A capillary electrophoretic method for the separation of the enantiomers of both ofloxacin and ornidazole is described. Several parameters affecting the separation were studied, including the type and concentration of chiral selector, buffer pH, voltage and temperature. Good chiral separation of the racemic mixtures was achieved in less than 16 min with resolution factors Rs=5.45 and 6.28 for ofloxacin and ornidazole enantiomers, respectively. Separation was conducted using a bare fused-silica capillary and a background electrolyte (BGE) of 50 mM H(3)PO(4)-1 M tris solution; pH 1.85; containing 30 mg mL(-1) of sulfated-beta-cyclodextrin (S-beta-CD). The separation was carried out in reversed polarity mode at 25 degrees C, 18 kV, detection wavelength at 230 nm and using hydrodynamic injection for 15 s. Acceptable validation criteria for selectivity, linearity, precision, and accuracy were studied. The limits of detection (LOD) and limits of quantitation (LOQ) of the enantiomers (ofloxacin enantiomer 1 (OF-E1), ofloxacin enantiomer 2 (OF-E2), ornidazole enantiomer 1 (OR-E1) and ornidazole enantiomer 2 (OR-E2)) were (0.52, 0.46, 0.54, 0.89) and (1.59, 1.40, 3.07, 2.70) microg mL(-1), respectively. The proposed method was successfully applied to the assay of enantiomers of both ofloxacin and ornidazole in pharmaceutical formulations. The computational calculations for the enantiomeric inclusion complexes rationalized the reasons for the different migration times between the ofloxacin and ornidazole enantiomers.
Acute sinusitis is most often a mild self-limiting disease. However, it may progress into severe and life threatening complications. One of the commonest being orbital complication of which visual loss is a direct consequence. In this 10 year retrospective study, the nature of orbital complication, clinical presentation and treatment modalities and outcome seen in children with acute sinusitis in a tertiary referral institute were reviewed. Of six patients, there was a case of preseptal cellulitis, 4 cases of subperiosteal abscess and one case of orbital abscess. Periorbital swelling was a common presenting feature. In 5 cases this was associated with proptosis with one case of impending optic nerve compression. The value of computed tomography and opthalmological examination as a component in the management plan is highlighted. All patients were treated with intravenous antibiotics but evidence of abscess collection warranted urgent surgical drainage in 5 patients, 3 being endoscopic drainage while external approach was done for the remaining 2 patients. Thus a child exhibiting orbital complication of acute sinusitis, prompt diagnosis and treatment is essential in obtaining the best outcome for the child.
Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are important events in COPD patients and place a large burden on healthcare resources. COPD patients with frequent exacerbations have accelerated decline in lung function, poorer health status and are at higher risk of mortality. The mainstay of treatment includes increasing short acting bronchodilator therapy and systemic glucocorticosteroids with or without antibiotics. Non invasive ventilation is indicated in those with respiratory failure with acidosis or hypercapnia. Preventive strategies to reduce exacerbations include smoking cessation, immunisation against influenza and S. pneumonia, chronic maintenance inhaled pharmacotherapy, pulmonary rehabilitation and self management education.
Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Endophytes, which are receiving increasing attention, have been found to be potential sources of bioactive metabolites following the discovery of paclitaxel producing endophytic fungi. In the present study, a total of 348 endophytes were isolated from different parts of 24 Malaysian medicinal plants. Three selected endophytes (HAB10R12, HAB11R3 and HAB21F25) were investigated for their antimicrobial and cytotoxic activities. For antimicrobial activity, HAB10R12 and HAB11R3 were found to be most active against bacteria and fungi, respectively. Their antimicrobial effects were comparable to, if not better than, a number of current commercial antibacterial and antifungal agents. Both HAB10R12 and HAB21F25 were found to be potential anticancer drug candidates, having potent activity against MCF-7 and HCT116 cell lines and warrant further investigation.
A simple, rapid and validated capillary electrophoretic method has been developed for the separation and determination of ofloxacin and ornidazole in pharmaceutical formulations with detection at 230 nm. Optimal conditions for the quantitative separations were investigated. Analysis times shorter than 4 min were obtained using a background electrolyte solution consisting of 25 mmol/L phosphoric acid adjusted with 1 M Tris buffer to pH 8.5, with hydrodynamic injection of 5 s and 20 kV separation voltage. The validation criteria for accuracy, precision, linearity and limits of detection and quantitation were examined and discussed. An excellent linearity was obtained in concentration range 25-250 microg/mL. The detection limits for ofloxacin and ornidazole were 1.03 +/- 0.11 and 1.80 +/- 0.06 microg/mL, respectively. The proposed method has been applied for the analysis of ofloxacin and ornidazole both individually and in a combined dosage tablet formulation. The proposed validated method showed recoveries between 96.16 and 105.23% of the nominal contents.
A 64-year old patient, who had bacteraemia, did not respond to vancomycin despite the MRSA isolate being sensitive to the antibiotic at MIC 2 microg/mL. Electron microscopy of the MRSA isolate showed thickening of the cell wall, which was not observed in MRSA with lower vancomycin MIC.
Group B streptococcus (GBS) is a leading cause of neonatal sepsis and is usually acquired via the woman's birth canal. GBS serotypes isolated from 200 pregnant women were determined. Serotypes V (19%) and VI (17%) were the most frequent followed by serotypes III (12%), Ia (11.5%) and IV (10%); 17% of the strains were non-typable. All isolates were susceptible to penicillin, 96% to erythromycin and 97.5% to clindamycin. The emergence of new GBS serotypes has important implications for vaccine prevention strategies.
The clinical outcome of bacteraemic patients is influenced by many factors. It is vital to know one's own local hospital epidemiological data so as to provide optimal care to the affected patients. This was a prospective, observational study carried out in the said patient population over a period of four months in the year 2005. One hundred and ninety one patients presented with bacteraemia over the study period. Fifty-two (27%) of the patients died. Mechanical ventilation, inappropriate empirical antibiotic usage, Chinese ethnicity and low serum albumin levels independently affected prognosis. These factors should alert physicians to those patients who require more intensive monitoring and care.
KEY WORDS:
Bacteraemia, Blood Culture Positive, Outcome, Risk factors, Kuala Lumpur, Malaysia
Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
BACKGROUND: Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus Aureus. Incidence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment.
OBJECTIVES: This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation.
SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2007), the Cochrane Central Register of Clinical Trials (The Cochrane Library 2007, Issue 4), MEDLINE (1996 to 2007) and EMBASE (January 1985 to 2007). We contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles
SELECTION CRITERIA: Randomized and quasi-randomized clinical trials comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis were selected.
DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. When in dispute, we consulted a third author.
MAIN RESULTS: Two trials met the inclusion criteria. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as "supportive therapy" versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic.
AUTHORS' CONCLUSIONS: There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded randomized clinical trials to determine whether antibiotics should be used in this common postpartum condition.
Invasive Neisseria meningitidis infection is rare but carries a high mortality rate. The carriage rate in the normal population is around 10% and can be higher in confined populations. A study on the prevalence of carriage of N. meningitidis was conducted among 3195 army recruits after 2 months of intensive training in an army camp. N. meningitidis was isolated from 37.0% of these recruits. Two hundred and ten of N. meningitidis isolates were subjected to serogrouping and 100 to antibiotic sensitivity testing by the disc diffusion method and E-test for penicillin. Ten (4.8%) of 210 Neisseria meningitidis serogrouped belonged to serogroup W135, 3.33% serogroup A and 81.4% belonged to either serogroup X, Y or Z. With the agar disc diffusion method, all the N. meningitidis showed susceptiblity to chloramphenicol, rifampicin, cefotaxime and levofloxacin; 85% of the strains were resistant to cotrimoxazole and 12.5% resistant to penicillin. However, based on minimum inhibitory concentration, none of the Neisseria meningitidis tested was resistant to penicillin.
Biofilms are adherent, multi-layered colonies of bacteria that are typically more resistant to the host immune response and routine antibiotic therapy. HA biomaterial comprises of a single-phased hydroxyapatite scaffold with interconnected pore structure. The device is designed as osteoconductive space filler to be gently packed into bony voids or gaps following tooth extraction or any surgical procedure. Gentamycin-coated biomaterial (locally made hydroxyapatite) was evaluated to reduce or eradicate the biofilm on the implant materials. The results indicated that the HA coated with gentamycin was biocompatible to human osteoblast cell line and the biofilm has been reduced after being treated with different concentrations of gentamycin-coated hydroxyapatite (HA).
Salmonella sp is a significant cause of morbidity and mortality. Although commonly infecting the gastrointestinal system, other presentations are not unheard of. Salmonella is an unlikely and an unusual cause of genital tract infection. We describe a woman with suspected pelvic inflammatory disease eventually confirmed as Salmonella O C2 infection.
Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
Principally, there are two problems in prescribing . They are prescribing decision and prescribing writing process, which contribute to 39% and 61% of prescription problems respectively. The first type of problem has more serious consequences and may even cause mortality. In that study, the issue is the appropriateness of prescribing antibiotics for upper respiratory tract infections (URTI). Over-prescribing of antibiotics in primary health care, especially for respiratory tract diseases is a problem worldwide . There are concerns about the rising prevalence of antibiotic resistant bacteria, cost and the potentially harmful consequences of unnecessary prescription such as drug interaction and allergy.
In the present study, samples of pond water, sediment and farmed species were collected at 12 fish and shrimp farms in Malaysia, Thailand and Vietnam to determine the biodiversity and environmental distribution of chloramphenicol-resistant (CmR) mesophilic heterotrophs in Southeast Asian aquaculture sites. Following isolation on Iso-Sensitest agar supplemented with 35mug ml(-1) Cm and dereplication using (GTG)(5)-PCR fingerprinting, 557 genotypically unique CmR strains were subjected to polyphasic identification. The 557 mesophilic heterotrophic CmR isolates represented 18 different genera largely dominated by the genera Escherichia (40.2%), Pseudomonas (11.7%), Acinetobacter (11.1%), Klebsiella (7.5%) and Bacillus (5.9%). A total of 439 CmR isolates were further assigned to 31 described species or species groups, mainly including organisms that have been associated with various human opportunistic infections such as Escherichia coli (n=219), Pseudomonas putida (n=47), Klebsiella pneumoniae (n=38) and Acinetobacter baumannii (n=23). Strains of Escherichia, and most notably, of E. coli, were the only common group of CmR heterotrophs irrespective of country, sample type or farm type. Together with other predominant but less widespread groups such as acinetobacters and pseudomonads, the results of this biodiversity study suggest that E. coli can be regarded as a potential indicator of Cm resistance in Southeast Asian aquaculture environments.
The purpose of this study was to investigate the antimicrobial efficacy of six groups of antibiotics and calcium hydroxide against Enterococcus faecalis biofilm in a membrane filter model. Two-day-old E. faecalis (ATCC 29212) biofilm was exposed to ampicillin, co-trimoxazole, erythr omycin, oxytetracycline, vancomycin, vancomycin followed by gentamicin, Ca(OH)(2), and phosphate-buffered saline (control). After 1 h of exposure, the antimicrobial activity was neutralized by washing each disc five times in PBS, and then the colony-forming units of the remaining viable bacteria on each disc were counted. The results revealed that only erythromycin, oxytetracycline and Ca(OH)2 showed 100% biofilm kill. An ANOVA with a Bonferroni post hoc test (P < 0.05) detected significant differences among the test agents, except in the ampicillin group versus the co-trimoxazole group. It is concluded that erythromycin, oxytetracycline and Ca(OH)2 are 100% effective in eliminating E. faecalis biofilm, whereas ampicillin, co-trimoxazole, vancomycin, and vancomycin followed by gentamicin are ineffective.
Salmonella osteomyelitis of the rib is a rare clinical entity. In our case, a muhidrug resistant Salmonella enterica serotype Typhi was isolated from an immuno-competent patient with osteomyclitis of the ribs, who was treated earlier with ciprotloxacin for typhoid fever. The patient was successfully treated for osteomyclitis with intravenous ceftriaxone.
Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
The crude methanol extract of Bearded Argostemma (Argostemma involucratum Hemsl., Rubiaceae) showed a good and broad spectrum of antibacterial activity against both Gram-negative and Gram-positive bacteria. The activity was increased on fractionation (hexane, dichloromethane and water), particularly in the aqueous fraction which was more active than the methanol extract and streptomycin (no activity was shown against tested moulds). Both the hexane and dichloromethane fractions were inactive. The objective of this experiment was to investigate the antibacterial activity of hexane, dichloromethane, and aqueous fractions of Argostemma involucratum Hemsl. The aqueous fraction of Bearded Argostemma may be a possible new option for the treatment of bacterial infections.