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Metronidazole
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Ralph and Kirby (1975a) showed that against Clostridium spp., the acid and hydroxy metabolites of metronidazole possess approximately 5% and 30% (respectively) of the activity of the parent compound. When tested against isolates of the B. fragilis group, the acid and hydroxy metabolites are bactericidal, exhibiting 5% and 65% (respectively) of the inhibitory effect of the parent drug (Haller, 1982; Pendland et al., 1994). Similar findings were reported by O’Keefe et al. (1982), who showed that the hydroxy metabolite, although less active than metronidazole, inhibited selected isolates of B. fragilis, Clostridium spp., and anaerobic cocci at levels within the range of susceptibility (O’Keefe et al., 1982). The hydroxy metabolite is very active in vitro against G. vaginalis, its MIC being 6.25–25% of that of metronidazole (Baldsdon and Jackson, 1981; Easmon et al., 1982). Some strains of G. vaginalis that were resistant to metronidazole were also resistant to its hydroxy metabolite (Jones et al., 1985). These authors also reported that most vaginal isolates of Prevotella melaninogenica and Prevotella oralis were sensitive to both metronidazole and its hydroxy metabolite. Vaginal isolates of Mobiluncus spp. are often resistant to metronidazole, but, when sensitive, they are also sensitive to its hydroxy metabolite (Jones et al., 1985).
Vaginitis
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
once these fActors hAve been excluded or treAted, An induction regimen with An Antimycotic followed by A long-term suppressive mAintenAnce regimen is indicAted. While this cAn be Accomplished with topicAl regimens, becAuse of the durAtion And frequency of therApy, orAl therApy is more convenient And offers A more reAlistic solution. It should be emphAsized thAt the therApy selected is Aimed At controlling symptomAtic episodes rAther thAn guArAnteeing thAt cure will be Achieved. The use of long-term suppressive mAintenAnce regimens hAs been confirmed in severAl prospective controlled studies [19,20]. Accordingly, After An induction regimen of fluconAzole 150 mg given every 72 hours for 3 doses, A weekly mAintenAnce regimen of fluconAzole 150 mg once weekly is suggested. Complete resolution of symptoms follows within A mAtter of weeks, And the pAtients remAin AsymptomAtic for the durAtion of therApy, which is recommended for 6 months. During this period, the pAtient invAriAbly remAins culture negAtive And AsymptomAtic. Following discontinuAtion of therApy After 6 months, ApproximAtely 50% of the pAtients rApidly become recolonized And develop recurrent symptoms of vvC. However, 50% of pAtients will return to An AttAck-free life with risks similAr to low-risk women. should symptomAtic recurrence rApidly follow discontinuAtion of therApy, repeAt reinduction And mAintenAnce therApy is recommended this time for At leAst 12 months. Frequently, even longer prolonged mAintenAnce regimens Are recommended And required. Epidemiology bv is the most common cAuse of vAginitis in women of childbeAring Age. It hAs been diAgnosed in 17%–19% of women seeking gynecologicAl cAre in fAmily prActice or student heAlth-cAre settings [1]. The worldwide prevAlence rAnges from 11% to 48% of women of reproductive Age, with vAriAtion According to populAtion studied [21]. The prevAlence increAses considerAbly in symptomAtic women Attending stD clinics, reAching 24%–37%. bv hAs been observed in 16%–29% of pregnAnt women. GArdnerellA vAginAlis hAs been found in 10%–31% of virgin Adolescent girls but is found significAntly more frequently Among sexuAlly Active women, reAching A prevAlence of 50%–60% in some At-risk populAtions. evAluAtion of epidemiologicAl fActors hAs reveAled A few clues of the cAuse of bv. use of An intrAuterine device And douching wAs found to be more common in women with bv. bv is significAntly more common Among blAck And sexuAlly Active women including lesbiAns. PAthogenesis And PAthology bv is not due to A single orgAnism And is the result of mAssive overgrowth of mixed complex florA or microbiotA, including peptostreptococci, BActeriodes spp., G. vAginAlis, Mobiluncus spp., genitAl mycoplAsmA, And A vAriety of recently described AnAerobes [22]. There is little inflAmmAtion, And the disorder represents A disturbAnce of the vAginAl microbiAl ecosystem rAther thAn A true infection of tissues. The overgrowth of mixed florA is AssociAted with A loss of the normAl
Site-specific delivery of polymeric encapsulated microorganisms: a patent evaluation of US20170165201A1
Published in Expert Opinion on Therapeutic Patents, 2018
Inderbir Singh, Pradeep Kumar, Viness Pillay
The gastrointestinal microbiome has been shown to play a vital role in regulation and progression of various diseases ranging from ulceratives colitis through allergies to cancers. Modulating the microbiome population either via decreasing disease-causing microorganisms and/or increasing probiotic microorganisms has been shown to be effective in the treatment of a numbers of diseases [1]. The presence of certain microbes or absence of normal microbes or alteration in the proportion of microbes has shown to be responsible for certain diseases or disorders. In Crohn’s disease, concentration of Eubacteria, Bacterioides, and Peptostreptococcus is increased whereas that of Bifidobacteria is decreased. In ulcerative colitis, the number of facultative anaerobes is increased. Bacterial vaginosis is characterized by the presence of Gardnerella and Mobiluncus spp. of bacteria and absence or reduction in number of Lactobacilli [1–4]. Probiotic bacteria Lactobacillus fermentum and Bifidobacterium lactis have been proved to reduce gliadin induced cellular damage. Enteric pathogens like Escherichia coli, Salmonella enteriditis, Yersina pseudotuberculosis, Listeria monocytogenes are associated with diseases like diarrhea, irritable bowel syndrome, and intestinal hemorrhages. Hence, live microorganisms (or probiotics) can improve the microbial balance of the host for curing respective diseases or disorders [1–5]. Several bacterial strains have been proven in clinical studies to be therapeutically effective against various diseases/disorders and are listed in Table 1 [1].
Comparison of microbial profiles and viral status along the vagina-cervix-endometrium continuum of infertile patients
Published in Systems Biology in Reproductive Medicine, 2023
Mark Jain, Elena Mladova, Anna Dobychina, Karina Kirillova, Anna Shichanina, Daniil Anokhin, Liya Scherbakova, Larisa Samokhodskaya, Olga Panina
The microbiological profiles were analyzed using the following commercial kits on a DT-Prime real-time PCR instrument (DNA-Technology, Moscow, Russia) according to the manufacturers’ protocols: ‘Femoflor 16’, ‘TNC Complex’, ‘Herpes Multiplex’ (cat# R1-P801-S3/6, R1-P111-S3/9, R1-P210-S3/9, respectively, (DNA-Technology, Moscow, Russia)). These reagents allowed quantitative analysis of the total bacterial load (based on the detection of conservative procaryotic sequences), Lactobacillus spp., Enterobacteriaceae, Streptococcus spp., Staphylococcus spp., Gardnerella vaginalis, Prevotella bivia, Porphyromonas spp., Eubacterium spp., Sneathia spp., Leptotrichia spp., Fusobacterium spp., Megasphaera spp., Veillonella spp., Dialister spp., Lachnobacterium spp., Clostridium spp., Mobiluncus spp., Corynebacterium spp., Peptostreptococcus spp., Atopobium vaginae, Candida spp., Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma genitalium as well as qualitative analysis of Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Herpes simplex viruses 1 & 2, Cytomegalovirus. The number of Homo sapiens DNA was also measured in every sample to control the biomaterial collection quality (>103 copies per reaction mixture). Real-time PCR data was analyzed automatically in the RealTime_PCR software (DNA-Technology, Russia) developed for the above-mentioned PCR kits. The recommended manufacturer cycle threshold value for qualitative analysis was 24, whereas during quantitative analysis DNA levels of less than 103 copies were considered negative. Some closely related taxa were analyzed collectively due to limitations of the applied real-time PCR assay. In such cases, the names of the taxa are listed together and joined by a “+” sign.