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PloS One 2023The negative consequences of Substandard and falsified (SF) medicines are widely documented nowadays and there is still an urgent need to find them in more efficient...
The negative consequences of Substandard and falsified (SF) medicines are widely documented nowadays and there is still an urgent need to find them in more efficient ways. Several screening tools have been developed for this purpose recently. In this study, three screening tools were used on 292 samples of ciprofloxacin and metronidazole collected in Cameroon. Each sample was then analyzed by HPLC and disintegration tests. Seven additional samples from the nitro-imidazole (secnidazole, ornidazole, tinidazole) and the fluoroquinolone (levofloxacin, ofloxacin, norfloxacin, moxifloxacin) families were analyzed to mimic falsified medicines. Placebo samples that contained only inert excipients were also tested to mimic falsified samples without active pharmaceutical ingredient (API). The three screening tools implemented were: a simplified visual inspection checklist, a low-cost handheld near infrared (NIR) spectrophotometer and paper analytical devices (PADs). Overall, 61.1% of the samples that failed disintegration and assay tests also failed the visual inspection checklist test. For the handheld NIR, one-class classifier models were built to detect the presence of ciprofloxacin and metronidazole, respectively. The APIs were correctly identified in all the samples with sensitivities and specificities of 100%. However, the importance of a representative and up-to-date spectral database was underlined by comparing models built with different calibration set spanning different variability spaces. The PADs were used only on ciprofloxacin samples and detected the API in all samples in which the presence of ciprofloxacin was confirmed by HPLC. However, these PADs were not specific to ciprofloxacin since they reacted like ciprofloxacin to other fluoroquinolone compounds. The advantages and drawbacks of each screening tool were highlighted. They are promising means in the frame of early detection of SF medicines and they can increase the speed of decision about SF medicines in the context of pharmaceutical post-marketing surveillance.
Topics: Humans; Metronidazole; Counterfeit Drugs; Substandard Drugs; Ciprofloxacin; Levofloxacin; Product Surveillance, Postmarketing
PubMed: 37566594
DOI: 10.1371/journal.pone.0289865 -
Clinical Laboratory Apr 2022The goal of the study was to analyze the clinical characteristics of Legionella cases caused by Legionella micdadei and explore the diagnosis and treatment. (Review)
Review
BACKGROUND
The goal of the study was to analyze the clinical characteristics of Legionella cases caused by Legionella micdadei and explore the diagnosis and treatment.
METHODS
The pathogen was identified by routine isolation and culture, biochemical identification, serum agglutination test, mass spectrometry identification, and routine PCR. Combined with the related literature review, the clinical diagnosis and treatment of Legionella micdadei were analyzed.
RESULTS
The patient suffered from pulmonary infection caused by Legionella micdadei. After treatment with moxi-floxacin for 2 weeks, the body temperature dropped and the shadow of the lung was completely absorbed after 2 months. Combined with literature analysis, 8 cases of Legionella micetidis, including 7 males and 1 female, aged from 27 to 57 years old, 6 cases with basic diseases, which were treated with azithromycin, erythromycin or levofloxacin, and all of them achieved good therapeutic effect.
CONCLUSIONS
The detection of Legionella should be strengthened in patients with pneumonia whose symptoms have no obvious improvement after antibiotic treatment. Azithromycin, erythromycin or levofloxacin are effective in the treatment of Legionella spp.
Topics: Adult; Azithromycin; Erythromycin; Female; Humans; Legionella; Legionellaceae; Legionellosis; Levofloxacin; Male; Middle Aged; Pneumonia
PubMed: 35443581
DOI: 10.7754/Clin.Lab.2021.210725 -
Gynecologie, Obstetrique, Fertilite &... Dec 2022Fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin) are antibiotics which pharmacological and therapeutic advantages resulted in a large use, now...
Fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin) are antibiotics which pharmacological and therapeutic advantages resulted in a large use, now restricted because of resistances emergence and adverse effect risk. For pregnant or breastfeeding women they still are a cause of concern, based on the joint toxicity described in children directly treated, thus limiting their use in these populations. However, the data about exposed pregnancies published over time have not so far confirm these fears and allow, when a fluoroquinolone is clearly indicated, not to deprive pregnant patients of the therapeutic benefit of these important antibiotics and to envisage their use whatever the term of the pregnancy, within the current scope of their prescription. During breastfeeding the use of some of them can be considered.
Topics: Child; Pregnancy; Humans; Female; Fluoroquinolones; Breast Feeding; Microbial Sensitivity Tests; Levofloxacin; Anti-Bacterial Agents; Fear
PubMed: 36435563
DOI: 10.1016/j.gofs.2022.11.001 -
Acta Poloniae Pharmaceutica May 2017The commercially available coated tablets containing either racemic form of ofloxacin (Tarivid 200 mg, OfloHexal 200 mg and Ofloxacin-Ratiopharm 200 mg) or only... (Comparative Study)
Comparative Study
The commercially available coated tablets containing either racemic form of ofloxacin (Tarivid 200 mg, OfloHexal 200 mg and Ofloxacin-Ratiopharm 200 mg) or only levofloxacin S-(-)-isomer (Tavanic 250 mg) were examined. The aim of our study was to establish the kinetics of dissolution rate process of ofloxacin optical isomers (S-(-) and R-(+)-ofloxacin) from solid oral dosage forms using flow-through cell method (USP 4 method). The concentrations of analytes (racemic ofloxacin and its enantiomers) in the samples of tablet extracts as well as in dissolution media (0.1 M/L HCl and phosphate buffer pH 6.8) were determined by validated high performance capillary electrophoresis method. The fraction of the average dose of the individual optical isomers of ofloxacin released from the examined tablets was calculated. In the case of the OfloHexal, Ofloxacin-Ratiopharm and Tavanic it was found to be around 100% for both S-(-) and R-(+)-ofloxacin in 0.1 M/L HCI after 30 min of dissolution test. The fraction of the average dose for the Tarivid tablets was approximately 50% at the same time. A similar results were observed for the Ofloxacin-Ratiopharm and Tavanic tablets examined in phosphate buffer (average fraction about 100% after 30 min), while in the case of Tarivid and OfloHexal the averige fraction of the dose determined in a buffer pH 6.8 was 14% and 44%, respectively. There were not found any differences in the kinetics of dissolution of the S-(-)-ofloxacin and R-(+)-ofloxacin isomers within the same formulation. However, statistically significant differences were found in the dissolution of ofloxacin enantiomers between different preparations.
Topics: Anti-Infective Agents; Calibration; Drug Compounding; Drug Liberation; Electrophoresis, Capillary; Isomerism; Kinetics; Levofloxacin; Limit of Detection; Models, Chemical; Models, Statistical; Ofloxacin; Reference Standards; Solubility; Tablets; Technology, Pharmaceutical
PubMed: 29513966
DOI: No ID Found -
Chemosphere Dec 2021Here, the antibiotic levofloxacin (LFX) widely used and detected in the environment was degraded by photoelectrolysis using a new electrode based on zinc oxide (ZnO) and...
Here, the antibiotic levofloxacin (LFX) widely used and detected in the environment was degraded by photoelectrolysis using a new electrode based on zinc oxide (ZnO) and a mixture of mixed oxides of ruthenium and titanium (MMO). The influence of the potential and irradiation of UV light was investigated in the photostability of the Ti/MMO/ZnO electrode and in the degradation of the antibiotic. The experiments were conducted at different pH values (5.0, 7.0 and 9.0) in sodium sulfate solution in a glass reactor with central lighting. It was observed that the new Ti/MMO/ZnO electrode has good stability under light irradiation and potential, presenting excellent photocurrent and high photoactivity in LFX photoelectrolysis. The removal efficiency of the compound was directly related to the formation of oxidizing species in solution, the photo-generated charges on the electrode and the electrostatic characteristics of the molecule. The mineralization rate, the formation of reaction intermediates and short chain carboxylic acids (acetic, maleic, oxalic and oxamic acid), in addition to the formation of N-mineral species (NO and NH) was dependent on the pH of the solution and the investigated processes: photoelectrolysis was more efficient than photolysis, which, in turn, was more efficient than electrolysis. The synergistic effect and the high rate of degradation of LFX after 4.0 h of treatment (100%) observed in photoelectrolysis at alkaline pH, was associated with the high stability of the Ti/MMO/ZnO electrode at this pH, the photoactivation of sulfate ions and the ease generation of oxidizing radicals, such as OH.
Topics: Catalysis; Electrodes; Electrolysis; Levofloxacin; Titanium; Water Pollutants, Chemical; Zinc Oxide
PubMed: 34182289
DOI: 10.1016/j.chemosphere.2021.131303 -
Ecotoxicology and Environmental Safety Jul 2018Fluoroquinolones are a class of antibiotics widely prescribed in both human and veterinary medicine of high environmental concern and characterized as environmental...
Fluoroquinolones are a class of antibiotics widely prescribed in both human and veterinary medicine of high environmental concern and characterized as environmental micropollutants due to their ecotoxicity and persistence and antibacterial resistance potential. Ofloxacin and levofloxacin are chiral fluoroquinolones commercialized as racemate and in enantiomerically pure form, respectively. Since the pharmacological properties and toxicity of the enantiomers may be very different, understanding the stereochemistry of these compounds should be a priority in environmental monitoring. This work presents the biodegradation of racemic ofloxacin and its (S)-enantiomer levofloxacin by the bacterial strains Labrys portucalensis F11 and Rhodococcus sp. FP1 at a laboratory-scale microcosm following the removal and the behavior of the enantiomers. Strain F11 could degrade both antibiotics almost completely when acetate was supplied regularly to the cultures. Enrichment of the (R)-enantiomer was observed in FP1 and F11 cultures supplied with ofloxacin. Racemization was observed in the biodegradation of the pure (S)-ofloxacin (levofloxacin) by strain F11, which was confirmed by liquid chromatography - exact mass spectrometry. Biodegradation of ofloxacin at 450 µg L by both bacterial strains expressed good linear fits (R > 0.98) according to the Rayleigh equation. The enantiomeric enrichment factors were comprised between - 22.5% to - 9.1%, and - 18.7% to - 9.0% in the biodegradation of ofloxacin by strains F11 and FP1, respectively, with no significant differences for the two bacteria under the same conditions. This is the first time that enantioselective biodegradation of ofloxacin and levofloxacin by single bacteria is reported.
Topics: Alphaproteobacteria; Anti-Bacterial Agents; Biodegradation, Environmental; Chromatography, Liquid; Levofloxacin; Ofloxacin; Rhodococcus; Stereoisomerism; Tandem Mass Spectrometry
PubMed: 29510309
DOI: 10.1016/j.ecoenv.2018.02.067 -
American Journal of Therapeutics Mar 2020
Topics: Anti-Bacterial Agents; Humans; Levofloxacin; Mania; Ofloxacin
PubMed: 32195669
DOI: 10.1097/MJT.0000000000001161 -
The Lancet. Oncology Feb 2020
Topics: Antibiotic Prophylaxis; Double-Blind Method; Febrile Neutropenia; Humans; Levofloxacin; Multiple Myeloma
PubMed: 32007199
DOI: 10.1016/S1470-2045(20)30008-5 -
The Lancet. Oncology Feb 2020
Topics: Antibiotic Prophylaxis; Double-Blind Method; Febrile Neutropenia; Humans; Levofloxacin; Multiple Myeloma
PubMed: 32007198
DOI: 10.1016/S1470-2045(19)30824-1 -
Journal of Chemotherapy (Florence,... Nov 2023During the Sars-Cov-2 pandemic, secondary pulmonary infections have increased, especially in critically ill patients, highlighting the need for new therapeutic options....
During the Sars-Cov-2 pandemic, secondary pulmonary infections have increased, especially in critically ill patients, highlighting the need for new therapeutic options. Trimethoprim-sulfamethoxazole (SXT) is the treatment of choice but the increase of resistant strains or adverse drug reactions limited its clinical use. Recently ceftazidime/avibactam (CZA) has been approved for the treatment of multi drug resistant (MDR) Gram-negative bacteria infections, including hospital acquired pneumonia. The aim of this study was to evaluate the activity of ceftazidime/avibactam (CZA) alone and in combination with aztreonam (ATM) against clinical isolates by E-test method. Susceptibility of SXT and levofloxacin (LEV) was also investigated. Our results showed 22% of resistance to CZA, 2% to SXT and 26% to LEV. CZA in combination with ATM demonstrated synergistic activity against 86% of the strains, including all those resistant to CZA. The combination of CZA with ATM provides a new therapeutic option for the treatment of severe respiratory infections in critically ill patients.
Topics: Humans; Aztreonam; Ceftazidime; Stenotrophomonas maltophilia; Critical Illness; Drug Combinations; Azabicyclo Compounds; Levofloxacin; Microbial Sensitivity Tests; Anti-Bacterial Agents
PubMed: 37615040
DOI: 10.1080/1120009X.2023.2247199