Microbiological Efficacy Research Articles

Clinical and microbiological efficacy of various methods of tonsillectomy

Introduction. There is an abundance of various methods of surgical treatment in the world, which include: classical tonsillectomy (TE), shaver TE, unipolar and bipolar bilateral TE, laser TE, palatine tonsil coblation, etc. However, there is still a risk of recurrence of chronic tonsillitis after TE there is a need for a study in the late postoperative period.Purpose of the study. Improving the efficiency of surgical treatment of patients with chronic tonsillitis based on the analysis of five main methods of surgical treatment of chronic tonsillitis according to clinical and laboratory criteria.Materials and methods. Patients were divided into 5 study groups depending on the method of tonsillectomy: The first group consisted of 60 patients after classical tonsillectomy. In the second group there were 55 patients after palatine tonsil coblation. The third group included 48 patients after laser tonsillectomy. The fourth group consisted of 64 patients after tonsillectomy using the surgitron apparatus. The fifth group consisted of 58 patients after microdebrider tonsillectomy.Results. By analysis, it was found that the best results were obtained in patients of the 1st group, who underwent classical tonsillectomy. In this group, there are fewer cases of subjective and objective clinical symptoms (sore throat, signs of subatrophic pharyngitis, hypertrophy of the lateral folds of the pharynx, remnants of the lymphoid tissue of the palatine tonsils, as well as postoperative cicatricial changes). In a laboratory study, patients of the 1st group had the lowest values of the indicators (ASL-O titer, CRP and DNase B levels, negative results of the Streptatest).

Tigecycline susceptibility among multi-drug resistant bacteria: A 7-year retrospective study

The emergence and spread of multidrug-resistant bacteria (MDR) are major public health issues worldwide. The objective of this study is to evaluate the microbiological efficacy of tigecycline against multi-drug-resistant bacteria and to explore its potential place in clinical practice. A retrospective study was carried out over 7 years, from January 2015 to December 2021, at the Avicenne Military Hospital. Were collected all bacteriological samples received for diagnostic purposes at the microbiology laboratory. Tigecycline susceptibility was tested among 846 isolates among the 4293 isolates during the study period. The overall frequency of MDR bacteria was of 14,3%. 60% of the MDR bacteria isolated were susceptible, 35% were declared resistant and 5% were declared intermediate. Co-resistance levels in MDR bacteria are high. Tigecycline remained active in vitro on most of the MDR bacteria tested. The susceptibility rates for tigecycline found were respectively 76%, 57%, and 34%, for the ESBL Enterobacteriaceae strains, the CPEs, and the multi-drug resistant Acinetobacter baumanii strains. In this study, the MDR bacteria isolated showed overall satisfying susceptibility rates to tigecycline.

РЕЗУЛЬТАТЫ ПРИМЕНЕНИЯ КОМБИНИРОВАННОЙ ПРОБИОТИЧЕСКОЙ ТЕРАПИИ ДЛЯ КОРРЕКЦИИ НАРУШЕНИЙ МИКРОБИОЦЕНОЗА КИШЕЧНИКА БОЛЬНЫХ ТУБЕРКУЛЕЗОМ С МНОЖЕСТВЕННОЙ ЛЕКАРСТВЕННОЙ УСТОЙ- ЧИВОСТЬЮ ВОЗБУДИТЕЛЯ

Introduction. About 90% of TB patients have side effects of anti-TB therapy in the form of gastrointestinal disorders. Currently, the role of disorders of the intestinal microbiocenosis in the formation of dyspepsia has been proven. In turn, dyspeptic syndrome leads to a decrease in patient adherence to treatment, which affects the effectiveness of tuberculosis treatment. The most dangerous in this regard are second-line anti-tuberculosis drugs used in the treatment of drug-resistant tuberculosis. Long-term use of these drugs requires the development and implementation of algorithms for the correction of microecological disorders of the intestine. The aim of the study was to evaluate the microbiological results of using a combined probiotic in persons with tuberculosis and multidrug-resistant pathogen in the course of anti-tuberculosis therapy. Material and methods. A prospective linear study included 30 patients with respiratory tuberculosis and multidrug-resistant pathogen. The study consisted in a two-stage study of the microbiocenosis of the intestinal biotope of these patients by a quantitative bacteriological method before and after combined probiotic therapy with a further comparison of the number of microorganisms. Statistical data processing was performed using the IBM SPSS program. Qualitative signs are represented by absolute and relative frequencies, expressed as a percentage, with 95% confidence intervals calculated for them by the Wilson method (rel.% [95% CI]). Quantitative data are presented in the work in the format of the median and interquartile range (Me (25th; 75th). For variables related to the ordinal scale and nonparametric quantitative variables, the Mann-Whitney U test was used to compare the two groups of observations. the compared groups were considered statistically significant with a statistical significance of less than 0.05. Results and discussion. The use of combined probiotic therapy in patients with multidrug-resistant tuberculosis did not compensate for the deficiency of obligate microorganisms - Bifidobacterium spp., Lactobacillus spp. However, in the process of probiotic therapy noted a decrease in the concentration of Enterococcus spp., E. Coli lac-, E. Coli hly +, Streptococcus spp., as well as a decrease in the titers and species structure of fungi of the genus Candida. A clinical example showing the microbiological and clinical efficacy of probiotic therapy in a patient with co-infection TB / HIV. Despite the changes received, the average population indicators for the region have not been achieved. Conclusion. It was found that the use of combined probiotic therapy in patients with multidrug-resistant tuberculosis led to a decrease in the pool of opportunistic microorganisms in the intestinal lumen and had a positive clinical effect in a patient with TB / HIV co-infection.

Subgingival application of 0.5% Azithromycin gel as a local drug delivery system as an adjunct to scaling and root planing in controlled diabetic patients- An in vivo study

Introduction: A recent trend involving the use of local delivery systems to deliver chemotherapeutic agents implies improved periodontal health. As part of this study, a locally delivered 0.5% azithromycin gel was evaluated for its clinical and microbiological efficacy in treating chronic periodontitis patients with controlled diabetes.
 Material and Methods: The split-mouth study design was used in this randomized control trial. The study included 50 sites from 25 patients who had pocket depths greater than 5 mm and were diagnosed with chronic periodontitis. Two treatment groups were randomly assigned: scaling and root planing only (control group) or scaling and root planing with 0.5% azithromycin gel (test group). At selected sites, gingival index, probing pocket depth, and clinical attachment level were analyzed for both groups at baseline, 6 weeks, and 12 weeks.
 Result & observations: Both the test and control groups had improved parameters when compared to baseline. The depth of the probing pocket was 6.64±1.07 mm and 7.36±1.15 mm at baseline, which decreased to 4.84±0.59 mm and 4.32±0.98 mm respectively at 12 weeks. The difference was statistically significant at p<0.001. Statistically significant difference in clinical attachment levels between baseline and 12 weeks, at p<0.001. The results of all microbiological categories improved significantly in both groups, while the test group showed a greater improvement.
 Conclusion: It was concluded that locally delivered azithromycin could be beneficial in treating chronic periodontitis patients with diabetes when used in conjunction with scaling and root planing.
 Keywords: Local drug delivery, Periodontal disease, Diabetes, Azithromycin gel.

What should be considered when choosing a drug for local therapy of nonspecific vaginitis and bacterial vaginosis

Vaginal infections are highly spread among the female population and they impact the woman’s organism, fetal development and child health. They remain an important medical and social problem, so the optimizing the treatment is very important. The article is a review of the modern domestic and foreign publications about the etiological factors, pathogenesis, and local pharmacotherapy of nonspecific and candidiasis vaginitis and bacterial vaginosis, including their manifestation during pregnancy. The issues of vaginal infections in non-pregnant and pregnant women, the main risk factors for their development, the range of pathogens of infectious lesions of the vagina, which are the most common - bacterial vaginosis (G. vaginalis and A. vaginae), nonspecific vaginitis (Streptococcus spp., S. aureus, coagulase-negative staphylococci, E. coli, etc.), candidiasis vaginitis (C. albicans and C. non-albicans), and the importance of changes in the composition of the vaginal microbiome in the development of these diseases are demonstrated. Based on the data from scientific publications, the article presents the analysis of the sensitivity of pathogenic flora to anti-infective methods. The attention is drawn to the risks of nonspecific and candidiasis vaginitis and bacterial vaginosis during pregnancy (miscarriage and premature birth, placental insufficiency, etc.), the advantages and disadvantages of systemic and local therapy for these diseases, the comparative characteristics of individual drugs for topical therapy are given, taking into account the composition and pharmacodynamics of their components.The clinical and pharmaceutical benefits of a complex preparation that includes ternidazole, neomycin sulfate, nystatin and prednisolone sodium metasulfobenzoate and has the bactericidal (including antianaerobic), fungicidal, antiprotozoal, and anti-inflammatory effects have been analyzed. Data on the microbiological and clinical efficacy of the drug, its storage effect on the vaginal microbiome, and features of innovative technology for the manufacture of its dosage form are presented.

Observation of clinical efficacy of the cefoperazone/sulbactam anti‐infective regimen in the treatment of multidrug‐resistant Acinetobacter baumannii lung infection

Sulbactam and sulbactam-containing β-lactam antibiotics are often used in the treatment of Acinetobacterbaumannii. We aimed to further examine the clinical efficacy of a cefoperazone/sulbactam anti-infective regimen in multidrug-resistant A.baumannii (MDRAB) lung infections. We conducted a retrospective analysis among patients with MDRAB lung infection and complete data who were treated at the geriatric intensive care unit of Jiangsu Province Hospital from January 2018 to December 2020. We collected general information, including age, sex, APACHE II score, anti-infective course, comorbid infections in other sites, other pathogens, cefoperazone/sulbactam regimen and concomitant medications, and adverse reactions. We used microbiological changes before and after treatment to assess microbiological efficacy, defined as microbial eradication and reduction. 121 patients were included, among which 96 (79.34%) were men and 25 (20.66%) were women. The median age was 76 (interquartile range [IQR] 62.5-83) years, median APACHE II score was 22 (IQR 19-26), and median treatment course was 8 (IQR 5-12.5) days. Among these patients, tigecycline was concomitantly used in 52 patients and the sulbactam dose was increased to 4g and above in 27 patients. The microbiological efficacy of conventional cefoperazone/sulbactam with/without tigecycline in MDRAB decreased with each consecutive year and a reduction in efficacy was linearly correlated with year, which was both statistically significant (p=0.039, 0.030, respectively). In 2020, the microbiological efficacy of a higher sulbactam dose combined with tigecycline was 75%, which was a significant improvement over the conventional dose (p=0.028). The 3-year data showed that the microbiological efficacy of conventional cefoperazone/sulbactam 3g eight hourly (q8h) without tigecycline was 32% and efficacy increased to 57.9% when the sulbactam dose was increased. Hence, the increased sulbactam dose significantly improved efficacy in MDRAB lung infection (p=0.049). Different doses of sulbactam combined with tigecycline increased the microbiological efficacy of MDRAB but the differences were not statistically significant. A cefoperazone/sulbactam-based anti-infective regimen showed some efficacy in MDRAB lung infection, but the microbiological efficacy of a cefoperazone/sulbactam 3g q8h regimen decreased over time. Increasing the sulbactam dose to 4g or more can improve efficacy. Minimum inhibitory concentration (MIC)-guided personalized medicine may be a future research direction.

The efficacy of activated zinc pyrithione in the treatment of IgE-independent atopic dermatitis in children

Introduction. Colonization of the skin with S. aureus and S. epidermidis in children with atopic dermatitis leads to the initiation of inflammation and worsening of the disease. The control of overcolonization with S. aureus is an important issue in pediatric dermatological practice. At the same time, to achieve a controlled level of colonization, it is preferable to prescribe non-steroidal external agents. Activated zinc pyrithione has a wide range of complementary pharmacodynamic effects, including anti-inflammatory, pro-apoptogenic, antimicrobial, and antifungal. The article presents the results of the use of zinc pyrithione in mild IgE-independent atopic dermatitis in children. The results of the main clinical studies confirming the effect of zinc pyrithione on the microbiome in AD and the severity of the disease were analyzed.Aim. To evaluate the therapeutic and microbiological efficacy of activated zinc pyrithione as monotherapy in patients with IgEindependent atopic dermatitis.Materials and methods. 30 patients aged 2 to 8 years with mild atopic dermatitis in the acute stage were divided into 2 groups. Group 1 received activated zinc pyrithione, group 2 received a combined topical steroid.Results. Both groups showed a significant reduction in S. aureus skin colonization. In both groups, in comparison with the initial state, a significant decrease in the severity of clinical manifestations of AD was obtained. The therapeutic efficacy of zinc pyrithione was 93.3%, clinical remission was observed in 73.3% of cases.Conclusion. The totality of currently available data on the clinical efficacy and safety of activated zinc pyrithione allows us to recommend it as one of the effective agents for external therapy of mild IgE-independent atopic dermatitis. The use of activated zinc pyrithione showed a rapid, pronounced positive result of treatment, a decrease in the risk of secondary infection in observed children with IgE-independent atopic dermatitis.

Polymyxin B-Based Regimens for Patients Infected with Carbapenem-Resistant Gram-Negative Bacteria: Clinical and Microbiological Efficacy, Mortality, and Safety.

BackgroundThe increasing prevalence of carbapenem-resistant Gram-negative bacteria (CR-GNB) represents a global healthcare crisis. This study explored the efficacy and safety of Polymyxin B (PMB)-based regimens and factors influencing their effectiveness.MethodsPatients with CR-GNB infections treated with PMB for more than three days were enrolled in this retrospective study from 1st June 2018 to 30th April 2020. Data were collected on patient characteristics, bacterial culture, and drug-sensitivity test results; anti-infection treatment regimens, particularly details of PMB use; and adverse drug reactions. Clinical and microbiological efficacy, mortality, and safety of PMB-based regimens in CR-GNB infected patients were evaluated. Univariate analysis and multivariate logistic regression analyses were used to assess factors influencing efficacy and mortality.ResultsA total of 373 CR-GNB strains were cultured from 268 patients. About 41.04% of patients used PMB loading dose of 1.01 (0.84–1.69) mg/kg. Maintenance dose was 0.85 (0.82–1.00) mg/kg q12h. The clinical efficacy rate was 36.57% (98/268), the total bacterial clearance rate of PMB was 39.42%, and the all-cause mortality rate was 33.96%. The adverse drug reaction rate was 19.58%, among which the incidence of renal toxicity was highest (8.21%). Multivariate logistic regression analysis showed that clinical efficacy, bacterial clearance rate, and all-cause mortality were associated with patient-related facts, including mechanical ventilation use, underlying diseases (such as respiratory disease), the type and site of CR-GNB infection, and PMB administration timing and loading dose.ConclusionPMB is a relatively safe and effective antibiotic drug for treatment of critically ill patients with CR-GNB infection; however, PMB use should be subject to guidelines recommendations for early administration, loading administration, and adequate administration, which could help to improve the clinical efficacy, microbiological efficacy, and mortality.

Clinical and microbiological rationale for the use of a herbal preparation in children with rhinopharyngitis

Introduction. The work includes the results of clinical and microbiological studies that determine the feasibility of using the herbal preparation EPS® 7630 for the treatment of rhinopharyngitis (RF) in children. The introduction provides a brief review of the literature data on the role of the microbial factor and the important contribution of dysbiotic disorders of the URT microflora in the development of the Russian Federation. The porpose of persistent properties of opportunistic microorganisms (UPM) is outlined: the ability to biofilm formation – BPO and inactivation of lysozyme – ALA as dysbiotic markers of RF, which create conditions for relapses and chronicity of the disease, reduce the effectiveness of antimicrobial therapy. Goal.The aim of the work was the clinical and microbiological substantiation of the effectiveness of using EPS® 7630 in the treatment of RF in children.Materials and methods. The study involved 79 children aged 3 to 15 years. 1st group – 43 children who received treatment, including, along with traditional treatment, the drug Umckalor EPS® 7630, 2nd group (comparison) – 36 children who did not receive the tested drug. Microbiological examination was carried out by taking swabs from the pharynx and nose before and after treatment; BPO and ALA were determined according to the methods of Bukharin O.V. et al. (1999).Results. Conducted clinical studies have established a reduction in the timing of relief of the main symptoms of RF (cough, rhinitis, sore throat, fever) in children treated with EPS® 7630 compared to the comparison group. Microbiological studies of microorganisms isolated from the nasopharynx of children with RF revealed the ability of EPS® 7630 to suppress bacterial persistence factors (BPO and ALA) by 60% or more from the initial level.Conclusions. The data obtained reveal one of the mechanisms of the antimicrobial action of EPS® 7630, which consists in suppressing the persistent potential of UPM and regulating the effect of the drug on the microbiocenosis of the URT. The clinical and microbiological efficacy of using EPS® 7630 in the treatment of RF in children has been proven.

Omadacycline pharmacokinetics and soft-tissue penetration in diabetic patients with wound infections and healthy volunteers using in vivo microdialysis.

ObjectivesWe assessed the plasma and soft-tissue pharmacokinetic exposure of omadacycline in infected patients with diabetic foot infection (DFI) and healthy volunteers using in vivo microdialysis.MethodsEight patients and six healthy volunteers were enrolled and received an omadacycline IV loading dose (200 mg) followed by two oral doses (300 mg) every 24 h. Microdialysis catheters were placed in the soft tissue near the infected diabetic foot wound (patients) or thigh (healthy volunteers). Plasma and dialysate fluid samples were collected, starting immediately prior to the third dose and continued for 24 h post-dose. Protein binding was determined by ultracentrifugation.ResultsThe mean ± SD omadacycline pharmacokinetic parameters in plasma for infected patients and healthy volunteers were: Cmax, 0.57 ± 0.15 and 1.14 ± 0.26 mg/L; t½, 16.19 ± 5.06 and 25.34 ± 12.92 h; and total omadacycline AUC0–24, 6.27 ± 1.38 and 14.06 ± 3.40 mg·h/L, respectively. The omadacycline mean plasma free fraction was 0.21 and 0.20 for patients and healthy volunteers, corresponding to free plasma AUC0–24 of 1.13 ± 0.37 and 2.78 ± 0.55 mg·h/L, respectively. Omadacycline tissue AUC0–24 was 0.82 ± 0.38 and 1.37 ± 0.48 mg·h/L for patients and volunteers, respectively.ConclusionsThe present study describes the plasma and soft-tissue exposure of omadacycline in patients with DFI and healthy volunteers. Integrating these data with the microbiological, pharmacokinetic/pharmacodynamic and clinical efficacy data is foundational to support clinical assessments of omadacycline efficacy specifically for DFI. This, coupled with the once-daily oral administration, suggests omadacycline could be an advantageous translational therapy for the hospital and outpatient setting.

Assessment of Microbiological Quality and Efficacy of Gbogbonise Epa Ijebu Herbal Remedy on Some Uropathogens

Background: Gbogbonise Epa Ijebu is a commercially sold native concoction in South-West, Nigeria, with the potential of curing many ailments as claimed by the manufacturer and vendors. This study investigated the antimicrobial quality and efficacy of Gbogbonise Epa Ijebu. Materials and Methods: A total of 20 samples of the herbal remedy were purchased from local vendors in Ilishan-Remo Community of Ogun State, Nigeria and were assessed for their microbiological quality using standard microbiological methods. Also, the efficacy of the herbal remedy was tested against some selected uropathogens using the Punch-hole agar diffusion method. Data generated were analyzed using the Instant GraphPad software package and P value <0.05 was considered statistically significant. Results: The outcome of the study shows that half (50%) of the herbal remedy samples examined were sterile, while the other half (50%) were contaminated with a microbial count of <10 CFU/mL. The microbial isolates recovered from the herbal remedy include: Staphylococcus aureus (8.3%), Coagulase negative Staphylococcus (75%) and Microsporium spp (16.7%). Assessment of the antimicrobial potential of the herbal remedy show that the test herbal remedy had strong inhibitory activity against Staphylococcus aureus (17±0.6 mm), Escherichia coli (16.3±0.3 mm), Pseudomonas aeruginosa (16.3±0.3 mm), Klebsiella pneumoniae (15±0.6 mm) and Proteus mirabilis (14±0.8 mm), except Candida albican, at a concentration of 200 mg/mL. The combined herbal solution and standard drug gave higher zone diameter of inhibition: Klebsiella pneumoniae (25±0.6 mm), Pseudomonas aeruginosa (24±0.6 mm), Staphylococcus aureus (23.7±0.3 mm), Escherichia coli (23.3±0.3 mm) and Candida albican (15±0.6mm), except Proteus mirabilis. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal/Fungicidal Concentration (MBC/MFC) of the herbal remedy for all the test isolates (except Candida albican) was 100mg/mL and 200mg/mL, respectively. The result of the phytochemical screening showed the presence of alkaloids, anthraquinones, cardiac glycosides, flavonoids, saponins and tannins, while steroids and resins were absent. Conclusion: The outcome of this study further strengthens the claim of efficacy made by the manufacturer and vendors of the herbal remedy. However, more attention should be given to quality preparations, packaging and storage in view of the general safety of the consumers.

Лечение хронического фарингита в фазе обострения: клинико-иммунологические и микробиологические аспекты

В статье представлены данные исследования, посвященного комплексной клинико-иммунологической и микробиологической оценке эффективности препарата Септолете Плюс в лечении хронического фарингита в стадии обострения. Исследование было проведено в группе из 100 пациентов, в лечении которых использовался препарат Септолете Плюс пастилки для рассасывания (до 6 пастилок в день в виде монотерапии на протяжении 5 дней). Полученные результаты свидетельствуют о положительной динамике клинического течения заболевания и состояния иммунных механизмов защиты на фоне назначения препарата Септолете Плюс. Препарат показал высокие бактерицидность и фунгицидность, а также отсутствие токсического влияния на клетки, находящиеся в ротоглоточном секрете, и клетки слизистой оболочки, а также умеренную иммуномодулирующую активность.

Fungal urinary tract infection in outpatient practice: approaches to diagnosis and treatment

Introduction. In recent years, the role of fungal infection in inpatient and outpatient patients has been increasing. At the same time, there are currently no recommendations on the duration of treatment of outpatient patients with fungal urinary tract infection (UTI). Aim of the study. Optimization of methods of diagnosis and treatment of outpatient patients with fungal UTI.Materials and methods. To detect fungi in urine, the E. Koneman et al. (1997) method was improved. 56 patients with fungal UTI were examined. The efficacy of fluconazole in the treatment of fungal UTI was studied in 53 patients.Results. Candida albicans was detected in 37% of cases of fungal UTI in outpatient patients. Risk factors for fungal UTI in outpatient patients include: antibacterial therapy, infravesical obstruction, type 2 diabetes mellitus and the presence of urinary drainage. The microbiological efficacy of fluconazole therapy for 7, 10 and 14 days was 83.0%, 94.3% and 96.2%, respectively. The growth of fungi in the urine a month after treatment was absent in 86.7% of patients. In outpatient patients with fungal UTI without type 2 diabetes mellitus, the efficacy of fluconazole at a dose of 150 mg per day for 7 days was 94.9%. In patients with type 2 diabetes mellitus after 7 days of therapy, the efficacy was 50.0%.Conclusions. The most common causative agent of fungal UTI in outpatient patients is Candida albicans. To detect fungi in urine, samples should be seeded on selective media, while increasing the seeding volume to 0.1 ml and extending the incubation time to 96 hours. Fluconazole is a highly effective treatment for fungal UTI at a dose of 150 mg per day for 7 days, however, in patients with diabetes mellitus, therapy should last at least 10 days.

Nephrotoxicity and Efficacy Assessment of Polymyxin B Use in Renal Transplant Patients.

PurposeThis study investigates the nephrotoxicity and efficacy assessment of polymyxin B (PMB) use in renal transplant patients.Patients and MethodsThis retrospective study included adult (>18 years of age) renal transplant patients who received PMB intravenous drip for more than 72 hours. Efficacy assessment of PMB included clinical treatment efficacy, microbiological efficacy at the end of PMB treatment, and in-hospital all-cause mortality. Nephrotoxicity of PMB was evaluated for further group comparison.ResultsWe enrolled 235 renal transplant patients in our study. After PMB treatment, 45 patients occurred PMB-nephrotoxicity, and the nephrotoxicity rate was 19.15%. Among them, 44 patients were RIFLE R stage, and one patient was RIFLE I stage. The dose of PMB used in patients was 40.0 (40.0–50.0) mg q12h with a loading dose of 41.8±9.8 mg. Multivariate logistic regression analysis showed that ICU admission, vasoactive agents, aminoglycosides, creatinine clearance rate before PMB use, and mean total hospital stay were independent risk factors of PMB-nephrotoxicity in kidney transplant patients. The clinical effective rate was 97.9%, and the microbiological clean rate was 66.7%.ConclusionOur study demonstrated that PMB low dose regimens might achieve good efficacy and less nephrotoxicity in renal transplant patients. We should evaluate the severity of the infection and renal function of patients, avoid the combined use of other nephrotoxic drugs, and minimize the course of use to reduce the occurrence of PMB-nephrotoxicity.

Modern approaches to the surgical treatment of chronic tonsillitis

At the moment, all over the world there are a large number of various methods of surgical treatment of chronic tonsillitis. In particular: classical tonsillectomy, cryosurgical method for removing the palatine tonsils, shaver tonsillectomy, monopolar and bipolar tonsillectomy, tonsillectomy with an ultrasonic scalpel, bipolar dissection using cutting instruments, laser tonsillectomy, coldablation. This article analyzes the existing methods, describes the fundamental technique for their implementation, as well as their advantages and disadvantages. Given the abundance of various surgical approaches to the treatment of chronic tonsillitis, there is a need for studies aimed at comparative study of their clinical and microbiological efficacy, including the postoperative period.

Bacterial meningitis in the practice of a primary care physician. Clinical and immunological efficacy of recombinant interleukin-2 in the complex therapy of bacterial meningitis

The article analyzes the pathogenetic features of bacterial meningitis and substantiates the scheme of complex therapy of the disease using the recombinant cytokine interleukin-2 (IL2). The clinical, immunological and microbiological efficacy of the complex therapy scheme has been revealed. It has been shown that the pleiotropic effects of recombinant IL-2, its effect on the activity of metabolic processes at the cellular and subcellular levels, the ability to stabilize the system of lipid peroxidation of cell membranes, the ability to influence the processes of clonal proliferation and differentiation of T- and B-lymphocytes, make its use justified in complex therapy of meningitis.

Clinical and Microbiological Efficacy of CSE-1034 in Treatment of Acute Bacterial Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

This study aimed to conduct a meta-analysis to assess the clinical and microbiological efficacy of CSE-1034 for treating acute bacterial infections in adult patients. PubMed, Embase, ClinicalTrials.gov, and Cochrane databases were searched from their inception until April 2022 for relevant randomized controlled trials (RCTs). Only RCTs evaluating CSE-1034 and comparators for treating acute bacterial infections in adult patients were included. The primary outcome was the clinical response rate at the end of treatment (EOT) evaluation. Five RCTs were included. A total of 950 patients (n:638 in the UTI group, n:186 in the lower respiratory tract infection group, n:70 in the bone and joint infection group, and n:56 in SSSI) were included in this meta-analysis; 478 and 472 patients received CSE-1034 and comparators, respectively. Overall, CSE-1034 had a higher clinical cure rate at EOT than did the comparators (95.3% [384/403] vs. 81% [319/394], RR, 1.2; 95%CI, 1.04-1.39; I2=92%). Moreover, the clinical failure rate of CSE-1034 was lower than that of the comparators (RR, 0.04; 95%CI, 0.01-0.13; I2=0%). CSE-1034 also had a higher microbiological eradication rate than the comparators (92.9% [315/339] vs. 71.1% [216/304], RR, 1.53; 95%CI, 1.06-2.21; I2=97%). The clinical and microbiological efficacy of CSE-1034 is comparable or even superior in treating acute bacterial infections.

Clinical and microbiological efficacy of "Bioplasmiх throat spray" in the treatment of chronic inflammatory diseases of the palatine tonsils

Topicality: Chronic inflammatory diseases of the tonsils occupy a significant place in the structure of otorhinolaryngological pathology. The transition of inflammation to a chronic form is associated with the suppression of factors of colonization resistance of this biotope, the emergence of pathogenic microorganisms such as St. рyogenes and S. aureus. Аgainst the background of developing dysbiosis and immune imbalance, a number of complications from organs and systems may develop. Therefore, the search for means for effective topical etiotropic treatment of chronic tonsillitis and, at the same time, gentle on the indigenous microflora, is relevant. Materials and methods: The study involved 52 patients with chronic tonsillitis. All patients were divided into 2 groups of 26 each. Subjects of the 1st group in local therapy used the bacterial component "Bioplasmix throat spray", and patients in the 2nd group – used the traditional course of treatment: washing the lacunae of the tonsils with antiseptic agent – decamethoxine at a concentration of 0.2 mg/ml. Results and discussion: Studies have shown the selective antimicrobial activity of "Bioplasmix Throat Spray". Thus, in relation to the main pathogens "Bioplasmix Throat Spray" showed a pronounced antibacterial effect and, at the same time, helped to normalize the population level of indigenous microflora, which indicates the restoration of colonization resistance of the biotope. The positive dynamics of the main complaints of patients and pharyngoscopic signs testified to the clinical effectiveness of "Bioplasmiх Throat Spray". The analysis of clinical indicators in patients of the 2nd group showed a decrease in the severity of patient complaints and objective signs of the disease during treatment with decamethoxine. The results of repeated microbiological studies showed that, unlike "Bioplasmiх Throat Spray", the broad spectrum of antimicrobial action of decamethoxine does not contribute to the restoration and maintenance of high population levels of indigenous microflora of thepalatine tonsils.

Is Cefoxitin a Carbapenem Sparing Agent in the Management of Urinary Tract Infections Caused by ESBL Producing Enterobacterales?

Background: Cefoxitin has shown in vitro activity against Extended-Spectrum β-Lactamase (ESBL) producing Enterobacterales. Outcome data regarding cefoxitin as a carbapenem sparing agent in the management of urinary tract infections (UTI) are scarce. We sought to evaluate the clinical and microbiologic efficacy of cefoxitin as compared to ertapenem. Methods: A retrospective observational study was conducted at our quaternary care institution between May 2015 and March 2019. We identified all patients who received cefoxitin for the treatment of UTI during the study period and used Charlson Comorbidity Index to select a matching cohort from patients who received ertapenem. Primary end points were clinical and microbiological cure. Results: Thirty patients who received cefoxitin were matched with 55 patients who received ertapenem. Clinical cure was marginally in favor of ertapenem: 83.2% in cefoxitin group versus 96.8% in ertapenem group (P = .042). However, 90-day recurrence was in favor of cefoxitin: 13.5% in cefoxitin group versus 34.8% in ertapenem group (P = .045). Microbiologic cure was not significant between the 2 groups with 88.6% success in cefoxitin versus 100% in ertapenem. Additionally, the group difference on 30-day recurrence or relapse rates and the 90-day mortality rate were not clinically significant. Conclusion: Cefoxitin achieved similar microbiologic cure rate when compared to ertapenem for the treatment of UTI caused by ESBL-producing Enterobacterales. No significant differences were found in 30-day recurrence/relapse or mortality rates. Larger randomized controlled trials are required to identify the clinical sittings in which cefoxitin could be used as a carbapenem-sparing agent in the treatment of UTI.

Treatment outcomes of secondary bacteraemia in patients treated with ceftaroline fosamil: pooled results from six phase III clinical trials

This exploratory pooled analysis assessed the efficacy and safety of ceftaroline fosamil and comparators across six phase III clinical trials in adults with community-acquired pneumonia (CAP) or complicated skin and soft-tissue infection (cSSTI) and secondary bacteraemia. In each trial, FOCUS 1 and 2 (CAP), Asia CAP trial, CANVAS 1 and 2 (cSSTI) and COVERS (cSSTI), patients were randomised to ceftaroline fosamil [600 mg q12h by 1-h i.v. infusion, except in COVERS (600 mg q8h by 2-h i.v. infusion), adjusted for renal function] or comparator. Efficacy assessments included clinical and microbiological responses at test-of-cure visit [microbiological modified intent-to-treat (mMITT) population]. Safety outcomes were assessed. The pooled mMITT population comprised 1976 patients, of whom 138 had baseline bacteraemia (ceftaroline fosamil, n=72; comparator, n=66). Predominant baseline blood pathogens were Staphylococcus aureus (n=29), Streptococcus pneumoniae (n=19) and other streptococci (n=12). Clinical cure rates in bacteraemic patients were 55/72 (76.4%) and 51/66 (77.3%) for ceftaroline fosamil and comparators, respectively, and in non-bacteraemic patients were 822/966 (85.1%) and 717/872 (82.2%). Favourable microbiological response rates in bacteraemic patients were 56/72 (77.8%) for ceftaroline fosamil and 54/66 (81.8%) for comparators, and in non-bacteraemic patients were 825/966 (85.4%) and 719/872 (82.5%). Adverse events in bacteraemic patients were consistent with the known ceftaroline fosamil safety profile or the underlying indications. These pooled clinical and microbiological efficacy data demonstrate generally favourable outcomes for ceftaroline fosamil in patients with CAP or cSSTI and secondary bacteraemia. [Trial Registration: NCT00621504, NCT00509106; NCT01371838; NCT00424190, NCT00423657; NCT01499277].