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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 -
Mikrochimica Acta May 2023Binder-free and efficient electrochemical sensing of levofloxacin (LF) was successfully developed based on the nitrogen-doped carbon nanodots (NCNDs). The NCNDs were...
Binder-free and efficient electrochemical sensing of levofloxacin (LF) was successfully developed based on the nitrogen-doped carbon nanodots (NCNDs). The NCNDs were synthesized by hydrothermal carbonation (180°C for 12 h), and the heteroatom was embedded in aqueous solution of ammonia (NH). Spectral and microscopic characteristization techniques were used to analyze the topological, crystallinity, and chemical binding behavior of synthesized biomass functional material. HR-TEM image revealed a uniform spherical dot (2.96 nm), and superior quantum yield efficiency (0.42 Φ). The NCNDs was drop coated on a glassy carbon electrode (GCE) and electrochemical sensing of LF was performed by cyclic voltammetry (CV), differential pulse voltammetry (DPV), and amperometric i-t curve in phosphate-buffered saline (PBS; pH = 7.0). The NCNDs modified electrode showed a sharp oxidation peak at +0.95 V (vs. Ag/AgCl) with a four-fold higher current response than the bare GC electrode. The NCNDs/GCE surface not only increases the current response, but has lower detection potential, and facilitates electron transfer reaction. Under optimized working parameters, the NCNDs/GCE showed wide linear concentrations range from 200 nM to 2.8 mM and a low detection limit (LOD) of 48.26 nM (S/N = 3). The electrode modified with NCNDs has high electrochemical sensing stability (RSD = 1.284 ± 0.05% over 5 days), and superior reproducibility (RSD = 1.682 ± 0.06% (n = 3)). Finally, the NCNDs modified GC electrode was successfully applied to quantify the concentration of LF in drug and river water samples with acceptable recovery percentages of 96.60-99.20% and 97.20-99.00% (n=3), respectively.
Topics: Carbon; Levofloxacin; Nitrogen; Reproducibility of Results; Biomass; Pharmaceutical Preparations; Water
PubMed: 37243779
DOI: 10.1007/s00604-023-05804-0 -
The Turkish Journal of Gastroenterology... Mar 2021It is known that clarithromycin resistance has increased over the years (success rate 60%). The aim of the study was to investigate the importance of regional...
BACKGROUND
It is known that clarithromycin resistance has increased over the years (success rate 60%). The aim of the study was to investigate the importance of regional antimicrobial resistance rates for full accuracy of both diagnosis and treatment of Helicobacter pylori infection.
METHODS
This study was carried out in the University Hospital Department of Gastroenterology. A total of 116 patients were evaluated with upper gastrointestinal endoscopy. Gastric antrum and corpus biopsy samples were taken for the rapid urease test (RUT), culture, and antimicrobial susceptibility testing for the presence of H. pylori. Antimicrobial susceptibilities of isolated H. pylori strains for clarithromycin and levofloxacin were determined by the epsilometer test (E-test). Minimal inhibitory concentration values for clarithromycin and levofloxacin were ≥1 and >1 μg/mL, respectively.
RESULTS
H. pylori infection was considered clinically positive in 93 (80.2%) patients with either the RUT, culture, or histopathological examination. Seventy (60.3%) of the patients had RUT positivity. Sixty (85.7%) of these 70 patients had RUT positivity within the first 20 min. Among the 90 patients, who had a histopathological examination, HLO was positive in 76 (84.4%) patients. Fifty-two (44.8%) out of 116 patients were culture positive. Resistance rates for both clarithromycin and levofloxacin were high. In these 52 culture-positive patients, resistance rates determined for clarithromycin and levofloxacin were 26.9% and 25.5%, respectively.
CONCLUSION
Clarithromycin or levofloxacin-based treatment regimen may not be an ideal alternative therapy for Turkish patients regardless of culture.
Topics: Anti-Bacterial Agents; Clarithromycin; Drug Resistance, Microbial; Helicobacter Infections; Helicobacter pylori; Humans; Levofloxacin; Turkey; Urease
PubMed: 34160356
DOI: 10.5152/tjg.2021.20210 -
Diagnostic Microbiology and Infectious... Apr 2020Increase in Helicobacter pylori resistance to fluoroquinolones has been reported in many countries. The aim of the study was to compare, for the first time to our... (Comparative Study)
Comparative Study
Increase in Helicobacter pylori resistance to fluoroquinolones has been reported in many countries. The aim of the study was to compare, for the first time to our knowledge, levofloxacin and delafloxacin activities against H. pylori, including numerous levofloxacin- and multidrug resistant strains. Minimal inhibitory concentrations (MICs) of six antibiotics against 71 consecutive clinical strains were determined. Delafloxacin MIC and MIC were 0.016 and 0.125 μg/mL versus 0.125 and ≥32 μg/mL, respectively, for levofloxacin. Against the 19 levofloxacin resistant strains, delafloxacin MICs and MICs were 0.094 and 0.38 μg/mL, respectively. Delafloxacin MICs against the 21 strains with double or multidrug resistance were ≤0.75 μg/mL. The low MICs, the activity against levofloxacin resistant and multidrug resistant H. pylori strains and the increased activity of the agent in acidic conditions make delafloxacin worthy of further investigation, aiming at optimizing fluoroquinolone-based eradication regimens.
Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Child; Drug Resistance, Multiple, Bacterial; Female; Fluoroquinolones; Helicobacter Infections; Helicobacter pylori; Humans; Hydrogen-Ion Concentration; Levofloxacin; Male; Microbial Sensitivity Tests; Middle Aged; Young Adult
PubMed: 31954595
DOI: 10.1016/j.diagmicrobio.2019.114980 -
Applied Biochemistry and Biotechnology Feb 2024Pseudomonas aeruginosa can develop resistance. Therefore, it is necessary to design proper treatment for it. Pseudomonas aeruginosa can develop resistance against...
Pseudomonas aeruginosa can develop resistance. Therefore, it is necessary to design proper treatment for it. Pseudomonas aeruginosa can develop resistance against levofloxacin due to the development of efflux pumps. However, the development of these efflux pumps cannot develop resistance against imipenem. Additionally, the MexCDOprJ efflux system which is responsible for the resistance of Pseudomonas aeruginosa to levofloxacin is highly susceptible to imipenem. The objective of the study was to evaluate the emergence of resistance of Pseudomonas aeruginosa against 750 mg levofloxacin, 250 mg imipenem, and a combination of 750 mg levofloxacin and 250 mg imipenem. An in vitro pharmacodynamic model was selected for the evaluation of the emergence of resistance. Pseudomonas aeruginosa strain 236, Pseudomonas aeruginosa strain GB2, and Pseudomonas aeruginosa strain GB65 were selected. Susceptibility testing of both antibiotics was done by agar dilution methodology. A disk diffusion bioassay was performed for antibiotics. RT-PCR measurement was done for the evaluation of expressions of Pseudomonas aeruginosa genes. Samples were tested at 2 h, 4 h, 6 h, 8 h, 12 h, 16 h, 24 h, and 30 h. Levofloxacin and imipenem both individually reported a decrease in colony-forming unit per milliliter of strength in the initial stage but in the later stage both develop resistance individually. Levofloxacin with imipenem had no resistance to Pseudomonas aeruginosa during 30 h. Time after the start of development of resistance or decrease in clinical efficacy was higher for levofloxacin and imipenem combination in all strains. The concentration of Pseudomonas aeruginosa at the time after the start of development of resistance or decrease in clinical efficacy was fewer for levofloxacin and imipenem combination. Levofloxacin with imipenem is recommended for the treatment of infection due to Pseudomonas aeruginosa.
Topics: Humans; Levofloxacin; Imipenem; Pseudomonas aeruginosa; Microbial Sensitivity Tests; Anti-Bacterial Agents; Pseudomonas Infections
PubMed: 37178250
DOI: 10.1007/s12010-023-04516-8 -
Microbiology Spectrum Oct 2022Pseudomonas aeruginosa (PA) biofilm infection is clinically prevalent and difficult to eradicate. In the present work, we aimed to evaluate the and efficacy of...
Pseudomonas aeruginosa (PA) biofilm infection is clinically prevalent and difficult to eradicate. In the present work, we aimed to evaluate the and efficacy of colistin (COL)-based combinations against PA biofilm. MICs and fractional inhibitory concentration indexes (FICIs) of four antibiotics (COL, amikacin, levofloxacin, and meropenem) to bioluminescent strain PAO1, carbapenem-resistant PAO1 (CRPAO1), and clinically isolated strains were assessed. Minimal biofilm eradication concentrations (MBECs) of monotherapy and combinations were examined by counting the live bacteria in biofilm, accompanied by visual confirmation using confocal laser-scanning microscopy. An animal biofilm infection model was established by implanting biofilm subcutaneously, and the therapeutic effect was evaluated according to the change in luminescence through a live animal bio-photonic imaging system. , even combined with 4 or 8 mg/L COL, meropenem needed to reach 128 or 256 mg/L to eradicate the biofilm. Moreover, 2 mg/L COL combined with 32 mg/L amikacin or 4-8 mg/L levofloxacin could kill the PAO1 and CRPAO1 in biofilm within 24 h. , COL combined with amikacin or levofloxacin could shorten the eradication time of biofilm than monotherapy. For PAO1 biofilm, combination therapy could eradicate the biofilm in all mice on the 5th day, whereas monotherapy only eradicated biofilms in almost half of the mice. For CRPAO1 biofilm, the biofilm eradication rate on the 6th day in the COL+ amikacin, amikacin, or COL alone regimen was 90%, 10%, or 40%, respectively. COL combined with levofloxacin did not show a better effect than each individual antibiotic. COL-based combinations containing levofloxacin or amikacin were promising choices for treating PA biofilm infection. Infections associated with PA biofilm formation are extremely challenging. When monotherapy fails to achieve optimal efficacy, combination therapy becomes the last option. After evaluating multiple drug combinations through a series of experiments and , we confirmed that colistin-based combinations containing levofloxacin or amikacin were promising choices for treating PA biofilm infection. The efficacy of these combinations derives from the different bactericidal mechanisms and the bacterial susceptibility to each antibiotic. This study provided a new regimen to solve the incurable problem of biofilm by using COL combined with other antibiotics.
Topics: Mice; Animals; Colistin; Amikacin; Levofloxacin; Pseudomonas aeruginosa; Meropenem; Drug Resistance, Multiple, Bacterial; Pseudomonas Infections; Biofilms; Anti-Bacterial Agents; Microbial Sensitivity Tests; Carbapenems; Drug Combinations
PubMed: 36102678
DOI: 10.1128/spectrum.01468-22 -
Journal of Hazardous Materials Jun 2022Herein, a flower-shaped fluorescent probe was proposed for hydrogen peroxide (HO) and levofloxacin (LVF) sensing based on MoOx QDs@Co/Zn-MOFs with porous structure. Both...
Herein, a flower-shaped fluorescent probe was proposed for hydrogen peroxide (HO) and levofloxacin (LVF) sensing based on MoOx QDs@Co/Zn-MOFs with porous structure. Both MoOx QDs and Co/Zn-MOFs exhibited peroxidase-like properties, and the combination of them greatly aroused the synergistic catalytic capabilities between them. In o-Phenylenediamine (OPD)-HO system, MoOx QDs@Co/Zn-MOFs efficiently catalyzed HO to produce •OH and then oxidized OPD to its oxidation product (OxOPD). The OxOPD could not only emit blue fluorescence, but also inhibit the fluorescent intensity of MoOx QDs through fluorescence resonance energy transfer (FRET). Moreover, when introducing LVF into the system, the fluorescent intensities of MoOx QDs increased along with the aggregation of themselves while that of OxOPD remained unchanged, which was explained by the joint behavior of FRET and photo-induced electron transfer (PET) instead of the conventional aggregation-induced emission enhancement (AIEE). With these observation, the proposed probe was employed for HO and LVF determination in biological samples with the limit of detection (LOD) of 32.60 pmol/L and 0.85 μmol/L, respectively, suggesting the method holds great promises for trace HO and LVF monitoring in eco-environment.
Topics: Fluorescent Dyes; Hydrogen Peroxide; Levofloxacin; Limit of Detection; Quantum Dots
PubMed: 35286934
DOI: 10.1016/j.jhazmat.2022.128605 -
Medicine Sep 2022Tuberculosis (TB) is one of the serious epidemics that highly threaten the global public health. To explore the treatment effect of Levofloxacin, Moxifloxacin, and... (Meta-Analysis)
Meta-Analysis
The treatment effect of Levofloxacin, Moxifloxacin, and Gatifloxacin contained in the conventional therapy regimen for pulmonary tuberculosis: Systematic review and network meta-analysis.
BACKGROUND
Tuberculosis (TB) is one of the serious epidemics that highly threaten the global public health. To explore the treatment effect of Levofloxacin, Moxifloxacin, and Gatifloxacin contained in the conventional therapy regimen for pulmonary tuberculosis.
METHODS
Medline, PubMed, Embase, and Cochrane Library were searched with the keyword such as "Levofloxacin," "Moxifloxacin," "Gatifloxacin," and "tuberculosis", through June 1992 to 2017. According to the inclusion and exclusion criteria, 2 researchers independently screened the literature, extracted the data, and evaluated the quality of the included studies. The Cochrane system was evaluated by RevMan5.2 and the network meta-analysis was performed by Stata 15.
RESULTS
A total of 891 studies were included, with a total of 6565 patients. The results of network meta-analysis showed that Moxifloxacin + conventional therapy (CT) regimen was superior to CT regimen only on the spectrum culture negative. Both Levofloxacin + CT and Moxifloxacin + CT were superior to the CT regimen in treatment success rate. For the adverse events, the Levofloxacin + CT showed much safer results than CT group, while Moxifloxacin + CT had more adverse events than CT group.
CONCLUSION
Levofloxacin, Moxifloxacin, and Gatifloxacin have different superiority, comparing to CT regimen in spectrum culture negative, treatment success rate, and adverse events. Hence, combined utilization of these quinolone is important on the clinical treatment for tuberculosis.
Topics: Antitubercular Agents; Fluoroquinolones; Gatifloxacin; Humans; Levofloxacin; Moxifloxacin; Network Meta-Analysis; Tuberculosis; Tuberculosis, Pulmonary
PubMed: 36197231
DOI: 10.1097/MD.0000000000030412 -
Letters in Applied Microbiology Sep 2022Pseudomonas aeruginosa is one of the most worrisome infectious bacteria due to its intrinsic and acquired resistance against several antibiotics and the recalcitrance of...
Pseudomonas aeruginosa is one of the most worrisome infectious bacteria due to its intrinsic and acquired resistance against several antibiotics and the recalcitrance of its infections; hence, the development of novel antimicrobials effective against multidrug-resistant P. aeruginosa is mandatory. In this work, silver nanoparticles obtained by green synthesis using a leaf extract and fungi were tested against a battery of clinical strains from cystic fibrosis, pneumonia and burnt patients, some of them with multidrug resistance. Both nanoparticles showed a potent antibacterial effect, causing severe damage to the cell wall, membrane and DNA, and inducing the production of reactive oxygen species. Moreover, the nanoparticles derived from fungi showed synergistic antibacterial effects with the antibiotics meropenem and levofloxacin for some clinical strains and both kinds of nanoparticles were nontoxic for larvae of the moth Galleria mellonella, encouraging further research for their implementation in the treatment of P. aeruginosa infections.
Topics: Anti-Bacterial Agents; Drug Resistance, Multiple, Bacterial; Humans; Levofloxacin; Meropenem; Metal Nanoparticles; Microbial Sensitivity Tests; Plant Extracts; Pseudomonas Infections; Pseudomonas aeruginosa; Reactive Oxygen Species; Silver
PubMed: 35687297
DOI: 10.1111/lam.13759 -
Journal of Veterinary Pharmacology and... Sep 2023Levofloxacin veterinary formulations are available in Argentina, China and India for the use in dogs, cattle, pig and sheep, but not currently in the rabbit. Only the...
In vitro and ex vivo antibacterial activity of levofloxacin against Pasteurella multocida and Escherichia coli isolated from rabbits (Oryctolagus cuniculus) - A preliminary study.
Levofloxacin veterinary formulations are available in Argentina, China and India for the use in dogs, cattle, pig and sheep, but not currently in the rabbit. Only the extra-label use in rabbits is possible. Levofloxacin is not labelled for veterinary use in the EU or the USA. The activity of levofloxacin against rabbit pathogens Pasteurella multocida (P. multocida) and Escherichia coli (E. coli) was evaluated. Minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were determined in broth and serum for 10 P. multocida isolates and 5 E. coli isolates from rabbits. One isolate of each bacterial species was used for the time-killing curve study in vitro and ex vivo. In vitro AUC /MIC ratios were used for building the inhibitory pharmacodynamic I model. The P. multocida MIC were 0.008-0.5 μg/mL, MBC - 0.015-0.5 μg/mL. Escherichia coli MIC was 0.008-0.03 μg/mL and MBC - 0.03-0.25 μg/mL. Bacterial counts were reduced to the limit of detection after 24 h with levofloxacin concentrations of 2 MIC and higher. All serum samples from rabbits treated with levofloxacin eliminated the bacteria within 24 h. AUC /MIC ratios for bacteriostatic, bactericidal and bacterial elimination effects for P. multocida and E. coli isolates were 21, 29 and 75 h and 27, 32 and 60 h, respectively. Proposed daily doses against P. multocida (MIC = 0.015 μg/mL) and E. coli (MIC = 0.03 μg/mL) isolates were calculated as ≤0.91 and ≤1.43 mg/kg, respectively. Fluoroquinolones are categorized by WHO as 'highest priority critically important antimicrobials'. Considering the increasing importance of antimicrobial stewardship, antimicrobials from a lower importance category that are active against the isolate of interest should be used in preference to fluoroquinolones. Fluoroquinolone use in veterinary medicine should be based on antimicrobial susceptibility testing in order to mitigate the risk to public health and prevent the spread of bacterial resistance.
Topics: Rabbits; Animals; Swine; Cattle; Dogs; Sheep; Levofloxacin; Pasteurella multocida; Escherichia coli; Anti-Bacterial Agents; Fluoroquinolones; Microbial Sensitivity Tests
PubMed: 37060264
DOI: 10.1111/jvp.13383