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Recent trends in advanced oxidation process-based degradation of erythromycin: Pollution status, eco-toxicity and degradation mechanism in aquatic ecosystems

Ashraf A, Liu G, Yousaf B, Arif M, Ahmed R, Irshad S, et al.

Sci Total Environ, 2021 Jun 10;772:145389.
PMID: 33578171 DOI: 10.1016/j.scitotenv.2021.145389

Wide spread documentation of antibiotic pollution is becoming a threat to aquatic environment. Erythromycin (ERY), a macrolide belonging antibiotic is at the top of this list with its concentrations ranging between ng/L to a few μg/L in various global waterbodies giving rise to ERY-resistance genes (ERY-RGs) and ERY- resistance bacteria (ERY-RBs) posing serious threat to the aquatic organisms. ERY seems resistant to various conventional water treatments, remained intact and even increased in terms of mass loads after treatment. Enhanced oxidation potential, wide pH range, elevated selectivity, adaptability and greater efficiency makes advance oxidation processes (AOPs) top priority for degrading pollutants with aromatic rings and unsaturated bonds like ERY. In this manuscript, recent developments in AOPs for ERY degradation are reported along with the factors that affect the degradation mechanism. ERY, marked as a risk prioritized macrolide antibiotic by 2015 released European Union watch list, most probably due to its protein inhibition capability considered third most widely used antibiotic. The current review provides a complete ERY overview including the environmental entry sources, concentration in global waters, ERY status in STPs, as well as factors affecting their functionality. Along with that this study presents complete outlook regarding ERY-RGs and provides an in depth detail regarding ERY's potential threats to aquatic biota. This study helps in figuring out the best possible strategy to tackle antibiotic pollution keeping ERY as a model antibiotic because of extreme toxicity records.

Matched MeSH terms: Erythromycin
Fulltext Determining the impact of pre-lecture educational video on comprehension of a difficult gross anatomy lecture

Hadie SNH, Simok AA, Shamsuddin SA, Mohammad JA

J Taibah Univ Med Sci, 2019 Aug;14(4):395-401.
PMID: 31488974 DOI: 10.1016/j.jtumed.2019.06.008

Objective: Students commonly perceive gross anatomy lectures as difficult because they contain complex information that requires three-dimensional visualisation in order to be understood. Without prior preparation, a gross anatomy topic expounded via lecture can be cognitively challenging. Hence, this study aimed to investigate the impact of a pre-lecture activity in the form of viewing a video on students' lecture comprehension.
Method: A quasi-experimental study was conducted using 254 first-year medical students with no prior exposure to the lecture topic during the 2016/17 and 2017/18 academic sessions. The students from each batch were divided into two groups and exposed to different video material. Group A watched an action movie, while Group B watched an educational video related to the lecture topic. After 15 min, both groups attended a lecture on the gross anatomy of the heart, which was delivered by a qualified anatomist. At the end of the lecture, their understanding of the material was measured through a post-lecture test using ten vetted multiple choice true/false questions.
Results: Group B's test scores were found to be significantly higher than Group A's (p > 0.001, t-stats [df] = -4.21 [252]).
Conclusion: This study concluded that the pre-lecture activity had successfully provided the students with some prior knowledge of the subject before they attended the lecture sessions. This finding was aligned with cognitive load theory, which describes a reduction in learners' cognitive load when prior knowledge is stimulated.

Matched MeSH terms: Erythromycin
Molecular insights into 14-membered macrolides using the MM-PBSA method

Yam WK, Wahab HA

J Chem Inf Model, 2009 Jun;49(6):1558-67.
PMID: 19469526 DOI: 10.1021/ci8003495

Erythromycin A and roxithromycin are clinically important macrolide antibiotics that selectively act on the bacterial 50S large ribosomal subunit to inhibit bacteria's protein elongation process by blocking the exit tunnel for the nascent peptide away from ribosome. The detailed molecular mechanism of macrolide binding is yet to be elucidated as it is currently known to the most general idea only. In this study, molecular dynamics (MD) simulation was employed to study their interaction at the molecular level, and the binding free energies for both systems were calculated using the molecular mechanics Poisson-Boltzmann surface area (MM-PBSA) method. The calculated binding free energies for both systems were slightly overestimated compared to the experimental values, but individual energy terms enabled better understanding in the binding for both systems. Decomposition of results into residue basis was able to show the contribution of each residue at the binding pocket toward the binding affinity of macrolides and hence identified several key interacting residues that were in agreement with previous experimental and computational data. Results also indicated the contributions from van der Waals are more important and significant than electrostatic contribution in the binding of macrolides to the binding pocket. The findings from this study are expected to contribute to the understanding of a detailed mechanism of action in a quantitative matter and thus assisting in the development of a safer macrolide antibiotic.

Matched MeSH terms: Erythromycin/metabolism; Erythromycin/chemistry
Refinement of a low-resolution crystal structure to better understand erythromycin interactions on large ribosomal subunit

Wahab HA, Yam WK, Samian MR, Najimudin N

J Biomol Struct Dyn, 2008 Aug;26(1):131-46.
PMID: 18533733

Macrolides are a group of diverse class of naturally occurring and synthetic antibiotics made of macrocyclic-lactone ring carrying one or more sugar moieties linked to various atoms of the lactone ring. These macrolides selectively bind to a single high affinity site on the prokaryotic 50S ribosomal subunit, making them highly effective towards a wide range of bacterial pathogens. The understanding of binding between macrolides and ribosome serves a good basis in elucidating how they work at the molecular level and these findings would be important in rational drug design. Here, we report refinement of reconstructed PDB structure of erythromycin-ribosome system using molecular dynamics (MD) simulation. Interesting findings were observed in this refinement stage that could improve the understanding of the binding of erythromycin A (ERYA) onto the 50S subunit. The results showed ERYA was highly hydrated and water molecules were found to be important in bridging hydrogen bond at the binding pocket during the simulation time. ERYA binding to ribosome was also strengthened by hydrogen bond network and hydrophobic interactions between the antibiotic and the ribosome. Our MD simulation also demonstrated direct interaction of ERYA with Domains II, V and with C1773 (U1782EC), a residue in Domain IV that has yet been described of its role in ERYA binding. It is hoped that this refinement will serve as a starting model for a further enhancement of our understanding towards the binding of ERYA to ribosome.

Matched MeSH terms: Erythromycin/metabolism*; Erythromycin/chemistry*
Fulltext Reverse micelle Extraction of Antibiotics using an Eco-friendly Sophorolipids Biosurfactant

Chuo SC, Abd-Talib N, Mohd-Setapar SH, Hassan H, Nasir HM, Ahmad A, et al.

Sci Rep, 2018 01 11;8(1):477.
PMID: 29323139 DOI: 10.1038/s41598-017-18279-w

Reverse micelles extraction of erythromycin and amoxicillin were carried out using the novel Sophorolipids biosurfactant. By replacing commonly used chemical surfactants with biosurfactant, reverse micelle extraction can be further improved in terms of environmental friendliness and sustainability. A central composite experimental design was used to investigate the effects of solution pH, KCl concentration, and sophorolipids concentration on the reverse micelle extraction of antibiotics. The most significant factor identified during the reverse micelle extraction of both antibiotics is the pH of aqueous solutions. Best forward extraction performance for erythromycin was found at feed phase pH of approximately 8.0 with low KCl and sophorolipids concentrations. Optimum recovery of erythromycin was obtained at stripping phase pH around 10.0 and with low KCl concentration. On the other hand, best forward extraction performance for amoxicillin was found at feed phase pH around 3.5 with low KCl concentration and high sophorolipids concentration. Optimum recovery of erythromycin was obtained at stripping phase pH around 6.0 with low KCl concentration. Both erythromycin and amoxicillin were found to be very sensitive toaqueous phase pH and can be easily degraded outside of their stable pH ranges.

Matched MeSH terms: Erythromycin/isolation & purification; Erythromycin/chemistry
Comparison of thermophilic Campylobacter spp. occurrence in two types of retail chicken samples

Tang, J.Y.H., Mohamad Ghazali, F., Saleha, A.A., Nishibuchi, M., Son, R.

International Food Research Journal, 2009;16(3):277-288.
MyJurnal

The aim of this study is to compare the occurrence of thermophilic Campylobacter spp. in chicken retail at wet markets and hypermarkets. Campylobacter contaminations in chicken samples from wet market (70.7%) were comparatively lower than chicken samples sold in hypermarket (91.4%). Of the 77 Campylobacter isolates, 59 (76.6%) were identified as Campylobacter jejuni and 18 (23.4%) isolates were identified as C. coli. All Campylobacterisolates are multi-resistant to the antimicrobial agents. Most of the isolates were resistant to tetracycline (92.2%) and erythromycin (98.7%). This study concluded that chicken samples from both wet market and hypermarket were contaminated with Campylobacter, most of which are antimicrobial-resistant strains.

Matched MeSH terms: Erythromycin
Fulltext Pharyngeal carriage of group A Streptococcus in Malaysian schoolchildren

Jamal F, George J, Aziz AA, Ahmad D

Family Practitioner, 1986;9(1):38-39.

Pharyngeal carriage of group A streptococcus was determined in 432 primary school children between the ages of 6 and 8 years. Beta-haemolytic streptococci were isolated from throat swab culture of 71 pupils, with a carrier rate of 16.4% (71/432) of which 9.4% (39/432) belonged to Lancefield's group A. Serogrouping of the isolates was determined by the coagglutination method and Lancefield's hot acid extraction method. 54.9% (39/71) of the total beta-hemolytic streptococci isolated belonged to group A , 25.3% (18/71) to group G, 15.4% (11/71) to group C and 1.4%(1/71) to group F. T typing pattern of group A streptococcus was determined by the standard agglutination method. Sensitivity to antibiotics was determined by the disc diffusion technique (comparative method). All group A streptococcal isolates were sensitive to penicillin and erythromycin, 6 strains (15.4%) were resistant to tetracycline and 1 strain (2.5%) was resistant to cephaloridine.

Matched MeSH terms: Erythromycin
Comparison of constructed wetland performance coupled with aeration and tubesettler for pharmaceutical compound removal from hospital wastewater

Khan RA, Khan NA, El Morabet R, Alsubih M, Khan AR, Khan S, et al.

Environ Res, 2023 Jan 01;216(Pt 1):114437.
PMID: 36181898 DOI: 10.1016/j.envres.2022.114437

Pharmaceutical compounds being able to alter, retard, and enhance metabolism has gained attention in recent time as emerging pollutant. However, hospitals which are part of every urban landscape have yet to gain attention in terms of its hospital wastewater treatment to inhibit pharmaceutical compounds from reaching environment. Hence this study evaluated performance of constructed wetland in combination with tubesettler and aeration based on removal efficiency and ecological risk assessment (HQ). The removal efficiency of constructed wetland with plantation was higher by 31% (paracetamol), 102% (ibuprofen), 46%, (carbamazepine), 57% (lorazepam), 54% (erythromycin), 31% (ciprofloxacin) and 20% (simvastatin) against constructed wetland without plantation. Constructed wetland with aeration efficiency increased for paracetamol, ibuprofen, carbamazepine, lorazepam, erythromycin, ciprofloxacin, and simvastatin removal efficiency were higher by 58%, 130%, 52%, 79%, 107%, 57%, and 29% respectively. In constructed wetland with plantation, removal efficiency was higher by 20% (paracetamol), 13% (ibuprofen), 4% (carbamazepine), 14% (lorazepam), 34% (erythromycin), 19% (ciprofloxacin) and 7% (simvastatin). High ecological risk was observed for algae, invertebrate and fish with hazard quotient values in range of 2.5-484, 10-631 and 1-78 respectively. This study concludes that if space is the limitation at hospitals aeration with constructed wetland can be adopted. If space is available, constructed wetland with tubesettler is suitable, economic and environmentally friendly option. Future research works can focus on evaluating other processes combination with constructed wetland.

Matched MeSH terms: Erythromycin
Fulltext Mycoplasma pneumoniae infection complicated by empyema: a rare presentation

Othman N, Yip CW, Samat NA

Med J Malaysia, 2005 Aug;60(3):389-91.
PMID: 16379202

Mycoplasma pneumoniae is a common causative agent for childhood pneumonia. However, empyema is a rare presentation. We report a case of a previously well child who presented with a right-sided empyema. M. pneumoniae was confirmed serologically with evidence of a four-fold rise in Mycoplasma IgM titre. The empyema required drainage procedures for more than two weeks. The infection resolved with a course of six weeks of treatment with erythromycin.

Matched MeSH terms: Erythromycin/therapeutic use
Fulltext Tetracycline resistant cholera in Kelantan

Ranjit K, Nurahan M

Med J Malaysia, 2000 Mar;55(1):143-5.
PMID: 11072502 MyJurnal

Sensitivity testing on Vibrio cholerae isolates during an epidemic in 1998 in Kelantan identified strains resistant to tetracycline. This prompted a change in the usual management of cholera in Kelantan. The antibiotic of choice was changed from tetracycline to erythromycin.

Matched MeSH terms: Erythromycin/therapeutic use
Characterisation and molecular cloning of an erythromycin resistance plasmid of Lactococcus lactis isolated from chicken cecum

Raha AR, Ross E, Yusoff K, Manap MY, Ideris A

J. Biochem. Mol. Biol. Biophys., 2002 Feb;6(1):7-11.
PMID: 12186776

An erythromycin resistance plasmid, pAJ01 was isolated from Loctococcus lactis isolate C5 that was isolated from a healthy two-week-old chicken cecum. A 4 kb plasmid was transformed into plasmidless L. lactis MG1363 before a restriction endonuclease map was constructed. It was then fused with pUC19 to form pAJ02, which can replicate in Escherichia coli XLI-Blue as well as L. lactis MG1363. The plasmid was stably maintained in Lactococcus for more than 100 generations.

Matched MeSH terms: Erythromycin/pharmacology*
Conjugal transfer of antibiotic resistances and plasmids from Campylobacter jejuni clinical isolates

Ansary A, Radu S

FEMS Microbiol Lett, 1992 Mar 01;70(2):125-8.
PMID: 1587459

Six Campylobacter jejuni clinical isolates were examined for the occurrence of plasmids in association with antibiotic resistances as well as conjugal transfer. All the isolates were found to carry three similar plasmids of 78 kb, 12.6 kb and 3.3 kb in size. Multiple resistance to at least three of the antibiotics tested was observed with resistance to tetracycline most common. En bloc transfer of donor resistances at frequencies ranging from 10(-8) to 10(-4) were seen in all but one of the isolates during conjugation. The conjugal transfer of erythromycin, neomycin and streptomycin were observed to occur at frequencies similar to that of chloramphenicol, kanamycin and tetracycline. In isolate ABA94, three different antibiotic resistance phenotypes of the transconjugants were seen. In addition to en bloc transfer of the donor resistances, in approximately 10% of the transconjugants the streptomycin resistance was lost although these transconjugants carried the donor complement of three plasmids. In a further 1% of the transconjugants, resistance to kanamycin only was detected and these transconjugants did not carry any plasmids.

Matched MeSH terms: Erythromycin/pharmacology
Conjugal transfer of plasmids and antibiotic resistance among Escherichia coli isolated from animals in a rural area in Sarawak (Malaysia)

Son R, Rusu G, Karim MI

J Appl Microbiol, 1997 Feb;82(2):240-4.
PMID: 12452600

Thirty-six strains of Escherichia coli isolated from animals in Bario, a remote area in Sarawak, Malaysia, were examined for presence of plasmid DNA and their susceptibility to nine antimicrobial agents. Of the total 36 isolates, five bovine and six canine isolates were found to contain plasmid DNA ranging in sizes from 2.6 to 70 kilobases. All were susceptible to chloramphenicol, erythromycin, gentamicin, nalidixic acid and neomycin but resistance to ampicillin (47%), erythromycin (19%), streptomycin (25%) and tetracycline (11%) was observed. Resistance was associated with carriage of a 47 kb (SC98), 70 kb, (SC133) and 56 and 4.6 kb (SC119) plasmids which were transmissible to the Escherichia coli K12 recipient. It is concluded that animals form a potential reservoir of R plasmids carrying E. coli in the study area.

Matched MeSH terms: Erythromycin/pharmacology
Fulltext Acne vulgaris in a family practitioner's clinic

Goh CS

Med J Malaysia, 1981 Jun;36(2):87-8.
PMID: 6211594
Matched MeSH terms: Erythromycin/therapeutic use
Detection of mecA and ermA genes and simultaneous identification of Staphylococcus aureus using triplex real-time PCR from Malaysian S. aureus strain collections

Sabet NS, Subramaniam G, Navaratnam P, Sekaran SD

Int J Antimicrob Agents, 2007 May;29(5):582-5.
PMID: 17314034

A triplex real-time polymerase chain reaction (PCR) assay was used for the simultaneous detection of mecA (methicillin resistance), ermA (erythromycin resistance) and femA (Staphylococcus aureus identification) genes in a single assay. Among 93 clinical S. aureus hospital isolates, there were 48 methicillin-resistant S. aureus (MRSA) and 45 methicillin-sensitive S. aureus (MSSA) isolates. Screening the isolates using the triplex real-time PCR assay, the mecA, ermA and femA genes were detected in all MRSA isolates. The triplex real-time PCR assay was completed within 3h and is a useful genotypic method for detecting the resistance determinants as well as for the identification of S. aureus isolates. These findings will assist the clinical laboratory in identifying these resistance genes and S. aureus rapidly, thus benefiting patient therapy. This study represents a valuable source of information for researchers to study the local antibiotic resistance pattern, which can increase our knowledge of the antibiotic resistance profile, using real-time PCR technology.

Matched MeSH terms: Erythromycin/pharmacology
Inducible clindamycin resistance among clinical isolates of Staphylococci

Ciraj AM, Vinod P, Sreejith G, Rajani K

Indian J Pathol Microbiol, 2009 1 13;52(1):49-51.
PMID: 19136780

INTRODUCTION: Clinical failure of clindamycin therapy has been reported due to multiple mechanisms that confer resistance to macrolide, lincosamide and streptogramin antibiotics. This study was undertaken to detect the presence of inducible clindamycin resistance among clinical isolates of staphylococci.
MATERIALS AND METHODS: The detection of inducible clindamycin resistance was performed by D-test using erythromycin and clindamycin discs as per CDC guidelines.
RESULTS: Among the 244 clinical isolates of staphylococci studied, 32 (13.1%) showed inducible clindamycin resistance and belonged to the MLSBi phenotype. Among the MLS B i phenotypes, 10 isolates were methicillin-resistant Staphylococcus aureus (38.4% of the total MRSA), 16 were methicillin-sensitive Staphylococcus aureus (12.9% of the total MSSA) and 6 were coagulase-negative staphylococci (6.3% of the total CONS).
CONCLUSION: The test for inducible resistance to clindamycin should be included in the routine antibiotic susceptibility testing, as it will help in guiding therapy.

Matched MeSH terms: Erythromycin/pharmacology
Fulltext Antimicrobial properties of erythromycin and colistin impregnated bone cement. An in vitro analysis

Ruzaimi MY, Shahril Y, Masbah O, Salasawati H

Med J Malaysia, 2006 Feb;61 Suppl A:21-6.
PMID: 17042224

Deep surgical site infection is a devastating consequence of total joint arthroplasty. The use of antibiotic impregnated bone cement is a well-accepted adjunct for treatment of established infection and prevention of deep orthopaedic infection. It allows local delivery of the antibiotic at the cement-bone interface and sustained release of antibiotic provides adequate antibiotic coverage after the wound closure. Preclinical testing, randomised and clinical trials indicate that the use of antibiotic-impregnated bone cement is a potentially effective strategy in reducing the risk of deep surgical site infection following total joint arthroplasty. The purpose of this study was to assess antibacterial activity of erythromycin and colistin impregnated bone cement against strains of organisms' representative of orthopaedic infections including Gram-positive and Gram-negative aerobic organisms: Staphylococcus aureus, coagulase-negative Staphylococci, Enterococcus sp., Proteus sp., Klebsiella sp., Pseudomonas sp., and Escherichia coli. Pre-blended Simplex P bone cement with the addition of erythromycin and colistin (Howemedica Inc) was mixed thoroughly with 20ml liquid under sterile conditions to produce uniform cylindrical discs with a diameter of 14mm and thickness of 2mm. 24-48 hour agar cultures of Staphylococcus aureus, coagulase-negative Staphylococci, Enterococcus sp.,Proteus sp., Klebsiella sp.,Pseudomonas sp., and Escherichia coli were used for the agar diffusion tests. The agar plates were streaked for confluent growth followed by application of erythromycin and colistin impregnated bone cement disc to each agar plate. The plates were incubated at 30 degrees C and examined at 24, 48, 72 hours, and four and five days after the preparation of the impregnated cement. The susceptibility of Staphylococcus aureus to the control discs was most clearly demonstrated showing a distinct zone of inhibition. The zone observed around coagulase-negative Staphylococci, Klebsiella sp., Pseudomonas sp., and Escherichia coli were also significant. However, there was no zone of inhibition or signs of antibacterial activity at the cemented surface were detected around discs with Enterococcus sp. and Proteus sp. The results showed that Simplex P bone cement with the addition of erythromycin and colistin was effective against most of the broad spectrum organisms encountered during total joint arthroplasty. The activity of Simplex P bone cement impregnated with erythromycin and colistin is mainly during the first 72 hours.

Matched MeSH terms: Erythromycin/administration & dosage; Erythromycin/pharmacology*
Pluronic-F127 composite film loaded with erythromycin for wound application: formulation, physicomechanical and in vitro evaluations

Alavi T, Rezvanian M, Ahmad N, Mohamad N, Ng SF

Drug Deliv Transl Res, 2019 04;9(2):508-519.
PMID: 29181832 DOI: 10.1007/s13346-017-0450-z

Composite film dressings composed of pluronic F127 (PL)-pectin (PC) and pluronic (PL) F127-gelatin (GL) were investigated as potential drug delivery system for wound healing. Composite films were solvent cast by blending PL with PC or GL in different ratios using glycerol (2.5%) as plasticizer. Erythromycin (ER) (0.1%) was incorporated in films as model hydrophobic antibiotic. The optimized composite films were characterized for physical appearance, morphology, mechanical profile, and thermal behavior. In addition, drug release, antibacterial activity, and cytocompatibility of the films were investigated to assess their potential as drug delivery system. The composite films exhibited excellent wound dressing characters in terms of appearance, stability, and mechanical profile. Moreover, ER-loaded composite films released ER in controlled manner, exhibited antibacterial activity against Staphylococcus aureus, and were non-toxic to human skin fibroblast. These findings demonstrate that these composite films hold the potential to be formulated as antibacterial wound dressing.

Matched MeSH terms: Erythromycin/administration & dosage*; Erythromycin/chemistry
Fulltext The Prophylactic Effect of Probiotic Enterococcus lactis IW5 against Different Human Cancer Cells

Nami Y, Haghshenas B, Haghshenas M, Abdullah N, Yari Khosroushahi A

Front Microbiol, 2015;6:1317.
PMID: 26635778 DOI: 10.3389/fmicb.2015.01317

Enterococcus lactis IW5 was obtained from human gut and the potential probiotic characteristics of this organism were then evaluated. Results showed that this strain was highly resistant to low pH and high bile salt and adhered strongly to Caco-2 human epithelial colorectal cell lines. The supernatant of E. lactis IW5 strongly inhibited the growth of several pathogenic bacteria and decreased the viability of different cancer cells, such as HeLa, MCF-7, AGS, HT-29, and Caco-2. Conversely, E. lactis IW5 did not inhibit the viability of normal FHs-74 cells. This strain did not generate toxic enzymes, including β-glucosidase, β-glucuronidase, and N-acetyl-β-glucosaminidase and was highly susceptible to ampicillin, gentamycin, penicillin, vancomycin, clindamycin, sulfamethoxazol, and chloramphenicol but resistant to erythromycin and tetracyclin. This study provided evidence for the effect of E. lactis IW5 on cancer cells. Therefore, E. lactis IW5, as a bioactive therapeutics, should be subjected to other relevant tests to verify the therapeutic suitability of this strain for clinical applications.

Matched MeSH terms: Erythromycin
A revisit to the effects of zinc salt on skin burn wound healing to reflect the risks in current pharmaceutical care

Osman MAH, Wong TW, Anuar NK

J Dermatolog Treat, 2020 Sep;31(6):651-654.
PMID: 31264929 DOI: 10.1080/09546634.2019.1639607

The lower limit of soluble zinc content that can possibly be applied onto a wounded skin as a healing promoter was not known. This study examined skin wound healing process of rats inflicted by partial thickness thermal burn wound as a function of applied soluble zinc contents (0.1 ml of zinc chloride solution 0.01% (w/w) or 5.0% (w/w)). The size, surface morphology and histological profiles of wound beds of untreated rats and those treated with zinc chloride solutions were characterized. A soluble zinc content as low as 10.5 μg/cm2 of skin negated skin wound healing when compared to the untreated rats. This was alarming as the commercial products currently in the market are formulated with a high level of zinc content. Albeit the zinc salt employed was water-insoluble, a minute fraction of soluble zinc might be available to the treatment sites. This could be partially responsible for the late adverse effects such as pruritis and inflammation reported with calamine/diphenhydramine lotion, medicated shampoo, Olay Complete defense moisturizing lotion and Zineryt® topical solution. The skin irritation was likely a resultant oxidative stress action of soluble zinc, where a small fraction could be adequate to negate the skin homeostasis.[Figure: see text]Key messagesZinc is essentially a cofactor for skin collagen formation.Soluble zinc content as low as 10.5 μg/cm2 of skin irritates skin and negates burn wound healing.Skin irritation of commercial products relates to minute soluble zinc content availability.

Matched MeSH terms: Erythromycin

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