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Roxithromycin
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
Overall, the various indications for roxithromycin are somewhat limited, since, despite a favorable pharmacokinetic profile, it does not have a major advantage in intrinsic activity over other newer macrolides, such as clarithromycin (see Chapter 61, Clarithromycin) or azithromycin (see Chapter 62, Azithromycin). Clarithromycin and azithromycin both demonstrate lower MICs than erythromycin, have high bioavailability and prolonged half-lives, and are therefore often the preferred agents versus roxithromycin. In those countries where roxithromycin is used regularly, it is generally for respiratory tract infections, especially mild to moderate cases of community-acquired pneumonia, often in combination with a beta-lactam agent.
Iatrogenic factors of Helicobacter pylori eradication failure: lessons from the frontline
Published in Expert Review of Anti-infective Therapy, 2023
Jinliang Xie, Dingwei Liu, Jianxiang Peng, Shuang Wu, Dongsheng Liu, Yong Xie
In addition, amoxicillin-clavulanate potassium and other uncommonly used or ineffective antibiotics were used in H. pylori eradication. It was irrational for some patients to treat H. pylori infection using amoxicillin-clavulanate potassium instead of amoxicillin. In an RCT study, bismuth quadruple therapy with amoxicillin-clavulanate and tetracycline showed 17.4% eradication rate by per-protocol analyses [31]. Clavulanate potassium is known as a β-lactamase inhibitor, while H. pylori do not produce β- lactamase, the addition of clavulanate potassium agent in the H. pylori treatment is maybe ineffective. Secondly, clavulanate potassium will exceed the normal dosage to meet the amoxicillin standard dose and increase the risk of drug-induced liver damage consequently. Otherwise, an insufficient dose of amoxicillin may reduce the efficacy and lead to eradication failure. At present, there is no consensus to recommend amoxicillin-clavulanate potassium to treat H. pylori infection. Besides, some patients used other not recommended or ineffective antibiotics, such as gentamicin, azithromycin, roxithromycin, etc. These antibiotics are not verified by clinical trials so they may affect the efficacy [9,22]. Moreover, some other not recommended treatments were used, such as non-high dual dose therapy, only one antibiotic therapy, etc. These informal treatments with an insufficient dose of regimens should be avoided to reduce the risk of treatment failure.
Antibacterial and anti-biofilm activities of paeonol against Klebsiella pneumoniae and Enterobacter cloacae
Published in Biofouling, 2021
Weidong Qian, Xinchen Li, Min Yang, Gennian Mao
The dense structure of biofilms provides additional protection to the associated microbial organisms, escaping the effect of antibiotics on biofilm cells, thereby causing infectious diseases. The dynamic biofilm life cycle on a medical device includes transport and initial attachment of bacterial cells, irreversible adhesion or attachment, microcolony formation, and maturation of the biofilm (Vertes et al. 2012). It is generally accepted that the initial attachment of bacterial cells to a surface is a critical step in biofilm formation (Habimana et al. 2014). Thus, the effect of paeonol on the initial adhesion of K. pneumoniae and E. cloacae cells to surfaces was explored. As depicted in Figure 4, paeonol at ¼ of the MIC reduced the adhesive capacity of K. pneumoniae and E. cloacae by 87.1% and 88.5% compared with the untreated group, respectively. Adhesion of K. pneumoniae and E. cloacae to the glass surface was inhibited by paeonol in a concentration-dependent manner. Similarly, roxithromycin has been reported to reduce the adhesion of K. pneumoniae in a dose-dependent manner (Favre-Bonte et al. 1998).
Oral antibiotics used in the treatment of chronic rhinosinusitis have limited penetration into the sinonasal mucosa: a randomized trial
Published in Xenobiotica, 2020
Joey Siu, Lilian Klingler, Yi Wang, Cheung-Tak Hung, Soo Hee Jeong, Susan Smith, Malcolm Drummond Tingle, Brett Wagner Mackenzie, Kristi Biswas, Richard George Douglas
A random block of five patients taking either doxycycline or roxithromycin had further samples taken for bacterial culture analysis and antibiotic susceptibility testing. This included a right-sided middle meatus swab at timepoints 1 and 2 as well as a right-sided ethmoid bulla tissue sample at timepoint 2. The presence or absence of Staphylococcus aureus and beta-haemolytic Streptococci on these samples were reported using colonial appearances and confirmed using Matrix-Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF). All other organisms were only isolated for genus identification using MALDI-TOF if they were considered a dominant organism. A dominant organism grew two times more than the other organisms present. Growths were defined as light (growth only in the initial inoculum), moderate (growth in the initial inoculum and streak lines but not over the entire plate) or heavy (growth over entire plate). Dominant isolates were also subcultured before testing the minimum inhibitory concentration required to inhibit the growth of 90% (MIC) of all identified organisms within the isolate to doxycycline, erythromycin and amoxicillin-clavulanic acid. This was performed using MIC strips (Liofilchem®) according to manufacturer instructions. Bacterial susceptibilities were interpreted using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria (EUCAST, 2020). Erythromycin was selected over roxithromycin as the closest macrolide drug due to the unavailability of roxithromycin test strips.