Ciprofloxacin Group Research Articles

Effect of nisin on microbiome-brain-gut axis neurochemicals by Escherichia coli-induced diarrhea in mice

The effects of nisin on the neurochemicals, Aquaporin-3 (AQP-3) and intestinal microorganisms in the brain-gut axis of mice were analyzed by using enzyme linked immune sorbent assay (ELISA) and high throughput sequencing in this investigation, to further revealed the relationship between intestinal flora abundance in mice and neurochemicals in the brain-gut axis. Using HE staining found damage of structure of small intestine villi in the model group (Escherichia coli O1, E. coli O1). Compared with normal control and ciprofloxacin groups, using ELISA showed that nisin increased the highest norepinephrine (NE) expression in the brain, expression of 5-hydroxytryptamine (5-HT) and dopamine (DA) in the duodenum, and increased the expression of AQP-3 in jejunum. Using high-throughput sequencing showed the highest diversity of cecal microflora in nisin group (ACE-index = 1417.25, Chao1-index = 1378.45), but the cecal microflora in the negative control group (ACE-index = 969.54, Chao1-index = 340.29) exhibited the lowest species diversity. Our data indicated that nisin regulates neurochemicals, AQP-3 and cecal microflora imbalance in mice.

Monitoring, evaluation and comparison of adverse effect profile of ciprofloxacin and ofloxacin in acute bacterial exacerbation of chronic bronchitis patients attending pulmonology department of tertiary care teaching hospital: a prospective observational study

Background: In 2016, FDA recommended that “serious side effects associated with flouroquinolones generally outweigh the benefits for the patients with acute sinusitis, acute bronchitis and uncomplicated UTI”. Throughout India the most commonly used flouroquinolones for above conditions are Ciprofloxacin, Ofloxacin, and Levofloxacin. In this scenario, the present study was undertaken to monitor, evaluate and compare the adverse effect profile of Ciprofloxacin and Ofloxacin in acute exacerbation of chronic bronchitis patients.Methods: Prospective, observational study done in 200 patients of tertiary care teaching hospital. The patients diagnosed with, acute bronchitis treated with Ciprofloxacin 500mg BD or Ofloxacin 400mg BD for 7 days were included in the study. The study duration was 6 months. ADR causality assessment was done with Naranjo algorithm. Statistical test applied was chi- square test.Results: 63 ADR were reported in Ofloxacin group and 19 ADR in Ciprofloxacin group. Insomnia was most frequent ADR (40%) in patients treated with Ofloxacin. There is high incidence of ADRs in ofloxacin group. chi square test showed this difference is statistically significant (p<0.05). Insomnia was significantly higher in ofloxacin group (p<0.05).Conclusions: In India frequently used and misused antimicrobials are fluoroquinolones. The present study concluded that no serious ADRs but ofloxacin group of patients have shown increased incidence of ADRs associated with CNS especially Insomnia. However, further large scale, multi-centric studies are needed to confirm these results.

Antibiotic prophylaxis in transarterial chemoembolization of hepatocellular carcinoma

Background and study aimsTransarterial chemoembolization remains a common treatment option in unresectable hepatocellular carcinoma. However, protocols for pre- and post-procedure care and the role of antibiotic prophylaxis have not been evaluated. The aim of this work was to compare 3 different groups of prophylactic antibiotics in patients undergoing chemoembolization and to compare the efficacy of intravenous versus oral route. Patients and methods180 hepatocellular carcinoma patients undergoing transarterial chemoembolization were selected. Patients were classified into 3 groups; Group 1: 60 patients; 30 received intravenous ceftriaxone, and 30 received oral cefixime. Group 2: 60 patients; 30 patients received intravenous levofloxacin and 30 received oral levofloxacin. Group 3: 60 patients; 30 received intravenous ciprofloxacin and 30 received oral ciprofloxacin. All antibiotics were given one day before intervention and for 4 days afterwards. Complete blood count, C-reactive protein, liver and renal function tests were assessed 1 and 5 days and then 1 month after the procedure. ResultsThe ciprofloxacin group gave better results than the other 2 groups regarding total and differential leucocytic count and C-reactive protein level. No significant difference was found between oral and intravenous routes among the 3 groups. None of the studied patients developed infections or liver abscess after chemoembolization. ConclusionThird generation cephalosporin, levofloxacin or ciprofloxacin all are effective as prophylaxis against post-chemoembolization infections. No significant difference between oral and intravenous administration among the 3 groups. Oral ciprofloxacin is an effective, safe and relatively inexpensive prophylaxis regimen.

Does ciprofloxacin prophylaxis during chemotherapy induce intestinal microflora resistance to ceftazidime in children with cancer?

To determine the susceptibility and minimal inhibitory concentrations (MIC) of ceftazidime, the commonly used empirical antibiotic in patients with febrile neutropenia, in Escherichia coli and Klebsiella pneumoniae isolated from the intestinal microflora of pediatric patients with cancer, who received ciprofloxacin prophylaxis during chemotherapy, children younger than 18 years with acute lymphoblastic leukemia or lymphoma scheduled to undergo chemotherapy were randomized to receive oral ciprofloxacin 20mg/kg/day or placebo from the beginning of their chemotherapy. Rectal swab cultures were taken before (R0) and at 1 (R1), 2 (R2), and 3 (R3) weeks during the intervention. The antimicrobial susceptibilities and MICs of ceftazidime and ciprofloxacin were determined via the E test. Of the total 87 patients enrolled, 44 received ciprofloxacin and 43 placebo. A total of 350 isolates were obtained, 62, 49, 46 and 22 from the ciprofloxacin group and 68, 54, 38 and 11 from the placebo group at R0, R1, R2 and R3, respectively. The percentages of ceftazidime susceptibility did not show significantly greater decreases from R0 to R1-R3 in the ciprofloxacin group compared to the placebo group. The MIC50s of ceftazidime showed significantly greater increases after ciprofloxacin prophylaxis during R1-R3 compared to R0 in the intervention group compared to the placebo group (R0, 0.12 vs. 0.12; R1, 0.19 vs. 0.12; R2, 0.19 vs. 0.12 and R3, 0.38 vs. 0.09μg/mL, respectively). Due to the increasing MIC50 of ceftazidime over time after ciprofloxacin prophylaxis, the use of ceftazidime in patients who have previously had ciprofloxacin prophylaxis needs to be closely monitored.

Effects of ciprofloxacin and quercetin on fetal brain development: a biochemical and histopathological study

Purpose Teratogens cause birth defects and malformations while human development is being completed. In pregnancy, urinary tract infection (UTI) is a common health problem caused by bacteria. The fluoroquinolones such as ciprofloxacin, levofloxacin, moxifloxacin, and gemifloxacin can treat various types of bacterial infections successfully. The aim of this study is to determine whether the use of ciprofloxacin during pregnancy causes oxidative stress on brain tissues of the fetus, and whether quercetin contributes to prevent this damage if stress has already occurred. Materials and methods In our study, 22 young female Wistar albino rats weighing 250 g were used. Rats were mated overnight in separate plastic cages. Female rats were regarded as pregnant when a vaginal plug was observed, and these were divided into four groups of control, ciprofloxacin, quercetin, and cipro + quercetin. Two daily i.p. 20 mg/kg doses of ciprofloxacin were administered to ciprofloxacin group between 7 and 17 d of pregnancy. Throughout the study, daily (20 d) 20 mg/kg quercetin was dissolved in corn oil and administered to the quercetin group by oral gavage. Rats were fed ad libitum throughout the study. Fetuses were taken by C-section on the 20th day of pregnancy. Thereafter, the brain tissues were subjected to histological assessments and biochemical analyzes. Results The experimental groups were compared with the control group; ciprofloxacin affected fetal development, especially caused damage to neurons in brain tissue and cause hemorrhagic defects. And also, it was determined that many parameters were affected such as antioxidant parameters, enzyme levels and levels of malondialdehyde (MDA) (a marker of lipid peroxidation). Quercetin is a member of flavonoid with strong antioxidant properties, and our results indicate that the use of ciprofloxacin in pregnancy can result damage to fetal brain tissue. Conclusions Unlike these results when some parameters are evaluated it is understood that this harmful effects suppressed by quercetin.

UNCOMPLICATED TYPHOID FEVER

Objectives: Objectives of this study were To compare the clinical andbacteriological cure rates of azithromycin and ciprofloxacin in the treatment of uncomplicatedtyphoid fever and To determine any difference in the clinical and bacteriological cure rateswithin the two groups of study. Study Design: Quasi experimental study. Setting: Departmentof Medicine, DHQ/ Teaching Hospital Dera Ghazi Khan. Period: April 2016 to September 2016.Patients and Methods: A total of 60 patients including both males and females over 18 yearsof age were included in the study by Simple random probability sampling. Patients fulfilling theinclusion criteria were divided in two equal groups of 30 by using the random numbers table.First group was treated with azithromycin one gram on day one and then 500 mg daily for nextsix days. Second group was treated with ciprofloxacin 500mg twice daily for ten days. All thedata was analyzed by the computer programme SPSS. Frequency, percentages, mean valuesand standard deviations were calculated for age, sex, symptoms, signs, culture reports, clinicalcure rates and bacteriological cure rates. Results: Most common clinical feature was fevernoted in 100% patients followed by headache (86.6%) and nausea / vomiting (76.6%). Out of60, 52 (86.6%) patients were culture positive. In Azithromycin group clinical and bacteriologicalresponses were achieved in 93.3% and 92.3% respectively while in ciprofloxacin group theywere 96.6% and 96.15% respectively. There was no significant statistical difference between theclinical and bacteriological cure rates among two groups. Conclusion: Both ciprofloxacin andazithromycin are equally effective in the treatment of uncomplicated typhoid fever.

Post-traumatic endophthalmitis prophylaxis with oral ciprofloxacin in comparison to intravenous cephazolin/gentamicin.

Background:Although posttraumatic endophthalmitis is an uncommon condition, it causes severe complications, so medical and pharmacological interventions for prevention of endophthalmitis after trauma are a major concern. The aim of this study was to evaluate the efficacy and clinical outcome of oral ciprofloxacin versus intravenous cefazolin/gentamicin for the prevention of endophthalmitis after penetrating ocular trauma.Materials and Methods:This was a retrospective, descriptive single-center study, including all cases of penetrating ocular trauma seen in the Feiz Hospital, a Tertiary Referral Eye Hospital in Isfahan, Iran, between 2011 and 2017. Data systemically recorded for each patient included clinical, ophthalmological, and demographic findings by a trained medical record abstractor or ophthalmologist reviewing patient records.Results:Six hundred and forty-five patients in cefazolin/gentamicin and 273 patients in oral ciprofloxacin groups were included in the study. Our study showed that the incidence of endophthalmitis was not significantly different between the two groups (P = 0.463). In patients with either sharp or blunt penetrating ocular trauma.Conclusion:Oral ciprofloxacin as a prophylactic treatment could prevent posttraumatic endophthalmitis as effective as injectable cefazolin/gentamicin. Due to easier consumption of oral ciprofloxacin and lower systemic complications, in all patients with penetrating eye trauma, oral administration of ciprofloxacin is preferable to intravenous or intramuscular types of antibiotics to reduce the risk of posttraumatic endophthalmitis.

Michael-Addition-Mediated Photonic Crystals Allow Pretreatment-Free and Label-Free Sensoring of Ciprofloxacin in Fish Farming Water.

Abuse of antibiotics results in a large number of antibiotics residues in the environment and even causes the problem of "super bacteria". Therefore, it is crucial to develop a powerful analytic method to monitor antibiotics quickly and simply. Photonic crystal (PC), as a sensing material, has promising application prospects. Herein, we try to use PC to realize pretreatment-free and label-free detection of Ciprofloxacin (CF) through Michael addition reaction. The recognition process is carried out by the Michael addition reaction between the piperazine group of CF and the o-benzoquinone group on the PC. The monodisperse microspheres with o-benzoquinone groups are prepared by polymerization and oxidation and then stacked to form PC. During the detection, the peak intensity of the PC decreases with the increasing CF concentration, and the linear range is from 2 to 512 μg/L. The limit of detection (LOD) is 0.76 μg/L. Furthermore, the PC retains 97% of the initial response after storage in a Petri dish at room temperature for 1 month, which shows that it has good stability. Moreover, CF in fish farming water can be detected directly without any pretreatment and label, and the results are in good accordance with the LC-MS-MS results. This Michael-addition-mediated PC is accurate, easily prepared, cost-efficient, and long-term stable. In addition, it is environmentally friendly, because little organic solvent is needed during both the preparation and the detection.

The role of Dexamethasone in clinical pharmaceutical treatment for patients with cataract surgery.

The aim of the present study is to determine the efficacy of dexamethasone (DEX) vs. indomethacin (IND) and ciprofloxacin (CIP) in modulating immediate inflammation following cataract surgery. A total of 644 patients with cataract were recruited and inflammation was investigated during the perioperative period. The management protocol was similar in both groups. Each drug was given four times a day for 30 days starting 7 days prior to surgery. The primary efficacy criteria for evaluation were the reduction in anterior chamber (AC) flare and AC inflammation score, in addition, a different secondary efficacy and safety evaluation criteria were maintained. The results demonstrated that the average inflammation score was 1.2±0.8 in the DEX group, which was significantly lower compared with the IND (1.9±0.7) and CIP (1.8±0.6) groups. Intra-ocular pressure was decreased following treatment with DEX, while intra-ocular pressure was slightly increased in the IND (1.9±0.7) and CIP (1.8±0.6) groups. The final visual outcomes for patients postcataract surgery were clinically superior in the DEX group compared with that of the IND and CIP groups (P=0.034 and P=0.042, respectively), but there was no significant difference between the ND and CIP groups (P=0.78). Outcomes indicated that AC inflammation, conjunctival hyperaemia, corneal and lid oedema, ocular infection, pain, photophobia, and tearing were significantly improved in each group. No significant poor local tolerance or adverse reaction was observed in the DEX, IND and CIP groups. In conclusion, the outcomes of the present study suggest that DEX serves an important role in the clinical pharmaceutical treatment of patients with cataract surgery.

Efficacy of Ceftriaxone, Cefepime, Doxycycline, Ciprofloxacin, and Combination Therapy for Vibrio vulnificus Foodborne Septicemia.

Foodborne Vibrio vulnificus infections are associated with higher rates of sepsis and mortality than wound infections; however, antibiotic efficacy studies have not been performed in foodborne infection models. The efficacies of ceftriaxone, cefepime, doxycycline, ciprofloxacin, and combination therapy were assessed in V. vulnificus intestinal infection in mice in order to model foodborne infections. In accordance with prior studies of cefotaxime, cefepime was synergistic with doxycycline and ciprofloxacin in vitro; combination therapy significantly decreased bacterial growth, by ≥2 log10 units, from that with antibiotic monotherapy (P < 0.01). In vivo, survival rates in the ceftriaxone (50%), doxycycline (79%), and ciprofloxacin (80%) groups were significantly higher than those in the control group (0%) (P < 0.0001). Survival was significantly higher with ceftriaxone-doxycycline (91%) or ceftriaxone-ciprofloxacin (100%) therapy than with ceftriaxone (50%) (P ≤ 0.05). Survival with cefepime-doxycycline (96%) or cefepime-ciprofloxacin (90%) therapy was significantly higher than that with cefepime alone (20%) (P < 0.001). There was no difference in survival between the combination therapy groups. Thus, we conclude that combination therapy was the most effective treatment for foodborne V. vulnificus septicemia. In a septic patient with a recent ingestion of raw seafood, cefepime in combination with doxycycline or ciprofloxacin should be initiated for coverage of resistant Gram-negative organisms and V. vulnificus pending a microbiological diagnosis. Once a diagnosis of foodborne V. vulnificus septicemia is established, treatment can safely transition to ceftriaxone in combination with doxycycline or ciprofloxacin.

Enhancement of antibacterial activity of ciprofloxacin hydrochloride by complexation with sodium cholate

Ciprofloxacin is a broad spectrum bactericidal anti-infective agent of the fluoroquinolones class used in treatment of many bacterial infections. In recent times, there has been increasing resistance to the antibiotic. In this work, we investigated the effect of making an ion- pair complex of Ciprofloxacin – hydrochloride with Sodium cholate on bacterial activity. The optimal ratio of the reactants and pH were determined using UV spectrometry. The complex was characterized by octanol-water partitioning, melting point, and IR spectrometry. The antibacterial activity of the complex was determined against Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus pneumoniae by the agar-well diffusion method. The complex was whitish to off-white in color and crystalline, with a melting point of 238 °C. The stoichiometry of the complex shows a molar ratio of 1:1 of sodium cholate to ciprofloxacin. The best pH for complexation was pH 9. The complex partitioned 3.38 times into octanol than in water. The FTIR revealed interaction between the 4-nitrogen atom in the 7-piperazinyl group of ciprofloxacin and the carbonyl of the cholate. The drug in complex form gave double the antibacterial activity of the uncomplexed drug. This study showed that development of hydrophobic ion pair complex enhances antibacterial activity of ciprofloxacin hydrochloride.

Does Olive Oil Attenuate Ciprofloxacin-Induced Renal Cortical Toxicity? Light and Electron Microscopic Study

Introduction: Ciprofloxacin (CPFX) is a broad spectrum antibiotic used for treatment of many infections. Olive oil is rich in compounds that have strong antioxidant activity.Aim: To assess CPFX-induced renal cortical structural changes in albino rats and to evaluate whether or not olive oil could attenuate such changes.Materials and Methods: Thirty two male albino rats were used and divided into 4 groups. Control group received distilled water, OO group received olive oil (5ml/kg/day), CPFX group received CPFX (20 mg/kg/day) and CPFX+OO group received both CPFX and olive oil as the previous groups. All medications were continued for 14 days. Renal cortex specimens were processed for light and electron microscopy. Morphometric study and statistical analysis for the results were also performed.Results: CPFX group revealed irregularity and shrinkage of renal corpuscles with loss of vascular component and capsular space obliteration. The mesangial cells were significantly increased. The renal tubules showed dilatation with significant increase in proximal convoluted tubules diameter, marked degeneration, significant increase in the darkly stained nuclei of their lining cells and intraluminal casts. Congested glomerular capillaries and peritubular blood vessels were also observed. Ultrastructurally, there were thickening of glomerular basement membrane, fusion of glomerular capillary endothelium and podocyte pedicles. Cytoplasmic empty areas and vacuolations, swollen mitochondria, nuclear changes were also found in the tubules. CPFX + OO group showed less structural changes.Conclusion: Olive oil has ameliorating effect on ciprofloxacin-induced renal cortical toxicity.

A Seven-Day Course of TMP-SMX May Be as Effective as a Seven-Day Course of Ciprofloxacin for the Treatment of Pyelonephritis

BackgroundThe Infectious Diseases Society of America guidelines recommend either 14 days of trimethoprim-sulfamethoxazole (TMP-SMX) or 7 days of ciprofloxacin for the treatment of pyelonephritis. Antibiotic courses of 7 days of TMP-SMX vs 7 days of ciprofloxacin for pyelonephritis have not been previously compared. We evaluated the odds of a subsequent, symptomatic urinary tract infection (UTI) for women with Escherichia coli pyelonephritis receiving a 7-day course of TMP-SMX vs a 7-day course of ciprofloxacin. MethodsWomen ages 16 years and older with E. coli pyelonephritis presenting to 5 health care facilities in the greater Maryland area between 2010 and 2016 receiving either TMP-SMX or ciprofloxacin were included. Patients were excluded if they met any of the following criteria: (a) pregnancy, (b) dialysis dependency, (c) E. coli not susceptible to the treatment prescribed, (d) polymicrobial urine culture, or (e) >48 hours of antibiotic therapy other than TMP-SMX or ciprofloxacin. ResultsOf 272 women meeting eligibility criteria, 81 (30%) and 191 (70%) received 7 days of TMP-SMX and 7 days of ciprofloxacin, respectively. In an adjusted model, the likelihood of a recurrent UTI within 30 days for the TMP-SMX and ciprofloxacin groups was similar (adjusted odds ratio 2.30; 95% confidence interval, 0.72-7.42). ConclusionsOur findings suggest that 7 days of TMP-SMX therapy may result in similar clinical outcomes compared with 7 days of ciprofloxacin for the treatment of pyelonephritis. Considering the frequency of pyelonephritis and risks of antibiotic resistance and associated toxicities, decreasing the duration of antibiotic therapy for pyelonephritis may impact a large number of women.

Comparison of Efficacy of Amoxicillin versus Ciprofloxacin in Postsurgical Management of Transalveolar Extraction.

Background:The transalveolar extraction and the use of pharmacological antibiotic therapy following the surgical procedure in management of postoperative infection go hand in hand in minor oral surgery. Attention has often been focused on antibiotic therapy administered at different time schedules (before or after surgery or both). This investigation reveals how the use of different molecules and dosages is critical in the postoperative period and has always provided positive result.Methodology:A prospective randomized study was carried out in 100 healthy controls of age group 20–50 years undergoing transalveolar extraction in the Department of Oral and Maxillofacial Surgery, Vivekanandha Dental College for Women. A 5-day regimen of amoxicillin or ciprofloxacin group of antibiotics along with regular analgesics was administered to the patients following transalveolar extraction. The patients were evaluated for postoperative infection, inflammation and wound care on postoperative days: day zero, day 2, day 5, day 7, day 15, day 30, and analyzed. A P < 0.05 was considered statistically significant.Results and Conclusion:A total of 100 patients aged 23–50 years (24.6–4.43) met the inclusion criteria. Male accounted for 44, while female were 55, giving male:female ratio 1:1.4. Postoperative infection was minimum with ciprofloxacin group as compared to amoxicillin group and was more significant (P < 0.005) on evaluation. A complete review has also been taken into an account, various strategies used such as surgical flaps, no traumatic osteotomy, and primary or secondary closure.

Efficacy and Safety of Ciprofloxacin Plus Fluocinolone in Otitis Media With Tympanostomy Tubes in Pediatric Patients

Acute otitis media with tympanostomy tubes (AOMT) in children commonly presents with otorrhea and negatively affects their daily activities. To evaluate the efficacy and safety of topical ciprofloxacin, 0.3%, plus fluocinolone acetonide, 0.025%, otic solution relative to ciprofloxacin, 0.3%, otic solution alone and fluocinolone acetonide, 0.025%, otic solution alone in the treatment of AOMT in children. Two twin multicenter, randomized, double-blind clinical trials with identical designs were conducted from June 24, 2011, through June 23, 2014, at ear, nose, and throat pediatric practices, general practices, hospitals, and clinical research centers. The study population comprised 662 children (331 in each trial) with AOMT in at least 1 ear who presented with moderate or severe purulent otorrhea for 3 weeks or less. Data analyses were performed on an intention-to-treat basis. Patients were randomly assigned to receive ciprofloxacin plus fluocinolone, ciprofloxacin alone, or fluocinolone alone twice daily for 7 days and were evaluated on days 1 (baseline), 3 to 5 (undergoing therapy), 8 to 10 (end of therapy), and 18 to 22 (test of cure). The primary efficacy measure was time to cessation of otorrhea. The principal secondary end point was sustained microbiological cure, defined as eradication or presumed eradication at end-of-therapy and test-of-cure visits. A total of 662 children participating in the 2 studies were randomized to receive ciprofloxacin plus fluocinolone (n = 223), ciprofloxacin alone (n = 221), or fluocinolone alone (n = 218). The median age was 2.5 years (range, 0.6-12.7 years). The median time to cessation of otorrhea was 4.23 days (95% CI, 3.65-4.95 days) in patients receiving ciprofloxacin plus fluocinolone compared with 6.95 days (95% CI, 5.66-8.20 days) in those receiving ciprofloxacin and not estimable findings in those receiving fluocinolone alone (P < .001). The clinical cure rate at the test-of-cure visit was 80.6% in the ciprofloxacin plus fluocinolone group, 67.4% in the ciprofloxacin group (difference, 13.2%; 95% CI, 5.0%-21.4%; P = .002), and 47.6% in the fluocinolone group (difference, 33.0%; 95% CI, 24.0%-42.0%; P < .001). The sustained microbiological cure rate was 79.7% in the ciprofloxacin plus fluocinolone group vs 67.7% in the ciprofloxacin group (difference, 12.0%; 95% CI, 0.8%-23.0%; P = .04) and 37.6% in the fluocinolone group (difference, 42.1%; 95% CI, 29.3%-54.8%; P < .001). Only 7 (3.1%) of the patients receiving ciprofloxacin plus fluocinolone, 8 (3.6%) of the patients receiving ciprofloxacin, and 10 (4.7%) of the patients receiving fluocinolone presented with adverse events related to study medication. The combination of ciprofloxacin plus fluocinolone is more effective than treatment with ciprofloxacin or fluocinolone alone for AOMT, and it is safe and well tolerated in children. clinicaltrials.gov Identifiers: NCT01395966 and NCT01404611.

The influence of antibiotics on the physical properties of endodontic cements

AimTo evaluate the influence of Metronidazole, Minocycline and Ciprofloxacin as a mixture or individually and of chlorhexidine on the push-out bond strength and surface microhardness of calcium silicate cements of differing particle size. Methodology120 extracted adult human premolars were decoronated and 2mm dentin slices were prepared. Specimens were divided equally into the following groups: normal saline and CHX, Metronidazole, Minocycline, Ciprofloxacin, and combination of Metronidazole, Minocycline and Ciprofloxacin. The specimens were irrigated with solutions and filled with endodontic cements. In the second part, the endodontic cements were mixed, placed in plastic tubes and then irrigated for 1 or 5min. Push-out and surface microhardness values were calculated and data were analyzed with three way ANOVA followed by Tukey's post-hoc test. ResultsThe normal saline and ciprofloxacin groups showed significantly higher and lower, respectively, push-out bond strength among the experimental groups (p<0.001 for all groups). Nano type cement showed higher push-out bond strength and microhardness than regular one at both time intervals. The mixture of antibiotics had significant effects on the push out and microhardness of calcium silicate cement. ConclusionsNano particle MTA resisted more than the conventional MTA to the effect of the irrigating solution and antibiotics in both hardness and push-out strength. Furthermore, the results of microhardness were consistent with the push-out strength in most cases. The microhardness test may be employed as a complimentary test to evaluate push-out strength of dental cements.

Melatonin can attenuate ciprofloxacin induced nephrotoxicity: Involvement of nitric oxide and TNF-α.

Ciprofloxacin is a synthetic broad-spectrum antimicrobial agent of fluoroquinolone family. The aim of our investigation was to evaluate the role of oxidative damage and inflammation in nephrotoxic potential of Ciprofloxacin and protective effects of melatonin against its nephrotoxicity in male Wistar rats. The animals were divided into six groups: Control, ciprofloxacin (100mg/kg/day, i.p), ciprofloxacin with three doses (2.5, 5 and 10mg/kg/day) of melatonin and a group which received ciprofloxacin (100mg/kg/day) plus vitamin E (100mg/kg/day) for 8 consecutive days. 24h after last injection, the animals were euthanized and kidney tissues were separated. Finally reactive oxygen species, glutathione content, lipid peroxidation, protein carbonyl, nitric oxide and TNF-α were evaluated. Also, pathological examination and measuring of kidney biochemical markers (BUN and Cr) were done. The administration of ciprofloxacin for 8days resulted in significant increase (P<0.01) in kidney biomarkers (BUN and Cr) and pathological changes. Also, Oxidative stress was evident in ciprofloxacin group by significantly (p<0.001) increased reactive oxygen species, lipid peroxidation and protein carbonyl level and decreased glutathione content (p<0.001). Increased in inflammation process was shown by increase in NO and TNF-α (P<0.001). Administration of melatonin was able to protect against deterioration in nephrotoxic markers and suppressed the increase in oxidative stress and inflammatory markers. Our study showed the critical role of oxidative damage and inflammation in ciprofloxacin-induced nephrotoxicity that markedly inhibited by administration of melatonin. So, melatonin can be suggested for prevention of ciprofloxacin-induced nephrotoxicity.

Current antibiogram pattern of Salmonella typhi and paratyphi isolates and response to treatment in a tertiary care centre

Objective: The objective of this study is to study the current antibiotic sensitivity pattern of Salmonella typhi and paratyphi isolates and the clinical response of children with culture positive enteric fever (EF) to the specific antibiotic used as suggested by the sensitivity pattern. Materials and Methods: This is a retrospective study analyzing the records of 197 children treated for blood culture positive EF during 3 years from January 2013 to December 2015. Antibiogram pattern of S. typhi/paratyphi and response pattern to the antibiotic used as per antibiogram were analyzed. Kirby Bauer’s disc diffusion method was used for antibiotic sensitivity using closed-loop stripping analysis standards. Temperature charts of the patients analyzed for response patternof fever to the antibiotic started. Results: 197 culture positive cases were included in the study (S. typhi=190 and paratyphi=7). Sensitivity pattern to 9 out of 10 antibiotics tested was high and was low only to nalidixic acid (6.3%). There were 184 (93.4%) children whose antibiogram showed high sensitivity to cephalosporins and were treated with intravenous ceftriaxone (Group 1). The majority of children in this group (172/184, 93.5%) became afebrile by 7 days of therapy. 13 (6.6%) children whose antibiogram showed resistance to cephalosporins were treated with intravenous ciprofloxacin (Group 2). 9 of this group became afebrile by 7 days. 12 children from Group 1 and 4 children from Group 2 were considered as either reduced susceptibility or resistance torespective antibiotics and were treated with either azithromycin or piperacillin-tazobactam over the next 5-7 days successfully. Conclusion: Appropriate diagnosis using blood cultures and using 3rd generation cephalosporins as the first line of the drug in treating children with EF can reduce the duration of treatment, promote better compliance, reduce relapse rates, and may help decrease multi-drug resistant S.typhi/partyphi strains in the community..

The Anti-Inflammatory and Anti-Microbial Effects of the Novel Herbal Formulation (WSY-1075) on Chronic Bacterial Prostatitis Rat Model

Objective: The aim of this study was to investigate the anti-inflammatory and anti-microbial effects of a new herbal formula (WSY-1075) in a chronic bacterial prostatitis rat model. Design and Method: Thirty two male Wistar rats were used in the study. Experimental chronic bacterial prostatitis was induced by instillation of bacterial suspension (Escherichia coli 108 per ml) into the prostatic urethra. Animals were followed for 4 weeks. After the induction of prostatitis, the rats were randomly divided into one of four treatment groups: control (n=8), ciprofloxacin (n=8), WSY-1075 (400 mg/kg) (n=8), and WSY-1075 (400 mg/kg) + ciprofloxacin (n=8). After 4 weeks of treatment, the prostatic pro-inflammatory cytokine (tumor necrosis factor-alpha, interleukin [IL]-6, and IL-8) levels, anti-oxidant effects (superoxide dismutase) and histological findings were noted. Results: The use of ciprofloxacin, WSY-1075, and WSY-1075 with ciprofloxacin showed statistically significant decreases in bacterial growth and improvements in the reduction of prostatic inflammation compared with the control group (P&lt;0.05). The WSY-1075 with ciprofloxacin group showed a statistically significant decrease in bacterial growth and improvement in prostatic inflammation compared with the ciprofloxacin group (P &lt;0.05). Conclusions: These results suggest that WSY-1075 may have anti-inflammatory and antimicrobial effects, as well as a synergistic effect with ciprofloxacin. Therefore, we suggest that the combination of WSY-1075 and ciprofloxacin may be effective in treating chronic bacterial prostatitis to obtain a higher rate of treatment success.

Impact of an electronic tool in prescribing primary prophylaxis with ciprofloxacin or granulocyte colony-stimulating factor for breast cancer patients receiving TC chemotherapy

The US Oncology Trial 9735 (doxorubicin and cyclophosphamide (AC) versus docetaxel and cyclophosphamide (TC)) reported febrile neutropenia (FN) in 5% of patients receiving TC chemotherapy, in the absence of routine primary prophylaxis with granulocyte colony-stimulating factor (G-CSF) or antibiotics. In contrast, higher rates of FNhave been reported in the 'real world' setting. This retrospective study compares the incidence and severity of FN and other TC-related toxicities before and after implementation of a primary prophylaxis computerized prescribing tool. Medical records of 207 patients receiving adjuvant TC between May 1, 2006, and November 1, 2011, were reviewed for toxicity. The incidence for each TC adverse event was measured by an incident rate ratio (IRR), and chi-square analysis was used to compare the differences in severity of TC toxicities before and after use of a primary prophylaxis computerized prescribing tool, and to compare G-CSF and ciprofloxacin groups. The implementation of a computerized prescribing tool significantly increased the proportion of patients prescribed primary prophylaxis (18.2 vs. 97.4%; p<0.001). Prior to the change in practice, the incidence of FN (incidence rate ratio 3.87; 95% CI [1.3, 11.5]) and neutropenia (OR 4.8; 95% CI [2.0, 11.7]) was significantly higher. Primary prophylaxis significantly reduced the rate of febrile neutropenia (20 vs. 5.3%, p=0.003). No significant differences were found in incidence and severity of other TC-related toxicities. Patients who did not receive G-CSF were at a greater risk for neutropenia (OR 5.1, 95% CI [1.06, 24.3]). There were insufficient patients treated with antibiotics alone to compare to those treated with G-CSF. Implementation of a computerized prescribing tool significantly increased the use of primary prophylaxis by treating physicians in patients receiving TC chemotherapy, which was associated with reduced incidence of febrile neutropenia.Further research efforts should focus on the incorporation and routine use of evidence-based practices using tools such as alerts and prompts, in order to optimize patient care and improve outcomes.