ABSTRACT
There has been an increase in the number of pertussis cases reported since the introduction of the acellular pertussis vaccine. While children that present with pertussis have a characteristic whooping cough, adults can simply have a persistent, nonspecific cough and remain undiagnosed. Macrolide antibiotics, such as azithromycin, are the currently recommended treatment for pertussis. Solithromycin is a new macrolide and the first fluoroketolide with broad activity against a wide spectrum of bacterial pathogens and has completed clinical development for community-acquired bacterial pneumonia. This study reports the potent in vitro activity of solithromycin against a collection of recent isolates of Bordetella pertussis.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bordetella pertussis/drug effects , Macrolides/pharmacology , Triazoles/pharmacology , Bordetella pertussis/isolation & purification , Humans , Microbial Sensitivity TestsABSTRACT
OBJECTIVE: To determine the temporal relationship between intrapartum clindamycin and vaginal Group B Streptococcus (GBS) colony counts. METHODS: In this prospective observational study, women with GBS-positive, clindamycin-sensitive, antenatal rectovaginal cultures, intrapartum vaginal cultures were collected just before the first clindamycin dose (T(0)) and then every 2 h for 8 h or until delivery. Colony counts were quantified using serial dilution. Results were standardized as percent of initial colony count and analyzed using sequential Friedman tests. RESULTS: Twenty-one women had positive intrapartum vaginal GBS cultures at T(0). With T(0) colony counts standardized to 100%, subsequent percents-of-baseline fell rapidly and significantly by T(2) and fell further at each subsequent point, reaching 0% by T(6). For 12 women cultured for the full 8 hours, the decline in GBS was significant at p < 0.001. CONCLUSIONS: Vaginal GBS colony counts fall rapidly after intrapartum clindamycin administration, similar to declines after penicillin. This represents a possible mechanism for efficacy of chemoprophylaxis.
Subject(s)
Antibiotic Prophylaxis/methods , Clindamycin/administration & dosage , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/drug therapy , Streptococcal Infections/drug therapy , Streptococcus agalactiae/drug effects , Streptococcus agalactiae/isolation & purification , Adolescent , Adult , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacology , Clindamycin/pharmacology , Colony Count, Microbial , Drug Administration Schedule , Female , Humans , Infant, Newborn , Parturition/physiology , Pregnancy , Pregnancy Complications, Infectious/microbiology , Streptococcal Infections/microbiology , Streptococcal Infections/prevention & control , Streptococcal Infections/transmission , Streptococcus agalactiae/growth & development , Vagina/drug effects , Vagina/microbiology , Young AdultABSTRACT
OBJECTIVE: The objective of the study was to determine the temporal relationship between intrapartum penicillin-G (PCN-G) and vaginal group B streptococcus (GBS) counts. STUDY DESIGN: In 50 women with GBS-positive antenatal cultures, intrapartum cultures were collected just before the first PCN-G dose and every 2 hours x 4 or until delivery. Colony counts were quantified using serial dilution. Results were standardized as percent of initial colony count and analyzed using sequential Wilcoxon tests. RESULTS: Of 50 subjects with GBS-positive antepartum cultures, 35 (70%) had positive intrapartum vaginal cultures, of which 27 received intrapartum PCN-G. Degree of vaginal colonization varied greatly between subjects, and counts (percents) were not normally distributed. From the T(0) (time = zero) colony count standardized to 100%, counts fell rapidly to means +/- SE and medians of 18.2 +/- -7.5% and 0.5% at T(2) (P < .0001), 2.5 +/- 1.7% and 0.02% at T(4) (P = .006), and less than 0.2% and 0.0% at T(6 and 8) (P = .07 and P = .46, respectively). CONCLUSION: Vaginal GBS colony counts fall rapidly after intrapartum PCN-G administration, which may partly explain the effectiveness of chemoprophylaxis.