Combination Of Antibacterial Drugs Research Articles

Subgroup analysis of phase 2 study of ceftolozane/tazobactam in neonates and young infants with pyelonephritis.

Ceftolozane/tazobactam is approved for the treatment of patients from birth to <18 y old with complicated urinary tract infections (cUTI). This post hoc analysis evaluated the safety, efficacy, and pharmacokinetics (PK) of ceftolozane/tazobactam compared with meropenem in neonates and young infants. NCT03230838 was a phase 2, randomized, active comparator-controlled, double-blind study of patients from birth to <18 y of age with cUTI, including pyelonephritis, given ceftolozane/tazobactam or meropenem in a 3:1 ratio. This subset analysis included only neonates and young infants < 3 mo of age. The microbiologic modified intent-to-treat population (mMITT) included 20 patients (ceftolozane/tazobactam, n = 14; meropenem, n = 6). All patients had pyelonephritis at baseline; two patients in each treatment group had bacteremia (overall 4/20, 20%). Escherichia coli was the most common baseline pathogen (overall 16/20, 80%). Safety and efficacy results were similar between treatment groups and consistent with the overall pediatric population. There were no serious drug-related adverse events (AEs), no discontinuations due to AEs, and no AEs leading to death in either treatment group. For the ceftolozane/tazobactam and meropenem treatment groups, clinical cure rates in the mMITT population were 92.9% and 100%, respectively. The population PK analysis of neonates and young infants demonstrated similar ceftolozane and tazobactam exposures to those of adults, achieving pharmacodynamic targets associated with clinical and microbiologic cure. Ceftolozane/tazobactam has a favorable safety profile and achieves high clinical cure and microbiologic eradication rates in neonates and young infants < 3 mo of age with cUTI and pyelonephritis. IMPORTANCE Extrapolation of antibacterial agent pharmacokinetics from adults to newborns and young infants may not be appropriate; similarly, the clinical manifestations of infectious diseases and outcomes following antibacterial treatment may not be similar. Ceftolozane/tazobactam is an antibacterial drug combination active against Pseudomonas aeruginosa and other multidrug-resistant gram-negative bacteria. A clinical study led to the approval for ceftolozane/tazobactam in patients from birth to 18 y of age who have complicated urinary tract infections, including those with serious kidney infections. Based on data collected during that clinical study, we compared newborns and young infants who were treated with ceftolozane/tazobactam (14 patients) and those who were treated with meropenem (6 patients). We found that ceftolozane/tazobactam treatment of newborns and young infants up to 3 mo of age who have complicated urinary tract infections demonstrated a favorable safety profile and high clinical cure and microbiologic eradication rates, similar to meropenem.

In Vivo Simulation of the Purulent Peritonitis

Currently, purulent-inflammatory diseases of the abdominal organs are the prevalent causes of complications and mortality. Treatment of these diseases complicated by peritonitis is one of the urgent problems in modern clinical medicine. Experiment is important for testing new treatment methods. This article provides a systematic analysis of the current in vivo models of the purulent peritonitis, which are used to test the options for surgical treatment and combinations of antibacterial drugs. We describe the most common models as well as rare simulations of specific peritonitis. It should be noted that despite the wide use of minimally invasive techniques, the literature has few reports on simulation of peritonitis through the laparoscopic approach.

ANALYSIS OF THESENSITIVITY OF STAPHYLOCOCCUS AUREUSTO ANTIBIOTICS IN PATIENTS WITH PURULENT-SEPTIC DISEASES

The purulent-septic infection caused by Staphylococcus aureus is one of the biggest problems of modern medicine. There are some strategies to control the increasing antibiotic resistance of bacteria. They are the development and introduction of new antibacterial drugs into surgical practice, the improvement of antimicrobial therapy methods and the rotation of antibacterial drugs [1, 2, 3]. Staphylococcus aureus is one of the most common causative agents of infections of various localizations. The development of mechanisms of antibiotic resistance of bacteria is more often determined by genes located on the bacterial chromosome or Rplasmids. Particular attention is paid to methicillinresistant staphylococci (MRS strains). They are registered in nosocomial or out-of-hospital infections. The resistance of staphylococci to β-lactam antibiotics is due to the presence of the mec A gene. It encodes the penicillin-binding protein (PBP). The mec A gene is located on a mobile genetic element. This element is called the staphylococcal chromosome cassette (SCCmec). Methicillin-resistant Staphylococcus aureus is resistant to all β-lactam antibiotics. Currently, it is necessary to use combinations of antibacterial drugs for the treatment of infections caused by methicillinresistant staphylococci.

Antibiotic Mixtures in Noninstrumental Endodontic Treatment of Primary Teeth with Necrotic Pulps: A Systematic Review.

Objective To compare the effectiveness of topical antibiotic mixtures used in noninstrumental endodontic treatment (NIET) of primary teeth. Methods Electronic databases including MEDLINE, the Cochrane Library, and Scopus database were searched. Randomized clinical trials evaluating the clinical and radiological outcomes of topical antibiotics used in NIET were selected. The revised Cochrane risk-of-bias tool (RoB 2.0) was used to assess the quality of the methodology of the included articles. Results Five articles comparing the outcomes of four different drugs combination were included. Three studies conducted to evaluate the success rate of two combinations of antibacterial drugs consisting of ciprofloxacin-minocycline-metronidazole (3 Mix) in one group and ciprofloxacin-minocycline-ornidazole in the other group showed no statistically significant difference between both groups (P > 0.05). The ciprofloxacin-minocycline-ornidazole group showed better results compared with the 3 Mix group. One study conducted to compare the effectiveness of 3 Mix with ciprofloxacin-tinidazole-minocycline reported no significant difference between both groups, and one study that compared 3 Mix and ciprofloxacin-metronidazole-clindamycin mixture concluded that the overall success rates of both groups were 80.96% and 76.20%, respectively, with no statistically significant difference. Conclusion Based on the overall success rates, the ciprofloxacin-minocycline-ornidazole mixture was considered more effective than the 3 Mix which was more effective than the ciprofloxacin-tinidazole-minocycline and the ciprofloxacin-metronidazole-clindamycin groups. Clinical Relevance. Different antibiotic combinations, showing good clinical and radiographic success in treating necrotic primary teeth, can be used effectively in NIET and this technique can be considered effective for teeth with advanced root resorption and when conventional endodontic treatment is contraindicated.

Traditional Chinese medicine for Helicobacter pylori infection

Background:Helicobacter pylori (Hp) is the only bacterium in the stomach. It is characterized by its ability to adhere to gastric mucosa and cause a series of pathological changes in the gastric mucosa. Modern research shows that Hp is an important pathogenic factor for chronic gastritis, gastroduodenal ulcer, and gastric cancer. Triple, quadruple, and triple combinations of antibacterial drugs, proton pump inhibitors, and bismuth aluminate preparations have been developed in modern medical research. Sequential therapy is used to treat Hp, but antibiotic resistance and repeated infections still exist. A large number of clinical trials have proved that traditional Chinese medicine has a good therapeutic effect on Hp. In this systematic review, we aim to evaluate the efficacy and safety of traditional Chinese medicine in the treatment of Hp.Methods and analysis:We will search for publications from Web of Science, PubMed, Science Direct, Wan Fang Data Knowledge Service Platform, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP database), China National Knowledge Infrastructure (CNKI) and EMBASE, which should be published from inception to December 2020. Two researchers will independently perform the selection of the studies, data extraction, and synthesis. The Cochrane Risk of Bias Tool will be used to evaluate the risk of bias in the randomized controlled trials. Statistical analysis will be performed by using the Cochrane Review Manager (RevMan 5.3) software. The I2 test will be used to identify the extent of heterogeneity. We will use the Egger funnel chart to evaluate possible publication biases, in addition, when possible we will perform a subgroup/meta-regression analysis. The strength of the evidence will be assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).Results and conclusions:This study will systematically evaluate the efficacy of traditional Chinese medicine in the treatment of Hp infection, and provide evidence for the clinical application of this treatment. The results of the research will be published in a peer-reviewed journal.Ethics:This systematic review will evaluate the efficacy of traditional Chinese medicine for Hp infection. Because all data used in this systematic review and meta-analysis have been published, this review does not require ethical approval.Trial registration number:INPLASY2020120057.

Negative pressure therapy for management of patients with enterocutaneous fistulas

Objective:To assess the benefits of negative pressure wound therapy (NPWT) in complex therapy of patients with enterocuta‑ neous fistulas.Methods: From 2014 to 2019 in Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine, 24 patients were managed with vacuum assisted techniques. For comparison, a comparable group of 23 observations (control) was formed retrospectively based on an analysis of medical records.Results: When using NPWT, the terms of wound cleansing and the formation of a laparostomy were reduced, and conditions were created for its early closure. With a small laparostomy, the use of NPWT contributed to self-epithelialization of the wound around the fistula.Conclusions: The use of NPWT more than halves the time of formation of a laparostomy, shortens the time for cleansing the wound and creates the conditions for its closure. Surgical tactics using NPWT can more than three times reduce the number of local complications in patients with unformed intestinal fistulas and less often change the combination of antibacterial drugs.

Microbial Biofilms: Modern Concepts

The review discusses modern ideas concerning the biofilms of microorganisms. The development phases, structure and components of biofilms are considered as possible antibiotic resistance factors (ARF). Examples of various types of ADB in biofilm bacteria are given. The process of collective regulation through coordination of gene expression in a bacterial population that mediates the specific behavior of cells is considered. Various approaches that affect the components of biofilms have been evaluated in order to reduce their resistance/integrity using a combination of antibacterial drugs and enzymes of various origins. Promising methods for influencing matrix components, signaling molecules, and adhesion factors are recognized. A promising way to increase the effectiveness of the effect of antibiotics on biofilms is the use of hydrolytic enzymes.

Evaluation of the antimicrobial efficacy of two combinations of drugs on bacteria taken from infected primary teeth (in vitro).

Using a combination of metronidazole, ciprofloxacin and minocycline (3Mix) for root canal disinfection of primary teeth is a well-known technique known as the lesion sterilisation and tissue repair therapy. Minocycline has the potential to cause discoloration in treated teeth and the permanent successors. This study aimed to assess the efficacy of a new combination of antibacterial drugs, in which minocycline is replaced with clindamycin. Thirty hopeless primary teeth according to our inclusion criteria were extracted and enrolled. The experiment was conducted in two parts: aerobic and anaerobic, and the efficacy of the two drug combinations, namely the 3Mix and the other mix (metronidazole, ciprofloxacin and clindamycin), for elimination of bacteria isolated from the primary teeth was evaluated and compared. Data were analysed using SPSS 21 via descriptive statistics and Friedman and Wilcoxon tests. Level of significance was considered at 0.05. Except for minocycline, none of the other antibiotics in the studied concentrations (25, 50 and 100μg/mL) were able to eliminate all the bacteria. Clindamycin alone was weaker than minocycline, but its combination with metronidazole and ciprofloxacin had the same potency with no significant difference. Replacement of minocycline with clindamycin in the 3Mix composition is practical and can be generalised to clinical studies and ultimately to the clinical setting.

LSTR 3mix-MP Important Efficacy Particularly Antibacterial and Periapical Lesions during Conservative Treatment in the Dentistry like RCT and Others Endodontics Management: Case Studies

Local sterilization and tissue repair which generally termed as LSTR, brings a radicular change in the field of conservative dentistry. Efficacy against antibacterial environment and non-surgical healing of periapical lesions much better than calcium hydroxide. LSTR 3Mix-MP, Using an antibacterial drug combination, therapy is a novel caries, pulpal treatment of primary tooth and root canal treatment. LSTR 3Mix-MP aims to eliminate causative bacteria from lesions and after sterilization, the host’s natural tissue recovery process usually the lesions are repaired or resolved. LSTR 3Mix MP where TAP (triple antibiotics paste) such as: Metronidazole, Ciprofloxacin, Minocycline and Vehicle MP Macrogol/polyethylene glycol and propylene glycol used to prepare. TAP has great antibacterial efficacy particularly against enterococci which remains after successful root canal treatment, effective eradication of the causative microorganisms during root canal treatment procedures. Residual infection in Root canal therapy has always been an area of interdermind or vague for a treating dental surgeon. Lesion sterilization and tissue repair (LSTR) therapy is a non-surgical or non-conventional endodontic treatment procedure that involves non-instrumentation or minimal instrumentation followed by placement of a triple antibiotic paste in a medication along with Macrogol and Propylene glycol.

Lesion Sterilization and Tissue Repair in Nonvital Primary Teeth: An In vivo Study.

Aim and Objective:The aim of this study is to evaluate the clinical and radiographic success of endodontic treatment of nonvital primary teeth using lesion sterilization and tissue repair (LSTR) therapy.Materials and Methods:A sample size of 40 primary molars from 34 children of 3–10 years of age were selected for the study. Nonvital primary molars were treated using LSTR technique with a combination of antibacterial drugs comprising ciprofloxacin, metronidazole, and doxycycline with propylene glycol as vehicle. The procedure was completed in a single appointment. Only analgesics were prescribed postoperatively. Postoperative evaluation was done after 1, 3, 6, and 12 months.Results:Clinical signs and symptoms got resolved in the 1st-month follow-up itself and continued in the subsequent visits. Radiographic evaluation showed a gradual improvement in success rates through the 12-month follow-up period.Conclusion:LSTR technique can be considered as an alternative treatment option for nonvital primary teeth avoiding a course of systemic antibiotics to the children. Doxycycline can be used in the drug combination instead of minocycline which also gives higher clinical and radiographic success.

Species-specific activity of antibacterial drug combinations.

The spread of antimicrobial resistance has become a serious public health concern, making once-treatable diseases deadly again and undermining the achievements of modern medicine1,2. Drug combinations can helpto fight multi-drug-resistant bacterial infections, yet they are largely unexplored and rarely used in clinics. Here we profile almost 3,000 dose-resolved combinations of antibiotics, human-targeted drugs and food additives in six strains from three Gram-negative pathogens-Escherichia coli, Salmonella enterica serovar Typhimurium and Pseudomonas aeruginosa-to identify general principles for antibacterial drug combinations and understand their potential. Despite the phylogenetic relatedness of the three species, more than 70% of the drug-drug interactionsthat we detected are species-specific and 20% display strain specificity, revealing a large potential for narrow-spectrum therapies. Overall, antagonisms are more common than synergies and occur almost exclusively between drugs that target different cellular processes, whereas synergies are more conserved and are enriched in drugs that target the same process. We provide mechanistic insights into this dichotomy and further dissect the interactions of the food additive vanillin. Finally, we demonstrate that several synergies are effective against multi-drug-resistant clinical isolates in vitro and during infections of the larvae of the greater wax moth Galleria mellonella, with one reverting resistance to the last-resort antibiotic colistin.

Analytical methods of ciprofloxacin and its combinations review

Ciprofloxacin is a second generic and an antibiotic generic drug. It is a very popular fluoroquinolone that can treat a number of bacterial infections. The quinolones are family or a group that has activity against both-negative and positive-gram bacteria, when compared to Ciprofloxacin. The first aim of this review is to provide a comprehensive update of analytical methods for determining the Ciprofloxacin and its combinations, binary or triple mixture use of endodontic treatment of primary teeth using a combination of antibacterial drugs. The other aim of this review is to evaluate clinical and radiographic success of the endodontic treatment of infected primary teeth using a combination of ciprofloxacin, metronidazole, minocycline, and clindamycin. Several methods were used in the analytical determination of Ciprofloxacin and its metabolites in human biological fluids (plasma) and in pharmaceutical preparations. various techniques have been reported, such as UV, TLC, GC-Mass, HPLC and RP-HPLC methods, for the determination of Ciprofloxacin alone and in its combinations by high performance liquid chromatography and reversed phase-high performance liquid chromatography. This review provides details on separation conditions for Ciprofloxacin alone and its combinations.

Combination Susceptibility Testing of Common Antimicrobials in Vitro and the Effects of Sub-MIC of Antimicrobials on Staphylococcus aureus Biofilm Formation.

The current study was conducted to evaluate the antibacterial combination efficacies, and whether the sub-inhibitory concentrations (sub-MIC) of antibiotics can influent on the biofilm formation of S. aureus. The minimum inhibitory concentration (MIC) of common antibacterial drugs was determined in vitro against clinical isolates of Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), and Pasteurella multocida (P. multocida) alone and in combination with each other by using the broth microdilution method and the checkerboard micro-dilution method analyzed with the fractional inhibitory concentration index (FICI), respectively. Regarding these results, antibacterial drug combinations were categorized as synergistic, interacting, antagonistic and indifferent, and most of the results were consistent with the previous reports. Additionally, the effects of sub-MIC of seven antimicrobials (kanamycin, acetylisovaleryltylosin tartrate, enrofloxacin, lincomycin, colistin sulfate, berberine, and clarithromycin) on S. aureus biofilm formation were determined via crystal violet staining, scanning electron microscopy (SEM) and real-time PCR. Our results demonstrate that all antibiotics, except acetylisovaleryltylosin tartrate, effectively reduced the S. aureus biofilm formation. In addition, real-time reverse transcriptase PCR was used to analyze the relative expression levels of S. aureus biofilm-related genes such as sarA, fnbA, rbf, lrgA, cidA, and eno after the treatment at sub-MIC with all of the six antimicrobials. All antibiotics significantly inhibited the expression of these biofilm-related genes except for acetylisovaleryltylosin tartrate, which efficiently up-regulated these transcripts. These results provide the theoretical parameters for the selection of effective antimicrobial combinations in clinical therapy and demonstrate how to correctly use antibiotics at sub-MIC as preventive drugs.

Морфологічні зміни тимусу курчат при різних схемах антибактеріальної терапії

The maximum number of products at the lowest cost – is the main thing, what modern poultry industry can be characterized. One of the most pressing problems at the moment is early antibiotic therapy and the associated safety of young poultry early age. In this regard, of particular interest for this study is how the most widely used antibacterial drugs effects on the one of key organs of the immune system – thymus. The article presents the data obtained in the course of the experiment, which determines how preventive treatment schemes, that includes usage single and multiple antibacterial drugs, influenced on the morphological status of the chickens thymus. We selected scheme and a combination of antibacterial drugs have not been studied previously. That was compared with the usage of probiotic Bolmol at the same treatment scheme. A comparison of morpho-functional state of the thymus of chickens 15-, 22- and 41-days-old, when applying several treatments schemes. The schemes of treatment included: the usage of one or two antibiotics during the cycle, compared with the usage of probiotic. We made the conclusions about the absence of the negative impact of selected drugs on the morphofunctional state of the thymus and the positive effect of probiotic «Bolmol». The morphometric parameters of the cortex and medulla in the lobules of the thymus of chicks 15-day-old, taking as an antibacterial drug probiotic Bolmol, were not significantly different from control values and were statistically significant when compared with chicks who used antibiotics: the width of the cortical area was on 15% and 29.09% wider then chickens receiving antibiotic treatment. This indicates a positive effect of probiotic Bolmol compared with antibacterial agents which were chosen. Thus, these data demonstrate that the use of probiotics in cyclic schemes of antibiotic prophylaxis contribute to the normal development of the thymus, which in turn leads to increased resistance and preservation of poultry. Was given the substantiation about safely usage of cyclic schemes of antibacterial drugs in the event of objective necessity.

Proteomic response of methicillin-resistant S. aureus to a synergistic antibacterial drug combination: a novel erythromycin derivative and oxacillin.

The use of antibacterial drug combinations with synergistic effects is increasingly seen as a critical strategy to combat multi-drug resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA). In this work, the proteome responses in MRSA under the stress of a sub-inhibitory dose of a synergistic drug combination of a novel erythromycin derivative, SIPI-8294, and oxacillin, were studied by label-free quantitative proteomics. Several control treatment groups were designed to isolate proteome responses potentially related to the synergy: (1) the non-synergistic drug combination of erythromycin and oxacillin, (2) SIPI-8294 only, (3) oxacillin only and (4) erythromycin only. Results showed that 200 proteins were differentially expressed in SIPI-8294/oxacillin-treated cells. Among these proteins, the level of penicillin binding protein 2a, the protein mainly responsible for oxacillin resistance in MRSA, was four times lower in the SIPI-8294/oxacillin group than in the erythromycin/oxacillin group, suggesting that SIPI-8294 may interfere with this known oxacillin resistance mechanism. Moreover, hierarchical clustering analysis of differentially expressed proteins under different treatments revealed that SIPI-8294/oxacillin elicits very different responses than the individual drugs or the non-synergistic erythromycin/oxacillin combination. Bioinformatic analysis indicated that the synergistic effect can be further traced to a disruption in oxidation-reduction homeostasis and cell wall biosynthesis.

Rational strategy of pharmacotherapy of patients with community-acquired pneumonia at elderly and senil eage

Introduction. Nonhospital pneumonia is the most common acute infectious infections disease of the lower respiratory tract. The incidence of the community-acquired pneumonia in Ukraine is 3 - 11 cases per 1,000 in adults per year and is the highest among the elderly and old patients. According to the foreign epidemiological studies, the incidence of nonhospital pneumonia in persons of young and middle-aged adults (&gt; 18 years) is 1 - 11,6 %; in the older age groups - 25 - 44 %. Mortality from nonhospital pneumonia without concomitant diseases is also the lowest (1-3 %) in those young and middle age. In patients over 60 years of age, if there is a serious comorbidity and in cases of severe nonhospital pneumonia, this figure reaches 15-30 %. To improve treatment outcome in nonhospital pneumonia and cost optimization in recent years a number of international and national recommendations were proposed. This help doctor to choose the most rational strategy for the management of patients in a specific clinical situation.The aim of the study. Retrospective analysis of case histories of patients older than 60 years with nonhospital pneumonia treated in the therapeutic department during the period from September 2010 to May 2013. Assessment of the quality of medical care and the practice of the appointment systemic antibacterial therapy in accordance with modern standards and quality indicators.Material and methods. Were selected 66 case histories of patients with nonhospital pneumonia, men were 41 people (62.1%), and women - 25 (37,9%), the average age was 69,5 ± 8.1 years. Based on the goal of the research objectives were: to assess the quality of medical aid for patients with nonhospital pneumonia and frequency of antibacterial therapy for patients with nonhospital pneumonia in a particular situation.; explore the features of administration of antibiotics at the start of therapy of the community-acquired pneumonia and compliance choice of antibiotic therapy to the national guidelines. Statistical data processing was carried out in the system of the SPT Statistica, version 8.0.Results and discussion. All hospitalized patients received systemic antibiotic therapy. Frequency assignments AMP patients at the outpatient stage was 21 %. Quick antibacterial therapy was in 15.1 % (n=10) cases, mainly in patients from 60 to 68 years, with no complications. Starting antibiotic therapy in most cases was chosen according to the national treatment guidelines. High efficiency of the combined antibacterial therapy compared with mono - antibacterial therapy was noted.Conclusions:The most effective antibacterial treatment was expected from the triple combination of antibacterial drugs: cephalosporins 3rd generation + fluoroquinolones + macrolides.The study has also noted the high relevance of the ongoing antibiotic therapy with existing national guidelines for management of patients with nonhospital pneumonia (89,9 %), which is comparable with the commitment to comply with the recommendations in the clinics of Europe and the USA.

Clinical evaluation of 3 Mix and Other Mix in non-instrumental endodontic treatment of necrosed primary teeth

Problem consideredThe objective was to evaluate and compare the clinical and radiographic efficacy of two different combinations of antibacterial drugs when used in non-instrumental endodontic treatment of necrosed primary teeth. Materials and methodForty teeth were randomly divided into two groups, viz. groups A and B having 20 teeth each. In Group A, 3 Mix (ciprofloxacin, metronidazole, and minocycline) and in Group B, Other Mix (ciprofloxacin, ornidazole, and minocycline) mixed with propylene glycol were used. Medication cavities of Group-A and B were filled with 3 Mix and Other Mix respectively followed by restoration of teeth. Clinical evaluation was done at 3 months whereas, clinical and radiographic evaluation was done at 6 and 12 months, respectively. ResultsBoth the groups showed 100% clinical success whereas, radiographic success rate was 81% with 3 Mix and 92% with Other Mix but, was not statistically significant. ConclusionsBoth the antibacterial pastes can be used effectively in non instrumental endodontic treatment of necrosed primary teeth and require more clinical trials to prove its efficacy.

Successful nonsurgical retreatment of resected teeth associated with persistent periapical lesion by placing triple Antibiotic paste and mineral trioxide aggregate apical plug - A case report

This article describes the nonsurgical management of traumatized teeth that had undergone apisectomy and associated with a large periapical lesion. A combination of antibacterial drugs consisting of metronidazole, ciprofloxacin and minocycline was used for root canal disinfection. The common problem encountered with this drug combination is tooth discoloration due to minocycline. Adhesive restoration was used to address this problem. Mineral trioxide aggregate apical plug was placed in the lateral incisor that had undergone unsuccessful root resection. On two year follow up the patient was asymptomatic and intraoral periapical radiograph showed successful healing with complete resolution of the periradicular lesion.

An In Vivo Platform for Rapid High-Throughput Antitubercular Drug Discovery

Treatment of tuberculosis, like other infectious diseases, is increasingly hindered by the emergence of drug resistance. Drug discovery efforts would be facilitated by facile screening tools that incorporate the complexities of human disease. Mycobacterium marinum-infected zebrafish larvae recapitulate key aspects of tuberculosis pathogenesis and drug treatment. Here, we develop a model for rapid in vivo drug screening using fluorescence-based methods for serial quantitative assessment of drug efficacy and toxicity. We provide proof-of-concept that both traditional bacterial-targeting antitubercular drugs and newly identified host-targeting drugs would be discovered through the use of this model. We demonstrate the model's utility for the identification of synergistic combinations of antibacterial drugs and demonstrate synergy between bacterial- and host-targeting compounds. Thus, the platform can be used to identify new antibacterial agents and entirely new classes of drugs that thwart infection by targeting host pathways. The methods developed here should be widely applicable to small-molecule screens for other infectious and noninfectious diseases.

Endodontic treatment of necrosed primary teeth using two different combinations of antibacterial drugs: An in vivo study

This study was conducted to evaluate clinical and radiographic success of endodontic treatment of infected primary teeth using two combinations of antibacterial drugs consisting of ciprofloxacin, metronidazole, and minocycline in one group and ciprofloxacin, ornidazole, and minocycline in the other group. The selected 40 teeth were randomly divided into two groups, viz. groups A and B with 20 teeth in each group. In Group A, antibacterial paste containing ciprofloxacin, metronidazole, and minocycline and in Group B, antibacterial paste containing ciprofloxacin, ornidazole, and minocycline mixed with propylene glycol were used. Medication cavities were filled with antibiotic pastes, depending on the groups followed by Glass Ionomer restorations and stainless steel crown placement. Clinical and radiographic evaluation was carried out at 3, 6, and 12 months intervals. Both the groups showed considerable clinical and radiographic success. There was no statistically significant difference between Group A and B. However, group B showed better results clinically and radiographically compared with group A. Both the antibacterial pastes, i.e., combination of ciprofloxacin, metronidazole, and minocycline and ciprofloxacin, ornidazole, and minocycline mixed with propylene glycol have shown good clinical and radiographic success in treating necrotic primary teeth.