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Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Naldixic acid, an early quinolone, was associated with pyloric stenosis (Czeizel et al., 2001), but the relationship is apparently not causal. Data are not adequate to exclude a risk of birth defects following exposure during the first trimester, but it seems unlikely that naldixic acid poses a substantial risk of birth defects. Three quinolones have not been studied during the first trimester of pregnancy: gatifloxacin (Tequin), garebixacin, and gemifloxacin.
Epidemiology of clubfoot
Published in R. L. Mittal, Clubfoot, 2018
Crider et al.51 observed, in a population-based study, that use of antibacterial agents in pregnancy are common, whereas sulfonamides and nitrofurantoin are risk factors for many congenital defects, including those of the limbs. The authors concluded from their study that there is a possibility of increased risk for congenital heart defects and recommended quinolones not be used during pregnancy. Whether the infection itself, the antibacterial, or both are responsible is to be investigated.
Information on level of drugs into breastmilk
Published in Wendy Jones, Breastfeeding and Medication, 2018
Quinolones are used to treat Gram-negative infections. They are used with caution in children as they have been found to produce arthropathy when given to immature animals. The significance in humans is unknown. Quinolones should not be taken with NSAID drugs as the combination may increase the risk of convulsions (BNF). Quinolones also prolong the QT interval so should not be used concurrently with other drugs with this effect. They may also alter blood sugars in diabetic subjects. It is not licenced for children under 1 year.
DFT based QSAR study on quinolone-triazole derivatives as antibacterial agents
Published in Journal of Receptors and Signal Transduction, 2022
Niloofar Ghasedi, Shahin Ahmadi, Sepideh Ketabi, Ali Almasirad
The accidental discovery of Nalidixic acid led to the development of a class of antibacterial drugs called fluoroquinolones. Today, quinolones are among the most important synthetic antibacterial agents, widely used in treating various infections. The clinical success of quinolones is due to features such as good bioavailability in oral administration, good tissue permeability, and relatively low toxicity. However, this widely used antibiotic class has been prone to resistance too. So there is the need to search for new representatives of this class, which have a potent antibacterial activity and the potential to overcome the bacterial resistance [2,3]. Hybrid molecules are chemical structures containing two or more structural domains with different biological functions and dual activities. Such hybrid molecules can overcome cross-drug resistance, create a broader range of effects, reduce toxicity, improve efficacy, and present new candidates with high potency against drug-resistant and drug-sensitive bacteria [1].
Using external data to assess the external validity of a randomised controlled trial
Published in Infectious Diseases, 2021
Adi Turjeman, Muhammad Awwad, Shachaf Shiber, Tanya Babich, Noa Eliakim-Raz, Angela Huttner, Stephan Harbarth, Leonard Leibovici, Dafna Yahav
The rate of clinical failure was significantly lower in excluded patients. These findings may have several explanations. First, RCT participants attended 2 follow-up visits at 14 and 28 days after completion of antibiotic therapy. During these visits clinical data and urine cultures were obtained. In excluded patients, data on 28-day outcomes was obtained from computerized medical records. Second, RCT patients tended to be older, had more classical UTI symptoms of lower UTI, and more often had previous recurrent UTI. These findings may indicate a more severe UTI compared to excluded patients, resulting in higher rates of clinical and microbiological failure in included patients. Third, as discussed above, quinolones are restricted due to safety and epidemiological reasons, although considered more effective in terms of clinical and microbiological success. Frequent use of quinolone therapy may have contributed to better outcomes in excluded patients, but, as mentioned above, other explanations are more likely.
Drug-delivering devices in the urinary tract: A systematic review
Published in Arab Journal of Urology, 2021
Panagiotis Kallidonis, Constantinos Adamou, Sara Villarrova Castillo, Despoina Liourdi, Evangelos Liatsikos, Dirk Lange
The antimicrobial effects of quinolones were studied in two articles [14,17]. Elayarajah et al. [14] used stents impregnated with a mixture of ofloxocin and ornidazole. Using a simplistic agar diffusion test they showed the impregnated stents to be effective at killing E. coli and S. epidermidis. In addition, they tested efficacy against preventing bacterial adhesion in artificial urine and found the number on the DES/DCS to be significantly lower compared to the conventional stent. Ma et al. [17] studied the characteristics and effiacy of three ciprofloxacin DES/DCS, differing in the composition of the antibiotic carrier. The stents remained in artificial urine for 120 days, over which time the coating degradation, antibiotic-release profile, the anti-bacterial activity, and cytotoxicity were assessed. It was found that ciprofloxacin release occured in three phases and was highly dependent on the degradation activity of the coating, except from the first 7 days (‘burst stage’). An inital burst release of antibiotics is important to ensure high enough concentrations to kill any introduced bacterial loads and prevent bacterial adhesion, colonisation and subsequent biofilm formation. Getting this amount right is critical, as the release of sub-optimal concentrations, especially over long periods of time, has a significant risk for inducing resistance. In general, it was shown that ciprofloxacin DES/DCS have good antibacterial activity against S. aureus and E. coli, and no cytotoxicity against human foreskin fibroblasts.