Nanotechnology and Delivery System for Bioactive Antibiofilm Dental Materials
Mary Anne S. Melo in Designing Bioactive Polymeric Materials for Restorative Dentistry, 2020
The biofilm bacteria and their toxins perturb gingival epithelial cells as the first stage in a cascade of inflammatory and immune processes that lead to the destruction of gingival tissues and ultimately, in susceptible patients, alveolar bone loss and tooth loss as a result of periodontal disease (Gorr and Abdolhosseini 2011). Mixed biofilms are communities of bacteria that communicate by quorum sensing to change the bacteria’s physiology. The biofilm contains channels to aid nutrient transport and is typically encapsulated by an extracellular polysaccharide matrix (ten Cate 2006). These features combine to make antibiotic treatment difficult. Traditional antibiotics were often selected against metabolically active bacteria in a planktonic state and are therefore less effective against the physiologically dormant bacteria encapsulated in a biofilm (ten Cate 2006). Meanwhile, the abuse of antibiotics in recent years has led to the emerging of drug-resistant bacterial strains (Chastre 2008). Currently, the first-line treatment for periodontitis is metronidazole. However, the beneficial effects of metronidazole are accompanied by undesirable side effects, including diarrhea, vomiting, metallic taste, headache, and dizziness. CHX is another potent antiplaque chemical agent, but its clinical application is limited by bitter taste and teeth stain (Eley 1999, Addy and Moran 1997).
Infections
Anne Lee, Sally Inch, David Finnigan in Therapeutics in Pregnancy and Lactation, 2019
Vaginitis due to the protozoan Trichomonas vaginalis is a common sexually transmitted disease. Infection classically presents with green-yellow frothy vaginal discharge, irritation of the vulval and urethra with pain and itching, painful sexual intercourse, and dysuria. Vaginal discharge is the most frequent complaint, but the classical appearance is only present in approximately 10% of women and many women have asymptomatic infection.2 The diagnosis is usually made on the history and examination with microscopic examination of a wet preparation of vaginal secretions or isolation of the organism on culture. There is a lack of data on whether infection has an adverse effect on pregnancy.91 Treatment is usually only recommended for symptomatic infection. Metronidazole (see bacterial vaginosis) is effective, with microbiological cure rates of more than 90% at seven days. It is recommended that partners also receive treatment.92 Other sexually transmitted diseases frequently co-exist with trichomonas infection and should be excluded in all cases.
Metronidazole
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 in Kucers’ The Use of Antibiotics, 2017
Metronidazole has been occasionally associated with an unpleasant metallic taste in the mouth, a furred tongue, nausea (rarely vomiting), and abdominal pain. Doses as high as 180 mg/kg body weight per day, when used in oncology patients as an adjunct to radiotherapy, produced slight nausea; higher doses of up to 300 mg/kg body weight per day were progressively less well tolerated and produced severe anorexia, nausea, and vomiting, which often persisted for 24–48 hours after the last dose (Deutsch et al., 1975). Pseudomembranous colitis due to C. difficile organisms that were susceptible to metronidazole has been described in a patient in association with metronidazole administration as the sole antimicrobial (Saginur et al., 1980).
ALSUntangled #66: antimycobacterial antibiotics.
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2023
Ellen S. Pierce, Paul Barkhaus, Morgan Beauchamp, Mark Bromberg, Gregory T. Carter, Jill Goslinga, David Greeley, Sky Kihuwa-Mani, Gleb Levitsky, Isaac Lund, Christopher McDermott, Gary Pattee, Kaitlyn Pierce, Meraida Polak, Dylan Ratner, Paul Wicks, Richard Bedlack
Rifabutin can cause leukopenia, neutropenia, thrombocytopenia, and hepatitis requiring laboratory monitoring (57). Rifabutin at the high dose of 600 mg/day, especially in combination with a macrolide antibiotic such as clarithromycin, can result in reversible anterior uveitis in a significant proportion of patients depending on their immune status (58,59). The treatment of drug-induced uveitis “occasionally” involves hospitalization (60). Clarithromycin can cause a metallic taste, 10% of patients may have nausea, diarrhea, abdominal pain, and/or headache (61), and there is an increased rate of sudden cardiac death compared to other antibiotics of 37/million clarithromycin doses (62). Clofazimine almost always causes brownish skin discoloration, and sometimes abdominal pain, but these side effects led to discontinuation of treatment in only 0.1% of patients (63). Nausea, vomiting, diarrhea, and abdominal pain are common side effects of metronidazole (64). Encephalopathy (65) and optic neuropathy (66) are rare side effects of metronidazole and are usually reversible with discontinuation of the drug. Based on these rare but potentially serious side effects, we assign a TOE “risks” grade of D (Table 1). Of additional interest, one case-control study suggests that any antibiotic use might increase the risk of developing ALS as well (67).
Potential applications of drug delivery technologies against radiation enteritis
Published in Expert Opinion on Drug Delivery, 2023
Dongdong Liu, Meng Wei, Wenrui Yan, Hua Xie, Yingbao Sun, Bochuan Yuan, Yiguang Jin
RE induces the microbial dysbiosis in the gut, causing intestinal infections, which would aggravate the symptoms including abdominal pain, distension, rectal bleeding, diarrhea [65]. Bactericide metronidazole has the ability to kill anaerobic and microaerobic bacteria, as well as immunoregulation, reducing the entry of pathogenic bacteria into the intestinal mucosa. As a result, metronidazole reduces the risk of rectal bleeding and contributes to the treatment of radiation proctitis [51]. Combinations of multiple drugs would take some advantages for the therapy of RE. The combination of oral metronidazole and mesalazine, as well as betamethasone enema, significantly decreases the symptoms including rectal bleeding and diarrhea in the chronic radiation proctitis patients, better than the treatment without metronidazole [66]. In addition to alleviation of rectal bleeding and frequency of diarrhea in radiation proctitis, rectal irrigation with 4% formalin in combination with oral metronidazole and ciprofloxacin is effective by reducing diarrhea and tenesmus in the patients with hemorrhagic radiation proctitis [67]. Moreover, early metronidazole intervention is effective by reducing the duration of RE, and prevents long-term complications and avoids hospitalization [52]. Therefore, antimicrobial drugs are necessary against local infections though their long-term utilization may lead to new intestinal flora imbalance.
In Vitro Activation of Macrophages by an MHC Class II-restricted Trichomonas Vaginalis TvZIP8-derived Synthetic Peptide
Published in Immunological Investigations, 2022
Victor Ermilo Arana-Argáez, Emanuel Ceballos-Góngora, María Elizbeth Alvarez-Sánchez, Antonio Euan-Canto, Julio Lara-Riegos, Julio César Torres-Romero
Trichomoniasis, a sexually transmitted infection (STI) caused by the flagellate protist parasite Trichomonas vaginalis, it has become a significant public health concern, with an estimated 276 million new cases each year and prevalence of 187 million of infected individuals, which constitutes over half of the curable STIs worldwide (Menezes et al. 2016; Newman et al. 2015). Chemotherapy with nitroimidazoles, metronidazole or tinidazole, remains as the only strategy that is used for the control of trichomoniasis. However, this limitation on a single drug class for treating the trichomoniasis, can contribute to the treatment failure due to undesirable side effects and/or to the development of nitroimidazoles-resistant strains of T. vaginalis (Bouchemal et al. 2017; Kirkcaldy et al. 2012).
Related Knowledge Centers
- Antibiotic
- Dracunculiasis
- Endocarditis
- Pelvic Inflammatory Disease
- Trichomoniasis
- Bacterial Vaginosis
- Antiprotozoal
- Giardiasis
- Amoebiasis
- Clostridioides Difficile Infection