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Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Ciprofloxacin exposure during the first trimester in 608 women was not associated with any increased frequency of infants with congenital anomalies. Among 70 pregnancies exposed to levofloxacin during the first trimester, the frequency of infants with birth defects was not increased. First trimester moxifloxacin exposure among 55 mothers was associated with an increased frequency (n=2) of respiratory system defects (Muanda et al., 2017). The study included 37 pregnancies exposed to norfloxacin during the first trimester, and no increased frequency of birth defects. The frequency of birth defects was not increased among 224 infants in the Swedish Registry whose mothers used ciprofloxacin during the first trimester (Kallen, 2019).
Anti-Infective Agents
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: The pregnancy experience in humans suggests low risk; however, the authors of one study recommended avoid giving Norfloxacin during pregnancy because safer alternatives are generally available. However, fluoroquinolones are commonly avoided in the perinatal period because of fears from fetal cartilage damage.
Gastroenterology and hepatology
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
Organisms should be cultured by directly collecting into blood culture bottles. It is most commonly seen in alcoholic cirrhosis and the causative organism is usually Escherichia coli, Klebsiella, S pneumoniae or Enterococci. (Compare this with the mixed growth seen in other forms of peritonitis.) Hence cefotaxime is regarded as the drug of choice for treatment. Norfloxacin is recommended for short-term prophylaxis.
In silico docking studies and synthesis of new phosphoramidate derivatives of 6-fluoro-3-(piperidin-4-yl)benzo[d]isoxazole as potential antimicrobial agents
Published in Journal of Receptors and Signal Transduction, 2020
Munichandra Reddy Sivala, Venkataramaiah Chintha, Krishna Murthy Potla, Sampath Chinnam, Naga Raju Chamarthi
All the synthesized compounds 4(a–j) were screened for their anti-bacterial and anti-fungal activity using agar disk diffusion method [43–44] with small modifications. The loop full of selected pure bacterial/fungal strains were inoculated in the Luria broth medium in 250-ml conical flasks separately and incubated at 37 °C in an incubator to produce 24-h active culture. The overnight active cultures were seeded into the Luria agar medium by Pour-plate technique. After solidification of medium, cavities were made in the Luria agar plates with the help of metallic borer. The solvent dimethylformamide (DMF) as negative control and different concentrations (25, 50, 75 and 100 µL) of the synthesized compounds were added to the cavities and petri plates were incubated at 37 ± 2°C in the incubator for 24 h. The zones of inhibition formed by these compounds against the particular test bacterial/fungal strains are determined. Norfloxacin and nystatin were used as standard drugs to compare the activity results.
Synthesis, antibacterial and anticancer activity, and docking study of aminoguanidines containing an alkynyl moiety
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2020
Bacterial resistance against most antibiotics presents a major problem of current times26–29. Therefore, it is crucial to evaluate the potential emergence of bacterial resistance against these biocides. The propensity for development of bacterial resistance of the synthesised compounds was evaluated by using the most active compound (3g) against both Gram-positive S. aureus and Gram-negative E. coli30,31. Norfloxacin, an antibiotic generally used to treat the Gram-positive infections, was used as a positive control for S. aureus, whereas colistin, a lipopeptide antibiotic active against Gram-negative bacteria, was used as a positive control for E. coli. These antibacterial agents were repeatedly challenged against bacteria at their sub-MIC values to allow bacteria to develop resistance. Resistance is usually defined as a > 4-fold increase in the original MIC32. Interestingly, little change in the MIC of compound 3g was observed over 20 generations. In comparison, an approximately 32-fold and 4 or 8-fold increase in MIC was observed for norfloxacin and colistin, respectively (Figure 2). The above results indicated that bacteria do not develop resistance against this type of aminoguanidine within the experimental time period.
Targeted drug delivery and drug resistant pathogens
Published in Expert Review of Respiratory Medicine, 2018
One potential solution to the above is the use of drugs that specifically accumulate in a body compartment with minimal or no accumulation elsewhere. Some examples of such drugs already exist: norfloxacin – a fluoroquinolone – concentrates in urine and was used primarily for treatment urinary tract infections (UTIs), however, the drug also impacted fecal flora. Similarly, nitrofurantoin is utilized for UTIs. Macrolides/azalides tend to accumulate at higher concentrations in pulmonary compartments and alveolar macrophages but serum concentrations approximate the mutant selection window (MSW) for some pathogens such that during bacteremia, the risk for resistance selection increases [2]. The MSW is bordered by the minimum inhibitory concentration (MIC) and mutant prevention concentration (MPC). The MSW has been argued to be the drug concentration range where selective amplification of bacterial cells, not inhibited by the MIC, occurs [3]. Dosing to exceed the MPC has been argued to prevent growth of organisms with reduced susceptibility to drug. Additionally, accumulation of macrolides/azalides in pulmonary compartments is not equal and agent specific differences require specific attention to appreciate the differences [4]. Just because two agents may give similar clinical outcomes does not mean the drugs are identical in terms of their specific characteristics. Appreciating the differences between individual drugs and drug classes may allow optimization of therapy and be consistent with antimicrobial stewardship principals.