Antibiotics Pub Date : 2024-09-18 DOI: 10.3390/antibiotics13090893

Alice Slotfeldt Viana, Laís Pires do Valle Tótola, Agnes Marie Sá Figueiredo

{"title":"ST105 Lineage of MRSA: An Emerging Implication for Bloodstream Infection in the American and European Continents","authors":"Alice Slotfeldt Viana, Laís Pires do Valle Tótola, Agnes Marie Sá Figueiredo","doi":"10.3390/antibiotics13090893","DOIUrl":"https://doi.org/10.3390/antibiotics13090893","url":null,"abstract":"Sequence-type 5 (ST5) of methicillin-resistant Staphylococcus aureus (MRSA), harboring the staphylococcal chromosomal cassette mec type IV (SCCmecIV), was first detected in Portugal. It emerged as a significant cause of healthcare-associated (HA) infection in pediatric units and was hence named the pediatric clone. Another ST5 lineage, which carries SCCmecII, also prevailed in the USA and Japan for multiple years. More recently, another MRSA lineage, ST105-SCCmecII, part of the evolution of clonal complex 5 (CC5) MRSA, has emerged as the cause of hospital-acquired bloodstream infection outbreaks in countries including Portugal, the USA, and Brazil. This article reviews studies on the epidemiology and evolution of these newly emerging pathogens. To this end, a search of PUBMED from inception to 2024 was performed to find articles reporting the occurrence of ST105 MRSA in epidemiologic studies. A second search was performed to find studies on MRSA, CC5, ST5, and SCCmecII. A search of PUBMED from 1999 to 2024 was also performed to identify studies on the genomics and evolution of ST5, CC5, and ST105 MRSA. Further studies were identified by analyzing the references of the previously selected articles from PUBMED. Most articles on ST105 MRSA were included in this review. Only articles written in English were included. Furthermore, only studies that used a reliable genotyping method (e.g., whole genome sequencing, or MLST) to classify the CC5 lineages were selected. The quality and selection of articles were based on the consensus assessment of the three authors in independent evaluations. In conclusion, ST105-SCCmecII is an emerging MRSA in several countries, being the second/third most important CC5 lineage, with a relatively high frequency in bloodstream infections. Of concern is the increased mortality from BSI in patients older than 15 years and the higher prevalence of ST105-SCCmecII in the blood of patients older than 60 years reported in some studies.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review 急性胰腺炎中抗生素的合理使用：范围审查

Antibiotics Pub Date : 2024-09-18 DOI: 10.3390/antibiotics13090894

Josep M. Badia, Sara Amador, Carmen González-Sánchez, Inés Rubio-Pérez, Alba Manuel-Vázquez, Montserrat Juvany, Estela Membrilla, José M. Balibrea, Xavier Guirao

{"title":"Appropriate Use of Antibiotics in Acute Pancreatitis: A Scoping Review","authors":"Josep M. Badia, Sara Amador, Carmen González-Sánchez, Inés Rubio-Pérez, Alba Manuel-Vázquez, Montserrat Juvany, Estela Membrilla, José M. Balibrea, Xavier Guirao","doi":"10.3390/antibiotics13090894","DOIUrl":"https://doi.org/10.3390/antibiotics13090894","url":null,"abstract":"Background: While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pancreatitis (AP) is recommended, studies indicate a high rate of inadequate treatment. Methods: A search of PubMed, Scopus, and Cochrane databases was conducted, focusing on primary research and meta-analyses. Data were categorized based on core concepts, and a narrative synthesis was performed. Results: The search identified a total of 1016 publications. After evaluating 203 full texts and additional sources from the grey literature, 80 studies were included in the review. The answers obtained were: (1) Preventive treatment does not decrease the incidence of IPN or mortality. Given the risks of bacterial resistance and fungal infections, antibiotics should be reserved for highly suspected or confirmed IPN; (2) The diagnosis of IPN does not always require microbiological samples, as clinical suspicion or computed tomography signs can suffice. Early diagnosis and treatment may be improved by using biomarkers such as procalcitonin and novel microbiological methods; (3) When indicated, early initiation of antibiotics is a key determinant in reducing mortality associated with IPN; (4) Antibiotics with good penetration into pancreatic tissue covering Gram-negative and Gram-positive bacteria should be used. Routine antifungal therapy is not recommended; (5) The step-up approach, including antibiotics, is the standard for IPN management; (6) Antibiotic duration should be kept to a minimum and should be based on the quality of source control and patient condition. Conclusions: Early antibiotic therapy is essential for the treatment of IPN, but prophylactic antibiotics are not recommended in AP. High-quality randomized controlled trials are required to better understand the role of antibiotics and antifungals in AP management.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nail Lacquer Containing Origanum vulgare and Rosmarinus officinalis Essential Oils and Biogenic Silver Nanoparticles for Onychomycosis: Development, Characterization, and Evaluation of Antifungal Efficacy 含牛至花和麝香草精油及生物银纳米粒子的指甲油用于治疗甲癣：开发、表征和抗真菌功效评估

Antibiotics Pub Date : 2024-09-17 DOI: 10.3390/antibiotics13090892

Sara Scandorieiro, Natalia Rodrigues de Oliveira, Monique de Souza, Lidiane Vizioli de Castro-Hoshino, Mauro Luciano Baesso, Gerson Nakazato, Renata Katsuko Takayama Kobayashi, Luciano Aparecido Panagio, Audrey Alesandra Stinghen Garcia Lonni

{"title":"Nail Lacquer Containing Origanum vulgare and Rosmarinus officinalis Essential Oils and Biogenic Silver Nanoparticles for Onychomycosis: Development, Characterization, and Evaluation of Antifungal Efficacy","authors":"Sara Scandorieiro, Natalia Rodrigues de Oliveira, Monique de Souza, Lidiane Vizioli de Castro-Hoshino, Mauro Luciano Baesso, Gerson Nakazato, Renata Katsuko Takayama Kobayashi, Luciano Aparecido Panagio, Audrey Alesandra Stinghen Garcia Lonni","doi":"10.3390/antibiotics13090892","DOIUrl":"https://doi.org/10.3390/antibiotics13090892","url":null,"abstract":"Onychomycosis is a common fungal nail infection for which new antifungals are needed to overcome antimicrobial resistance and the limitations of conventional treatments. This study reports the development of antifungal nail lacquers containing oregano essential oil (OEO), rosemary essential oil (REO), and biogenic silver nanoparticles (bioAgNPs). The formulations (F) were tested against dermatophytes using agar diffusion, ex vivo nail infection, and scanning electron microscopy techniques. They were evaluated for their pharmacotechnical characteristics and by FTIR-PAS to assess permeation across the nail. F-OEO and F-OEO/bioAgNPs were promising candidates for the final nail lacquer formulation, as they permeated through the nail and showed antifungal efficacy against dermatophytes-contaminated nails after 5 days of treatment. Treated nails exhibited decreased hyphae and spores compared to the untreated control; the hyphae were atypically flattened, indicating loss of cytoplasmic content due to damage to the cytoplasmic membrane. The formulations were stable after centrifugation and thermal stress, maintaining organoleptic and physicochemical characteristics. Both F-OEO and F-OEO/bioAgNPs had pH compatible with the nail and drying times (59–90 s) within the reference for nail lacquer. For the first time, OEO and bioAgNPs were incorporated into nail lacquer, resulting in a natural and nanotechnological product for onychomycosis that could combat microbial resistance.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recurrent Cystitis in Women—A Real-World Analysis of Bacteria Spectrum and Resistance Situation for Calculated Therapy 妇女复发性膀胱炎--细菌谱和耐药性情况的真实世界分析，以便计算治疗方案

Antibiotics Pub Date : 2024-09-16 DOI: 10.3390/antibiotics13090890

Philipp J. Spachmann, Maximilian Radlmaier, Stefan Denzinger, Maximilian Burger, Johannes Breyer, Wolfgang Otto, Marco J. Schnabel, Daniel Vergho

{"title":"Recurrent Cystitis in Women—A Real-World Analysis of Bacteria Spectrum and Resistance Situation for Calculated Therapy","authors":"Philipp J. Spachmann, Maximilian Radlmaier, Stefan Denzinger, Maximilian Burger, Johannes Breyer, Wolfgang Otto, Marco J. Schnabel, Daniel Vergho","doi":"10.3390/antibiotics13090890","DOIUrl":"https://doi.org/10.3390/antibiotics13090890","url":null,"abstract":"Recurrent cystitis in women represents an everyday challenge; however, little to no data regarding this population are available. This study aimed to evaluate this collective with respect to a rational calculated antibiotic therapy. Urine cultures and antibiograms from a urological office were retrospectively evaluated from patient data collected between January 2017 and June 2019. The evaluation was conducted using SPSS ©. In total, 84 female patients, who were aged between 18 and 87 years old (median 60 years), suffered from recurrent cystitis. Escherichia coli was found in 53.9% of cases, Staphylococcus aureus and enterococci were each found in 6.7%, and Proteus spp. and Streptococcus agalactiae were each found in 5.6%. The resistance levels to ciprofloxacin (CIP), trimethoprim–sulfamethoxazole (TRS), nitrofurantoin (NIT), and nitroxoline (NOX) were 18.2%, 30.7%, 16.1%, and 12.5% in the tested cases, respectively. Regarding E. coli, resistance to CIP, TRS, and NIT was found in 17.8%, 25%, and 4.2% of the tested cases, and no resistance to NOX was found. The resistance level to CIP was in a tolerable range of <20% in the overall cohort and the E. coli subgroup. More than a quarter of the bacteria were resistant to TRS. The low resistance rates for NIT and NOX are remarkable, promoting the use of these substances if they are not yet used.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute Diarrhea in a Tertiary Emergency Department: From Readmission Determinants to Antibiotic Prescription 三级医院急诊科的急性腹泻：从再入院决定因素到抗生素处方

Antibiotics Pub Date : 2024-09-16 DOI: 10.3390/antibiotics13090891

Marcello Covino, Antonella Gallo, Fiammetta Maria Rognoni, Maria Caterina Parlangeli, Benedetta Simeoni, Francesco Franceschi, Francesco Landi, Massimo Montalto

{"title":"Acute Diarrhea in a Tertiary Emergency Department: From Readmission Determinants to Antibiotic Prescription","authors":"Marcello Covino, Antonella Gallo, Fiammetta Maria Rognoni, Maria Caterina Parlangeli, Benedetta Simeoni, Francesco Franceschi, Francesco Landi, Massimo Montalto","doi":"10.3390/antibiotics13090891","DOIUrl":"https://doi.org/10.3390/antibiotics13090891","url":null,"abstract":"Acute diarrhea represents a major public health issue, and the management of adult patients admitted to the emergency department (ED) for this problem is still challenging. In a retrospective analysis on more than 20,000 patients visiting a tertiary ED for acute diarrhea and then being discharged home, we found that age > 65 years, onset of symptoms > 24 h since ED admission, refusal of hospitalization, and a history of chronic renal and liver diseases were independently associated with ED readmission for abdominal symptoms within 7 days. In the younger group, the presence of comorbidities significantly impacted on ED readmission, while fever and alteration of serum creatinine were the main determinants in the older group. Antibiotics were prescribed in about 25% of patients, although diarrhea etiology (viral or bacterial) was usually not available. According to international guidelines, fluoroquinolones were the most prescribed class, showing an inverse correlation to ED readmission. However, β-lactams and probiotics were also commonly prescribed; the latter were independently correlated to ED readmission in the elderly group. A comprehensive, guideline-based approach, including a detailed clinical history and laboratory and comorbidity assessment, should be encouraged to support physicians in the management of different age subgroups of adults admitted to the ED for acute diarrhea.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Three in One with Dual-Functional Hydrogel of Lactoferrin/NZ2114/LMSH Promoting Staphylococcus aureus-Infected Wound Healing 乳铁蛋白/NZ2114/LMSH 双功能水凝胶三合一促进金黄色葡萄球菌感染伤口愈合

Antibiotics Pub Date : 2024-09-15 DOI: 10.3390/antibiotics13090889

Kun Zhang, Xuanxuan Ma, Da Teng, Ruoyu Mao, Na Yang, Ya Hao, Jianhua Wang

{"title":"Three in One with Dual-Functional Hydrogel of Lactoferrin/NZ2114/LMSH Promoting Staphylococcus aureus-Infected Wound Healing","authors":"Kun Zhang, Xuanxuan Ma, Da Teng, Ruoyu Mao, Na Yang, Ya Hao, Jianhua Wang","doi":"10.3390/antibiotics13090889","DOIUrl":"https://doi.org/10.3390/antibiotics13090889","url":null,"abstract":"Wound infections caused by Staphylococcus aureus often result in localized suppurative lesions that severely impede the healing process, so it is urgent to develop a dress with efficient antimicrobial and pro-healing functions. In this study, the bifunctional injectable hydrogel lactoferrin (Lf)/NZ2114/lithium magnesium silicate hydrogel (LMSH) was first successfully prepared through the electrostatic interaction method. The physical, biological, and efficacy properties are systematically analyzed with good shear-thinning capacity and biocompatibility. More importantly, it inhibits infection and promotes wound healing in a mouse wound infection model after 14 d treatment, and the bactericidal rate and healing rate were over 99.92% and nearly 100%, respectively. Meanwhile, the massive reduction of inflammatory cells, restoration of tissue structure, and angiogenesis in mice showed the anti-inflammatory and pro-healing properties of the hydrogel. The healed wounds showed thickening with more hair follicles and glands, suggesting that the hydrogel Lf/NZ2114/LMSH (Three in One) could be a better dressing candidate for the treatment of S. aureus-induced wound infections.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"208 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of T2 Magnetic Resonance (T2MR®) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients 评估 T2MR® 技术在败血症患者中早期检测 ESKAPEc 病原体的效果

Antibiotics Pub Date : 2024-09-14 DOI: 10.3390/antibiotics13090885

Celestino Bonura, Domenico Graceffa, Salvatore Distefano, Simona De Grazia, Oscar Guzman, Brian Bohn, Mariachiara Ippolito, Salvatore Campanella, Angelica Ancona, Marta Caputo, Pietro Mirasola, Cesira Palmeri, Santi Maurizio Raineri, Antonino Giarratano, Giovanni Maurizio Giammanco, Andrea Cortegiani

{"title":"Evaluation of T2 Magnetic Resonance (T2MR®) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients","authors":"Celestino Bonura, Domenico Graceffa, Salvatore Distefano, Simona De Grazia, Oscar Guzman, Brian Bohn, Mariachiara Ippolito, Salvatore Campanella, Angelica Ancona, Marta Caputo, Pietro Mirasola, Cesira Palmeri, Santi Maurizio Raineri, Antonino Giarratano, Giovanni Maurizio Giammanco, Andrea Cortegiani","doi":"10.3390/antibiotics13090885","DOIUrl":"https://doi.org/10.3390/antibiotics13090885","url":null,"abstract":"Bloodstream infections (BSIs) and sepsis are a major cause of morbidity and mortality. Appropriate early antibiotic therapy is crucial for improving the survival of patients with sepsis and septic shock. T2 magnetic resonance (T2MR®) technology may enable fast and sensitive detection of ESKAPEc pathogens directly from whole-blood samples. We aimed to evaluate concordance between the T2Bacteria® Panel and standard blood culture and its impact on antibiotic therapy decisions. We conducted a single-centre retrospective study on patients with sepsis-induced hypotension or septic shock admitted to general, post-operative/neurosurgical, and cardiothoracic Intensive Care Units who were tested with the T2Bacteria® Panel from January 2021 to December 2022. Eighty-five consecutively admitted patients were included, for a total of 85 paired tests. A total of 48 ESKAPEc pathogens were identified by the T2Bacteria® Panel. The concordance rate between the T2Bacteria® Panel and blood cultures was 81% (69/85), with 20 concordant-positive and 49 concordant-negative cases. For the 25 microorganisms grown from accompanying blood cultures, blood pathogen coverage by the T2Bacteria® Panel was 88%. In this cohort of severely ill septic patients, the T2Bacteria® Panel was highly concordant and was able to detect more ESKAPEc pathogens, with a significantly shorter turn-around time compared to conventional blood cultures. The T2Bacteria® Panel also significantly impacted decisions on antibiotic therapy.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Towards Sustainable Antibiotic Use in Aquaculture and Antimicrobial Resistance: Participatory Experts’ Overview and Recommendations 实现水产养殖中抗生素的可持续使用和抗菌药耐药性：参与式专家概述和建议

Antibiotics Pub Date : 2024-09-14 DOI: 10.3390/antibiotics13090887

Daniela R. Farías, Rolando Ibarra, Rodrigo A. Estévez, Michael F. Tlusty, Oskar Nyberg, Max Troell, Ruben Avendaño-Herrera, Wendy Norden

{"title":"Towards Sustainable Antibiotic Use in Aquaculture and Antimicrobial Resistance: Participatory Experts’ Overview and Recommendations","authors":"Daniela R. Farías, Rolando Ibarra, Rodrigo A. Estévez, Michael F. Tlusty, Oskar Nyberg, Max Troell, Ruben Avendaño-Herrera, Wendy Norden","doi":"10.3390/antibiotics13090887","DOIUrl":"https://doi.org/10.3390/antibiotics13090887","url":null,"abstract":"Notably, 56 worldwide experts gathered for the Antimicrobial Assessment on Global Aquaculture Production (AGAP) series of workshops to (1) evaluate the current state of knowledge on antimicrobial use and identify existing gaps; (2) formulate strategies to identify ecologically relevant impact indicators and establish thresholds for assessment; (3) identify pivotal socioeconomic factors and effective governance mechanisms essential for implementing monitoring practices in aquaculture and extending them across sectors and countries for aquaculture sustainability; (4) develop pathways to enhance our comprehension between antibiotic use in aquaculture and antimicrobial resistance; and (5) explore potential antibiotic monitoring tools that can be universally adapted and implemented across region and sectors. The main outcomes were a roadmap for establishing investigation priorities on the relevant topics regarding antibiotic use in aquaculture, socioeconomic drivers for using antibiotics and behaviors that need more robust and transparent regulatory frameworks to guide farmers, training on antimicrobial use, and access to veterinarians and extension services agents for education. Overall, the workshop evidenced the power of collaboration in addressing complex global challenges to achieve sustainable aquaculture. Despite diligent efforts, some constraints may have inadvertently narrowed the possibility of having more experts and left some pertinent topics unaddressed, but they are needed in the discussion.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Two Novel Hydrate Salts of Norfloxacin with Phenolic Acids and Their Physicochemical Properties 诺氟沙星与酚酸的两种新型水合盐及其理化性质

Antibiotics Pub Date : 2024-09-14 DOI: 10.3390/antibiotics13090888

Di Liang, Fei Li, Jingzhong Duan, Wei Sun, Xiaoyan Yu

{"title":"Two Novel Hydrate Salts of Norfloxacin with Phenolic Acids and Their Physicochemical Properties","authors":"Di Liang, Fei Li, Jingzhong Duan, Wei Sun, Xiaoyan Yu","doi":"10.3390/antibiotics13090888","DOIUrl":"https://doi.org/10.3390/antibiotics13090888","url":null,"abstract":"Norfloxacin (NORF) is a broad-spectrum quinolone that is widely utilized for the treatment of various bacterial infections and is considered one of the most commonly used fluoroquinolone antibiotics. However, NORF’s clinical utility is limited by its poor water solubility and relatively low oral bioavailability. This study presents an optimization and synergistic enhancement approach through salt/co-crystal, aiming to maximize the biopharmaceutical properties of NORF with the use of phenolic acid. Following this strategy, two new hydrate salts of NORF with phenolic acid, namely, NORF—3,5-DBA hydrate (salt 1) and NORF—VA hydrate (salt 2), were prepared and systematically confirmed. Two hydrate salts were produced by means of the slow evaporation crystallization method, and the structures were determined through single-crystal X-ray diffraction (SCXRD). Additionally, powder X-ray diffraction (PXRD), Fourier-transform infrared (FT-IR) spectroscopy, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and high-performance liquid chromatography (HPLC) were applied to analyze the features of the two salts. The experimental results indicated that the formation of the two salts could enhance the solubility and improve the release behavior of NORF. Interestingly, the physicochemical properties of NORF were significantly improved as a result, leading to an enhancement in its antibacterial activity. This was demonstrated by the enhanced inhibition of bacterial strains and the lower minimum inhibitory concentration values.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Establishment of an Antimicrobial Stewardship Program to Spare the Use of Oral Fluoroquinolones for Acute Uncomplicated Cystitis in Outpatients 制定抗菌药物管理计划，使门诊患者在治疗急性非复杂性膀胱炎时避免使用口服氟喹诺酮类药物

Antibiotics Pub Date : 2024-09-14 DOI: 10.3390/antibiotics13090886

Tomoyuki Kato, Masayuki Nagasawa, Ippei Tanaka, Yuka Seyama, Reiko Sekikawa, Shiori Yamada, Eriko Ishikawa, Kento Kitajima

{"title":"Establishment of an Antimicrobial Stewardship Program to Spare the Use of Oral Fluoroquinolones for Acute Uncomplicated Cystitis in Outpatients","authors":"Tomoyuki Kato, Masayuki Nagasawa, Ippei Tanaka, Yuka Seyama, Reiko Sekikawa, Shiori Yamada, Eriko Ishikawa, Kento Kitajima","doi":"10.3390/antibiotics13090886","DOIUrl":"https://doi.org/10.3390/antibiotics13090886","url":null,"abstract":"The increase in fluoroquinolone (FQ)-resistant Escherichia coli (EC) is a serious global problem. In addition, much of acute uncomplicated cystitis (AUC) cases are caused by EC. FQs have been selected for the treatment of cystitis in outpatients, and there is concern about treatment failure. It is therefore necessary to select appropriate antimicrobials to spare FQs. However, there are few reported effective antimicrobial stewardship programs (ASPs) for outpatients. We aimed to establish the effective ASP for outpatients diagnosed with AUC caused by EC, to spare the use of FQs, and to explore optimal oral antimicrobials for AUC. The study subjects were outpatients treated for AUC caused by extended-spectrum β-lactamase-non-producing EC (non-ESBL-EC). Based on the antibiogram results, we recommended cefaclor (CCL) as the initial treatment for AUC, and educated clinical pharmacists who also worked together to advocate for CCL or cephalexin (CEX) prescriptions. FQ usages decreased, and cephalosporin (Ceph) prescriptions increased in all medical departments. The Ceph group (n = 114; CCL = 60, CEX = 54) in the non-FQ group had fewer treatment failures than the FQ group (n = 86) (12.3% vs. 31.4%). Cephs, including CCL and CEX, were effective treatments for AUC caused by non-ESBL-EC. Antimicrobial selection based on antibiogram results and the practice of an ASP in collaboration with clinical pharmacists were useful for optimizing antimicrobial therapy in outpatients.","PeriodicalId":8151,"journal":{"name":"Antibiotics","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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