clinical Laboratory Standards (NCCLS). The strains were also tested for beta-lactamase production with nitrocefin (Oxoid, Basingstoke, UK). RESULTS All strains were susceptible to penicillins in vitro, however, the MICs of amoxicillin and amoxicillin-clavulanic acid (MIC(90) = 0.75 microg mL(-1)) were lower than for benzylpenicillin (MIC(90) = 3.0 microg mL(-1)). All strains studied were also susceptible to vancomycin and moxifloxacin, whilst 95.2% were susceptible to chloramphenicol. Amongst the isolates, 85.7% were susceptible to tetracycline and doxycycline and 80.9% to ciprofloxacin. The MIC of erythromycin ranged from 0.38 to >256 microg mL(-1); only 28.5% of the strains were susceptible (MIC < or = 0.5 microg mL(-1)). Limited susceptibility was also observed with azithromycin which was active against only 14.2% of isolates. No strains produced beta-lactamase. CONCLUSION Enterococcus faecalis isolates were completely susceptible, in vitro, to amoxicillin, amoxicillin-clavulanic acid, vancomycin and moxifloxacin. Most isolates were susceptible to chloramphenicol, tetracycline, doxycycline or ciprofloxacin. Erythromycin and azithromycin were least effective.
Collapse
Affiliation(s)
- E T Pinheiro
- Department of Endodontic, Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba, Brazil
| | | | | | | | | | | |
Collapse
|
40
|
|
41
|
Rolston KVI, Frisbee-Hume S, LeBlanc B, Streeter H, Ho DH. In vitro antimicrobial activity of moxifloxacin compared to other quinolones against recent clinical bacterial isolates from hospitalized and community-based cancer patients. Diagn Microbiol Infect Dis 2003; 47:441-9. [PMID: 14522520 DOI: 10.1016/s0732-8893(03)00115-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The in vitro spectrum of moxifloxacin (a C-8-methoxyquinolone) was compared to that of ciprofloxacin and levofloxacin against 924 recent clinical isolates from cancer patients. Moxifloxacin was more active than the comparator agents against Gram-positive pathogens, with potent activity against Aerococcus spp., Listeria monocytogenes, Micrococcus spp., Rhodococcus equi, and Stomatococcus mucilaginous, methicillin-susceptible Staphylococcus spp., all beta hemolytic streptococci, viridans streptococci and Streptococcus pneumoniae. It also had good to moderate activity against Bacillus spp., Corynebacterium spp., Enterococcus faecalis, and methicillin-resistant staphylococci. Although ciprofloxacin was the most active agent tested against the Enterobacteriaceae, moxifloxacin inhibited the majority of these isolates at < or =2.0 microg/ml. Moxifloxacin was the least active of the three agents tested against Pseudomonas aeruginosa, but had significant activity against other non-fermentative Gram-negative bacilli including Acinetobacter spp., Flavobacterium spp., Pseudomonas spp. other than P. aeruginosa, and Stenotrophomonas maltophilia. The overall broad spectrum of moxifloxacin, and its availability for both oral and parenteral administration, warrants its evaluation for the prevention and treatment of infections in cancer patients.
Collapse
Affiliation(s)
- Kenneth V I Rolston
- Section of Infectious Diseases, Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA.
| | | | | | | | | |
Collapse
|
42
|
Abstract
Several recently developed quinolones have excellent activity against a broad range of aerobic and anaerobic bacteria and are thus potential drugs for the treatment of serious anaerobic and mixed infections. Resistance to quinolones is increasing worldwide, but is still relatively infrequent among anaerobes. Two main mechanisms, alteration of target enzymes (gyrase and topoisomerase IV) caused by chromosomal mutations in encoding genes, or reduced intracellular accumulation due to increased efflux of the drug, are associated with quinolone resistance. These mechanisms have also been found in anaerobic species. High-level resistance to the newer broad-spectrum quinolones often requires stepwise mutations in target genes. The increasing emergence of resistance among anaerobes may be a consequence of previous widespread use of quinolones, which may have enriched first-step mutants in the intestinal tract. Quinolone resistance in the Bacteroides fragilis group strains is strongly correlated with amino acid substitutions at positions 82 and 86 in GyrA (equivalent to positions 83 and 87 of Escherichia coli). Several studies have indicated that B. fragilis group strains possess efflux pump systems that actively expel quinolones, leading to resistance. DNA gyrase seems also to be the primary target for quinolones in Clostridium difficile, since amino acid substitutions in GyrA and GyrB have been detected in resistant strains. To what extent other mechanisms, such as mutational events in other target genes or alterations in outer-membrane proteins, contribute to resistance among anaerobes needs to be further investigated.
Collapse
Affiliation(s)
- H Oh
- Department of Laboratory Medicine, Division of Clinical Bacteriology, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden
| | | |
Collapse
|