Antibiotic Solution Research Articles

Physico-Chemical Characterizations of Composited Calcium-Ortho-Phosphate Porous Particles and Their Controlled Release Behavior of Clindamycin Phosphate and Amikacin Sulfate

The porous particles prepared from composited calcium–ortho-phosphate (biphasic), Thai silk fibroin, gelatin, and alginate, with an organic to inorganic component ratio of 15.5:84.5, were tested for their abilities to control the release of the commercialized antibiotic solutions, clindamycin phosphate (CDP) and amikacin sulfate (AMK). The in vitro biodegradability tests complying to the ISO 10993-13:2010 standard showed that the particles degraded <20 wt% within 56 days. The drugs were loaded through a simple adsorption, with the maximum loading of injection-graded drug solution of 43.41 wt% for CDP, and 39.08 wt% for AMK. The release profiles from dissolution tests of the drug-loaded particles varied based on the adsorption methods used. The drug-loaded particles (without a drying step) released the drug immediately, while the drying process after the drug loading resulted in the sustained-release capability of the particles. The model-fitting of drug release profiles showed the release driven by diffusion with the first-ordered kinetic after the initial burst release. The released CDF and AMK from particles could sustain the inhibition of Gram-positive bacteria and Gram-negative bacteria, respectively, for at least 72 h. These results indicated the potential of these composited particles as controlled-release carriers for CDP and AMK.

Development of pilot-scale plasma bubble reactors for efficient antibiotics removal in wastewater

Plasma bubble (PB) is a promising technology to control antibiotic wastewater pollution. However, the practical implementation of PB technology at the industrial-scale is still underdeveloped. In addition, the influence of different discharge modes for PB on wastewater treatment is largely unknown. This study designed pilot-scale PB reactors with different discharge modes to investigate the degradation effect of norfloxacin (NOR) and tetracycline (TC) in bulk tap water. Results indicate that the dielectric barrier discharge (DBD) mode with low average discharge power demonstrates superior degradation ability and higher production of O3(g) and .O2−(aq) compared to the spark mode which exhibits the high-intensity spark discharge in the tip area of the tube. After 40 min of treatment in a Double DBD reactor, 97.4% and 100% of NOR and TC are removed from 2 L tap water, attributed to the accumulation of antibiotic molecules by PBs and the in-situ generation of O3(g) and .O2−(aq) produced by plasma. Furthermore, a larger-scale PB reactor is developed by creating an array of four DBD reactors, effectively degrading 8 L mixed antibiotics solution. This study provides valuable insights for PB reactor design and the degradation performance of antibiotic wastewater, which will contribute to the further development of synergistic systems for plasma degradation.

Primary delayed sternal closure in adult cardiac surgery: a systematic review of protocols.

Primary delayed sternal closure (DSC) is a useful tool in the management of certain critically unstable patients after cardiac surgery, but there is a paucity of consensus management guidelines. This review aimed to identify critical key areas in DSC management. Systematic literature search was conducted in January 2023 and performed using Embase and PubMed. For original research articles were included that described outcomes and/or protocols for primary adult DSC patients, excluding articles on pediatric patients and secondary DSC. Eleven retrospective review original articles examined protocols for adult patients undergoing DSC. Hemodynamic instability and uncontrolled bleeding/coagulopathy were the two most common indications. Time to chest closure ranged 22 hours - 8.7 days. A range of dressings were employed, including Esmark and VAC dressings, with about half of authors not disclosing details. VAC was endorsed by several authors specifically for management of uncontrolled hemorrhage/coagulopathy. There was no consensus regarding irrigation solution for mediastinal prepping, with or without antibiotic solution. There was a lack of consensus on antibiotic selection and duration, varying from 2 and 3 multidrug regimens of broad-spectrum antibiotics, with/without antifungals. Mediastinal re-exploration varied from undefined intervals to regimented 24-48-hour interval re-explorations, with final closures in the OR or ICU. The optimum care for the patient with an open chest is evolving, and although there is a lack of a consensus DSC protocol, this review identifies mediastinal management, antimicrobial prophylaxis, and mediastinal re-exploration schedules/protocols as key areas for study to determine optimal care for DSC patients.

Focused Insights into Liposomal Nanotherapeutics for Antimicrobial Treatment.

Addressing infectious conditions presents a formidable challenge, primarily due to the escalating issue of bacterial resistance. This, coupled with limited financial resources and stagnant antibiotic research, compounds the antibiotic crisis. Innovative strategies, including novel antibiotic development and alternative solutions, are crucial to combat microbial resistance. Nanotherapeutics offers a promising approach to enhance drug delivery systems. Integration into lipid-based nanoscale delivery systems, particularly through therapeutic substance encapsulation in liposomal carriers, significantly prolongs drug presence at infection sites. This not only reduces toxicity but also shields antibiotics from degradation. Lipidic carriers, particularly liposomes, exhibit remarkable specificity in targeting infectious cells. This holds great promise in combating antimicrobial resistance and potentially transforming treatment for multi-drug resistant infections. Leveraging liposomal carriers may lead to breakthroughs in addressing drugresistant bacterial infections. This review emphasizes the potential of antimicrobial-loaded liposomes as a novel delivery system for bacterial infections. Encapsulating antimicrobial agents within liposomes enhances treatment efficiency. Moreover, liposomal systems counteract challenges posed by antimicrobial resistance, offering hope in managing persistent multidrug-resistant infections. In the battle against bacterial resistance and the antibiotics crisis, the use of antimicrobial-loaded liposomes as delivery vehicles shows great promise. This innovative approach not only extends drug effectiveness and reduces toxicity but also provides a path to address highly resistant infectious conditions. As research advances, liposomal nanotherapeutics may emerge as a transformative solution in the fight against bacterial infections.

Antibiotic-Mediated Plasmonic Resonance on a Novel Nanopillar Metasurface Array.

This study demonstrates a silicon nanopillar metasurface coupled with localized surface plasmon resonance (LSPR) mediated by the presence of cephalexin antibiotics in solution for biosensing applications. A facile fabrication process was developed to create the metasurface on silicon wafers with a unique resonance signature. The resulting metasurface consists of periodic nanopillars approximately 180 nm in diameter, 210 nm deep, and with a controlled edge-to-edge separation of 200 nm. These dimensions were chosen based on a finite element method simulation that was used to investigate the ideal parameters to produce the desired resonance effect in the metasurface reflection spectra. Optimization of the nanopillar surface properties and the sidewall angle allowed for replication of the simulations. This metasurface was coupled with BSA-coated gold nanospheres (BSANS) to mediate the redshift of peak resonance wavelength values, occurring only in the presence of the antibiotic linker. The device fabricated herein exhibits a significant 22 nm wavelength shift resulting from changes to the local refractive index in the presence of the BSANS-antibiotic coupling. Further enhancement of the binding events is promoted by the LSPR hot spots formed between the nanoparticles and the metasurface allowing for sensitive and real-time detection.

Kinetic and thermodynamic analysis of engineered alginate–chitosan hydrogel based scaffolds for drug delivery applications

The synthesis of stimulus–responsive hydrogel–based scaffolds has been extensively investigated for controlled drug delivery applications. This study focused on synthesizing alginate and chitosan–based scaffolds for potential use in releasing antibiotic antimycotic solution (AAS) drugs. The controlled release of AAS from AAS–loaded alginate–chitosan scaffolds was investigated under distinct temperatures viz. 37 °C, 25 °C, and 10 °C, labeled as scaffolds A, B, and C, respectively. Porosity assessment revealed consistent and substantial mean porosity percentage of 95.06 ± 2.01 % across all scaffolds. The lower temperature of 10 °C significantly contributed to a gradual and consistent cumulative release of 91.67 ± 1.47 %, compared to 37 °C (94.07 ± 1.89 %) and 25 °C (92.75 ± 1.51 %). The Korsmeyer–Peppas model exhibited high R2 values (0.98, 0.97 to 0.99) for scaffolds A, B, and C, indicating its suitability for describing the in–vitro release of AAS. Furthermore, the obtained release exponent values (0.60, 0.65, and 0.72 for scaffolds A, B, and C, respectively) suggest non–Fickian diffusion as the primary mechanism governing drug release. The release was also pH–dependent, with slower release at acidic (pH 3) and faster release under basic conditions (pH 8) due to varying swelling ratios. Evaluation of thermodynamic parameters viz. Ea, ΔG, ΔH and ΔS, using the rate constant of the Korsmeyer–Peppas model, revealed positive values of ΔH > 0 and ΔS > 0, indicating the prevalence of hydrophobic interactions in the release process.

Game-Changing Antibiotic Solutions for Chronic UTIs in Women

Urinary tract infections (UTIs) are prevalent in primary healthcare settings, with persistent recurrences posing significant challenges. These recurrences necessitate extended antibiotic use, adversely affecting patients' quality of life, mental health, and physical activity. The evolving defense mechanisms of bacteria against the host immune system and antibiotics complicate treatment. This article examines the pathomechanisms of recurrent UTIs, focusing on bacterial defense factors. Understanding these mechanisms is essential for developing innovative treatments, particularly non-antibiotic methods, to reduce antibiotic use and its associated side effects, thereby improving patients' overall well-being. The review synthesizes current knowledge on the pathomechanisms, diagnostics, and treatments for recurrent UTIs, emphasizing the impact on patients' mental and physical health. It highlights innovative, non-antibiotic treatment approaches.

Comparative Evaluation of the Effect of Various Irrigating Solutions on the Push-Out Bond Strength of Biodentine and Mineral Trioxide Aggregate: An In Vitro Study

Introduction: A successful endodontic treatment is ba¬sed on combination of adequate instrumentation, irrigation and obturation of canal system. The objectives of endodontic irrigants are lubrication of root canal, removal of microorganisms, pulp, dentinal remnants and dissolution of tissues. The objective of root-end filling is establishment of proper apical hermetic seal. Aim: To evaluate and compare the effect of various irrigating solutions on push-out bond strength of Biodentine and Mineral trioxide aggregate (MTA). Materials and Method: Sixty-four extracted human single rooted teeth were decoronated 1.5-2 mm coronal to cemento-enamel junction. The root canals were prepared and divided into four groups (n=16): Group I- Normal Saline (Control group), Group II- Triple antibiotic solution, Group III- 2% Chlorhexidine, Group IV- Morinda citrifolia solution. Mid root dentin was sectioned horizontally and irrigated further with respective irrigating solutions for 5 minutes and divided into 2 subgroups: Subgroup A- Biodentine and Subgroup B- MTA. The root-end filling material was incrementally placed and embedded in acrylic blocks. Samples were tested for push-out bond strength using universal testing machine. Results: The highest push-out bond strength was shown by 2% Chlorhexidine group when used with Biodentine and lowest when normal saline was used with Biodentine. Conclusion: All experimental irrigating solutions increased the push-out bond strength of MTA and Biodentine.

Comparing 0.05% chlorhexidine gluconate monotherapy to conventional antibiotic irrigation in de-novo penile prosthesis implantation: a two-center prospective randomized controlled non-inferiority study (preliminary results).

Infection remains a significant concern following penile prosthesis (PP) implantation surgery. Published guidelines have indicated the use of pre-operative intravenous (IV) antibiotics but have not provided specific recommendations regarding intra-operative irrigation. For long in our practice, we have been using a combination of antibiotics for irrigation (rifampin 600 mg/L of sterile water, gentamicin 80 mg/L of sterile water). Recently, 0.05% chlorhexidine gluconate (CHG) (Irrisept®) (Irrimax Corp, Lawrenceville, GA, USA), has shown promise as an alternative irrigant, with potential advantages in terms of cost, ease of administration and reduced antibiotic resistance risk. The study aims to assess the non-inferiority of CHG antiseptic irrigation compared to conventional combined antibiotic irrigation in preventing postoperative infections for men undergoing de-novo PP implantation. This is a two-center Institutional Review Board (IRB) approved prospective randomized controlled non inferiority trial, involving men undergoing de-novo PP implantation with a predetermined non-inferiority margin of 4%. Patients were randomly assigned into one of two groups: the CHG irrigation or the group receiving conventional antibiotic irrigation. All patients received IV antibiotics preoperatively and were sent home on oral antibiotics for 2 weeks post-operatively. The primary endpoint of this trial was to evaluate the incidence of PP infections. Secondary objectives encompassed the assessment of simplicity of use and cost-effectiveness. A hundred patients were enrolled in our study so far (50 in each arm). Only one case of PP infection necessitating explanation was reported in each arm. Moreover, the use of CHG irrigation offered the potential advantages of ease of administration and less cost as compared to antibiotic irrigation solutions. Preliminary data from this non-inferiority study demonstrate that CHG irrigation is non-inferior to conventional antibiotic irrigation in preventing postoperative infection following PP implantation. These findings support the consideration of CHG irrigation as a viable alternative during PP implantation, offering both clinical effectiveness and potential cost savings as well as reducing the risk of antibiotic resistance. ClinicalTrials.gov NCT06489431.

Key features of hospitals antibiotic stewardship software solutions needed for successfully optimizing patient outcomes while fighting antibiotic resistance on a global scale – a shared experience

Key features of hospitals antibiotic stewardship software solutions needed for successfully optimizing patient outcomes while fighting antibiotic resistance on a global scale – a shared experience

Presoaking hamstring autograft with vancomycin does not jeopardize its biomechanical properties, including graft elongation, after cyclic loading.

Presoaking the graft with vancomycin before implantation has been shown to reduce the risk of postoperative infection after anterior cruciate ligament reconstruction (ACLR). However, the effects of presoaking on the graft biomechanical properties remain unclear. This study aimed to determine whether presoaking the graft with vancomycin affects the graft biomechanical properties and length after cyclic loading. Ten paired (20 specimens) gracilis and semitendinous tendons were harvested from fresh-frozen human cadaveric specimens. Two tendons were folded in half to make four strands, and the grafts were randomized into the vancomycin and control groups. The graft was exposed to the antibiotic solution for 15 min (5 mg/mL) and prepared by mixing 1 g of vancomycin with 200 mL of normal saline (NaCl 0.9%). The control group was soaked in normal saline for 15 min. The prepared grafts were attached to the actuator of a dynamic tensile-testing machine. All grafts were tested with 3000 cycles of cyclic loading followed by a pull-to-failure. The cyclic loading protocol consisted of position and load control blocks to simulate the graft in vivo in the postoperative phase after ACLR. Presoaking in vancomycin did not jeopardize the biomechanical properties of the graft. In addition, presoaking with vancomycin did not elongate the grafts. No significant differences were found in the mean Young's modulus and the mean total elongation of the graft of the specimen between the vancomycin group and the control group. Presoaking the graft with vancomycin jeopardized neither its biomechanical properties nor elongation even after cyclic loading in this in vitro study. It is suggested that vancomycin presoaking could be considered a safe and effective preventive measure for postoperative infections after ACLR. Not applicable.

A multiband terahertz metamaterial sensor evaluated using a multiresponse variable fusion framework for the precise detection of trace fluoroquinolone antibiotics

A specific structural multiband terahertz (THz) metamaterial sensor (TMS) was designed herein to improve the sensitivity of detecting multiple trace fluoroquinolone (FQ) antibiotics in water, and a multiple resonance response competition and selection fusion (MRR-CSF) framework was proposed for accurate FQ analysis. The TMS based on three-concentric C4-symmetrical split-ring (TC4) structures generated five bands at 0.797, 0.900, 1.097, 1.198, and 1.777 THz. The multiband resonance signals for three types of FQs, including enrofloxacin (ENR), pefloxacin (PEF), and nadifloxacin (NAD), were detected by the TMS, which increased as the antibiotic concentrations increased (5–140 ng/L). The proposed method can solve the problems of low accuracy and poor robustness of conventional single-response regression by combining selected and fused TMS-effective resonance response variables with three multivariate regression strategies. The calculated comprehensive metrics also provide an objective evaluation of multiband TMS performance. The designed TMS combined with the proposed MRR-CSF framework showed 21 %–27 %, 13 %–17 %, and 12 %–13 % improvements in the detection accuracy for ENR, PEF, and NAD, respectively, according to the univariate regression results. The limit of detection for the ENR, PEF, and NAD antibiotic solutions was achieved at 5 ng/L, and the reliable range of recoveries (100 % ± 25 %), average recoveries (>90 %), and relative standard deviation values (<5 %) were obtained for the concentration prediction of newly prepared FQs. This study demonstrates the promising prospect of applying the multiband TMS combined with the MRR-CSF framework for accurate biochemical sensing and detection.

Electrochemical Detection of Ornidazole By Means of an Electrode Modified with Copper-Iron Nanoparticles and Carbon Black

Antibiotics have become fundamental tools in our fight against disease but their accumulation in the aquatic environment due to discharges from manufacturing plants, hospitals and farms, and to misuse by the public has seen them emerge as water pollutants. Their presence constitutes a serious environmental and health risk due to their toxicity and due to the risk of antimicrobial resistance (AMR), which may render antibiotics ineffective when employed to fight infection. Assessing the impact of antibiotic pollution on water quality, drinking water, recreational/bathing water, and the impact on life is critical for our health and wellbeing.Ornidazole is a member of the nitroimidazole antibiotic family that is heavily employed in the treatment of both human and animal infections [1]. This widespread use has led to the accumulation of the antibiotic in aquatic environments, posing a serious health risk due to its toxicity and the risk of AMR [2]. For this reason, novel and environmentally friendly methods of rapidly and accurately detecting its presence in the environment are vital to mitigate its pollution and harmful effects.In this study two materials are combined to enhance the conductivity and ability of a glassy carbon electrode sensor to detect ornidazole. Carbon black, a material composed of 95% carbon with a structure similar to graphite [3] is functionalized using a novel green method with tannic acid. This is then combined with a layered double hydroxide (LDH) to act as a source of metal nanoparticles. LDH’s are a combination of transition metals with the general formula [M1-x 2+M3+ x(OH)2]x+(An-)x/n.mH2O where M is two different metals and A is the intercalated anion between the stacked layers of M2+/M3+ ions to produce a 2D layered nanosheet structure [4]. These LDHs are synthesized hydrothermally, which involves combining sources of the desired metals into a sealed autoclave and heating to produce a high vapour pressure environment.Functionalized carbon black was dispersed and drop-casted onto the surface of the electrode. After drying, it was decorated by means of drop-casting with a dispersion of the LDH containing the desired elements. The LDH is then easily reduced by means of cyclic voltammetry to embed the nanoparticles of the desired elements into the carbon black, producing a stable modified electrode. LDH’s containing a variety of elements were investigated for their ability to detect ornidazole. The optimum element combination was concluded to be copper-iron nanoparticles. The procedure for the synthesis and modification of the electrode can be seen in Figure 1.The carbon black-copper iron (CuFe) modified sensor shows excellent sensitivity compared to bare glassy carbon and is capable of detecting ornidazole concentrations from 0.2 μM to 600 μM, displaying excellent stability over multiple uses. Studies were performed to characterize the carbon black-CuFe material using SEM, XRD, XPS, FTIR, and EDX. Investigations were carried out into the behaviour of the sensor at varying pH values and to determine the reaction kinetics of detection. To study the selectivity of the sensor interferants were introduced to the antibiotic solution and experiments were performed in real water samples gathered from various locations.[1] Q. Wang, C. Wang, Q. Wang, & Z. Wang, Journal of Agricultural and Food Chemistry., 2019, 67(41), 11527-11535[2] W. El, N. Tajat, A. Idelahcen, M. Tamimi, S. Qourzal, A. Assabbane, & I. Bakas, Microchemical Journal, 2023, 195, 109397[3] J. M. Martín-Martínez, Adhesion Science and Engineering : Surfaces, Chemistry and Applications, 2002, Chapter 13, 573-675[4] A., Karmakar, K., Kannimuthu, S., Sam Sankar, K., Sangeetha, R., Madhu, & S., Kundu. Journal of Materials Chemistry A. 2020 Figure 1

Layered Double Hydroxides As a Method for Decorating Electrodes with Metal Particles for Sensing the Antibiotic Ornidazole

The use of metallic particles and nanoparticles to improve the detection capabilities of sensors has been widely reported in literature and thus, a method of decorating electrodes reliably and easily with metallic particles is of great interest. In this regard, Layered Double Hydroxides (LDHs) are of particular interest to act as a source of metal particles. LDHs are inorganic two-dimensional compounds with the general formula [M1-x 2+M3+ x(OH)2]x+(An-)x/n.mH2O where M is two different metals and A is the intercalated anion between the stacked layers of divalent and trivalent M2+/M3+ ions to produce a 2 nanosheet structure [1]. In this study LDHs are synthesised hydrothermally, which involves placing metallic salts of the desired metals into an aqueous solution in a sealed autoclave and heating to a high temperature to produce a high vapour pressure environment. From this method various elements can be combined to produce bimetallic and trimetallic LDHs.The obtained LDH powder is then dispersed in ethanol and water using ultrasonication and layered onto the electrode surface by means of drop-casting. It can then be easily reduced using cyclic voltammetry to act as an efficient method of decorating an electrode with metallic particles of the desired elements. In this study, a variety of layered double hydroxides were synthesised using combinations of different elements and then subsequently used to reduce metal particles onto a glassy carbon electrode.A variety of bimetallic and trimetallic LDH compounds containing copper, iron, cobalt, and nickel were investigated. To compare the sensing capabilities of these reduced metal particles, the reduction of the antibiotic ornidazole was used as an analyte. Ornidazole is a member of the nitroimidazole antibiotic family that is heavily employed in the treatment of both human and animal infections [2]. This widespread use has led to the accumulation of the antibiotic in aquatic environments, posing a serious health risk due to its toxicity and the risk of antimicrobial resistance [3]. Thus, a sensor capable of quickly and reliably detecting the antibiotic is of great importance. To enhance the conductivity of the modified sensors, a drop-casted layer of functionalised carbon black was combined with the metallic particles.For the detection of ornidazole, the copper-iron (CuFe) particles were concluded to be optimum, displaying a detection range of 0.2 uM to 600 uM. Characterisation studies were performed on the CuFe particles using SEM, XRD, XPS, FTIR, and EDX. Investigations were carried out into the behaviour of the sensor at varying pH values and to determine the reaction kinetics of detection. To study the selectivity of the sensor interferants were introduced to the antibiotic solution and experiments were performed in real water samples gathered from various locations.[1] A., Karmakar, K., Kannimuthu, S., Sam Sankar, K., Sangeetha, R., Madhu, & S., Kundu. Journal of Materials Chemistry A. 2020[2] Q. Wang, C. Wang, Q. Wang, & Z. Wang, Journal of Agricultural and Food Chemistry., 2019, 67(41), 11527-11535[3] W. El, N. Tajat, A. Idelahcen, M. Tamimi, S. Qourzal, A. Assabbane, & I. Bakas, Microchemical Journal, 2023, 195, 109397

Minocycline-rifampin-impregnated penile prosthesis surfaces retain antimicrobial activity following irrigation with 0.05% chlorhexidine gluconate and antibiotic solutions.

0.05% Chlorhexidine gluconate (CHG; Irrisept [IrriMax]) is a commercial wound irrigation solution approved by the Food and Drug Administration that has seen recent adoption in the field of prosthetic urology; however, no study has evaluated whether 0.05% CHG is compatible with the minocycline-rifampin-impregnated surface (InhibiZone) of the AMS 700 penile prosthesis (Boston Scientific). To evaluate whether 0.05% CHG alters the antibiotic efficacy of the minocycline-rifampin-impregnated penile prosthesis surface. Discs (8 mm) were taken by a punch biopsy (Sklar) from sterile penile prosthesis reservoirs whose surfaces had been impregnated with rifampin and minocycline. Discs (n = 10) were suspended in 0.05% CHG, vancomycin and gentamicin, or normal saline for 2minutes to simulate intraoperative irrigation. Discs were then rinsed in normal saline to remove any unbound solution and incubated with methicillin-sensitive Staphylococcus aureus for 48hours. Adherent surface bacteria were suspended by shaking in a 0.3% Tween 20 solution, serially diluted, plated onto 3M PetriFilms, and counted. Kirby-Bauer disc diffusion assays were conducted to generalize findings across various organisms. Outcomes included (1) bacterial adherence to the implant surface measured as bacterial counts (in colony-forming units per milliliter) and (2) bacterial growth reduction measured as zones of inhibitions (in millimeters). Incubation of implant surfaces in 0.05% CHG did not alter recovered bacterial counts as compared with normal saline and vancomycin/gentamycin. Similarly, within a single bacterial species, 0.05% CHG and vancomycin/gentamycin did not alter zone-of-inhibition measurements in Kirby-Bauer disc diffusion studies. This study demonstrates in vitro that 0.05% CHG may be used directly on the minocycline-rifampin-impregnated surface without altering the antibiotic efficacy of the coating. Strengths include that this is the first study to evaluate if 0.05% CHG affected the minocycline-rifampin-impregnated surface. Limitations include the use of in vitro studies, which serve as a proxy for in vivo practices and may not be entirely accurate or translatable in a clinical setting. 0.05% CHG does not alter the antimicrobial activity of the minocycline-rifampin-impregnated surface as compared with vancomycin/gentamycin and normal saline in vitro; however, its efficacy in clinical practice remains to be evaluated.

Membrane fouling analysis of air-gap membrane distillation (AGMD) for recovery of water and removal of antibiotics from a model wastewater containing antibiotics and humic acid

The study investigates the efficiency of air-gap membrane distillation (AGMD) in water recovery and antibiotics removal from wastewater, focusing on high-concentration scenarios. Experimental findings reveal enhanced membrane performance with increasing the feed temperature, resulting in vapor permeate fluxes of up to 5 kg/m2.h at higher temperatures. Despite experiencing flux reduction caused by fouling from humic acid (HA) in the feed antibiotics solution, the antibiotics consistently maintain near-complete rejection rates (>99%) over 48 h. The foulant on the membrane surface was illustrated by SEM imaging. To know the temperature polarization and the fouling resistance, mathematical modeling was used, and it validates experimental results, elucidating temperature polarization effects and mass transfer coefficients. An increase in feed flow rates reduced thermal boundary layers, enhancing heat flux. Higher temperatures reduced HA fouling resistance. Therefore, AGMD proves effective in water recovery and antibiotics removal, with mathematical models aiding fouling understanding for future research and detailed computational fluid dynamics (CFD) models.

Dens invaginatus Type II in an Immature Lateral Incisor With Apical Periodontitis Treated With Regenerative and Strategic Antimicrobial Procedures: A Case Report

Dens invaginatus is a developmental dental anomaly that can predispose the tooth to pulp and periradicular disease. Management of this condition can be challenging because of anatomic and microbiologic issues. This case report describes the regenerative endodontic treatment using a strategic antimicrobial protocol for management of an immature maxillary lateral incisor with type-II dens invaginatus associated with apical periodontitis in a 13-year-old patient. The tooth presented with a complex anatomy and was associated with an active sinus tract. Because the true root canal was not negotiable in its coronal part due to the presence of the dens invaginatus, the closed end of the invagination (pseudocanal) was perforated to permit access to the apical segment of the true root canal for cleaning and disinfection. Both the invagination and the true canal were treated using an antimicrobial regimen based on chemomechanical preparation with sodium hypochlorite irrigation, supplementary disinfection with passive ultrasonic irrigation and interappointment calcium hydroxide medication. After 2 exchanges of calcium hydroxide medication, the sinus tract did not disappear, then the antimicrobial protocol was changed to include an antibiotic solution for irrigation and antibiotic paste for intracanal medication. After signs and symptoms disappeared, regenerative endodontic treatment was performed by inducing blood clot formation within the root canal. The coronal canal segment including the invagination was filled with Biodentine. Follow-up including cone-beam computed tomography examination showed complete healing of the apical periodontitis lesion and mineralized tissue formation at the apical portion of the true root canal.

In vivo and in vitro efficacy of the ithmid kohl/zinc-oxide nanoparticles, ithmid kohl/Aloe vera, and zinc-oxide nanoparticles/Aloe vera for the treatment of bacterial endophthalmitis

The aim of this study was to investigate the efficacy of the ithmid kohl/zinc-oxide nanoparticles (ZnONPs), ithmid kohl/Aloe vera, and ZnONPs/Aloe vera in the treatment of bacterial endophthalmitis. The endophthalmitis model was prepared by contaminating both eyes of 24 healthy adult male albino rabbits with a clinical isolate of Klebsiella pneumoniae. The animals were randomly divided into eight groups (A-H) according to the treatment. Group A received 1 ml of ithmid kohl/ZnONPs ointment, group B received 1 ml of ithmid kohl/Aloe vera gel ointment, group C received 1 ml of ZnONPs/Aloe vera gel ointment, and groups D, E, and F were treated with 1 ml of ithmid kohl solution (0.5 g/ml in distilled water), 1 ml of ZnONPs (0.5 g/ml) colloidal dispersion, and 1 ml of Aloe vera gel, respectively. Group G received 100 μl of a tetracycline antibiotic solution (final concentration: 16 µg/ml), and group H received sterile distilled water (no treatment). In vitro antibacterial activity was evaluated against K. pneumoniae using the agar well diffusion. The combination of ithmid kohl/ZnONPs was the most effective formulation for treating endophthalmitis model in infected rabbits within 2 days. In vitro antibacterial assay confirmed the potential of the ithmid kohl/ZnONPs formulation, which had the largest zone of inhibition (31 mm) among the compounds tested. The preparation of the ithmid kohl/ZnONPs formulation and its in vivo experiment in albino rabbits for the treatment of bacterial endophthalmitis was an innovative approach that has shown promise and may potentially serve as a viable alternative in clinical practice.

Does Soaking Fresh Frozen Costal Cartilage in an Antibiotic Solution Reduce Postoperative Infection in Rhinoplasty?

Fresh frozen costal cartilage (FFCC), from the Musculoskeletal Transplant Foundation (MTF), has recently gained popularity for use in revision rhinoplasty or primary rhinoplasty when there is a paucity of autologous cartilage. However, there are currently no guidelines related to the use of intraoperative antibiotic soaking to reduce postoperative infection rates when using MTF FFCC. This study aimed to evaluate the efficacy of intraoperative antibiotic soaks in reducing surgical site infection rate when using MTF FFCC grafts in rhinoplasty. A retrospective chart review of patients who underwent rhinoplasty with the use of MTF FFCC in the senior author's practice was conducted between May 2017 and June 2022. The inclusion criteria were rhinoplasty cases using MTF FFCC with minimum of 12 months of follow-up. Fisher exact test was conducted to determine significance in rates of postoperative infection for patients who underwent rhinoplasty with the use of MTF FFCC with (1) intraoperative antibiotic solution soak versus (2) no antibiotic solution soak. A total of 310 patients were included and separated into two cohorts, MTF FFCC intraoperative antibiotic solution soak (n = 200) and no antibiotic solution soak (n = 110). There were a total of four (1.3%) cases of infection, all in the antibiotic soak group. There was no statistically significant difference between the rate of infection in the two cohorts (P = 0.301). Our retrospective cohort study demonstrates that soaking MTF FFCC in an antibiotic solution intraoperatively does not reduce postoperative infection rates in rhinoplasty.

Comparative Analysis of the Cytotoxic Effects of Modified Triple Antibiotic Hydrogel: Insights From Experimental Models.

The effectiveness of intracanal medicaments (ICMs) in root canal therapy is critical for successful dental treatments, yet their cytotoxic effects pose significant challenges. This research uses zebrafish embryos and dental pulp stem cells (DPSCs) to identify the optimal concentration that balances antibacterial efficacy with minimal toxicity. This study aims to address the need for effective ICMs in dentistry by formulating and assessing the embryotoxicity and cytocompatibility of a novel carrageenan-based modified triple antibiotic paste (MTAP) hydrogel at different concentrations (1, 5, and 10 mg/mL) using a zebrafish model and cell culture assay. The hydrogel was formulated by combining antibiotic solutions (ciprofloxacin, metronidazole, and amoxicillin) with carrageenan and xanthan gum. Zebrafish embryos were exposed to varying concentrations of MTAP hydrogel, chlorhexidine (CHX), calcium hydroxide (CaOH2), and plain carrageenan to assess developmental toxicity, survival rate, heart rate, hatching rate, and macrophage migration. The cytotoxicity against DPSCswas examined within a timeframe of 6, 24, and 72 hours with the use of the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyltetrazolium bromide (MTT) assay. The analysis revealed developmental toxicity with malformations observed at higher concentrations of MTAP hydrogel, CaOH2, and CHXmedicaments, indicating potential toxicity. Significant impacts on survival, heart rate, and hatching rate were noted in the CaOH2 and CHX groups, as well as at higher MTAP hydrogel concentrations, emphasizing the importance of dosage considerations. The neutral red assay confirmed toxicity, with macrophage migration observed in CaOH2, CHX, and higher MTAP hydrogel concentrations. Lower concentrations, particularly at 1 mg/mL, showed no adverse effects on zebrafish embryos and larvae. These findings align with cell viability investigations, which demonstrated that higher antibiotic concentrations resulted in decreased cell proliferation and viability over time. Conversely, at a lower concentration of 1 mg/mL, cell proliferation notably increased after 72 hours.Plain MTAP and CHX exhibited the highest toxicity levels in the MTTassay. The study concludes that while higher concentrations of MTAP hydrogel exhibit toxic effects, the hydrogel at 1 mg/mL demonstrates no adverse impact on zebrafish embryos, larvae, and DPSCs. These findings underscore the necessity of optimizing ICM concentrations to balance antibacterial efficacy and minimal cytotoxicity.