bluuebunny/crossref_metadata_2025 huggingface dataset:
In vitro susceptibilities of Rickettsia rickettsii and Rickettsia conorii to roxithromycin and pristinamycin
Authors: Drancourt M , Raoult D
Published: June 2012

In vitro susceptibilities of Rickettsia rickettsii and Rickettsia conorii to roxithromycin, pristinamycin, and the pristinamycin compounds, P1 and P2, were determined by a dye uptake assay and a plaque assay. The MICs were 1 microgram/ml for roxithromycin, 2 micrograms/ml for pristinamycin, greater than 256 micrograms/ml for P1, and 2 micrograms/ml for P2. Compounds P1 and P2 did not share synergetic activity. The toxicity of each compound was determined by a dye uptake assay. Toxic concentrations were 128 micrograms/ml for roxithromycin, 32 micrograms/ml for pristinamycin, greater than 256 micrograms/ml for P1, and 32 micrograms/ml for P2. Roxithromycin and pristinamycin could be useful in the treatment of Rocky Mountain spotted fever and Mediterranean spotted fever.
Chloramphenicol resistance in Pseudomonas cepacia because of decreased permeability
Authors: Burns J L , Hedin L A , Lien D M
Published: June 2012

The mechanism of chloramphenicol resistance was examined in a high-level-resistant isolate of Pseudomonas cepacia from a patient with cystic fibrosis. We investigated potential resistance mechanisms, including production of chloramphenicol acetyltransferase, ribosomal resistance, and decreased permeability. This strain (MIC, 200 micrograms/ml) had no detectable chloramphenicol acetyltransferase activity. In in vitro translation experiments in which we compared the resistant isolate with a susceptible strain of P. cepacia, inhibition of amino acid incorporation was equivalent even in organisms that were preincubated with sub-MICs of chloramphenicol. A 21.9-kilobase (kb) fragment of DNA was cloned which coded for chloramphenicol resistance; this fragment was expressed in P. cepacia but not in Escherichia coli. Quantitation of chloramphenicol uptake in the isogenic pair of susceptible and resistant organisms revealed a nearly 10-fold decrease of drug entry into the resistant strain. Comparison of isolated outer membrane proteins and lipopolysaccharide patterns identified no significant differences between the isogenic pair of organisms. We concluded that the mechanism of chloramphenicol resistance in this strain is decreased permeability.
Effect of age and renal function on cefonicid pharmacokinetics
Authors: Trang J M , Monson T P , Ackerman B H , Underwood F L , Manning J T , Kearns G L
Published: June 2012

Cefonicid (15 mg/kg) was administered intravenously at a constant rate of infusion over 15 min to 10 geriatric patients (mean age, 77 years) and to 4 young subjects (mean age, 35 years). Model-dependent and noncompartmental pharmacokinetic parameters were calculated and found to be congruous; noncompartmental data are reported. Significant differences in the values for area under the curve, mean residence time, total body clearance, and renal clearance were observed between the geriatric and young groups. Mean elimination half-life values were 9.59 and 4.88 h for the geriatric and young groups, respectively. Total body and renal clearances were inversely correlated to age and directly correlated to creatinine clearance. Free fraction was not correlated to albumin concentration but was correlated exponentially to total cefonicid concentration. Despite the prolonged half-life values observed in our geriatric patients, the difference in mean trough concentrations was slight. Daily administration of a 15-mg/kg dose should provide adequate concentrations in serum and should not produce appreciable accumulation in geriatric patients.
Pharmacokinetics and bioavailability of carbovir, a carbocyclic nucleoside active against human immunodeficiency virus, in rats
Authors: Yeom Y H , Remmel R P , Huang S H , Hua M , Vince R , Zimmerman C L
Published: June 2012

Carbovir is a novel carbocyclic nucleoside which has been shown to have potent in vitro activity against human immunodeficiency virus, the causative agent of acquired immunodeficiency syndrome. Sprague-Dawley male rats were used to investigate the pharmacokinetics and bioavailability of carbovir. Six rats received carbovir (20 mg/kg of body weight) through the jugular vein, and blood samples were collected through the femoral vein 2, 5, 10, 15, 20, 30, 45, 60, 75, 90, 120, 150, 180, and 240 min after the dose. Four of these rats also received a 60-mg/kg oral dose of carbovir, and a similar blood sampling schedule was followed. Whole-blood samples were prepared by solid-phase extraction, and the carbovir concentration in the samples was analyzed by reversed-phase high-pressure liquid chromatography. The profile of carbovir concentration in blood versus time after the intravenous dose was biexponential, with a very rapid distribution phase. Terminal elimination half-life was 21.4 +/- 4.37 min, and total body clearance was 55.2 +/- 13.8 ml/min per kg, which was within the range of the hepatic blood flow. The volume of distribution at steady state was 1,123 +/- 250 ml/kg. The blood/plasma ratio and the plasma protein binding of carbovir in rat blood were determined in vitro by ultrafiltration. The plasma protein binding of carbovir was only 20% and was not concentration dependent. However, the blood/plasma ratio decreased significantly as concentration increased, indicating saturable binding sites in erythrocytes. After the oral dose, the terminal half-life was 81.0 +/- 67.6 min, indicating that oral carbovir followed "flip-flop" kinetics, with absorption being much slower than elimination of the drug from the body. Oral bioavailability was 0.101 +/- 0.035. Double peaks were present in the concentration-time profile for each rat receiving the oral dose, indicating either a delay in stomach emptying of the drug or slow dissolution of precipitated carbovir in the stomach and upper small intestine.
Efficacy of phosphonylmethoxyalkyl derivatives of adenine in experimental herpes simplex virus and vaccinia virus infections in vivo
Authors: De Clercq E , Holý A , Rosenberg I
Published: June 2012

The phosphonylmethoxyalkyl derivatives (S)-9-(3-hydroxy-2-phosphonylmethoxypropyl)adenine [(S)-HPMPA], 9-(2-phosphonylmethoxyethyl)adenine (PMEA), and 9-(2-phosphonylmethoxyethyl)-2,6-diaminopurine (PMEDAP) were evaluated for their in vivo efficacies in several animal model infections, i.e., mice infected intravenously with vaccinia virus and mice infected intracutaneously, intraperitoneally, or intracerebrally with herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2) or thymidine kinase-deficient (TK-) HSV-1. (S)-HPMPA inhibited the development of tail lesions caused by vaccinia virus if it was administered intraperitoneally or subcutaneously at a dosage as low as 5 mg/kg per day. All three compounds completely suppressed the development of skin lesions and the mortality associated therewith in hairless or athymic nude mice inoculated intracutaneously with HSV-1 or TK- HSV-1, if they were administered topically at a concentration as low as 0.1%; when (S)-HPMPA was applied topically at a concentration of greater than or equal to 0.3%, it completely abrogated mortality resulting from intracutaneous HSV-2 infection. Most dramatic were the effects shown by the compounds in mice inoculated intracerebrally with HSV-1, HSV-2, or TK- HSV-1, in which all three compounds given intraperitoneally at a dose of 50 or 100 mg/kg per day effected a significant reduction in the mortality rate of HSV-1-infected mice. The mortality of mice infected intracerebrally with HSV-2 or TK- HSV-1 was significantly reduced even when (S)-HPMPA was given at doses as low as 10 mg/kg per day. These data point to the great potential of the phosphonylmethoxyalkylpurines for both topical and parenteral treatment of HSV-1, HSV-2, and TK- HSV-1 infections.
Comparison of broth microdilution and agar dilution for susceptibility testing of Neisseria gonorrhoeae
Authors: Geers T A , Donabedian A M
Published: June 2012

Broth microdilution was compared with agar dilution to test the susceptibilities of 170 clinical isolates of Neisseria gonorrhoeae to several antimicrobial agents. Percents agreement between the two methods within 1 doubling dilution were 98.8% for enoxacin, 94.3% for penicillin G, 93.5% for spectinomycin, and 98.4% for ceftriaxone.
Early treatment of Campylobacter jejuni enteritis
Authors: Williams M D , Schorling J B , Barrett L J , Dudley S M , Orgel I , Koch W C , Shields D S , Thorson S M , Lohr J A , Guerrant R L
Published: June 2012

The bacteriologic and clinical effects of early antibiotic treatment of Campylobacter jejuni enteritis were studied. Erythromycin rapidly eliminated C. jejuni from stools, whereas trimethoprim-sulfamethoxazole did not. Despite its bacteriologic effectiveness, erythromycin did not reduce the duration or severity of diarrhea, abdominal pain, or other symptoms.
Characterization of the porins of Campylobacter jejuni and Campylobacter coli and implications for antibiotic susceptibility
Authors: Page W J , Huyer G , Huyer M , Worobec E A
Published: June 2012

The major outer membrane protein was extracted from Campylobacter coli by Triton X-100/EDTA fractionation of cell envelopes. This heat-modifiable protein was shown to have pore-forming activity in black lipid bilayers. The C. coli porin formed a relatively small cation-selective pore with a mean single-channel conductance of 0.53 +/- 0.16 nS in 1.0 M KCl. There was no evidence of oligomer formation, which suggested that each protein monomer formed a pore. Pore-forming activity of the C. coli porin and similarly prepared Campylobacter jejuni porin was also measured in liposome-swelling assays. These results confirmed the cation selectivity of both pores. The C. coli porin formed a small pore, which hindered the penetration of solutes with a molecular weight of 262, and a larger pore, which hindered the penetration of solutes with a molecular weight of 340, in a protein-concentration-dependent manner. C. jejuni formed one size of pore that was slightly larger than the C. coli pore and just permitted the passage of solutes, with a molecular weight of 340. A review of the literature concerning in vitro screening of antimicrobial agents tended to confirm the low permeability of the C. jejuni outer membrane to hydrophilic antimicrobial agents except when the molecules had molecular weights of less than 360. The porins of C. jejuni and C. coli may contribute to intrinsic resistance to antimicrobial agents, whereas alternative (nonporin) routes of antimicrobial agent uptake may be more important determinants of susceptibility to antimicrobial agents.
Role of lipids in augmenting the antibacterial activity of benzoyl peroxide against Propionibacterium acnes
Authors: Decker L C , Deuel D M , Sedlock D M
Published: June 2012

Antimicrobial activity and physicochemical properties of benzoyl peroxide (BP) were investigated to determine the mechanism of action for the compound as an antiacne agent. The MICs and MBCs against nine strains of Propionibacterium acnes ranged between 100 and 800 micrograms/ml in a nutrient broth system, with a median fourfold increase in activity demonstrated when lipid was added. The partition coefficient of BP in a 50:50 artificial skin lipid and water system was greater than 2,500, with the concentration of BP soluble in lipid measured at 1.12% and in water at 0.005%. When BP was incubated in the presence of a lipid mixture, reaction products were formed, with evidence that at least some of these compounds possessed antibacterial activity. These results suggest that BP reduces the P. acnes numbers in sebaceous follicles because of good lipid solubility and interaction with the lipid component, the latter property contributing to the antimicrobial activity of the compound in a high-lipid environment.
Safety and tolerance of ocular administration of recombinant alpha interferon
Authors: Turner R B , Durcan F J , Albrecht J K , Crandall A S
Published: June 2012

The safety, tolerance, and levels of drug in the nasal cavity produced by an ocular formulation of interferon were determined at four dosages in a placebo-controlled, double-masked trial. Interferon given by the ocular route was generally well tolerated, although a dose-related occurrence of subjective symptoms was detected.
Low-level methicillin resistance in strains of Staphylococcus aureus
Authors: Chambers H F , Archer G , Matsuhashi M
Published: June 2012

Two strains of Staphylococcus aureus expressing borderline or low-level methicillin resistance by one or more in vitro test methods were examined for resistance in vivo and for biochemical and genetic markers of methicillin resistance. In vivo, nafcillin was equally effective against experimental aortic valve endocarditis in rabbits, regardless of whether they were infected by a fully susceptible or a low-level-resistant strain. Resistance did not emerge during therapy. For the more resistant of the two low-level-resistant strains, methicillin was as effective as nafcillin. Nafcillin was ineffective against endocarditis caused by a truly methicillin-resistant strain, and resistance emerged on therapy. The low-level-resistant strains did not produce the low-affinity penicillin-binding protein 2a that is associated with methicillin resistance and did not contain DNA that hybridized with probes that recognized the methicillin resistance determinant. Low-level resistance in S. aureus is a phenomenon that is biochemically and genetically distinct from true methicillin resistance. These strains actually are susceptible to beta-lactam antibiotics. The clinical problem posed by these strains is not a therapeutic one but, instead, one of how to differentiate them from those that are truly methicillin resistant.
Interaction between oral ciprofloxacin and caffeine in normal volunteers
Authors: Healy D P , Polk R E , Kanawati L , Rock D T , Mooney M L
Published: June 2012

The influence of multiple doses of ciprofloxacin on the disposition of caffeine and its major metabolite, paraxanthine, was investigated in healthy volunteers. Ten xanthine-free, fasting males were given 100 mg of caffeine orally 24 h before being given ciprofloxacin and again with the third dose of ciprofloxacin (750 mg administered every 12 h). Blood samples were serially collected after both doses of caffeine and after the first and last doses of ciprofloxacin. Ciprofloxacin significantly increased the half-life of caffeine (from 5.2 +/- 1.2 to 8.2 +/- 2.5 h) and the area under the caffeine concentration-time curve (from 16.3 +/- 6.6 to 25.9 +/- 7.8 micrograms.h/ml) while decreasing the total body clearance (from 106 +/- 41.6 to 58.2 +/- 28.8 ml/min per 1.73 m2). In addition, the rate of conversion of caffeine to paraxanthine was significantly delayed. There was no significant linear correlation between the urinary recovery of oxociprofloxacin at 0 to 12 h and the change in the area under the caffeine concentration-time curve. There was also a small but statistically significant increase in the area under the ciprofloxacin concentration-time curve during simultaneous administration of caffeine. We concluded that ciprofloxacin causes a significant increase in the half-life of caffeine and in the area under the caffeine concentration-time curve by reducing total body clearance. This interaction is due at least in part to a delay in the conversion of caffeine to paraxanthine. The clinical significance of these observations remains to be determined. Lastly, caffeine may alter the kinetics of ciprofloxacin, a possibility which should be more fully explored.
Combinations of 3'-azido-3'-deoxythymidine (zidovudine) and phosphonoformate (foscarnet) against human immunodeficiency virus type 1 and cytomegalovirus replication in vitro
Authors: Eriksson B F , Schinazi R F
Published: June 2012

Combinations of 3'-azido-3'-deoxythymidine and phosphonoformate produced a moderate synergistic inhibitory effect against human immunodeficiency virus type 1 in vitro at concentrations that are easily achieved in humans. The synergistic effect was more pronounced with increasing concentrations and was not secondary to toxic effects of the drugs. 3'-Azido-3'-deoxythymidine neither inhibited the replication of human cytomegalovirus in human embryonic lung fibroblasts nor interfered with the anticytomegalovirus effect of phosphonoformate. By using partially purified reverse transcriptase of human immunodeficiency virus type 1 and human cytomegalovirus DNA polymerase, various combinations of 3'-azido-3'-deoxythymidine-5'-triphosphate and phosphonoformate produced strong indications of additive interactions. The synergistic interactions in infected cells and the additive effects observed at the reverse transcriptase level indicate that mechanisms other than the reverse transcriptase may be of importance for the inhibition of human immunodeficiency virus replication by these two compounds. A concomitant treatment of cytomegalovirus infections, such as cytomegalovirus retinitis, with phosphonoformate in patients with acquired immunodeficiency syndrome receiving 3'-azido-3'-deoxythymidine may be appropriate, and this combination may also be useful in controlling human immunodeficiency virus infection.
Comparative in vitro activity of ceftibuten (Sch 39720) against bacterial enteropathogens
Authors: Shawar R , LaRocco M , Cleary T G
Published: June 2012

Ceftibuten is a new orally active cephalosporin with significant bioavailability. Its in vitro activity was compared with those of other agents against 383 strains of enteric pathogens derived from clinical specimens. Ceftibuten was very active against the strains of the family Enterobacteriaceae tested (overall MIC for 90% of strains tested, 0.25 microgram/ml) but was less active against Campylobacter jejuni (MIC for 90% of strains, 16 micrograms/ml). The MBC was one to two dilutions higher than the corresponding MICs for most pathogens tested.
Pharmacokinetics of gentamicin in neonates on extracorporeal membrane oxygenation
Authors: Southgate W M , DiPiro J T , Robertson A F
Published: June 2012

Extracorporeal membrane oxygenation (ECMO) has been used in more than 1,000 infants in 50 centers in the United States. The extracorporeal circuit contains approximately 400 ml of blood, an amount exceeding the blood volume of most full-term neonates. The effect of this additional blood volume on drug disposition is unknown. In this study, we determined the pharmacokinetic parameters of gentamicin in 10 infants on ECMO. Gentamicin concentrations were determined by a fluorescence polarization immunoassay. Pharmacokinetic parameters were determined from these concentrations by using a two-compartment model. Our study demonstrated a mean steady-state volume of distribution of 0.51 +/- 0.11 liters/kg, a figure similar to that in previous studies of full-term infants. The elimination half-life was found to be prolonged (mean, 573 +/- 263 min). The creatinine level in the plasma of the infants was found to be a statistically significant predictor of elimination half-life. Recommendations regarding initial dosing levels of gentamicin in infants on ECMO are made.
Selection of orally active antifungal agents from 3,5-substituted isoxazolidine derivatives based on acute efficacy-safety profiles
Authors: Palmer G C , Ordy M J , Simmons R D , Strand J C , Radov L A , Mullen G B , Kinsolving C R , St Georgiev V , Mitchell J T , Allen S D
Published: June 2012

Routine in vitro screening of a new synthetic series of 3,5-substituted 2-methylisoxazolidines revealed that three imidazole analogs (PR 967-248, PR 967-234, and PR 969-566) and, to a lesser extent, a triazole analog (PR 988-399) exerted rather potent antifungal activity against three systemic and four dermatophytic classes of fungi. When tested in vivo for ability to eradicate Candida vaginitis in the rat, the triazole derivative, PR 988-399, was effective after oral administration. In this in vivo test for efficacy, PR 967-234 and PR 969-566 reduced but did not eradicate the infection, while PR 967-248 was inactive. PR 988-399 was, moreover, 4- to 13-fold less potent than the three imidazoles in inhibiting testosterone synthesis in isolated rat Leydig cells. After oral or intravenous administration, PR 988-399 and PR 969-566 elicited the fewest cardiovascular and behavioural side effects in conscious dogs. The rat safety study consisted of oral dosing followed by evaluation of the exploratory motor activity of the naive animals in a novel environment. Motor activity was suppressed least by PR 988-399 and most by PR 969-566. In a battery of mouse behavioural-neuromuscular-drug interaction tests, PR 988-399 and PR 969-566 produced the fewest central-behavioural-neuromuscular signs. These efficacy-safety evaluations were performed with ketoconazole as a positive reference standard. The sequence of drug testing with respect to efficacy-safety considerations appears to be a suitable approach for early detection of orally active antifungal agents such as PR 988-399 for more advanced development.
Feline immunodeficiency virus, a model for reverse transcriptase-targeted chemotherapy for acquired immune deficiency syndrome
Authors: North T W , North G L , Pedersen N C
Published: June 2012

Feline immunodeficiency virus (FIV), formerly called feline T-lymphotropic lentivirus, causes an immune deficiency in cats that is very similar to the acquired immune deficiency syndrome in humans (N. C. Pedersen, E. M. Ho, M. L. Brown, and J. K. Yamamoto, Science 235:790-793, 1987). We have examined the reverse transcriptase of this virus to determine whether it is similar enough to the reverse transcriptase of the human immunodeficiency virus type 1 (HIV-1) to enable its use as a model for chemotherapy for acquired immune deficiency syndrome. The FIV reverse transcriptase is similar to that of HIV-1 in sensitivity to the noncompetitive inhibitor phosphonoformate (Ki, 0.3 microM) and relative insensitivity to phosphonoacetate. This enzyme was also sensitive to two competitive inhibitors, the 5'-triphosphates of 2', 3'-dideoxythymidine (Ki, 3.4 nM) and 3'-azido-3'-deoxythymidine (AZT; Ki, 6.2 nM). The ratios of Ki/Km for these two competitive inhibitors are similar to the ratios calculated from previously reported data for the HIV-1 enzyme assayed under identical conditions. In contrast, the FIV enzyme is different from the reverse transcriptase of avian myeloblastosis virus in sensitivity to those inhibitors. The replication of FIV in Crandell feline kidney cells was inhibited by AZT; virus production was inhibited more than 95% by 1.0 microM AZT.
Role of sodium in the protective effect of ticarcillin on gentamicin nephrotoxicity in rats
Authors: Ohnishi A , Bryant T D , Branch K R , Sabra R , Branch R A
Published: June 2012

Coadministration of sodium ticarcillin with an aminoglycoside is known to reduce the nephrotoxicity of the aminoglycoside. However, it is not known whether the penicillin or the obligatory sodium load confers protection. To investigate this, gentamicin has been administered intraperitoneally in doses of 50, 60, or 80 mg/kg per day for 12 days in groups of rats receiving either a normal or a low sodium intake. Alterations in creatinine clearance have been measured. Salt depletion resulted in an enhanced nephrotoxic response with a shift in the dose-response curve to the left. Administration of sodium ticarcillin to rats with a salt-depleted intake at a dose sufficient to replace sodium intake conferred an equal degree of protection to rats with a normal salt intake. We report that the obligatory salt supplement with ticarcillin is sufficient to account for the renal sparing effect of the combination treatment without having to infer a direct chemical interaction of penicillin with the aminoglycoside.
Resistance emerging after pefloxacin therapy of experimental Enterobacter cloacae peritonitis
Authors: Lucain C , Regamey P , Bellido F , Pechére J C
Published: June 2012

Resistance emerging after pefloxacin therapy was investigated in an experimental Enterobacter cloacae infection. Mice were inoculated intraperitoneally (mean inoculum, 0.9 X 10(8) CFU) with one of four strains initially susceptible to quinolones and treated with a single 25-mg/kg dose of pefloxacin. This therapy produced a net decrease of bacterial counts in the peritoneal fluid, but with the of the isolates, posttherapy (PT1) strains emerged with decreased susceptibilities to quinolones (4- to 1,024-fold), to the structurally unrelated antibiotics (4- to 16-fold) chloramphenicol and trimethoprim, and sometimes to tetracycline and beta-lactam compounds. In a second set of experiments, new mice were similarly infected with PT1 strains and treated with up to five 25-mg/kg doses of pefloxacin. Compared with parent isolates, PT1 strains produced similar disease and peritoneal bacterial count in the control animals. In treated mice posttherapy (PT2) strains emerged that showed 8- to 64-fold increases in quinolone MICs compared with the PT1 strains inoculated. All PT1 and PT2 strains showed altered outer membrane protein patterns, principally marked by a decreased 37,000-molecular-weight band generally accompanied by an increased 42,000-molecular-weight band. Whole cells from all PT1 and PT2 strains, exposed to [14C]pefloxacin for 15 to 60 s, bound significantly less radioactivity than the corresponding parent strains. After partial purification, DNA gyrase extracted from the most resistant isolates (one PT1 and the PT2 strains) showed a 100- to 450-fold 50% inhibitory concentration increase for pefloxacin. Altogether, pefloxacin can select in vivo two types of resistant strain, one with only decreased permeability and another with decreased permeability combined with altered DNA gyrase.
SHV-5, a novel SHV-type beta-lactamase that hydrolyzes broad-spectrum cephalosporins and monobactams
Authors: Gutmann L , Ferré B , Goldstein F W , Rizk N , Pinto-Schuster E , Acar J F , Collatz E
Published: June 2012

SHV-5 (pI 8.2), a novel broad-spectrum beta-lactamase encoded by a ca. 150-kilobase plasmid, was found in Klebsiella pneumoniae 160. SHV-5 beta-lactamase caused decreased susceptibility to most penicillins, cephalosporins, and monobactams, except imipenem and compounds which have a C6 or C7 alpha-methoxy substituent. beta-Lactamase inhibitors (clavulanic acid, sulbactam, and tazobactam) inhibited its activity and showed a synergistic effect when associated with different hydrolyzable beta-lactam compounds. Hybridization studies suggested that this enzyme may be related to, or derived from, the SHV enzyme. Increased MICs of cephamycins and temocillin associated with a decreased synergistic effect of the inhibitors on K. pneumoniae 160 might be linked to a decrease in two outer membrane proteins.
Serial trough and peak amikacin levels in plasma as predictors of nephrotoxicity
Authors: Contreras A M , Gamba G , Cortés J , Santiago Y , Nares F , Jimenez-Sanchez G , Bobadilla J , López G , Valadez A , Espinosa A
Published: June 2012

We studied 113 patients treated with intravenous amikacin to determine the value of determining serial trough and peak amikacin levels in plasma for predicting nephrotoxicity. Thirteen patients (11.5%) developed renal toxicity, with significant increases from 48 to 96 h in both peak and trough amikacin levels (6.7 +/- 4.7 [standard deviation] days before the serum creatinine rose). The nontoxicity group had no change or even showed decrements in amikacin levels in plasma. A higher nephrotoxicity risk was seen in patients with increments greater than 1 microgram/ml between 48 and 96 h, with odds ratios of 16.4 for trough, 8 for peak, and 7.2 for both levels. We suggest that an increment of at least 1 microgram/ml in amikacin levels in plasma from 48 to 96 h may predict the appearance of renal toxicity.
In vitro evaluation of the determinants of bactericidal activity of ampicillin dosing regimens against Escherichia coli
Authors: White C A , Toothaker R D , Smith A L , Slattery J T
Published: June 2012

An in vitro flow model was used to examine the influence of peak concentration (Cmax), the area under the antibiotic concentration-time curve (AUC), the magnitude of AUC above the MIC, and the aggregate time the antibiotic concentration exceeds the MIC (TMIC) on the bactericidal effect of ampicillin against Escherichia coli ATCC 12407. Bacteria in the log phase were exposed to therapeutically realistic drug regimens. Ampicillin concentration and bacterial density (CFU per milliliter) were measured over time. Four parameters reflecting bactericidal activity were quantitated: difference between initial and minimum and initial and final bacterial densities, area under the bacterial density-time curve, and a fourth parameter, sigma, which is a function of these three. Multiple regression analysis confirmed AUC as the major factor in predicting bactericidal activity. An AUC of greater than 70 micrograms.h/ml correlated with the lack of emergence of resistance.
Broad-spectrum antiviral activities of neplanocin A, 3-deazaneplanocin A, and their 5'-nor derivatives
Authors: De Clercq E , Cools M , Balzarini J , Marquez V E , Borcherding D R , Borchardt R T , Drach J C , Kitaoka S , Konno T
Published: June 2012

The neplanocin A analogs, 3-deazaneplanocin A, 9-(trans-2',trans-3'-dihydroxycyclopent-4'-enyl)adenine (DHCA), and 9-(trans-2',trans-3'-dihydroxycyclopent-4'-enyl)-3-deazaadenine (DHCDA), all potent inhibitors of S-adenosylhomocysteine (AdoHcy) hydrolase, were studied for their broad-spectrum antiviral potential. 3-Deazaneplanocin A, DHCA, and DHCDA proved specifically effective against vesicular stomatitis virus, vaccinia virus, parainfluenza virus, reovirus, and rotavirus. Their selectivity was greater than that of neplanocin A, particularly against vesicular stomatitis virus and rotavirus. As could be expected from adenosine analogs that are directly targeted at AdoHcy hydrolase, 3-deazaneplanocin A, DHCA, and DHCDA were fully active in adenosine kinase-deficient cells, implying that their activity did not depend on phosphorylation by adenosine kinase. None of the AdoHcy hydrolase inhibitors showed selective activity against human immunodeficiency virus (type 1). 3-Deazaneplanocin A at a dose of 0.5 mg/kg per day conferred marked protection against a lethal infection of newborn mice with vesicular stomatitis virus.
Mobility of gentamicin resistance genes from staphylococci isolated in the United States: identification of Tn4031, a gentamicin resistance transposon from Staphylococcus epidermidis
Authors: Thomas W D , Archer G L
Published: June 2012

Homologous genes encoding resistance to gentamicin, tobramycin, and kanamycin through the bifunctional acetylating [AAC(6')] and phosphorylating [APH(2")] aminoglycoside-modifying enzyme were identified in staphylococci isolated from patients in the United States. The mobility of gentamicin resistance (Gmr) genes found on a prototype conjugative plasmid (pGO1) was compared with that of genes cloned from chromosomal sites. Plasmid-encoded Gmr genes and flanking sequences were introduced onto a temperature-sensitive plasmid (pRN3208) from pGO1 by homologous recombination between insertion sequence-like elements present on both replicons. Growth of Staphylococcus aureus strains containing the temperature-sensitive recombinant (pGO161) at the nonpermissive temperature for plasmid replication (42 degrees C) revealed no translocation of Gmr from its plasmid location. A transposon (Tn551) resident on the same replicon did translocate. Chromosomal Gmr determinants were cloned, together with the gene for trimethoprim resistance (dfrA), from three geographically distinct S. epidermidis isolates; two were subcloned onto temperature-sensitive Escherichia coli-S. aureus shuttle plasmids as 7.2-kilobase BglII fragments. Growth of both recombination-deficient and-proficient S. aureus strains containing the cloned genes at 42 degrees C allowed detection of transposition of Gmr sequences and identification of insertion into random chromosomal sites. We have designated this 5-kilobase transposon from S. epidermidis as Tn4031.
In vitro activities of daptomycin and other antimicrobial agents against vancomycin-resistant gram-positive bacteria
Authors: de la Maza L , Ruoff K L , Ferraro M J
Published: June 2012

A comparative evaluation of daptomycin and eight other antimicrobial agents was performed by the agar dilution technique with 56 strains of vancomycin-resistant gram-positive bacteria, including Leuconostoc, Lactobacillus, and Pediococcus spp. Erythromycin, deptomycin, clindamycin, and gentamicin exhibited the greatest activities, whereas penicillin, ampicillin, and cefotaxime showed moderate activities. The organisms were all highly resistant to vancomycin and cefoxitin.
In vitro studies of Chlamydia trachomatis susceptibility and resistance to rifampin and rifabutin
Authors: Treharne J D , Yearsley P J , Ballard R C
Published: June 2012

Although rapid emergence of antibiotic-resistant mutants of Chlamydia trachomatis occurs when the organism is grown in subinhibitory concentrations of rifampin, no such mutants could be demonstrated when the organism was propagated under the same conditions in subinhibitory levels of the related drug rifabutin.
Pharmacokinetics of amikacin in hematologic malignancies
Authors: Kaojarern S , Maoleekoonpairoj S , Atichartakarn V
Published: June 2012

The pharmacokinetics of amikacin in 10 patients with hematologic malignancies and 1 patient with aplastic anemia were investigated. At an administered dose of 7 mg/kg of body weight, a volume of distribution of 0.4 liters/kg, an elimination half-life of 3.0 h, and a total body clearance of 2.1 ml/min per kg, amikacin achieved a peak level in blood of 21 micrograms/ml. Results of the study revealed that there was a marked increase in volume of distribution of amikacin in these patients compared with normal.
Reduction in biliary excretion of ceftriaxone by diclofenac in rabbits
Authors: Merle-Melet M , Seta N , Farinotti R , Carbon C
Published: June 2012

The effects of diclofenac, a nonsteroidal anti-inflammatory drug, on biliary excretion of ceftriaxone were evaluated in rabbits. In a previous study, we demonstrated that diclofenac increased the extravascular diffusion and antibacterial efficacy of ceftriaxone without any effect on serum protein binding and urinary excretion of this antibiotic. We perfected a surgical procedure that allowed the study of biliary secretion in conscious rabbits with a stable hemodynamic state. The kinetic study was carried out on the fourth day of treatment with ceftriaxone alone (30 mg/kg per day given intramuscularly; group 1) or combined with diclofenac (1.5 mg/kg per 12 h given intramuscularly; group 2). Cumulative biliary excretion of ceftriaxone over 6 h was significantly reduced in group 2 (5,291.6 +/- 2,017.5 micrograms in group 1 versus 1,379.1 +/- 567.1 micrograms in group 2). This phenomenon occurred without any change in biliary flow. Indocyanine green clearance (20 mg/kg) increased in animals treated with ceftriaxone alone compared with the saline-treated control group (55.04 +/- 4.68 versus 33.29 +/- 7.52 ml/min per kg, respectively). Diclofenac alone caused a significant decrease in indocyanine green clearance compared with clearance in controls (25.05 +/- 4.74 versus 33.29 +/- 7.52 ml/min per kg), and indocyanine green clearance appeared not significantly different from control values in animals receiving ceftriaxone plus diclofenac. These results suggest that (i) ceftriaxone could increase hepatic blood flow and (ii) reduction of the hepatic clearance of ceftriaxone by diclofenac may be due to hepatic hemodynamic variations involving diclofenac inhibition of prostaglandin synthesis, although an interaction of diclofenac with hepatic uptake of ceftriaxone cannot be ruled out.
Therapeutic evaluation of free and liposome-encapsulated amphotericin B in the treatment of systemic candidiasis in mice
Authors: Gondal J A , Swartz R P , Rahman A
Published: June 2012

Various doses of amphotericin B encapsulated into unilamellar vesicles of 0.1 micron diameter (lip-AMB) (1.0 to 20.0 mg/kg of body weight) were compared with free amphotericin B (AMB) (0.5 to 2.0 mg/kg of body weight) in a murine model of disseminated candidiasis. CD2F1 mice injected intravenously with 3 x 10(5) Candida albicans cells were treated with either single- or multiple-dose regimens. Untreated infected mice had a median survival of 7 days, with all mice dead by 12 days. Single doses of AMB resulted in a median survival range from 18 to 23.5 days, with less than or equal to 38% survival by day 42. Single doses of lip-AMB resulted in 88 to 100% survival by day 42. The multiple-dose AMB regimen provided median survival of only 30 to 33 days, with less than or equal to 38% survival by day 42. The multiple-dose lip-AMB regimen resulted in greater than 90% survival by day 42. With single-dose regimens, lip-AMB levels in plasma were severalfold higher than AMB levels in plasma. By 10 h, at equivalent doses, lip-AMB levels in plasma were much higher, whereas AMB levels in plasma were not detectable. Compared with normal values, the blood urea nitrogen, serum glutamic pyruvic transaminase, serum glutamic oxaloacetate transaminase, and serum lactate dehydrogenase levels were not significantly altered by high doses of lip-AMB treatment. Viable C. albicans was recoverable from the kidneys of some of the lip-AMB-treated mice at day 42. Thus, encapsulation into unilamellar liposomes enhances the antifungal efficacy of amphotericin B while reducing the toxicity normally associated with administration of free amphotericin B.
Comparative activity in vitro of 16 antimicrobial agents against penicillin-susceptible meningococci and meningococci with diminished susceptibility to penicillin
Authors: Pérez Trallero E , Garcia Arenzana J M , Ayestaran I , Muñoz Baroja I
Published: June 2012

Broad-spectrum cephalosporins were very active against strains of Neisseria meningitidis with both penicillin susceptibility and diminished penicillin susceptibility. Ceftriaxone was the most active antibiotic. Increases in MIC for 90% of meningococci with diminished susceptibility to penicillin of greater than or equal to 16-fold were observed for amdinocillin, cefuroxime, aztreonam, and imipenem; 2-fold increases were observed for ceftazidime, mezlocillin, and piperacillin. No differences were observed for non-beta-lactam antibiotics.
In vitro activities of new oral beta-lactams and macrolides against Campylobacter pylori
Authors: García-Rodríguez J A , García Sánchez J E , García García M I , García Sánchez E , Muñoz Bellido J L
Published: June 2012

The in vitro activities of amoxicillin, cefuroxime, ceftetrame, cefetamet, cefixime, tigemonam, erythromycin, roxithromycin, and dirithromycin against 30 clinical isolates of Campylobacter pylori were determined by an agar dilution technique. Roxithromycin and amoxicillin (MICs for 90% of isolates tested, 0.01 and 0.06 micrograms/ml, respectively) were the most active antibiotics tested, but all strains were susceptible to all antimicrobial agents tested.
Diverse potential of beta-lactamase inhibitors to induce class I enzymes
Authors: Weber D A , Sanders C C
Published: June 2012

The ability of various beta-lactamase inhibitors to induce class I beta-lactamases was assessed. Clavulanate was the most active compound, inducing Morganella morganii, Aeromonas caviae, and Enterobacter aerogenes over a broad concentration range and Citrobacter freundii, Pseudomonas aeruginosa, and Serratia marcescens at high concentrations. Disk approximation tests paralleled these results, with clavulanate, but not sulbactam or tazobactam, antagonizing the activity of several beta-lactams against these organisms.
Decay of the ampicillin-induced lysis process in amino acid-deprived Escherichia coli
Authors: Kusser W , Pisabarro A G , De Pedro M A , Ishiguro E E
Published: June 2012

The ability to induce the ampicillin-mediated lysis of amino acid-deprived Escherichia coli by relaxing the stringent response decreased progressively during the course of amino acid deprivation, apparently because of a time-dependent decay in a key lysis event. The decay of this labile activity was not apparent when ampicillin treatment was initiated early and maintained continuously throughout the amino acid starvation period.
Homology of mecA gene in methicillin-resistant Staphylococcus haemolyticus and Staphylococcus simulans to that of Staphylococcus aureus
Authors: Ubukata K , Nonoguchi R , Song M D , Matsuhashi M , Konno M
Published: June 2012

A penicillin-binding protein of molecular weight 76,000 inducible by beta-lactams was detected in methicillin-resistant Staphylococcus haemolyticus and Staphylococcus simulans. DNA from these strains hybridized to the mecA gene from Staphylococcus aureus; however, the chromosomal HindIII fragments containing the mecA genes were 3.4 kilobases in S. haemolyticus and 4.3 kilobases in S. simulans.
Oral ciprofloxacin compared with parenteral antibiotics in the treatment of osteomyelitis
Authors: Gentry L O , Rodriguez G G
Published: June 2012

We undertook a prospective, randomized comparison of oral ciprofloxacin with standard parenteral therapies for the treatment of biopsy-proven osteomyelitis caused by susceptible organisms. Following surgical debridement, the ciprofloxacin patients received 750 mg twice a day, and the other patients received a broad-spectrum cephalosporin or a nafcillin-aminoglycoside combination intravenously (i.v.). There were 31 evaluable patients in the ciprofloxacin group, treated an average of 56 days, and 28 in the i.v. group, treated an average of 47 days. Clinical success rates were 24 of 31 (77%) for the ciprofloxacin group and 22 of 28 (79%) for the i.v. group. Of the seven failures in the ciprofloxacin group, one was due to a persistent Klebsiella pneumoniae infection and six were due to relapse of the infection within 1 year of therapy. Of the six failures in the i.v. group, one was due to an Enterobacter aerogenes strain which emerged resistant and five were due to relapse. The most troublesome etiology was polymicrobial osteomyelitis involving Pseudomonas aeruginosa, in which five of six (83%) regimens failed. Adverse reactions occurred infrequently, i.e., in 1 of 31 (3%) of the ciprofloxacin patients and in 4 of 28 (14%) of the i.v. patients, yet all reactions responded to therapy and none required protocol deviation. Our data indicate that oral ciprofloxacin monotherapy is as safe and effective as conventional parenteral therapy in cases of osteomyelitis caused by susceptible organisms.
Outer membrane protein D2 catalyzes facilitated diffusion of carbapenems and penems through the outer membrane of Pseudomonas aeruginosa
Authors: Trias J , Nikaido H
Published: June 2012

The outer membrane of imipenem-resistant mutants of Pseudomonas aeruginosa with decreased permeability to imipenem was shown by Western (immuno-) blotting to contain protein D1 and to lack protein D2. Protein D2 was purified and was shown to allow the permeation of imipenem at a rate higher than expected from its molecular weight. Spontaneous imipenem-resistant mutants of P. aeruginosa PAO1 appeared at a frequency of 10(-8) in the laboratory and did not synthesize protein D2. Experiments performed with intact cells carrying plasmid pHN4 containing the gene for L-1 beta-lactamase from Pseudomonas maltophilia showed that this channel could also be used by SM-7338, Sch 33755, and Sch 33440 but apparently not by Sch 34343 or Sch 29482.
In vitro inhibition of the infectivity and replication of human immunodeficiency virus type 1 by combination of antiretroviral 2',3'-dideoxynucleosides and virus-binding inhibitors
Authors: Hayashi S , Fine R L , Chou T C , Currens M J , Broder S , Mitsuya H
Published: June 2012

We tested the in vitro inhibitory activities of three 2',3'-dideoxynucleosides and two inhibitors of viral binding in combinations against the infectivity and cytopathic effect of human immunodeficiency virus type 1. 3'-Azido-2',3'-dideoxythymidine, 2',3'-dideoxyinosine, or 2',3'-dideoxycytidine, combined with recombinant soluble CD4 (sCD4), brought about synergistic antiretroviral activity without toxicity at clinically achievable concentrations. Combinations of 2',3'-dideoxynucleosides plus dextran sulfate exerted similar synergistic antiviral effects without concomitant increases in toxicities. When sCD4 and dextran sulfate were combined, apparent antagonism was observed. We confirmed that no combination of sCD4 plus 3'-azido-2',3'-dideoxythymidine, 2',3'-dideoxyinosine, or 2',3'-dideoxycytidine significantly increased the inhibitory effect on colony formation of human myeloid-monocytic bone marrow cells in vitro at the concentrations used in this study. These data might have clinical relevance for the treatment of patients infected with human immunodeficiency virus.
Pharmacokinetics and tissue penetration of a single dose of ornidazole (1,000 milligrams intravenously) for antibiotic prophylaxis in colorectal surgery
Authors: Martin C , Bruguerolle B , Mallet M N , Condomines M , Sastre B , Gouin F
Published: June 2012

Levels in serum and tissue penetration of ornidazole were studied after a single intravenous injection of 1,000 mg given to 14 patients for prophylaxis of surgical infection. They were scheduled for elective colorectal surgery. Adequate levels in blood (greater than or equal to MIC for 90% of Bacteroides fragilis strains tested) were found in all patients throughout the procedure and up to hour 24. Mean-maximal (15 min) and last-determined (24 h) ornidazole levels in serum were 24 +/- 5.2 and 6.3 +/- 1.4 mg/liter, respectively. beta-Phase elimination half-life was 14.1 +/- 2.7 h, and clearance and apparent volume of distribution were 47 +/- 12 ml/min and 0.9 +/- 0.13 liters/kg, respectively. In all patient, adequate levels in tissue were found in the abdominal wall and the epiploic fat at time of incision and in the colonic wall at time of anastomosis. At time of closure, all but one patient had adequate levels in tissue in the abdominal wall and the epiploic fat. No anaerobic nor aerobic infection occurred in the study patients.
Anti-human immunodeficiency virus effects of dextran sulfate are strain dependent and synergistic or antagonistic when dextran sulfate is given in combination with dideoxynucleosides
Authors: Busso M E , Resnick L
Published: June 2012

The effects of three molecular weight ranges of dextran sulfate on five different human immunodeficiency virus (HIV) isolates (from patients with acquired immunodeficiency syndrome), alone and in combination with dideoxynucleosides, were investigated in vitro. The higher the molecular weight range of dextran sulfate, the more potent the activity as assessed by a quantitative syncytium formation assay. Although all five HIV isolates had similar susceptibilities to the inhibitory effects of dideoxynucleosides, the two clinical isolates of HIV (HIV type 1 [HIV-1] TM and SP) exhibited a pattern of reduced susceptibility to dextran sulfate when compared with the two cloned isolates (HIV-1 WMF and HIV-2 ROD) and a prototype laboratory strain (HIV-1 IIIB). In combination with dideoxynucleosides, the high-molecular-weight range of dextran sulfate (500,000) resulted in an antagonistic response directed against the two clinical isolates of HIV (HIV-1 TM and SP) when the antiviral concentrations of dextran sulfate were in the ineffective range. Additive or synergistic effects were seen with the other three HIV isolates and all five HIV isolates when the low-molecular-weight range of dextran sulfate (8,000) was used. The results of these studies raise issues on the impact of drug-resistant strains on disease progression and the use of dextran sulfate in combination with nucleoside analogs for the clinical management of HIV disease.