Gatifloxacin: a review of its use in the treatment of bacterial infections in the US

Gatifloxacin hydrochloride confers broad-spectrum antibacterial activity against phytopathogenic bacteria

Bacterial diseases pose significant threats to agriculture and natural ecosystems, causing substantial crop losses and impacting food security. Until now, there has been a less efficient control strategy against some bacterial diseases such as bacterial wilt, caused by Ralstonia solanacearum. In this study, we screened a library of 58 microorganism-derived natural products for their antibacterial activity against R. solanacearum. Gatifloxacin hydrochloride exhibited the best inhibitory effect with an inhibition rate of 95% at 0.0625 mg/L. Further experiments demonstrate that gatifloxacin hydrochloride inhibits R. solanacearum growth in a concentration-dependent manner, with the minimum inhibitory concentration of 0.125 mg/L. Treatment with 0.5 mg/L of gatifloxacin hydrochloride killed more than 95% of bacteria. Gatifloxacin hydrochloride significantly inhibited biofilm formation by R. solanacearum. Gatifloxacin hydrochloride also shows good antibacterial activity against Pseudomonas syringae pv. tomato DC3000 and Xanthomonas campestris pv. vesicatoria. Exogenous application of gatifloxacin hydrochloride suppressed disease development caused by R. solanacearum and P. syringae. In summary, our results demonstrate the great potential of microorganism-derived compounds as broad-spectrum antibacterial compounds, providing alternative ways for the efficient control of bacterial plant diseases.

Discovery of 2-aryl and 2-pyridinylbenzothiazoles endowed with antimicrobial and aryl hydrocarbon receptor agonistic activities

Benzothiazole is a privileged scaffold in medicinal chemistry present in diverse bioactive compounds with multiple pharmacological applications such as analgesic, anticonvulsant, antidiabetic, anti-inflammatory, anticancer and radioactive amyloidal imagining agents. We reported in this work the study of sixteen functionalized 2-aryl and 2-pyridinylbenzothiazoles as antimicrobial agents and as aryl hydrocarbon receptor (AhR) modulators. The antimicrobial activity against Gram-positive (S. aureus and M. luteus) and Gram-negative (P. aeruginosa, S. enterica and E. coli) pathogens yielded MIC ranging from 3.13 to 50 μg/mL and against the yeast C. albicans, the benzothiazoles displayed MIC from 12.5 to 100 μg/mL. All compounds showed promising antibiofilm activity against S. aureus and P. aeruginosa. The arylbenzothiazole 12 displayed the greatest biofilm eradication in S. aureus (74%) subsequently verified by fluorescence microscopy. The ability of benzothiazoles to modulate AhR expression was evaluated in a cell-based reporter gene assay. Six benzothiazoles (7, 8-10, 12, 13) induced a significant AhR-mediated transcription and interestingly compound 12 was also the strongest AhR-agonist identified. Structure-activity relationships are suggested herein for the AhR-agonism and antibiofilm activities. Furthermore, in silico predictions revealed a good ADMET profile and druglikeness for the arylbenzothiazole 12 as well as binding similarities to AhR compared with the endogenous agonist FICZ.

Novel carboxymethyl chitosan-graphene oxide hybrid particles for drug delivery

We describe an electrostatic droplet generation method to prepare a novel carboxymethyl chitosan-graphene oxide hybrid particles for delivery purpose. Under an adjustable electrostatic field, graphene oxide and carboxymethyl chitosan mixed solution was sprayed as uniform micro-droplets, which were solidified as particles in CaCl₂ solution. Such hybrid particles are wished to have excellent stability in saline solution, and better delivery properties than pristine carboxymethyl chitosan particles. The effects of micro-droplets generation conditions on particles formation were systematically investigated. At conditions of 40 mg/ml of carboxymethyl chitosan, 2 mg/ml of graphene oxide, 3 ml/h of feed speed, electrostatic field parameters was 9 kV and 20 cm, uniformly sized carboxymethyl chitosan-graphene oxide particles in the diameter range of 250-300 μm was successfully prepared. In NaCl saline, these particles could maintain stable for at least a week, while pristine carboxymethyl chitosan particles quickly collapsed within an hour. The results of loading experiments showed that carboxymethyl chitosan-graphene oxide particles could effectively adsorb gatifloxacin, ofloxacin, bovine serum albumin, lysozyme, doxorubicin hydrochloride. And gatifloxacin was chosen as a model drug to study the exact effect of graphene oxide content on the loading and release properties. In 40:2 group, the highest loading capacity of 0.45 ± 0.19 mg/mg was achieved, and also a good sustained release was available. Above all, we believed that carboxymethyl chitosan-graphene oxide particles as a versatile carrier, has great potential in Medicine and Pharmacy.

Safety considerations of fluoroquinolones in the elderly: an update

The fluoroquinolones ciprofloxacin, levofloxacin, moxifloxacin and gemifloxacin are widely used for the treatment of various types of bacterial infections. Overall, these antibacterial agents can be considered safe and well tolerated drugs. Comparative studies have evaluated the use of quinolones in elderly and younger populations. Although age per se does not seem to decrease their tolerability, specific adverse effects of the quinolones must be considered when they are chosen for antibacterial treatment. Renal function declines consistently with age and doses of renally excreted quinolones (e.g. ofloxacin, levofloxacin, gatifloxacin) need to be adjusted if a clinically relevant reduction of creatinine clearance is identified. Reactions of the gastrointestinal tract, such as nausea, dyspepsia, vomiting or diarrhoea, are among the most often registered adverse drug reactions during therapy with fluoroquinolones. Treatment with a quinolone causes diarrhoea less frequently than treatment with other classes of antimicrobials. Conflicting data have been published with respect to the incidence of Clostridium difficile-associated diarrhoea in quinolone-treated patients. Hypersensitivity reactions, often manifested on the skin, occur less commonly during therapy with quinolones than, for example, during therapy with beta-lactam antibacterials. Adverse reactions of the CNS are of particular concern in the elderly population. Given the CNS excitatory effects of quinolones, elderly patients should be monitored carefully for such symptoms. It is likely that many signs of possible adverse reactions, such as confusion, weakness, loss of appetite, tremor or depression, are often mistakenly attributed to old age and remain unreported. Quinolones should be used with caution in patients with known or suspected CNS disorders that predispose to seizures (e.g. severe cerebral arteriosclerosis or epilepsy). Quinolones can cause QT interval prolongation. They should be avoided in patients with known prolongation of the QT interval, patients with uncorrected hypokalaemia or hypomagnesaemia and patients receiving class IA (e.g. quinidine, procainamide) or class III (e.g. amiodarone, sotalol) antiarrhythmic agents. Tendinitis and tendon ruptures are recognized as quinolone-induced adverse effects that can occur during treatment or as late as several months after treatment. Chronic renal diseases, concomitant use of corticosteroids and age >60 years are known risk factors for quinolone-induced tendopathies. Overall, the specific adverse-effect profile of quinolones must be considered when they are chosen for treatment of bacterial infections. Because of physiological changes in renal function and when certain co-morbidities are present, some special considerations are necessary when elderly patients are treated with these drugs.

Levofloxacin : a review of its use as a high-dose, short-course treatment for bacterial infection

Levofloxacin (Levaquin) is a fluoroquinolone antibacterial that is the L-isomer of ofloxacin. A high-dose (750 mg) short-course (5 days) of once-daily levofloxacin is approved for use in the US in the treatment of community-acquired pneumonia (CAP), acute bacterial sinusitis (ABS), complicated urinary tract infections (UTI) and acute pyelonephritis (AP). The broad spectrum antibacterial profile of levofloxacin means that monotherapy is often a possibility in patients with CAP at times when other agents may require combination therapy, although levofloxacin can be used in combination therapy when necessary. The high-dose, short-course levofloxacin regimen maximizes its concentration-dependent bactericidal activity and may reduce the potential for resistance to emerge. In addition, this regimen lends itself to better compliance because of the shorter duration of treatment and the convenient once-daily administration schedule. Oral levofloxacin is rapidly absorbed and is bioequivalent to the intravenous formulation; importantly, patients can transition between the formulations, which results in more options in regards to the treatment regimen and the potential for patients with varying degrees of illness to be treated. Levofloxacin has good tissue penetration and an adequate concentration can be maintained in the urinary tract to treat uropathogens. Levofloxacin is generally well tolerated and has good efficacy in the treatment of patients with CAP, ABS, complicated UTI and AP. The efficacy and tolerability of levofloxacin 500 mg once daily for 10 days in patients with CAP, ABS and UTIs is well established, and the high-dose, short-course levofloxacin regimen has been shown to be noninferior to the 10-day regimen in CAP and ABS, and to have a similar tolerability profile. Similarly, the high-dose, short-course levofloxacin regimen is noninferior to ciprofloxacin in patients with complicated UTI or AP. Thus, levofloxacin is a valuable antimicrobial agent that has activity against a wide range of bacterial pathogens; however, its use should be considered carefully so that the potential for resistance selection can be minimized and its usefulness in severe infections and against a range of penicillin- and macrolide-resistant pathogens can be maintained.

Oral gatifloxacin in the outpatient treatment of children with cancer fever and neutropenia

BACKGROUND

Fever in neutropenic (FN) patients requires immediate broad-spectrum antibiotics, however, such patients do not represent a homogeneous population and the majority of them are at low risk of developing complication. Gatifloxacin (GA) is an alternative, though it has not been thoroughly studied in Pediatrics yet. The aim of this study was to evaluate oral GA in oncology pediatric patients with FN and low risk of infectious complications.

METHODS

We conducted a prospective study in patients submitted to chemotherapy and FN, from the ages of 3 to 21 years old, with solid tumors, acute lymphoid leukemia, and lymphomas without comorbidities and treated as outpatient with oral GA. Safety and adverse effects were monitored.

RESULTS

We evaluated 108 patients with 201 episodes of FN. The average age was 10.8 years, 64.8% of the patients were male. Osteosarcoma accounted for 22% of the episodes, rhabdomyosarcoma for 13%, acute lymphoid leukemia, lymphomas and Ewing sarcoma, for 11% each. Among the 174 episodes exclusively treated as outpatients, the average duration of neutropenia was 4.8 days, the average duration of fever was 2.4 days; the average duration of the treatment was 8.1 days. The treatment was successful in 75.9%, analyzing only the first episodes. No patient died during the study. Adverse events included diarrhea, vomiting, increased liver enzymes, arthralgia, and ECG changes.

CONCLUSION

Oral GA is effective and safe in the management of oncology pediatric patients with FN at low risk of infectious complications in the outpatient setting.

Stability indicating high-performance thin-layer chromatographic determination of gatifloxacin as bulk drug and from polymeric nanoparticles

A simple, sensitive, selective, precise and stability indicating high-performance thin-layer chromatographic method for determination of gatifloxacin both as a bulk drug and from polymeric nanoparticles was developed and validated as per the International Conference on Harmonization (ICH) guidelines. The method employed thin-layer chromatography (TLC) aluminium plates precoated with silica gel 60F-254 as the stationary phase and the mobile phase consisted of n-propanol-methanol-concentrated ammonia solution (25%) (5:1:0.9, v/v/v). This solvent system was found to give compact spots for gatifloxacin (R(f) value of 0.60+/-0.02). Densitometric analysis of gatifloxacin was carried out in the absorbance mode at 292 nm. The linear regression analysis data for the calibration plots showed good linear relationship with r=0.9953 with respect to peak area in the concentration range of 400-1200 ng spot(-1). The mean value (+/-S.D.) of slope and intercept were 9.66+/-0.05 and 956.33+/-27.67, respectively. The method was validated for precision, accuracy, ruggedness and recovery. The limits of detection and quantitation were 2.73 and 8.27 ng spot(-1), respectively. Gatifloxacin was subjected to acid and alkali hydrolysis, oxidation, photodegradation and dry heat treatment. The drug undergoes degradation under acidic and basic conditions and upon wet and dry heat treatment. The degraded products were well separated from the pure drug. The statistical analysis proves that the developed method for quantification of gatifloxacin as bulk drug and from polymeric nanoparticles is reproducible and selective. As the method could effectively separate the drug from its degradation products, it can be employed as stability-indicating one.