RESUMEN
Hidradenitis Suppurativa (HS) is a chronic inflammatory skin disease that may have profound effects on the patient's quality of life. A personalized HS combination therapy treatment was prescribed to a 54-year-old female suffering from multiple painful sores, as follows: naltrexone capsules titrated from 0.5 mg up to 4.5 mg; pentoxifylline 5%, rifampin 2%, clindamycin 1%, and glycolic acid topical cream. Clinical improvements were observed using two disease-specific outcome measures: Hurley Staging System and HS Score. The patient's HS improved from Stage II (moderate) to Stage I (mild), and the HS score decreased from 103 points with five anatomical regions reported, to 19 points with only three regions affected. Furthermore, the before and after treatment photographs showed a visible reduction in the number of boils/skin abscesses and an overall recovery. Improvements were also observed across all domains of the patient's self-reported quality of life (Hidradenitis Suppurativa Quality of Life Assessment). The patient did not experience any undesirable effects. Compounded medications may be customized to meet the patient's special needs and may be adjusted throughout the course of treatment to match the patient's individual progress. Although further studies are necessary, this personalized, combination therapy may be a key treatment option in HS.
Asunto(s)
Clindamicina , Quimioterapia Combinada , Hidradenitis Supurativa , Pentoxifilina , Rifampin , Humanos , Femenino , Hidradenitis Supurativa/tratamiento farmacológico , Persona de Mediana Edad , Clindamicina/administración & dosificación , Clindamicina/uso terapéutico , Pentoxifilina/administración & dosificación , Pentoxifilina/uso terapéutico , Rifampin/administración & dosificación , Administración Oral , Calidad de Vida , Administración Tópica , Antibacterianos/administración & dosificación , Resultado del Tratamiento , Combinación de MedicamentosRESUMEN
The individual physicochemical stabilities of Allopurinol, Clindamycin Hydrochloride, Naltrexone Hydrochloride, Spironolactone and Ursodiol in the proprietary suspending vehicle PCCA SuspendIt® have been previously studied and published by the author. Accordingly, Beyond-Use-Dates (BUDs) of 180 days were assigned to the five drugs based on the results of the respective studies. The data were donated to the United States Pharmacopeia (USP) for possible adoption as Official Compounded Drug Monographs. Following an extensive review process, all five studies were approved and published by the USP. However, due to a lack of microbiological stability information, the BUDs were limited to 90 days. The current study was undertaken as a follow-up project to determine the microbiological stability of these five drugs in PCCA SuspendIt® utilizing the same compounding procedures from the original studies. A stable extemporaneous product is defined as one that retains at least 90% of the initial drug concentration throughout the sampling period and is protected against microbial growth. The goal was to provide a viable, compounded alternative for Allopurinol, Clindamycin Hydrochloride, Naltrexone Hydrochloride, Spironolactone and Ursodiol in a thixotropic liquid dosage form, with an extended BUD of 6 months to meet patient needs. Given that the physical and chemical stabilities of all five drugs have been previously established and adopted by the USP as official compounded monographs, additional microbiological stability data would allow the official BUDs in the USP to be extended to 180 days to conform to the physicochemical stabilities. The current study showed that the preservative system in PCCA SuspendIt® successfully protected all the suspensions from growth of challenge microorganisms per the USP Chapter <51> AME Test. The results of the current study combined with the previous physicochemical studies demonstrate the following: Allopurinol is physically, chemically and microbiologically stable in PCCA SuspendIt for 180 days in the refrigerator and at room temperature over a bracketed allopurinol concentration range of 10 - 20 mg/mL. Clindamycin Hydrochloride is physically, chemically and microbiologically stable in PCCA SuspendIt for 180 days in the refrigerator and at room temperature at a concentration of 10-mg/mL of clindamycin. Naltrexone Hydrochloride is physically, chemically and microbiologically stable in PCCA SuspendIt for 180 days in the refrigerator and at room temperature, over a bracketed naltrexone hydrochloride concentration range of 0.5 - 5.0 mg/mL. Spironolactone is physically, chemically and microbiologically stable in PCCA SuspendIt for 180 days in the refrigerator and at room temperature at a concentration of 5 mg/mL of spironolactone. Ursodiol is physically, chemically and microbiologically stable in PCCA SuspendIt for 180 days in the refrigerator and at room temperature, over a bracketed ursodiol concentration range of 50 - 100 mg/mL. Taken collectively, the current study in conjunction with the earlier studies provide viable, compounded alternatives for Allopurinol, Clindamycin Hydrochloride, Naltrexone Hydrochloride, Spironolactone and Ursodiol in the suspending vehicle PCCA SuspendIt in liquid dosage forms, with an extended beyond-use-date to meet patient needs.
Asunto(s)
Alopurinol , Clindamicina , Composición de Medicamentos , Estabilidad de Medicamentos , Naltrexona , Clindamicina/química , Clindamicina/administración & dosificación , Alopurinol/química , Naltrexona/química , Naltrexona/administración & dosificación , Espironolactona/química , Administración OralRESUMEN
PURPOSE: The aim of this study was to quantify the prophylactic effect of high-dose gentamicin and clindamycin antibiotic-loaded bone cement (ALBC) during revision total hip (rTHA) or knee (rTKA) arthroplasty for aseptic reasons. The hypothesis was that the raw surgical site infection (SSI) rate is lower when this particular cement is used in comparison with cement loaded with standard-dose gentamicin during rTHA or rTKA for aseptic reasons. METHODS: This retrospective study included 290 consecutive patients undergoing aseptic rTHA or rTKA. Two consecutive cohorts were defined: the first (control group) involved 145 patients where ALBC with gentamicin only was used; the second (study group) involved 145 patients where ALBC with high-dose gentamicin and clindamycin was used. The primary endpoint was the raw SSI rate after 24 months. RESULTS: The raw SSI rate was 8/145 (6%) in the control group and 13/145 (9%) in the study group (odds ratio 0.62, p = 0.26). There was a significant impact of the presence of any risk factor on the SSI rate (15/100 versus 6/169, odds ratio = 4.25, p = 0.002), but no significant impact of any individual risk factor. No complication or side effect related to ALBC was observed in either group. CONCLUSION: These results do not support the routine use of gentamicin and clindamycin ALBC for fixation of revision implants after rTHA and rTKA for aseptic reasons.
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Antibacterianos , Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Cementos para Huesos , Clindamicina , Gentamicinas , Infecciones Relacionadas con Prótesis , Reoperación , Infección de la Herida Quirúrgica , Humanos , Gentamicinas/administración & dosificación , Clindamicina/administración & dosificación , Artroplastia de Reemplazo de Cadera/efectos adversos , Artroplastia de Reemplazo de Cadera/métodos , Estudios Retrospectivos , Masculino , Femenino , Artroplastia de Reemplazo de Rodilla/efectos adversos , Anciano , Antibacterianos/administración & dosificación , Persona de Mediana Edad , Infección de la Herida Quirúrgica/prevención & control , Infecciones Relacionadas con Prótesis/prevención & control , Infecciones Relacionadas con Prótesis/etiología , Factores de RiesgoRESUMEN
Introduction. Maternal screening tests and prophylactic antibiotics are important to prevent neonatal and infant group B streptococcal (GBS) infections.Hypothesis/Gap Statement. The performance of enrichment broth media for GBS screening that are available in Japan is unclear. Whole-genome data of GBS isolates from pregnant women in Japan is lacking.Aim. The aim of this study was to compare the protocol performance of six enrichment broths and two subculture agar plates, which were all available in Japan, for GBS detection. In addition, we showed whole-genome data of GBS isolates from pregnant women in Japan.Methodology. We collected 133 vaginal-rectal swabs from pregnant women visiting clinics and hospitals in Nagasaki Prefecture, Japan, and compared the protocol performance of 6 enrichment broths and 2 subculture agar plates. All GBS isolates collected in this study were subjected to whole-genome sequencing analysis.Results. We obtained 133 vaginal-rectal swabs from pregnant women at 35-37 weeks of gestation from 8 private clinics and 2 local municipal hospitals within Nagasaki Prefecture, Japan. The detection rate of the protocol involving the six enrichment broths and subsequent subcultures varied between 95.5 and 100â%, depending on the specific choice of enrichment broth. The GBS carriage rate among pregnant women in this region was 18.8â%. All 25 isolates derived from the swabs were susceptible to penicillin, whereas 48 and 36â% of the isolates demonstrated resistance to erythromycin and clindamycin, respectively. The distribution of serotypes was highly diverse, encompassing seven distinct serotypes among the isolates, with the predominant serotype being serotype V (n = 8). Serotype V isolates displayed a tendency towards increased resistance to erythromycin and clindamycin, with all resistant isolates containing the ermB gene.Conclusion. There was no difference in performance among the culture protocols evaluated in this study. GBS strains isolated from pregnant women appeared to have greater genomic diversity than GBS strains detected in neonates/infants with invasive GBS infections. To confirm this result, further studies with larger sample sizes are needed.
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Antibacterianos , Infecciones Estreptocócicas , Streptococcus agalactiae , Vagina , Humanos , Streptococcus agalactiae/genética , Streptococcus agalactiae/efectos de los fármacos , Streptococcus agalactiae/aislamiento & purificación , Streptococcus agalactiae/clasificación , Femenino , Embarazo , Japón/epidemiología , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/epidemiología , Antibacterianos/farmacología , Vagina/microbiología , Medios de Cultivo/química , Complicaciones Infecciosas del Embarazo/microbiología , Complicaciones Infecciosas del Embarazo/epidemiología , Recto/microbiología , Pruebas de Sensibilidad Microbiana , Secuenciación Completa del Genoma , Adulto , Clindamicina/farmacología , Genoma BacterianoRESUMEN
Bone infections are still a major problem in surgery. To avoid severe side effects of systemically administered antibiotics, local antibiotic therapy is increasingly being considered. Using a pressure-based method developed in our group, microporous ß-TCP ceramics, which had previously been characterized, were loaded with 2% w/v alginate containing 50 mg/mL clindamycin and 10 µg/mL rhBMP-2. Release experiments were then carried out over 28 days with changes of liquid at defined times (1, 2, 3, 6, 9, 14, 21 and 28d). The released concentrations of clindamycin were determined by HPLC and those of rhBMP-2 by ELISA. Continuous release (anomalous transport) of clindamycin and uniform release (Fick's diffusion) of BMP-2 were determined. The composites were biocompatible (live/dead, WST-I and LDH) and the released concentrations were all antimicrobially active against Staph. aureus. The results were very promising and clindamycin was detected in concentrations above the MIC as well as a constant rhBMP-2 release over the entire study period. Biocompatibility was also not impaired by either the antibiotic or the BMP-2. This promising approach can therefore be seen as an alternative to the common treatment with PMMA chains containing gentamycin, as the new composite is completely biodegradable and no second operation is necessary for removal or replacement.
Asunto(s)
Antibacterianos , Materiales Biocompatibles , Proteína Morfogenética Ósea 2 , Clindamicina , Staphylococcus aureus , Antibacterianos/farmacología , Antibacterianos/química , Antibacterianos/administración & dosificación , Proteína Morfogenética Ósea 2/química , Proteína Morfogenética Ósea 2/farmacocinética , Clindamicina/administración & dosificación , Clindamicina/química , Clindamicina/farmacocinética , Humanos , Materiales Biocompatibles/química , Staphylococcus aureus/efectos de los fármacos , Cinética , Fosfatos de Calcio/química , Animales , Ensayo de Materiales , Proteínas Recombinantes/química , Cerámica/química , Factor de Crecimiento Transformador beta , Alginatos/química , Implantes Absorbibles , Pruebas de Sensibilidad MicrobianaRESUMEN
Abstract: This retrospective study reviewed the macrolide resistance rates of Group A Streptococcus (GAS) isolates in the Northern Territory from 2012 to 2023. Clindamycin and erythromycin resistance rates peaked in 2021, at 6.0% and 12.2% respectively, and then returned to near baseline at 1-2% in 2023. Increased resistance rates were identified in the Top End of Australia from mid-2020, followed 15 months later by high rates in central Australia in 2022. Factors associated with resistant isolates were living in a rural region and of age 18 years and older. Possible explanations include a transient clonal introduction of a resistant GAS strain to the Northern Territory from 2020 to 2022. Ongoing surveillance is required to monitor regional trends and identify temporal variations in resistant isolates.
Asunto(s)
Antibacterianos , Clindamicina , Farmacorresistencia Bacteriana , Eritromicina , Infecciones Estreptocócicas , Streptococcus pyogenes , Clindamicina/farmacología , Humanos , Eritromicina/farmacología , Northern Territory/epidemiología , Streptococcus pyogenes/efectos de los fármacos , Antibacterianos/farmacología , Infecciones Estreptocócicas/epidemiología , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/tratamiento farmacológico , Estudios Retrospectivos , Femenino , Adulto , Masculino , Adolescente , Persona de Mediana Edad , Niño , Adulto Joven , Preescolar , Anciano , Pruebas de Sensibilidad Microbiana , LactanteRESUMEN
Clindamycin is a lincosamide-derivate antibiotic that has been widely used both systemically and topically for approximately 5 decades. The antimicrobial profile of clindamycin primarily covers several gram-positive bacteria and anaerobic bacteria, with multiple clinical applications supported in the literature and with widespread real-world use. Topical clindamycin has been used primarily for the treatment of acne vulgaris, with both monotherapy and combination therapy formulations available commercially. This article reviews the use of clindamycin as a topical agent with emphasis on therapy for acne vulgaris, and addresses modes of action, reported anti-inflammatory properties that may relate to therapeutic outcomes, recommendations to avoid the emergence of antibiotic-resistant bacteria, tolerability and safety considerations, and published data from clinical studies completed over a span of several years. A discussion of a newly FDA-approved triple-combination formulation is also included. J Drugs Dermatol. 2024;23(6):438-445. doi:10.36849/JDD.8318.
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Acné Vulgar , Administración Cutánea , Antibacterianos , Clindamicina , Humanos , Acné Vulgar/tratamiento farmacológico , Clindamicina/administración & dosificación , Clindamicina/uso terapéutico , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Resultado del Tratamiento , Farmacorresistencia BacterianaRESUMEN
BACKGROUND: Topical clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% gel (CAB) is the first fixed-dose triple-combination approved for the treatment of acne. This post hoc analysis investigated the efficacy and safety of CAB in pediatric (<18 years) and adult (greater than or equal to 18 years) participants. METHODS: In two multicenter, double-blind, phase 3 studies (NCT04214639 and NCT04214652), participants greater than or equal to 9 years of age with moderate-to-severe acne were randomized (2:1) to 12 weeks of once-daily treatment with CAB or vehicle gel. Pooled data were analyzed for pediatric and adult subpopulations. Assessments included treatment success (greater than or equal to 2-grade reduction from baseline in Evaluator's Global Severity Score and a score of 0 [clear] or 1 [almost clear], inflammatory/noninflammatory lesion counts, Acne-Specific Quality of Life (Acne-QoL) questionnaire, treatment-emergent adverse events (TEAEs), and cutaneous safety/tolerability. RESULTS: At week 12, treatment success rates for both pediatric and adult participants were significantly greater with CAB (52.7%; 45.9%) than with vehicle (24.0%; 23.5%; P<0.01, both). CAB-treated participants in both subgroups experienced greater reductions from baseline versus vehicle in inflammatory (pediatric: 78.6% vs 50.4%; adult: 76.6% vs 62.8%; P<0.001, both) and noninflammatory lesions (pediatric: 73.8% vs 41.1%; adult: 70.7% vs 52.2%; P<0.001, both). Acne-QoL improvements from baseline to week 12 were significantly greater with CAB than with a vehicle. Most TEAEs were of mild-to-moderate severity; no age-related trends for safety/tolerability were observed. Conclusions: CAB gel demonstrated comparable efficacy, quality of life improvements, and safety in pediatric and adult participants with moderate-to-severe acne. As the first fixed-dose, triple-combination topical formulation, CAB represents an important new treatment option for patients with acne. J Drugs Dermatol. 2024;23(6):394-402. doi:10.36849/JDD.8357.
Asunto(s)
Acné Vulgar , Peróxido de Benzoílo , Clindamicina , Fármacos Dermatológicos , Combinación de Medicamentos , Geles , Calidad de Vida , Humanos , Acné Vulgar/tratamiento farmacológico , Clindamicina/administración & dosificación , Clindamicina/efectos adversos , Clindamicina/análogos & derivados , Niño , Método Doble Ciego , Adolescente , Femenino , Masculino , Adulto , Peróxido de Benzoílo/administración & dosificación , Peróxido de Benzoílo/efectos adversos , Resultado del Tratamiento , Adulto Joven , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Administración Cutánea , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Clostridioides difficile is the main pathogen of antimicrobial-associated diarrhoea and health care facility-associated infectious diarrhoea. This study aimed to investigate the prevalence, toxin genotypes, and antibiotic resistance of C. difficile among hospitalized patients in Xi'an, China. RESULTS: We isolated and cultured 156 strains of C. difficile, representing 12.67% of the 1231 inpatient stool samples collected. Among the isolates, tcdA + B + strains were predominant, accounting for 78.2% (122/156), followed by 27 tcdA-B + strains (27/156, 17.3%) and 6 binary toxin gene-positive strains. The positive rates of three regulatory genes, tcdC, tcdR, and tcdE, were 89.1% (139/156), 96.8% (151/156), and 100%, respectively. All isolates were sensitive to metronidazole, and the resistance rates to clindamycin and cephalosporins were also high. Six strains were found to be resistant to vancomycin. CONCLUSION: Currently, the prevalence rate of C. difficile infection (CDI) in Xi'an is 12.67% (156/1231), with the major toxin genotype of the isolates being tcdA + tcdB + cdtA-/B-. Metronidazole and vancomycin were still effective drugs for the treatment of CDI, but we should pay attention to antibiotic management and epidemiological surveillance of CDI.
Asunto(s)
Antibacterianos , Toxinas Bacterianas , Clostridioides difficile , Infecciones por Clostridium , Heces , Genotipo , Hospitales , Clostridioides difficile/genética , Clostridioides difficile/efectos de los fármacos , Clostridioides difficile/aislamiento & purificación , Clostridioides difficile/clasificación , Humanos , China/epidemiología , Antibacterianos/farmacología , Infecciones por Clostridium/microbiología , Infecciones por Clostridium/epidemiología , Toxinas Bacterianas/genética , Hospitales/estadística & datos numéricos , Heces/microbiología , Farmacorresistencia Bacteriana/genética , Prevalencia , Pruebas de Sensibilidad Microbiana , Femenino , Persona de Mediana Edad , Masculino , Anciano , Adulto , Proteínas Bacterianas/genética , Diarrea/microbiología , Diarrea/epidemiología , Metronidazol/farmacología , Adulto Joven , Enterotoxinas/genética , Adolescente , Vancomicina/farmacología , Clindamicina/farmacología , Anciano de 80 o más AñosRESUMEN
BACKGROUND: Periodontal diseases may benefit more from topical treatments with nanoparticles rather than systemic treatments due to advantages such as higher stability and controlled release profile. This study investigated the preparation and characterization of thermosensitive gel formulations containing clindamycin-loaded niosomes and solid lipid nanoparticles (SLNs) loaded with fluconazole (FLZ), as well as their in vitro antibacterial and antifungal effects in the treatment of common microorganisms that cause periodontal diseases. METHODS: This study loaded niosomes and SLNs with clindamycin and FLZ, respectively, and assessed their loading efficiency, particle size, and zeta potential. The particles were characterized using a variety of methods such as differential scanning calorimetry (DSC), dynamic light scattering (DLS), and Transmission Electron Microscopy (TEM). Thermosensitive gels were formulated by combining these particles and their viscosity, gelation temperature, in-vitro release profile, as well as antibacterial and antifungal effects were evaluated. RESULTS: Both types of these nanoparticles were found to be spherical (TEM) with a mean particle size of 243.03 nm in niosomes and 171.97 nm in SLNs (DLS), and respective zeta potentials of -23.3 and -15. The loading rate was 98% in niosomes and 51% in SLNs. The release profiles of niosomal formulations were slower than those of the SLNs. Both formulations allowed the release of the drug by first-order kinetic. Additionally, the gel formulation presented a slower release of both drugs compared to niosomes and SLNs suspensions. CONCLUSION: Thermosensitive gels containing clindamycin-loaded niosomes and/or FLZ-SLNs were found to effectively fight the periodontitis-causing bacteria and fungi.
Asunto(s)
Clindamicina , Fluconazol , Geles , Liposomas , Nanopartículas , Tamaño de la Partícula , Enfermedades Periodontales , Clindamicina/administración & dosificación , Clindamicina/uso terapéutico , Nanopartículas/química , Fluconazol/administración & dosificación , Fluconazol/farmacología , Enfermedades Periodontales/tratamiento farmacológico , Antifúngicos/administración & dosificación , Antifúngicos/farmacología , Antibacterianos/administración & dosificación , Antibacterianos/farmacología , Microscopía Electrónica de Transmisión , Temperatura , Rastreo Diferencial de Calorimetría , Candida albicans/efectos de los fármacos , Viscosidad , Lípidos/química , HumanosRESUMEN
Our research aims to reduce the bacterial resistance of clindamycin against Gram-positive bacteria and expand its range of bacterial susceptibility. First, we optimized the structure of clindamycin based on its structure-activity relationship. Second, we employed the fractional inhibitory concentration method to detect drugs suitable for combination with clindamycin derivatives. We then used a linker to connect the clindamycin derivatives with the identified combined therapy drugs. Finally, we tested antibacterial susceptibility testing and conducted in vitro bacterial inhibition activity assays to determine the compounds. with the highest efficacy. The results of our study show that we synthesized clindamycin propionate derivatives and clindamycin homo/heterodimer derivatives, which exhibited superior antibacterial activity compared to clindamycin and other antibiotics against both bacteria and fungi. In vitro bacteriostatic activity testing against four types of Gram-negative bacteria and one type of fungi revealed that all synthesized compounds had bacteriostatic effects at least 1000 times better than clindamycin and sulfonamides. The minimum inhibitory concentration (MIC) values for these compounds ranged from 0.25 to 0.0325 mM. Significantly, compound 5a demonstrated the most potent inhibitory activity against three distinct bacterial strains, displaying MIC values spanning from 0.0625 to 0.0325 mM. Furthermore, our calculations indicate that compound 5a is safe for cellular use. In conclusion, the synthesized compounds hold great promise in addressing bacterial antibiotic resistance.
Asunto(s)
Antibacterianos , Clindamicina , Diseño de Fármacos , Farmacorresistencia Bacteriana Múltiple , Bacterias Gramnegativas , Pruebas de Sensibilidad Microbiana , Clindamicina/farmacología , Clindamicina/síntesis química , Antibacterianos/farmacología , Antibacterianos/síntesis química , Antibacterianos/química , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Bacterias Gramnegativas/efectos de los fármacos , Relación Estructura-Actividad , Humanos , Bacterias Grampositivas/efectos de los fármacos , Antifúngicos/farmacología , Antifúngicos/síntesis química , Antifúngicos/químicaRESUMEN
Pet food have been considered as possible vehicles of bacterial pathogens. The sudden boom of the pet food industry due to the worldwide increase in companion animal ownership calls for pet food investigations. Herein, this study aimed to determine the frequency, antimicrobial susceptibility profile, and molecular characteristics of coagulase-negative staphylococci (CoNS) in different pet food brands in Brazil. Eighty-six pet food packages were screened for CoNS. All isolates were identified at species level by MALDI-TOF MS and species-specific PCR. Antimicrobial susceptibility testing was performed by disc diffusion and broth microdilution (vancomycin and teicoplanin only) methods. The D-test was used to screen for inducible clindamycin phenotype (MLS-B). SCCmec typing and detection of mecA, vanA, vanB, and virulence-encoding genes were done by PCR. A total of 16 (18.6 %) CoNS isolates were recovered from pet food samples. Isolates were generally multidrug-resistant (MDR). All isolates were completely resistant (100 %) to penicillin. Resistances (12.5 % - 75 %) were also observed for fluoroquinolones, sulfamethoxazole-trimethoprim, tetracycline, rifampicin, erythromycin, and tobramycin. Isolates were susceptible to vancomycin (MICs <0.25-1 µg/mL) and teicoplanin (MICs <0.25-4 µg/mL). Intriguingly, 3/8 (37.5 %) CoNS isolates with the ERYRCLIS antibiotype expressed MLS-B phenotype. All isolates harboured blaZ gene. Seven (43.8 %) isolates carried mecA; and among them, the SCCmec Type III was the most frequent (n = 5/7; 71.4 %). Isolates also harboured seb, see, seg, sej, sem, etb, tsst, pvl, and hla toxin virulence-encoding genes (6.3 % - 25 %). A total of 12/16 (75 %) isolates were biofilm producers, while the icaAB gene was detected in an S. pasteuri isolate. Herein, it is shown that pet food is a potential source of clinically important Gram-positive bacterial pathogens. To the best of our knowledge, this is the first report of MLS-B phenotype and MR-CoNS in pet food in Latin America.
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Antibacterianos , Clindamicina , Coagulasa , Pruebas de Sensibilidad Microbiana , Staphylococcus , Staphylococcus/efectos de los fármacos , Staphylococcus/genética , Staphylococcus/aislamiento & purificación , Brasil , Antibacterianos/farmacología , Coagulasa/metabolismo , Animales , Clindamicina/farmacología , Meticilina/farmacología , Alimentación Animal/microbiología , Microbiología de Alimentos , Mascotas/microbiología , Farmacorresistencia Bacteriana Múltiple/genéticaRESUMEN
The complexity of chronic wounds creates difficulty in effective treatments, leading to prolonged care and significant morbidity. Additionally, these wounds are incredibly prone to bacterial biofilm development, further complicating treatment. The current standard treatment of colonized superficial wounds, debridement with intermittent systemic antibiotics, can lead to systemic side-effects and often fails to directly target the bacterial biofilm. Furthermore, standard of care dressings do not directly provide adequate antimicrobial properties. This study aims to assess the capacity of human-derived collagen hydrogel to provide sustained antibiotic release to disrupt bacterial biofilms and decrease bacterial load while maintaining host cell viability and scaffold integrity. Human collagen harvested from flexor tendons underwent processing to yield a gellable liquid, and subsequently was combined with varying concentrations of gentamicin (50-500 mg/L) or clindamycin (10-100 mg/L). The elution kinetics of antibiotics from the hydrogel were analyzed using liquid chromatography-mass spectrometry. The gel was used to topically treat Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium perfringens in established Kirby-Bauer and Crystal Violet models to assess the efficacy of bacterial inhibition. 2D mammalian cell monolayers were topically treated, and cell death was quantified to assess cytotoxicity. Bacteria-enhanced in vitro scratch assays were treated with antibiotic-embedded hydrogel and imaged over time to assess cell death and mobility. Collagen hydrogel embedded with antibiotics (cHG+abx) demonstrated sustained antibiotic release for up to 48 hours with successful inhibition of both MRSA and C. perfringens biofilms, while remaining bioactive up to 72 hours. Administration of cHG+abx with antibiotic concentrations up to 100X minimum inhibitory concentration was found to be non-toxic and facilitated mammalian cell migration in an in vitro scratch model. Collagen hydrogel is a promising pharmaceutical delivery vehicle that allows for safe, precise bacterial targeting for effective bacterial inhibition in a pro-regenerative scaffold.
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Antibacterianos , Biopelículas , Colágeno , Hidrogeles , Staphylococcus aureus Resistente a Meticilina , Biopelículas/efectos de los fármacos , Antibacterianos/farmacología , Antibacterianos/administración & dosificación , Humanos , Colágeno/química , Hidrogeles/química , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Clindamicina/farmacología , Clindamicina/administración & dosificación , Pruebas de Sensibilidad Microbiana , Administración Tópica , Gentamicinas/farmacología , Gentamicinas/administración & dosificaciónRESUMEN
AIM: This study aimed to compare the bond strength of AH Plus sealer to root canal dentin when used with or without various antibiotics including amoxicillin, clindamycin, and triple antibiotic mixture (TAM). MATERIALS AND METHODS: A total of 80 single-rooted extracted human teeth were instrumented and obturated with gutta-percha and four different sealer-antibiotic combinations (n = 20). Group I: AH Plus without any antibiotics, Group II: AH Plus with amoxicillin, Group III: AH Plus with clindamycin, and Group IV: AH Plus with TAM. After seven days, the roots were sectioned perpendicular to their long axis and 1 mm thick slices were obtained from the midroots. The specimens were subjected to a push-out bond strength test and failure modes were also evaluated. Data was analyzed using Kruskal-Wallis and Dunn's post hoc tests. RESULTS: Group IV had significantly higher bond strength compared to other groups (p ≤ 0.05). No significant differences were found between other groups. While the sealer-antibiotic groups predominantly showed cohesive failure modes, the control group displayed both cohesive and mixed failure modes. CONCLUSION: Within the limitations of this study, the addition of TAM increased the push-out bond strength of AH Plus. CLINICAL SIGNIFICANCE: Amoxicillin, clindamycin, or TAM can be added to AH Plus for increased antibacterial efficacy without concern about their effects on the bond strength of the sealer. How to cite this article: Adl A, Shojaei NS, Ranjbar N. The Effect of Adding Various Antibiotics on the Push-out Bond Strength of a Resin-based Sealer: An In Vitro Study. J Contemp Dent Pract 2024;25(3):231-235.
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Amoxicilina , Antibacterianos , Recubrimiento Dental Adhesivo , Resinas Epoxi , Materiales de Obturación del Conducto Radicular , Humanos , Materiales de Obturación del Conducto Radicular/química , Técnicas In Vitro , Clindamicina , Ensayo de Materiales , Análisis del Estrés Dental , Obturación del Conducto Radicular/métodosRESUMEN
A woman in her late 30s presented with sudden diminution of vision, redness and pain in the right eye (OD) of 10 days' duration. Best corrected visual acuity (BCVA) was 20/160 in OD and 20/20 in the left eye (OS). Anterior segment of OD showed keratic precipitates, flare 3+, cells 2+ and a festooned pupil. Vitreous haze and cells were seen in OD. Frosted branch angiitis (FBA) was seen in all quadrants in OD and old Toxoplasma scar was seen in both eyes. Serum toxoplasma immunoglobulin G (IgG) was positive and IgM negative, and PCR of an aqueous humour sample was negative for Toxoplasma She was diagnosed with toxoplasa retinochoroiditis in OD and treated with intravitreal clindamycin injections, oral anti-Toxoplasma antibiotics and steroids. Three months later, her BCVA in OD was 20/40 with resolving inflammation. She presented 2 months later with a new focus of retinochoroiditis without FBA and an old Toxoplasma scar.
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Coriorretinitis , Toxoplasma , Toxoplasmosis Ocular , Humanos , Femenino , Coriorretinitis/tratamiento farmacológico , Coriorretinitis/diagnóstico , Coriorretinitis/parasitología , Toxoplasmosis Ocular/diagnóstico , Toxoplasmosis Ocular/tratamiento farmacológico , Toxoplasmosis Ocular/complicaciones , Toxoplasma/aislamiento & purificación , Adulto , Imagen Multimodal , Vasculitis/tratamiento farmacológico , Vasculitis/diagnóstico , Vasculitis/complicaciones , Agudeza Visual , Clindamicina/uso terapéutico , Clindamicina/administración & dosificación , Tomografía de Coherencia Óptica , Antibacterianos/uso terapéuticoRESUMEN
BACKGROUND: Multiple treatment options exist for the management of moderate-to-severe acne. However, the comparative effectiveness (efficacy/safety) of moderate-to-severe acne treatments has not been systematically examined. METHODS: A systematic literature review (SLR) was conducted to identify randomized controlled trials of ≥4 weeks of treatment (topical, oral, physical, or combinations) for moderate-to-severe facial acne in patients aged ≥9 years. Efficacy outcomes included: percentage of patients achieving ≥2-grade reduction from baseline and “clear” or “almost clear” for global severity score (treatment success); absolute change in inflammatory (ILs reduction); and noninflammatory lesion counts (NILs reduction). A random-effects network meta-analysis (NMA) was conducted for the efficacy outcomes. Treatments were ranked with posterior rank plots and surface under cumulative ranking values. Results: Eighty-five studies were included in the SLR/NMA. Topical triple-agent fixed-dose combination (FDC) gel (clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1%) and combinations of double-agent fixed-dose topical treatments with oral antibiotics (TOA3) consistently ranked in the top 3 treatments. Topical triple-agent FDC gel was numerically superior to TOA3 for treatment success (log-odds ratios: 1.84 [95% credible interval (CrI) 1.36 to 2.29]) and 1.69 (95% CrI: 1.01 to 2.32) vs placebo/vehicle). TOA3 was numerically superior to topical triple-agent FDC gel for reduction of ILs (mean difference: -8.21 [-10.33 to -6.13]) and -10.40 [-13.44 to -7.14] vs placebo/vehicle) and NILs (mean difference: -13.41 [-16.69 to -10.32] and -17.74 [-22.56 to -12.85] vs placebo/vehicle). CONCLUSIONS: Based on this SLR/NMA, topical triple-agent FDC gel was the most efficacious and safe treatment for moderate-to-severe acne. J Drugs Dermatol. 2024;23(4): doi:10.36849/JDD.8148.
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Acné Vulgar , Fármacos Dermatológicos , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto , Índice de Severidad de la Enfermedad , Acné Vulgar/tratamiento farmacológico , Acné Vulgar/diagnóstico , Humanos , Resultado del Tratamiento , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/uso terapéutico , Administración Cutánea , Combinación de Medicamentos , Clindamicina/administración & dosificación , Clindamicina/uso terapéutico , Administración OralRESUMEN
We report the case of a young, immunocompetent, non-pregnant woman diagnosed with acute abdomen 3 weeks after an ultrasound-guided transvaginal oocyte retrieval (TVOR). Peritoneal fluid, obtained during exploratory laparoscopy, yielded Mycoplasma hominis as the sole pathogen. The patient's symptoms and signs improved after 24-hour treatment with intravenous clindamycin, ampicillin and gentamycin. Complete resolution was achieved with oral doxycycline for 14 days.
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Infecciones por Mycoplasma , Peritonitis , Femenino , Humanos , Mycoplasma hominis , Donación de Oocito , Doxiciclina , Clindamicina/uso terapéutico , Peritonitis/tratamiento farmacológico , Peritonitis/etiología , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/tratamiento farmacológicoRESUMEN
Targeted therapy represents a real opportunity to improve the health and lives of patients. Developments in this field are confirmed by the fact that the global market for drug carriers was worth nearly $40 million in 2022. For this reason, materials engineering and the development of new drug carrier compositions for targeted therapy has become a key area of research in pharmaceutical drug delivery in recent years. Ceramics, polymers, and metals, as well as composites, are of great interest, as when they are appropriately processed or combined with each other, it is possible to obtain biomaterials for hard tissues, soft tissues, and skin applications. After appropriate modification, these materials can release the drug directly at the site requiring a therapeutic effect. This brief literature review characterizes routes of drug delivery into the body and discusses biomaterials from different groups, options for their modification with clindamycin, an antibiotic used for infections caused by aerobic and anaerobic Gram-positive bacteria, and different methods for the final processing of carriers. Examples of coating materials for skin wound healing, acne therapy, and bone tissue fillers are given. Furthermore, the reasons why the use of antibiotic therapy is crucial for a smooth and successful recovery and the risks of bacterial infections are explained. It was demonstrated that there is no single proven delivery scheme, and that the drug can be successfully released from different carriers depending on the destination.
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Antibacterianos , Infecciones Bacterianas , Materiales Biocompatibles , Clindamicina , Sistemas de Liberación de Medicamentos , Humanos , Clindamicina/uso terapéutico , Clindamicina/administración & dosificación , Materiales Biocompatibles/química , Sistemas de Liberación de Medicamentos/métodos , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/prevención & control , Portadores de Fármacos/química , AnimalesRESUMEN
The aim of this study was to describe a case of a patient with ocular toxoplasmosis, which has resulted in Kyrieleis plaques formation (segmental periarteritis associated with severe inflammation) and later follow-up and alternative treatment due to documented allergy to sulfonamide. A 33-year-old Brazilian woman diagnosed with acute toxoplasmosis, initially treated with sulfonamide, developed a critical cutaneous rash. Cotrimoxazole was changed to clindamycin and pyrimethamine, and prednisone was started. The medication was maintained for 45 days. Four months later, she developed retinal lesions suggestive of toxoplasmosis with Kyrieleis plaques in the upper temporal vessels. Pyrimethamine, clindamycin, and prednisone were initiated until healing. She presented reactivation months later, and a suppressive treatment with pyrimethamine was instituted for one year. This is the first report to use the combination of clindamycin with pyrimethamine in the treatment and recurrence prophylaxis for OT in a documented allergy to sulfonamide.