Macrolide Group Research Articles

Treatment of Macrolide-resistant Mycoplasma pneumoniae Pneumonia in Children: A Meta-analysis of Macrolides Versus Tetracyclines.

The global prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia infections, particularly in children, is on the rise. It is imperative to assess the clinical efficacies of alternative antibiotics such as tetracyclines to ensure effective treatment, mitigate antibiotic resistance, enhance clinical outcomes, and minimize the spread of resistant strains among MRMP-infected children. The objective of this study was to compare the therapeutic efficacies of macrolides and tetracyclines in treating MRMP pneumonia in children. We systematically searched the literature to identify comparative studies that examined the clinical outcomes of macrolide and tetracycline antibiotics in children with MRMP pneumonia. We conducted a meta-analysis of the mean duration of fever, hospital stay duration, therapeutic efficacies, and time to defervescence to compare macrolides and tetracyclines. Eleven studies involving 1143 patients compared the clinical efficacies of macrolides and tetracyclines in children with MRMP pneumonia. The studies were conducted in China, Japan, and Korea, and the outcomes of febrile days, hospital stay duration, therapeutic efficacy, and time to defervescence were analyzed. The macrolides studied were azithromycin and clarithromycin, whereas the tetracyclines included minocycline and doxycycline. The pooled estimate of 5 studies showed that the mean duration of febrile days and hospital stay was longer in the macrolides group than tetracycline group [weighted mean difference = 1.64 days, 95% confidence interval (CI): 0.68-2.59, weighted mean difference = 1.22 days, 95% CI: 0.82-1.62, respectively]. The therapeutic efficacy was significantly lower in the macrolide group than in the tetracycline group (odds ratio: 0.33, 95% CI: 0.20-0.57). The clinical efficacy of tetracycline treatment was superior to that of macrolide treatment in children with MRMP pneumonia. However, further research is required to validate these findings and inform evidence-based clinical practice guidelines.

Phenotypic Analysis and Antibiogram of Oral Infections-Causing Bacteria Isolated from Dental Patients

Oral infections are commonly observed in individuals and frequently result in enduring inflammatory states that impact the teeth, such as caries, the gingival tissues surrounding the teeth, including gingivitis and endodontic lesions, as well as the structures that provide support to the teeth, such as periodontitis. A total of 100 clinical samples were collected from patients with various oral infections. The individuals in the study encompassed a wide range of ages, ranged from 9 to 70 years, over the timeframe between October 2023 and December 2023. Fifty pathogenic bacterial strains were obtained from specimens of clinical origin, with the genus Streptococcus accounting for 27 of these isolates, representing 54% of the total, the highest proportion observed among all specie. The specimens were identified through the examination of cultural and microscopic features, in addition to being confirmed using the Vitek2 system for species-level diagnosis. The multidrug-resistant isolates exhibited resistance to various antibiotics including Erythromycin (100%) classified under the Macrolide group, Cefotaxime (100%), Cefepime (100%), Ceftriaxone (100%), and Penicillin (96.29%) which falls under the βeta-Lactam category. Additionally, resistance was also observed against Clindamycin (92.59%) which is categorized as a Lincosamide antibiotic. In the susceptibility testing of antibiotics, Augmentin demonstrated the highest level of activity among the tested molecules, thereby affirming its overall efficacy against oral streptococci. Additionally, Trimethoprimsulfamethoxazole and Ampicillin exhibited favorable activity, while Vancomycin also demonstrated effectiveness against oral streptococci.

Transfer of Some Macrolide Group Antibiotics from Spiked Milk to Melting Cheese and Determination of Their Processing Factor with LC–MS/MS

Transfer of Some Macrolide Group Antibiotics from Spiked Milk to Melting Cheese and Determination of Their Processing Factor with LC–MS/MS

Unveiling Resistance and Virulence Mechanisms under Darwinian Positive Selection for Novel Drug Discovery for Gardnerella vaginalis

Gardnerella vaginalis is a Gram-variable bacillus capable of causing bacterial vaginosis, a condition prevalent in reproductive-age women, this bacterium is present in almost 100% of cases and is also considered a gateway to various sexually transmitted infections. This organism exhibits high pathogenicity linked to virulence and resistance genes acquired throughout evolution, showcasing elevated resistance to a broad spectrum of drug classes. This study conducted comparative genomic analyses to identify these genes and correlate their presence with positive Darwinian selection. Additionally, new drug targets were selected through docking and molecular modeling, guided by the heightened antimicrobial resistance exhibited by this microbial species. The available genomes of G. vaginalis were analyzed, and the orthologous genes were delineated and positively selected, whereby 29 groups were found. Of these genes, one of great importance was predicted, Mef(A), which is related to resistance to the macrolide group of antibiotics, which are one of the main choices for the treatment of sexually transmitted infections. Additionally, two potential protein candidates were selected as drug targets. These proteins were linked with a natural compound each and are considered good potential drug targets. The analyses in this study contribute to analyzing the evolution of the species and how resistance genes are related to their permanence as a potential pathogen.

Occurrence, Fate, and Removal of Selected Antibiotics in Advanced Biological Urban Wastewater Treatment Plant

Wastewater treatment plants (WWTPs) are considered as one of the most important point sources for releasing antibiotics into the natural environment. In this study, the occurrence, fate, and removal of three antibiotics, ciprofloxacin (CIP), sulfamethoxazole (SMX), and azithromycin (AZI), belong to quinolone, sulfonamide, and macrolide groups, respectively were investigated seasonally in a large-scale urban WWTP. While the occurrence concentrations of the investigated antibiotics in raw wastewater were found between about 0.26 and 0.73 μg/L in the summer season, it was determined in the range of approximately 0.41 and 4.6 μg/L in the winter season. Although the removal efficiencies obtained for antibiotics in the pre-treatment stage of the studied advanced biological WWTP were not very high, the most treated compound in the pre-treatment stage was determined as CIP (up to 23.8%). Total removal efficiencies of the investigated antibiotics in the WWTP varied mainly based on the biological treatment stage of the WWTP. At the same time, removal efficiencies of the antibiotics obtained in the biological treatment also changed considerably depending on the seasons. Among all the investigated antibiotic compounds, it was determined that AZI was the compound that was least affected by the seasons in terms of the total removal efficiency obtained in WWTP. According to the annual average total removal efficiencies, it was determined that SMX (25.7%), CIP (71.3%), and AZI (89.2%) were treated poorly, moderately, and highly in WWTP, respectively. However, advanced biological WWTP was determined to be insufficient for the complete removal of total antibiotics.

Determination of antimicrobial susceptibility and virulence-related genes of Trueperella pyogenes strains isolated from various clinical specimens in animals

In this study, a total of 32 Trueperella pyogenes strains isolated from different disease specimens in cattle, sheep and goats were examined. Antimicrobial susceptibility of the isolates to 10 antimicrobials were determined using the E-test method and MIC values of the antimicrobials were investigated. The genes that play a role in the antimicrobial resistance or virulence of T. pyogenes were determined by PCR using gene specific primers. In the study, all the isolates were susceptible to penicillin and cephalosporin. The highest resistance rate in the isolates was determined against streptomycin (56.25%) and tetracycline (53.12%) and MIC90 values for these antimicrobials were found to be >256 μg/ml and 12 μg/ml, respectively. The ermX gene was found to be positive in 8 (80%) of 10 isolates that were resistant to macrolide group antimicrobials. Among 20 aminoglycoside resistant isolates, aadA1, aadA9, strA-strB, and aac(6’)-aph(2’’) genes were determined in 5 (25%), 14 (70%), 7 (35%) and 1 (5%) of the isolates, respectively. When the presence of virulence-related genes in the isolates was examined, nanP (93.75%), fimA (93.75%) and plo (90.62%) genes were detected in the majority of the isolates. While the cbpA gene was negative in all isolates, the fimG gene was found in a limited number of the isolates (15.62%). It was concluded that streptomycin and tetracycline resistance should be considered in T. pyogenes isolates. Also, nanP, fimA and plo genes may have an important role in the pathogenesis of the infections.

Risk of Mortality and Cardiovascular Events in Patients with Chronic Obstructive Pulmonary Disease Treated with Azithromycin, Roxithromycin, Clarithromycin, and Amoxicillin.

Background: Prior research has raised concerns regarding the use of macrolides and their association with an increased risk of cardiovascular events. Methods: We conducted a cohort study, where we explored the cardiovascular risks associated with the treatment of COPD patients using macrolide antibiotics-namely azithromycin, clarithromycin, and roxithromycin-with amoxicillin serving as a reference. The study focused on COPD patients in an outpatient setting and included a thorough 3-year follow-up. Patients were categorized into four groups based on their treatment. The primary analysis utilized an adjusted Cox model, supplemented by sensitivity analysis through inverse probability of treatment weighting. Results: No significant differences were found in major adverse cardiovascular events (MACE-stroke, acute myocardial infarction, cardiovascular death) between the macrolide groups, and the amoxicillin/hazard ratios (HR) were azithromycin HR = 1.01, clarithromycin HR = 0.99, and roxithromycin HR = 1.02. Similarly, sensitivity analysis showed no disparities in all-cause mortality and cardiovascular death among the groups. Conclusions: Overall, the study revealed no evidence of increased risk of MACE, all-cause mortality, or cardiovascular death in COPD patients treated with these macrolides compared to amoxicillin over a 3-year period.

A Novel Approach for Single-Step Analyte Fractionation of Raw Milk Prior to Antibiotic Residue Trace Analysis as an Alternative to QuEchERS-Based Extraction.

Antibiotic residues in milk are a well-known hazard in the dairy food chain. Detection methods for these residues, such as nonspecific microbiological inhibitor tests or group-specific receptor tests, are relatively inexpensive, easy to use, and widely applied to ensure food safety. In contrast, specific detection by liquid chromatography-tandem mass spectrometry (LC-MS/MS)-although a critical, complimentary method to confirm the results of nonspecific testing-is relatively costly, time-consuming, and laborious. Furthermore, sample processing before LC-MS/MS analysis requires unique preparation procedures for different groups of antibiotic compounds. To simplify and speed up specific antibiotic residue detection, a low-cost, passive, and single-step method to fractionate analytes in raw milk was developed. Untreated raw milk was fractionated into its water and fat/protein phases using a Fractionation of Milk for Trace Analysis of Contaminants and Residues for Antibiotics (FraMiTrACR® AB) fractionation unit. The water fraction was then analyzed by LC-MS/MS. The analyte fractionation method was evaluated against a Quick Easy Cheap Effective Rugged and Safe (QuEChERS)-based method for sample preparation. Our method allows qualitative and quantitative detection of substances from the penicillin, cephalosporin, macrolide, lincosamide, sulfonamide, tetracycline, and fluoroquinolone groups of antibiotics. Detection limits are below the legally prescribed maximum residue levels, allowing reliable, specific, and rapid validation of a positive result in nonspecific microbiological inhibitor tests. Analyte fractionation by FraMiTrACR AB is a faster alternative to QuEChERS-based sample preparation for the detection of antibiotic substances in milk. This method describes a low-cost, environmentally friendly, passive, and single-step milk analyte fractionation. As an alternative to QuEChERS-based preparation, this fractionation method simplifies and speeds up the process for specific antibiotic residue detection.

Profil Penggunaan Antibiotik untuk Pengobatan Pasien COVID-19 di Salah Satu Rumah Sakit Kota Bitung

Background: The overuse and misuse of antibiotics during the COVID-19 pandemic is one of the biggest concern that needs attention, considering antimicrobioal resistance has been a major threat to global health. According to WHO, this condition can make the infection difficult to treat, increasing the risk of disease spread and mortality. The significant increase in the number of COVID-19 cases in North Sulawesi and the excessive use of antibiotics in COVID-19 patients, shows that research that aims to describe the use of antibiotics in COVID-19 is needed as an early detection of irrational use of antibiotics.Methods: This study was carried out in one of the COVID-19 Referral Hospital in the city of Bitung. The data of this study was collected by purposive sampling and conducted retrospectively. Sources of secondary data is from the patient medical records and patient treatment records. In this study 148 samples that meet the inclusion criteria are used. The inclusion criteria is hospitalized patients which is confirmed with COVID-19 during the period of July-December 2021, received antibiotic therapy during the treatment period, and medical record data.Result: The result shows that the mostly used antibiotics for COVID-19 theraphy are Azithromycin tablets 47.97% from the macrolide groups; Ceftriaxone injection 20.32% and Cefixime tablets 16.67% from the cephalosporin groups; and Levofloxacin infusion 8.94% from the fluoroquinolones group.Conclusion : Patients at the productive age is most likely to get exposed with COVID-19. The clinical symptoms frequently occur in the mild category (68.92%). The use of antibiotics in COVID-19 patients at one of the COVID-19 Referral Hospitals in Bitung City is in accordance with the 3rd edition of the COVID-19 Management Guidelines, and the mostly used antibiotics is Azithromycin tablets as many as 118 patients (47.97%).

Analytical and antimicrobial study of herbo-mineral formulation Shwasakasari Rasa in selected respiratory micro-organism

Shwasakasari Rasa (SKR) is mentioned in Rasa Yoga Sagar,[1] (part 2) as a remedy of Shwasa & Kaasa Roga. This type of Rasa Aushadhi are more effective against bacteria. These drugs have a multi dimension effect like Broad-spectrum antibiotics. The Rasaushadies mentioned in Ayurvedic Pharmacopoeia should be analysed for physical & chemical properties to confirm purity & safety before administration in human beings. Hence it become obligatory to adopt modern analytical methodology for better understanding and interpretation of physio-chemical changes occurred during the process. SKR was analysed on the following parameter Organoleptic parameter, Physiochemical analysis, Advanced physiochemical analysis. SKR sample was tested for antimicrobial activity against standard strains of Staphylococcus aureus, Klebsiella pneumonia and Streptococcus pneumonia. The prepared Shwasakasari Rasa was studied for their MIC (Minimum Inhibitory Concentration & the zone of inhibition. The prepared drug was compared with Azithromycin (standard drug) of macrolide group to evaluate its antimicrobial efficacy. These tests was conducted in, S.R Labs & Research Centre, Jaipur.

Systematic Review and Meta-analysis: Macrolide in the Treatment of Chronic Rhinosinusitis After Endoscopic Sinus Surgery.

To evaluate the efficacy and safety of macrolide antibiotics therapy in patients with chronic rhinosinusitis (CRS) receiving endoscopic sinus surgery. PubMed, Web of Science, Embase, and Cochrane Library. The electronic databases were comprehensively searched on June 2, 2022, for randomized controlled trials on macrolide antibiotics in the treatment of patients undergoing CRS endoscopic surgery. The primary outcome measures were the sinonasal outcome test (SNOT) score and the visual analog scale (VAS) score. The secondary outcome measures were the nasal endoscopy score (NES), the sinus computed tomography score, and adverse events. A total of 8 studies were included, involving 606 patients who used macrolide for a long time. Meta-analysis showed that no significant difference was observed in SNOT (standardized mean difference [SMD] = -0.13; 95% confidence interval [CI]: -0.38 to 0.13, I2 = 0%) and VAS (SMD = -0.10; 95% CI, -0.88 to 0.68, I2 = 81%) between the macrolide and placebo groups. However, macrolide outperformed the placebo in improving NES (SMD = -0.32; 95% CI, -0.62 to -0.03, I2 = 21%). The use of macrolide did not increase the incidence of adverse events. Long-term use of macrolide after CRS surgery may not significantly improve the quality of life and disease severity of the patients but may play a role in improving postoperative NES in patients with CRS. There is still no sufficient evidence to determine whether the disease phenotype of CRS or the patient's race will affect the efficacy of long-term use of macrolide after CRS.

Effect of antibiotic therapy of genital mycoplasmosis in pregnant cows on cytological and immunological characteristics of vaginal secretions

Purpose: the aim is to study the therapeutic efficacy of the macrolide group antibiotic tulatromycin and its effect on the immunological and cytological characteristics of vaginal secretions.Materials and methods. For the experiment, 2 groups of 8 animals each were formed. The first group - cows without clinical signs of vaginitis with a positive PCR test for Mycoplasma spp.; the second group - clinically healthy cows with a negative PCR test for Mycoplasma spp. The first group of cows, the group for the treatment of genital mycoplasmosis, used the antibiotic traksovet 100 (tulatromycin) at a dose of 2.5 mg per 1 kg of animal body weight, subcutaneously, once 40 days before the expected delivery. Vaginal secretions were collected from both groups of cows, in which the content of Ig G, Ig M, Ig A, sIg A, lysozyme activity and cytological examination of the vaginal smear were determined.Results. The use of tulatromycin in cows with genital mycoplasmosis leads to a decrease in the content of Ig M and sIg A in vaginal secretions, which reach the values of these indicators in healthy animals. A less pronounced positive effect is observed with respect to the activity of the vaginal secretion lysozyme, which, although significantly increased, remains lower than in healthy cows. Cytological examination of vaginal smears against the background of antibiotic therapy showed a significant decrease in the number of epithelium and leukocytes.Conclusion. The use of traksovet 100 antibiotic as etiotropic therapy for cows with genital mycoplasmosis leads to the elimination of the pathogen from the vaginal mucosa in 75 % of sick animals and provides partial restoration of cytological and immunological characteristics of vaginal secretions.

Dynamics of the content of immunoglobulins in the blood serum and vaginal secretion of cows with genital mycoplasmosis during treatment with tulathromycin

An important task of industrial animal husbandry is to maintain the reproductive health of female animals. Indolent diseases of the reproductive system remain a big problem. Little information is available on the immunopathogenesis of genital mycoplasmosis. Antibiotic treatment with drugs from tetracycline, macrolide or fluoroquinolone groups is the main approach to treatment of mycoplasmosis. The aim of the present work was to study the dynamics of immunoglobulin contents in blood serum and vaginal secretions of cows with genital mycoplasmosis during therapy with tulathromycin, a semi-synthetic macrolide antibiotic drug.
 We studied two groups of cows at their interlactation period (n = 8), aged 3-4 years. Control group consisted of clinically healthy cows. The cows from experimental group had confirmed genital mycoplasmosis. They were treated with Traxovet 100 antibiotic (tulathromycin) at a dose of 2.5 mg per 1 kg of animal body weight, by subcutaneous route, 40 days before the expected delivery. Blood serum and vaginal secretions were collected in both groups of animals. The contents of IgG, IgM, IgA immunoglobulins, and sIgA in the vaginal secretion were determined by radial immunodiffusion (Mancini technique).
 On the 14th day of the experiment, a significant increase in the IgG contents and decreased levels of IgM and IgA were observed in the blood of the cows from experimental group. However, these indexes still remained lower than in healthy cows. In vaginal secretions, a significant decrease in the IgM and sIgA amounts was detected. The immunoglobulin levels in vaginal secretions after antibiotic therapy did not differ from the healthy cows.
 The use of tulathromycin for treatment of genital mycoplasmosis in pregnant cows shows high therapeutic efficacy, but does not lead to a complete normalization of their immunoglobulin status.

Antimicrobial susceptibility of Rhodococcus equi strains isolated from foals in Chile

Rhodococcus equi is responsible for foal pneumonia worldwide, with a significant economic impact on the production and breeding of horses. In Chile, the first case was reported in 2000, and since then, its incidence has been increasing. Distinctive characteristics of R. equi as an intracellular pathogen in macrophages, emergence of virulence plasmids encoding surface lipoprotein antigens, and appearance of antibiotic resistance against macrolides and rifampicin have significantly complicated the treatment of R. equi pneumonia in foals. Therefore, in vitro susceptibility studies of first-line and newer antibiotics against R. equi are the first step to establishing effective treatments and optimizing new therapeutic options. The aim of the present study is to determine the susceptibility profile of fourteen strains of R. equi isolated from foals in Chile to several antibiotics of the macrolide group including azithromycin, amikacin, tildipirosin and gamithromycin as well as others such as rifampicin, doxycycline and ceftiofur. Identification of R. equi in collected isolates from foals in Chile has been performed by CAMP test and PCR based on detecting of the gene encoding the 16 S rRNA. The presence of genes encoding virulence plasmids was also determined using PCR. Results obtained have demonstrated presence of virulent R. equi strains in Chile. In vitro susceptibility pattern to different antibiotics has shown better results for doxycycline and rifampicin similar to previous studies performed. Current macrolides have been evaluated in order to consider alternative treatment options in a context of emerging resistance to classic macrolides and rifampicin, obtaining better results with gamithromycin (MIC range of 0.125 to 128 mg/ml) than with tildipirosin (MIC range of 16 to 128 mg/ml). An adequate diagnosis of bacterial susceptibility based on antibiograms is necessary to treat the Rhodococcus equi infection in foals.

Systemic antibiotic treatment for meibomian gland dysfunction-A systematic review and meta-analysis.

To review the efficacy and safety of oral doxycycline antibiotics versus macrolides in the treatment of meibomian gland dysfunction (MGD). Systematic review and meta-analysis. We performed a systematic search of electronic databases for all peer-reviewed published studies which included clinical outcomes of oral antibiotic MGD treatment. Individual study data were extracted and evaluated in a weighted pooled analysis, including total sign and symptom scores, meibomian gland secretion score, tear break-up time (TBUT), fluorescein staining score and rate of complications. Two thousand nine hundred and thirty-three studies were found, of which 54 were eligible for the systematic review, and six prospective studies were ultimately included for analysis, reporting on 563 cases from three countries. Age of affected patients ranged between 12 and 90 years. Overall, both treatment methods induced improvement in MGD signs and symptoms. In pooled analysis, macrolides were significantly superior in the total signs score (pooled standardized mean difference (SMD) -0.51, 95% confidence interval (CI): -0.99 to -0.03), meibomian gland secretion score (pooled SMD -0.25, 95%CI: [-0.48, -0.03]), TBUT (SMD -0.31, 95%CI: [-0.50, -0.13]) and fluorescein staining score (SMD -1.01, 95%CI: [-1.72, -0.29]). Moreover, while no severe complications were reported for both treatments, the macrolide group exhibited significantly less adverse events (pooled odds ratio 0.24 with a 95% CI of 0.16 to 0.34). Both macrolides and tetracyclines are effective treatments for MGD. In this study, macrolides exhibited better efficacy and safety profile compared to tetracyclines.

Antibiotic pollution of the Yellow River in China and its relationship with dissolved organic matter: Distribution and Source identification

Understanding the sources of antibiotics is important for managing antibiotic contamination and preventing environmental risks in the aquatic environment. In this study, the distribution of dissolved organic matter (DOM) and 24 antibiotics from four typical classes (quinolones, macrolides, sulfonamides and tetracyclines) in the Yellow River basin containing distinct sources of pollution was investigated. In particular, relationships between the antibiotic concentrations and fluorescent properties of DOM were to be established to identify antibiotic sources. A total of 22 antibiotics were detected, with maximum concentrations ranging from 0.27 to 30.14 ng/L in the mainstream of the Yellow River. Of these antibiotics, only erythromycin (ERY) and sulfamethoxazole (SMX) posed potential risks to aquatic organisms. Spatially, tetracyclines were mainly distributed in the upstream reaches of the river, and quinolones were largely distributed in the midstream. High levels of sulfonamides were present downstream of the investigated river. Only EYR belonging to the macrolide group was detected and had a high downstream concentration. EEM-PARAFAC analysis showed that DOM was composed of visible fulvic acid-like fluorescence fraction (C1), ultraviolet fulvic acid-like fluorescence fraction (C2) and protein-like fraction (C3). Using Pearson correlation analysis, this study demonstrated a close relationship between DOM spectral parameters and antibiotic concentrations in the Yellow River basin. Specifically, r (C3, C2) was significantly and positively correlated with the concentrations of SMX, sulfadoxine (SDX), and ERY, while humification index (HIX) had an opposite relationship with these antibiotics. These results suggested that SMX, SDX and ERY were mainly discharged from wastewater treatment plants into the mainstream of the Yellow River. This work provides a powerful demonstration that DOM plays an important role in indicating the occurrence and sources of antibiotics in the aquatic environment.

Investigation of tylosin and tilmicosin residues in meat by high-performance liquid chromatography method.

In this study, the presence and level of macrolide group antibiotics (tylosin and tilmicosin) were analyzed by the High-Performance Liquid Chromatography (HPLC) method in a total of 126 raw meat samples, including 42 chicken breast and 84 beef neck, available for consumption in the Burdur province (Turkey). The method demonstrated good linearity (R2 > 0.999) over the assayed concentration range (0.10-10 μg/mL). Intra-day and inter-day recoveries were used to express the accuracy of the method at three different levels of 0.5, 1, 2.5 μg/mL. Intraday recoveries and relative standard deviation values ranged from 97.270 (0.054)% to 98.643 (0.061)%, and inter-day recoveries and relative standard deviation values ranged from 97.057 (0.070)% to 98.197(0.042)% for tylosin. Intraday recoveries and relative standard deviation values ranged from 96.360 (0.065)% to 98.153 (0.046)%, and inter-day recoveries and relative standard deviation values ranged from 96.050 (0.058)% to 97.053 (0.096)% for tilmicosin. The limit of detection (LOD) value was calculated as 0.473 μg/kg for tylosin, and 0.481 μg/kg for tilmicosin; the limit of quantification (LOQ) value was calculated as 1.561 μg/kg for tylosin, and 1.587 μg/kg for tilmicosin. In general, tylosin and tilmicosin were determined in the range of 8-256 μg/kg and 30-447 μg/kg, respectively, in chicken breast meat samples; also, they were detected in the range of 36-1209 μg/kg and 30-1102 μg/kg, respectively, in beef neck meat samples. It was also found that the residues of tylosin and tilmicosin in chicken and beef meats from the market were at a much higher level than the acceptable limits specified in the regulations. This creates serious problems in terms of the ecosystem, food technology, and public health, and causes significant economic losses.

Granulomatous perioral dermatitis

Parents of patient S., born in 2018 applied with complaints of rashes on the skin of her daughter's face, accompanied by itching for a year. Topically used cream methylprednisolone aceponate and methylene blue. Objectively: the pathological process was widespread, localized on the skin of the face. On the skin of the face, congestive hyperemia, multiple miliary pustules, vesicles, already opened in places, covered with serous crusts, multiple pink papules were visualized periorally. When conducting a histological examination of the affected area of the skin of the face, characteristic signs for granulomatous dermatitis were revealed: in the follicles, foci of necrosis, macrophages with an admixture of neutrophilic leukocytes, single eosinophils and giant multinucleated cells. In the deep layers of the dermis, rough, unevenly thickened and in places multidirectional bundles of collagen fibers with signs of necrosis and the presence of giant cell granulomas, as well as numerous giant cell granulomas without necrosis, exocytosis of lymphocytes, which is characteristic of granulomatous dermatitis, were determined. The diagnosis was made: Perioral dermatitis, granulomatous form. We were prescribed a long-term oral administration of an antibiotic of the macrolide group, externally calcineurin blockers, emollients and ointments containing zinc. On the background of the ongoing treatment, the rash resolved. There was a stable remission.

Effect of medical treatment on eradication of biofilms in chronic rhinosinusitis

Background: Long-term macrolides and intranasal corticosteroids have evidence-based recommendations. It has been reported that macrolide therapy caused objective and subjective improvements which correlated to the duration of therapy. Topical nasal steroids are the mainstay of treatment in CRS. It is proposed that intranasal steroid may increase the restoration of normal epithelium. Methods: Sample size of 24 in each group is sufficient to detect the difference between positivity rate with 80% power and 5% level of significance clinically diagnosed cases of CRS with nasal polyps in age group of 18-60 years were taken. Outcome was measured with multiple scoring systems like SNOT-20, CT scoring, endoscopic scoring system. Results: Significant improvement was seen in the SNOT-20 scores with p value of 0.011 and endoscopic scores with p value of 0.001 in group having macrolides along with steroids pre-operatively however the scores post-surgery didn’t show any significant change in both groups. The efficacy of macrolide with nasal steroidal spray or nasal spray alone showed no further benefit in the subjective outcome measures post operatively. Also, no statistically significant eradication of biofilms or decrease in density could be appreciated in both groups. Furthermore, there was no significant difference in recurrence rate. Conclusions: Our result demonstrated the subjective improvement in patients of macrolide group post treatment which could be attributed to its anti-inflammatory effect. Even though macrolides in combination with nasal spray reflected some improvement in the secondary outcomes but the primary outcome of eradication of biofilms couldn’t be achieved.

Применение метода глобальных триггеров для выявления нежелательных лекарственных реакций у пациентов стационара инфекционного профиля

The widespread use of macrolide antibiotics in clinical practice emphasizes the need to address issues related to their safety and the possible development of adverse drug reactions (ADRs). One of the common methods of identifying ADRs through retrospective analysis of medical records is the global trigger tool (GTT) proposed in 2003. Objective. Study aimed to conduct a retrospective analysis of medical records of patients of the infectious hospital for the detection of triggers of ADRs. Material and methods. A retrospective study of medical records of 150 patients who were treated at the Infectious Clinical Hospital No.1 in 2020-2022, using the GTT was carried out. The selection of medical records to search for the triggers was performed by random sampling from the records with established diagnoses of lower respiratory tract infections (bronchitis, pneumonia) and upper respiratory tract infections (sinusitis, tonsillitis). Results. After an analysis of 150 case histories, 36 triggers and 22 cases of ADRs were identified by two independent investigators. It was found that the most frequently used antibiotic from the macrolide group was azithromycin, which was prescribed in 131 cases (87.3%). In the remaining 19 patients, erythromycin was prescribed (12.7%). Discussion. All of the identified ADRs were classified as having been temporarily detrimental to the patients’ health. Most of the detected ADRs occurred during the use of standard treatment regimens and were not preventable. Conclusion. It was found that the application of GTT in clinical practice will allow to identify implicit adverse events and simplify their search in general.