A new understanding on the prerequisite of antibiotic biodegradation in wastewater treatment: Adhesive behavior between antibiotic-degrading bacteria and ciprofloxacin.

The extensive exploration of antibiotic biodegradation by antibiotic-degrading bacteria in biological wastewater treatment processes has left a notable gap in understanding the behavior of these bacteria when exposed to antibiotics and the initiation of biodegradation processes. This study, therefore, delves into the adhesive behavior of Paraclostridium bifermentans, isolated from a bioreactor treating ciprofloxacin-laden wastewater, towards ciprofloxacin molecules. For the first time, this behavior is observed and characterized through quartz crystal microbalance with dissipation (QCM-D) and atomic force microscopy. The investigation further extends to identify key regulatory factors and mechanisms governing this adhesive behavior through a comparative proteomics analysis. The results reveal the dominance of extracellular proteins, particularly those involved in nucleotide binding, hydrolase, and transferase, in the adhesion process. These proteins play pivotal roles through direct chemical binding and the regulation of signaling molecule. Furthermore, QCM-D measurements provide evidence that transferase-related signaling molecules, especially tyrosine, augment the binding between ciprofloxacin and transferases, resulting in enhance ciprofloxacin removal by P. bifermentans (increased by ∼1.2-fold). This suggests a role for transferase-related signaling molecules in manipulating the adhesive behavior of P. bifermentans towards ciprofloxacin. These findings contribute to a new understanding of the prerequisites for antibiotic biodegradation and offer potential strategies for improving the application of antibiotic-degrading bacteria in the treatment of antibiotics-laden wastewater.

Detoxification of Ciprofloxacin in an Anaerobic Bioprocess Supplemented with Magnetic Carbon Nanotubes: Contribution of Adsorption and Biodegradation Mechanisms.

In anaerobic bioreactors, the electrons produced during the oxidation of organic matter can potentially be used for the biological reduction of pharmaceuticals in wastewaters. Common electron transfer limitations benefit from the acceleration of reactions through utilization of redox mediators (RM). This work explores the potential of carbon nanomaterials (CNM) as RM on the anaerobic removal of ciprofloxacin (CIP). Pristine and tailored carbon nanotubes (CNT) were first tested for chemical reduction of CIP, and pristine CNT was found as the best material, so it was further utilized in biological anaerobic assays with anaerobic granular sludge (GS). In addition, magnetic CNT were prepared and also tested in biological assays, as they are easier to be recovered and reused. In biological tests with CNM, approximately 99% CIP removal was achieved, and the reaction rates increased ≈1.5-fold relatively to the control without CNM. In these experiments, CIP adsorption onto GS and CNM was above 90%. Despite, after applying three successive cycles of CIP addition, the catalytic properties of magnetic CNT were maintained while adsorption decreased to 29 ± 3.2%, as the result of CNM overload by CIP. The results suggest the combined occurrence of different mechanisms for CIP removal: adsorption on GS and/or CNM, and biological reduction or oxidation, which can be accelerated by the presence of CNM. After biological treatment with CNM, toxicity towards Vibrio fischeri was evaluated, resulting in ≈ 46% detoxification of CIP solution, showing the advantages of combining biological treatment with CNM for CIP removal.

Ternary nanoparticle complex of antibiotic, polyelectrolyte, and mucolytic enzyme as a potential antibiotic delivery system in bronchiectasis therapy.

Antibiotic-polyelectrolyte nanoparticle complex (or nanoplex in short) has been recently demonstrated as a superior antibiotic delivery system to the native antibiotic in bronchiectasis therapy owed to its ability to overcome the lung's mucus barrier and generate high localized antibiotic exposure in the infected sites. The present work aimed to further improve the mucus permeability, hence the antibacterial efficacy of the nanoplex, by incorporating mucolytic enzyme papain (PAP) at the nanoplex formation step to produce PAP-decorated antibiotic-polyelectrolyte nanoplex exhibiting built-in mucolytic capability. Ciprofloxacin (CIP) and dextran sulfate (DXT) were used as the models for antibiotics and polyelectrolyte, respectively. The results showed that the PAP inclusion had minimal effects on the physical characteristics, preparation efficiency, and dissolution of the CIP-DXT nanoplex. The optimal CIP-(DXT-PAP) nanoplex exhibited size and zeta potential of approximately 200 nm and -50 mV with CIP and PAP payloads of 60% and 32% (w/w), respectively. The nanoplex was prepared at high efficiency with larger than 80% CIP and PAP utilization rates. The CIP-(DXT-PAP) nanoplex exhibited tenfold improvement in the mucus permeability compared to its CIP-DXT nanoplex counterpart, resulting in the former's superior bactericidal activity against clinical Pseudomonas aeruginosa biofilm in the presence of mucus barrier. A trade-off, nevertheless, existed between antibacterial efficacy and cytotoxicity towards human lung epithelium cells upon the incorporation of PAP above a certain concentration threshold. Therefore, the optimal dosing of the CIP-(DXT-PAP) nanoplex must be carefully determined.

Proteomic mechanisms for the stimulatory effects of antibiotics on Microcystis aeruginosa during hydrogen peroxide treatment.

Application of low dosage of H2O2 at early stage of cyanobacterial life cycle is a promising route for cyanobacterial bloom mitigation, which could minimize adverse effects on non-target organisms. Besides, influence of co-existing contaminants on cyanobacterial bloom mitigation under combined pollution conditions remains unclear. This study assessed the influence of a mixture of four frequently detected antibiotics (tetracycline, sulfamethoxazole, ciprofloxacin and amoxicillin) during H2O2 treatment of Microcystis aeruginosa at early growth stage. H2O2 significantly (p < 0.05) inhibited growth rate, chlorophyll a content, Fv/Fm and rETRmax in a dose-dependent manner at low doses of 0.25-1 mg L-1, through downregulating proteins involved in cell division, cellular component organization, gene expression and photosynthesis. Although H2O2 increased microcystin content in each cyanobacterial cell through the upregulation of microcystin synthetases (mcyC and mcyF), total microcystin concentration in H2O2 treated groups was significantly (p < 0.05) reduced due to the decrease of cell density. Existence of 80 and 200 ng L-1 mixed antibiotics during H2O2 treatment facilitated the scavenging of ROS by antioxidant enzymes and significantly (p < 0.05) stimulated growth, photosynthesis, microcystin synthesis and microcystin release in H2O2 treated cells, through the upregulation of proteins involved in photosynthesis, oxidation-reduction process, biosynthesis, gene expression and transport. Mixed antibiotics increased the hazard of M. aeruginosa during H2O2 treatment, through the stimulation of microcystin synthesis and release at the proteomic level. Each target antibiotic should be controlled below 5 ng L-1 before the application of H2O2 for eliminating the interference of antibiotics on cyanobacterial bloom mitigation.

Evaluating the efficacy of an algae-based treatment to mitigate elicitation of antibiotic resistance.

Antibiotics in the effluents of municipal wastewater treatment plants (WWTP) may create selective pressures to induce antibiotic resistance in bacteria downstream. This study evaluates ciprofloxacin (CIP) removal by a freshwater alga, Scenedesmus dimorphus, to assess the efficacy of algae-based tertiary treatment in reducing effluent-induced CIP resistance. Results show significant CIP removal in light-exposed samples without algae and experimental algae (EA) samples: 53% and 93%, respectively, over 144 h. A residual antibiotic potency assay reveals that untreated CIP is significantly more growth-inhibiting to a model bacterium (Escherichia coli) than the algae-treated and light-exposed samples during short exposures (6 h). Adaptive laboratory evolution (ALE), again using E. coli, reveals that treated samples exhibit reduced capacity to elicit CIP resistance during sustained exposures compared to untreated CIP. Finally, observed CIP resistance in the CIP-exposed ALE lineages is corroborated via genotype characterization, which reveals the presence of resistance-associated mutations in gyrase subunit A (gyrA) that are not present in ALE lineages exposed to algae treated or light-exposed samples. As such, algae-mediated tertiary treatment could be effective in suppressing CIP resistance in bacterial communities downstream from WWTP. In addition, ALE is useful for assessing the potential of wastewater-relevant samples to elicit antibiotic resistance downstream.

Ciprofloxacin removal during secondary domestic wastewater treatment in high rate algal ponds.

This study investigated the removal of antibiotic ciprofloxacin during the treatment of real wastewater using high rate algal ponds (HRAP). When spiked at 2 mg/L into primary domestic wastewater, ciprofloxacin (CPX) was efficiently removed from laboratory scale photobioreactors continuously operated under various durations of artificial illumination and hydraulic residence times. Subsequent batch tests conducted with reactor microcosms showed CPX removal was mainly caused by photodegradation during daytime, and sorption to biomass during night time. These findings were confirmed during an experiment conducted in a 1000 L pilot HRAP operated outdoors, as well as during outdoor batch assays conducted using pilot HRAP microcosms. While these results highlight a potentially interesting treatment capacity in comparison to conventional biological treatment, further research must confirm these findings at relevant pollutant concentration (ng-µg/L) and determine the fate and potential toxicity of degradation products.

Comparison of biological and advanced treatment processes for ciprofloxacin removal in a raw hospital wastewater.

The treatability of ciprofloxacin (CIP) antibiotic was investigated using a single aerobic, a single anaerobic, an anaerobic/aerobic sequential reactor system, a sonicator and a photocatalytic reactor with TiO2 nanoparticles in a raw hospital wastewater in Izmir, Turkey. The effects of increasing organic loading on the performance of all biological systems were investigated, while the effects of power and time on the yields of sonication and photocatalysis were determined. The maximum COD and CIP yields were 95% and 83% in anaerobic/aerobic sequential reactor system at an HRT of 10 days and at an OLR of 0.19 g COD/L × day after 50 days of incubation, respectively. The maximum CH4 gas production was 580 mL day(-1) at an HRT of 6.7 days. The maximum COD and CIP yields were 95% and 81% after 45 min sonication time at a power of 640 W and a frequency of 35 kHz while the maximum yield of COD and CIP were 98% and 88% after 45 min UV irradiation time with a UV power of 210 W using 0.5 g L(-1) TiO2. Among the aforementioned treatment processes, it was found that the highest treatment yields for COD (98%) and CIP (88%) pollutants were obtained with the photocatalytic process due to high OH((●)) radical productions.

Antibiotic combination therapy can select for broad-spectrum multidrug resistance in Pseudomonas aeruginosa.

Combination therapy with several antibiotics is one strategy that has been applied in order to limit the spread of antimicrobial resistance. We compared the de novo evolution of resistance during combination therapy with the ß-lactam ceftazidime and the fluoroquinolone ciprofloxacin with the resistance evolved after single-drug exposure. Combination therapy selected for mutants that displayed broad-spectrum resistance, and a major resistance mechanism was mutational inactivation of the repressor gene mexR that regulates the multidrug efflux operon mexAB-oprM. Deregulation of this operon led to a broad-spectrum resistance phenotype that decreased susceptibility to the combination of drugs applied during selection as well as to unrelated antibiotic classes. Mutants isolated after single-drug exposure displayed narrow-spectrum resistance and carried mutations in the MexCD-OprJ efflux pump regulator gene nfxB conferring ciprofloxacin resistance, or in the gene encoding the non-essential penicillin-binding protein DacB conferring ceftazidime resistance. Reconstruction of resistance mutations by allelic replacement and in vitro fitness assays revealed that in contrast to single antibiotic use, combination therapy consistently selected for mutants with enhanced fitness expressing broad-spectrum resistance mechanisms.

Human mesenchymal stromal cells can uptake and release ciprofloxacin, acquiring in vitro anti-bacterial activity.

BACKGROUND AIMS: Traditional antibiotic therapy is based on the oral or systemic injection of antibiotics that are often unable to stop a deep infection (eg, osteomyelitis). We studied whether or not bone marrow stromal cells (BM-MSCs) are able to uptake and release ciprofloxacin (CPX), a fluoroquinolone considered the drug of choice for the treatment of chronic osteomyelitis because of its favorable penetration into poorly vascularized sites of infection. METHODS: Human bone marrow stromal cells (BM-MSCs) were primed with CPX (BM-MSCsCPX) according to a methodology previously standardized in our laboratory for paclitaxel (PTX). The anti-microbial activity of CPX released from BM-MSCs cells (BM-MSCsCPX-CM) or supernatant from cell lysate (BM-MSCsCPX-LYS) was evaluated by agar dilution and microdilution methods on three bacterial strains (Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa). To investigate whether or not primed cells (BM-MSCsCPX) were able to directly act on the bacterial growth, co-colture was performed by mixing E. coli suspension to an increasing number of BM-MSCsCPX. The anti-bacterial activity was determined as number of BM-MSCsCPX that completely inhibited bacterial growth. RESULTS: The results demonstrated that BM-MSCsCPX are able to uptake and then release CPX in the conditioned medium. The loaded antibiotic maintains its active form throughout the process as tested on bacteria. CONCLUSIONS: Our findings suggest that CPX-loaded MSCs may represent an important device for carrying and delivering CPX (and perhaps other antibiotics) into infected deep microenvironments; they could be used for local application and by systemic infusion when their homing capacity into the bone is cleared.

Ciprofloxacin treatment failure in a murine model of pyelonephritis due to an AAC(6')-Ib-cr-producing Escherichia coli strain susceptible to ciprofloxacin in vitro.

AAC(6')-Ib-cr is a plasmid-mediated quinolone resistance mechanism described worldwide for Escherichia coli. Since it confers in vitro only a low level of resistance to ciprofloxacin, we evaluated its impact on the in vivo activity of ciprofloxacin. Isogenic strains were obtained by transferring plasmid p449, harboring aac(6')-Ib-cr, into the quinolone-susceptible strain E. coli CFT073-RR and its D87G gyrA mutant. MICs were 0.015, 0.06, 0.25, and 0.5 µg/ml against E. coli strains CFT073-RR, CFT073-RR/p449, CFT073-RR GyrA(r), and CFT073-RR GyrA(r)/p449, respectively. Bactericidal activity was reduced at 1× the MIC for the three resistant derivatives, while at a fixed concentration of 0.5 µg/ml, 99.9% killing was observed for all strains except E. coli CFT073-RR GyrA(r)/p449. In the murine model of pyelonephritis, an optimal regimen of ciprofloxacin (10 mg/kg of body weight twice a day [b.i.d.]) significantly decreased the bacterial count in the kidneys of mice infected with E. coli CFT073 (1.6 versus 4.3 log10 CFU/g of kidney compared to untreated controls; P = 0.0001), while no significant decrease was observed for E. coli CFT073-RR/p449 (2.7 versus 3.1 log10 CFU/g; P = 0.84), E. coli CFT073-RR GyrA(r) (4.2 versus 4.1 log10 CFU/g; P = 0.35), or E. coli CFT073-RR GyrA(r)/p449 (2.9 versus 3.6 log10 CFU/g; P = 0.47). While pharmacokinetic and pharmacodynamic (PK/PD) parameters accounted for ciprofloxacin failure against gyrA-containing mutants, this was not the case for the aac(6')-Ib-cr-containing strains, suggesting an in situ hydrolysis of ciprofloxacin in the latter case.

Chitosan-dextran sulphate nanocapsule drug delivery system as an effective therapeutic against intraphagosomal pathogen Salmonella.

OBJECTIVES: The ability to target conventional drugs efficiently inside cells to kill intraphagosomal bacteria has been a major hurdle in treatment of infective diseases. We aimed to develop an efficient drug delivery system for combating infection caused by Salmonella, a well-known intracellular and intraphagosomal pathogen. Chitosan-dextran sulphate (CD) nanocapsules were assessed for their efficiency in delivering drugs against Salmonella. METHODS: The CD nanocapsules were prepared using the layer-by-layer method and loaded with ciprofloxacin or ceftriaxone. Antibiotic-loaded nanocapsules were analysed in vitro for their ability to enter epithelial and macrophage cells to kill Salmonella. In vivo pharmacokinetics and organ distribution studies were performed to check the efficiency of the delivery system. The in vivo antibacterial activity of free antibiotic and antibiotic loaded into nanocapsules was tested in a murine salmonellosis model. RESULTS: In vitro and in vivo experiments showed that this delivery system can be used effectively to clear Salmonella infection. CD nanocapsules were successfully employed for efficient targeting and killing of the intracellular pathogen at a dosage significantly lower than that of the free antibiotic. The increased retention time of ciprofloxacin in the blood and organs when it was delivered by CD nanocapsules compared with the conventional routes of administration may be the reason underlying the requirement for a reduced dosage and frequency of antibiotic administration. CONCLUSIONS: CD nanocapsules can be used as an efficient drug delivery system to treat intraphagosomal pathogens, especially Salmonella infection. This delivery system might be used effectively for other vacuolar pathogens including Mycobacteria, Brucella and Legionella.

Studies of ciprofloxacin encapsulation on alginate/pectin matrixes and its relationship with biodisponibility.

Screening of ciprofloxacin (Cip) with selected biopolymers brings about 90% antibiotic interactions with a coacervate composed of alginate/high metoxylated pectin in 2:1 ratio. Fourier transform infrared spectroscopy analysis provides information about the nature of this interaction, revealing ionic and hydrophobic patterns among the molecules. Alginate/high methoxylated pectin gel microspheres developed by ionic gelation encapsulates 46.8 ± 5.0% Cip. The gel matrix can release Cip in a sustained manner, releasing 42.7 ± 0.2% in 2 h under simulated stomach pH conditions, and 83.3 ± 1.1% Cip release in 80 mM phosphate at pH = 7.40 (intestinal). The increase of sodium chloride from 50 to 200 mM implies a Cip release from 69.0 ± 1.5% to 95.1 ± 3.6% respectively in 2 h. Scanning electron microscopy revealed the cohesive effect of HM pectin over alginate molecules on the microsphere surface. Those results guarantee all Cip contained in the alginate/HM pectin microspheres could be released in an established kinetic profile along the gastrointestinal tract, avoiding the Cip undesirable side effects during absorption.

Otitis externa por Staphylococcus aureus resistente a meticilina en un lactante / External otitis by Methicillin-resistant Staphylococcus aureus in an infant

Se presenta el caso clínico de un niño que presentó una otitis externa a los dos meses de edad. El cultivo ótico mostró un Staphylococcus aureus resistente a meticilina (SARM). Se realizó un estudio familiar en ambos padres resultando los cultivos nasales negativos. Posteriormente, estudiando la historia familiar se supo que la madre había tenido en el momento del parto un cultivo de herida quirúrgica positivo a SARM con el mismo antibiograma que el que presentaba el niño. Como en ese periodo de tiempo no se había hecho ningún tratamiento en el niño se volvió a repetir el cultivo para valorar la necesidad o no de tratamiento persistiendo el SARM. Se realizó tratamiento local con ciprofloxacino, siendo el cultivo de control negativo(AU)

We reported the case of a child two months old, with external otitis by Methicillin-Resistant Staphylococcus Aureus (MRSA). Nasal swabs were collected from the father and the mother with negative result. An intra-familial vertical transmission was identified later(AU)

Characterization of cyanide-trapped methylated metabonates formed during reactive drug metabolite screening in vitro.

Reactive metabolites are estimated to be one of the main reasons behind unexpected drug-induced toxicity, by binding covalently to cell proteins or DNA. Due to their high reactivity and short lifespan, reactive metabolites are analyzed after chemical trapping with nucleophilic agents such as glutathione or cyanide. Recently, unexplained and uncharacterized methylated reaction products were reported in a human liver microsome based reactive metabolite trapping assay utilizing potassium cyanide as a trapping agent. Here, a similar assay was utilized to produce mono- or dimethylated and further cyanide-trapped reaction products from propranolol, amlodipine and ciprofloxacin, followed by ultra-performance liquid chromatography/time-of-flight mass spectrometry (UPLC/TOF-MS) and ultra-performance liquid chromatography/tandem mass spectrometry (UPLC/MS/MS) experiments for their more detailed structural elucidation. Formation of all observed cyanide-trapped products was clearly NADPH-dependent and thus metabolism-mediated. The suggested reaction pathways included N-methylation leading to iminium formation in primary and/or secondary amines preceded by cytochrome P450 (CYP)-mediated reactions. As the methylation reaction was suggested to be involved in formation of the actual reactive iminium ion, the observed cyanide-trapped products were experimental artifacts rather than trapped reactive metabolites. The results stress that to avoid overestimating the formation of reactive metabolites in vitro, this methylation phenomenon should be taken into account when interpreting the results of cyanide-utilizing reactive metabolite trapping assays. This in turn emphasizes the importance of identification of the observed cyano conjugates during such studies. Yet, metabolite identification has a high importance to avoid overestimation of in vitro metabolic clearance in the cases where this kind of metabonate formation has a high impact in the disappearance rate of the compound.

Enrofloxacin-based therapeutic strategy for the prevention of endometritis in susceptible mares.

Enrofloxacin (EFX) is often used empirically to prevent uterine infections in mares in order to improve efficiency on Commercial Embryo Transfer Farms. This study investigated the uterine distribution of EFX and its metabolite ciprofloxacin (CFX) in mares and assessed the minimal inhibitory concentrations (MIC) of EFX against various common pathogens as a basis for establishing a rational dosing schedule. Plasma and uterine pharmacokinetic (PK) studies were performed in two groups (n = 5) of healthy mares following intravenous (i.v.) administration of EFX at either 2.5 and at 5 mg/kg bodyweight. Plasma and endometrial tissue samples, taken before for up to 48 h after treatment were analysed by Reverse Phase HPLC. MIC values for wild strains of Gram-negative (Escherichia coli, Pseudomonas aeruginosa) and Gram-positive bacteria (beta-haemolytic streptococci) ranged from 0.25-2 and 1.5-3.0 microg/mL respectively. In terms of tissue distribution, the sum of the endometrial concentrations of the parent drug (EFX) and its active metabolite (CFX) (in terms of AUC), exceeded those in plasma by 249% and 941% following administration of EFX at 2.5 and 5 mg/kg respectively. After i.v. treatment with EFX at 5 mg/kg, endometrial concentrations of EFX and CFX above the MIC value were detected for 36-48 and 22-43 h posttreatment for Gram-negative and -positive isolates respectively. Concentrations above MIC were maintained for much shorter periods at the lower (2.5 mg/kg) treatment dose. Based on these results, a conventional dose (5 mg/kg) of EFX given prebreeding followed by two further doses at 36-48 h postbreeding are proposed as a rational strategy for using of EFX as a preventative therapy against a variety of common bacterial strains associated with equine endometritis.

Antimycobacterial activities of selected medicinal plants from Zimbabwe against Mycobacterium aurum and Corynebacterium glutamicum.

The spread of multi-drug resistant tuberculosis necessitates the discovery of new classes of antibacterials and compounds that inhibit macromolecules involved in these resistant mechanisms. Thirty ethanol extracts from nineteen selected plants from Zimbabwe were screened against Mycobacterium aurum and Corynebacterium glutamicum using the agar disk diffusion method. These two organisms were used as models for Mycobacterium tuberculosis. The amount of ciprofloxacin accumulated and effluxed by the test organism was used to determine whether the plant extracts could also act as drug efflux pump inhibitors. Vernonia adoensis and Mangifera indica extracts at 500 mg/disk had the highest growth inhibitory activity against M. aurum and C. glutamicum respectively. The extract from Parinari curatellifolia had an MIC of 8 µg/ disk and an MBC of 63 µg/disk; an MIC of 125 µg/disk and an MBC of >500 µg/disk against M. aurum and C. glutamicum respectively. All the plant extracts were bacteriostatic and showed antagonistic effects when combined with rifampicin. The extract from P. curatellifolia made M. aurum and C. glutamicum accumulate the highest amount of ciprofloxacin. The accumulation of ciprofloxacin caused by P. curatellifolia extract was greater than that caused by the drug efflux inhibitor reserpine. This plant may serve as a source of lead compounds in the search of new antimycobacterials with new mechanisms of action.

Removal of ciprofloxacin in simulated digestive media by activated charcoal entrapped within zinc-pectinate beads.

Beads made of a zinc-pectinate matrix containing activated charcoal were designed for the adsorption of colonic residual antibiotics responsible of the emergence of resistance. Bead stability was shown to correlate with bead zinc content, 0.08 mg/mg being the minimal amount of zinc that protects the egg-box structure against total disintegration. Moreover, the stability in simulated gastro-intestinal media was shown to be related to the composition of the incubation medium. Indeed, gastric medium was shown to extract a large amount of zinc inducing an early disintegration of the beads in the intestinal medium, making necessary their protection by gastro-resistant capsules. Simulated intestinal medium buffered by phosphate was not adapted for the disintegration studies since the formation of a zinc phosphate precipitate on beads surface enhances their resistance to further degradation by pectinases contained in colonic medium. On the other hand, beads incubated in HEPES were stable in intestinal medium and nicely degraded by pectinases contained in simulated colonic medium. Despite this stability, coating with Eudragit RS was needed to prevent the early adsorption of antibiotics in intestinal medium. Adsorption studies in the simulated colonic medium show that the adsorption capacity of activated charcoal is not modified after its encapsulation within pectin beads making the elimination of ciprofloxacin reaching the colon clinically feasible.

Ciprofloxacin 0.3%/dexamethasone 0.1% topical drops for the management of otic infections.

The American Academy of Otolaryngology-Head and Neck Surgery has recommended that, where possible, infections of the external auditory canal and middle ear be treated with topical preparations. The advantages of topical therapy include i) excellent efficacy; ii) decreased risk of systemic side effects; iii) less likelihood of selecting for resistant strains of microorganisms; and iv) lack of potential for ototoxicity. One advantage of topical therapy arises as a consequence of a very high concentration of antibiotic in topical preparations reaching the site of infection. Ciprofloxacin 0.3%/dexamethasone 0.1% (Ciprodex) is the only ototopical drop approved for use in both the middle ear and external auditory canal that combines a fluoroquinolone with a steroid. At 0.3% (3000 mcg/ml), the ciprofloxacin concentration of Ciprodex exceeds the MIC of virtually all relevant organisms by a very considerable margin. The clinical efficacy of ciprofloxacin/dexamethasone suspension has been demonstrated in several large prospective clinical trials. It has been consistently equal to or superior to comparator drugs. The authors believe that the use of topical ciprofloxacin/dexamethasone will increase as the advantages of fluoroquinolone/steroid combination therapy become more widely recognized.

The combined effects of alpha-tocopheryl acetate supplementation and enrofloxacin administration on oxidative stability of turkey meat.

1. The combined effects of dietary supplementation of vitamin E and enrofloxacin administration on the oxidative stability of turkey meat were assessed. 2. Enrofloxacin concentrations found in muscles and liver samples from turkeys receiving 200 g/kg of alpha-tocopheryl acetate plus 50 mg/kg of enrofloxacin without a withdrawal period were higher than those of samples administered with 50 mg/kg of enrofloxacin alone. Similarly, meat samples from turkeys receiving 50 mg/kg of enrofloxacin with withdrawal plus 200 mg/kg of alpha-tocopheryl acetate showed a significantly lower vitamin E accumulation than meat samples of the treatment with enrofloxacin without withdrawal plus vitamin E. 3. The results indicated an interaction between the antioxidant and the antibiotic in their effects on oxidation susceptibility and the abiotic safety of meat from turkeys fed on supplemented diets. A mutual stabilisation of both compounds by reducing the effects of free radicals or by affecting the absorption of the compounds is suggested.