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Linezolid
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
Pythium insidiosum, the main human pathogen of the fungus-like oomycetes, has proven difficult to treat with antifungal therapy because it does not produce ergosterol, the main target of these drugs. Loreto et al. (2014) therefore tested the activity of a number of antibacterial drugs against Pythium in vitro and found linezolid to be active with an MIC90 of 4 mg/l (range 1–8 mg/l) using Etest, and 32 mg/l (4–32 mg/l) at 48 hours. Further work is required to resolve this discrepancy between methods.
Unusual Presentation of Pythium Keratitis as Peripheral Ulcerative Keratitis: Clinical Dilemma
Published in Ocular Immunology and Inflammation, 2022
Anahita Kate, Bhupesh Bagga, Lalit K. Ahirwar, Dilip K. Mishra, Savitri Sharma
In the initial postoperative period, the patient was continued on the same preoperative combination antibiotic therapy. After four days of inoculation, typical flat, submerged, colorless colony of Pythium insidiosum was grown in culture on blood agar (Figure 3). The organism was identified by zoospore formation and confirmed by ITS-based DNA sequencing (GenBank ME 492909). Tested on Mueller Hinton agar by disc diffusion assay, the organism produced large zone of inhibition against linezolid and azithromycin (36 and 30 mm, respectively) and these antibiotics showed low MIC of 2 μg/ml and 1.5 μg/ml, respectively, indicating susceptibility of the organism to both the drugs.3 The patient was then started on hourly topical linezolid 0.2% .
Pythium insidiosum keratitis: Review of literature of 5 years’ clinical experience at a tertiary eye care center
Published in Seminars in Ophthalmology, 2023
Pratima Vishwakarma, Bhupesh Bagga
Pythiosis, a lethal and uprising infective condition affecting humans and animals, is caused predominantly by Pythium insidiosum.1 In humans, it can result in cutaneous or subcutaneous, ocular, vascular, or disseminated forms of infection.2 Its systemic and subcutaneous involvement was well known earlier,3 while ocular involvement in the form of Pythium insidiosum keratitis was first reported in humans in 1988.4 Recently, an animal model has also been developed for corneal infection in rabbits.5 Initially it was reported more commonly from Thailand and Israel,6 but now due to increased awareness of this under-reported organism worldwide, it is found to be widely prevalent.