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BMC Women's Health Jun 2023The aim of this retrospective study was to investigate whether oral antibiotics (doxycycline and metronidazole) combined with intrauterine perfusion (gentamicin and...
Combined oral antibiotics and intrauterine perfusion can improve in vitro fertilization and embryo transfer pregnancy outcomes in patients with chronic endometritis and repeated embryo implantation failure.
BACKGROUND
The aim of this retrospective study was to investigate whether oral antibiotics (doxycycline and metronidazole) combined with intrauterine perfusion (gentamicin and dexamethasone) are beneficial for patients with repeated implantation failure (RIF) and chronic endometritis (CE) to improve clinical pregnancy outcomes.
METHODS
Patients with RIF and CE were diagnosed using hysteroscopy and histology together. A total of 42 patients were enrolled in the study. All patients received oral antibiotics (doxycycline combined with metronidazole) and 22 patients underwent intrauterine perfusion (gentamicin combined with dexamethasone) immediately after the end of oral antibiotic therapy. Pregnancy outcomes were evaluated during the first in vitro fertilization (IVF) and embryo transfer (ET) cycle.
RESULTS
For the first D3 ET after treatment with oral antibiotics (doxycycline and metronidazole) combined with intrauterine perfusion (gentamicin and dexamethasone), higher embryo implantation rate (30.95% vs. 26.67%, P = 0.0308), clinical pregnancy rate (30% vs. 50%, P < 0.001), live birth rate (33.33% vs. 45.45%, P < 0.0001). No fetal malformations or ectopic pregnancies were observed.
CONCLUSION
We report oral antibiotics (doxycycline and metronidazole) combined with intrauterine perfusion (gentamicin and dexamethasone) as a novel treatment for CE to improve the outcomes of successful pregnancy compared with those of oral antibiotics alone.
Topics: Female; Pregnancy; Humans; Doxycycline; Metronidazole; Pregnancy Outcome; Endometritis; Retrospective Studies; Perfusion; Anti-Bacterial Agents; Embryo Transfer; Fertilization in Vitro; Gentamicins; Chronic Disease; Embryo Implantation; Dexamethasone
PubMed: 37391748
DOI: 10.1186/s12905-023-02443-8 -
American Family Physician Nov 2020
Topics: Administration, Cutaneous; Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Deprescriptions; Dermatitis, Perioral; Erythromycin; Glucocorticoids; Humans; Metronidazole; Recurrence; Risk Factors; Tacrolimus; Triamcinolone
PubMed: 33179894
DOI: No ID Found -
Microbiology Spectrum Aug 2022Infections with the sexually transmitted parasite Trichomonas vaginalis are normally treated with metronidazole, but cure rates are suboptimal and recurrence rates...
Infections with the sexually transmitted parasite Trichomonas vaginalis are normally treated with metronidazole, but cure rates are suboptimal and recurrence rates following treatment are high. Therefore, our objective was to assess the antitrichomonas activities of three other 5-nitroimidazole drugs and compare them with metronidazole. T. vaginalis isolates ( = 94) isolated from South African women presenting with vaginal discharge syndrome at two sexually transmitted disease clinics in KwaZulu-Natal were grown from frozen stock. Twofold serial dilutions (16 to 0.25 mg/L) of metronidazole, tinidazole, ornidazole, and secnidazole were prepared in Diamond's broth. The MICs were read after 48 h of anaerobic incubation at 37°C. An MIC of <2 mg/L was defined as susceptible, an MIC of 2 mg/L was defined as intermediate, and an MIC of >2 mg/L was defined as resistant. Sixty-one percent (57/94) of the T. vaginalis isolates were susceptible to metronidazole, 80% (75/94) were susceptible to tinidazole, 75% (71/94) were susceptible to secnidazole, and 89% (84/94) were susceptible to ornidazole. Resistance levels were 11%, 2%, and 1% for metronidazole, tinidazole, and secnidazole, respectively, while no resistance was observed for ornidazole. Intermediate scores were 28% for metronidazole, 18% for tinidazole, 24% for secnidazole, and 11% for ornidazole. Isolates from a proportion of women with bacterial vaginosis (BV) had higher MICs, and no isolates from women coinfected with another sexually transmitted infectious organism were resistant to any of the antimicrobials tested. This study showed that among T. vaginalis isolates in KwaZulu-Natal, there is no resistance to ornidazole. Of the 5-nitroimidazoles, metronidazole showed the highest level of resistance. The very low levels of resistance for the other three antimicrobials indicate that all three are viable options as a replacement for metronidazole if these findings are found to correlate with clinical outcomes. Trichomonas vaginalis is the most common nonviral sexually transmitted infection associated with reproductive sequelae and HIV acquisition risk worldwide. Despite its role in reproductive health, a high prevalence in South Africa, and the reported metronidazole resistance worldwide, no alternative regimens have been tested against T. vaginalis in our setting. This study compared the susceptibility patterns of three other 5-nitroiminazoles (secnidazole, tinidazole, and ornidazole), which are active against T. vaginalis with metronidazole . Metronidazole, the drug of choice for the treatment of trichomoniasis, showed the highest level of resistance, while the three regimens showed very low levels of resistance. These data indicate that all three are viable options as a replacement for metronidazole if these findings are found to correlate with clinical outcomes.
Topics: Female; Humans; Metronidazole; Nitroimidazoles; Ornidazole; South Africa; Tinidazole; Trichomonas vaginalis
PubMed: 35863010
DOI: 10.1128/spectrum.00912-22 -
International Journal of Colorectal... Aug 2023Surgical site infections (SSIs) are common in colorectal surgery. Mechanical bowel preparation (MBP) in conjunction with oral antibiotics (OABs) have been shown to... (Observational Study)
Observational Study
PURPOSE
Surgical site infections (SSIs) are common in colorectal surgery. Mechanical bowel preparation (MBP) in conjunction with oral antibiotics (OABs) have been shown to reduce SSI rates. It however is still unclear which OABs to use, and how this can be implemented in practice.
METHODS
This is a prospective observational study carried out in Swansea Bay University Health Board during 2019-2021, evaluating the introduction of OABs in a stepwise manner on the incidence of SSI in major colorectal surgery. A control group having MBP only was compared to two OAB groups: one group had MBP plus metronidazole only and the second MBP plus metronidazole and neomycin. A 30-day follow-up after surgery was ascertained via chart review and telephone contact. Logistic regression was performed to estimate the relation between OAB use and SSI, with adjustment for confounding. In a subset of patients, faecal samples were analysed through 16S rRNA amplicon sequencing before and after OAB treatment, depicting the impact of the gut microbiome.
RESULTS
In total 160 patients were analysed: 46 patients had MBP only, whilst 76 patients had MBP plus metronidazole only and 38 patients had MBP with metronidazole/neomycin. The SSI rate in the entire cohort was 33.8%, whilst the adjusted ORs for the single- and dual-OAB groups were 0.76 (95% CI: 0.17-1.81) and 0.50 (95% CI: 0.17-1.52). The microbial analysis demonstrated that the relative abundance for many bacterial genera was changed before and after OAB treatment, but no link with SSI development could be shown.
CONCLUSIONS
Introduction of OABs in conjunction with MBP in colorectal surgery is feasible, and may potentially lead to lower rates of SSI, as well as altering the community structure of the faecal microbiome. More research is needed, especially considering different OABs and mechanistic studies of the gut microbiome in the context of colorectal surgery.
Topics: Humans; Anti-Bacterial Agents; Surgical Wound Infection; Metronidazole; Antibiotic Prophylaxis; Colorectal Surgery; RNA, Ribosomal, 16S; Neomycin; Preoperative Care; Elective Surgical Procedures; Administration, Oral; Cathartics
PubMed: 37555867
DOI: 10.1007/s00384-023-04497-4 -
Gut Microbes Dec 2023Inflammatory bowel disease (IBD) represents a prominent chronic immune-mediated inflammatory disorder, yet its etiology remains poorly comprehended, encompassing...
Inflammatory bowel disease (IBD) represents a prominent chronic immune-mediated inflammatory disorder, yet its etiology remains poorly comprehended, encompassing intricate interactions between genetics, immunity, and the gut microbiome. This study uncovers a novel colitis-associated risk gene, namely Ring1a, which regulates the mucosal immune response and intestinal microbiota. Ring1a deficiency exacerbates colitis by impairing the immune system. Concomitantly, Ring1a deficiency led to a genus-dominated pathogenic microenvironment, which can be horizontally transmitted to co-housed wild type (WT) mice, consequently intensifying dextran sodium sulfate (DSS)-induced colitis. Furthermore, we identified a potential mechanism linking the altered microbiota in Ring1aKO mice to decreased levels of IgA, and we demonstrated that metronidazole administration could ameliorate colitis progression in Ring1aKO mice, likely by reducing the abundance of the genus. We also elucidated the immune landscape of DSS colitis and revealed the disruption of intestinal immune homeostasis associated with Ring1a deficiency. Collectively, these findings highlight Ring1a as a prospective candidate risk gene for colitis and suggest metronidazole as a potential therapeutic option for clinically managing genus-dominated colitis.
Topics: Animals; Mice; Colitis; Gastrointestinal Microbiome; Immune System; Metronidazole; Prevotella
PubMed: 37655448
DOI: 10.1080/19490976.2023.2251646 -
Archives of Razi Institute Aug 2023() is considered a challenging type of bacteria that is difficult to treat with the currently used antibiotics, such as amoxicillin, erythromycin, and metronidazole,...
() is considered a challenging type of bacteria that is difficult to treat with the currently used antibiotics, such as amoxicillin, erythromycin, and metronidazole, which have proven ineffective against these bacteria. In this study, modern technology was used to treat these bacteria by converting the aforementioned antibiotics to their nano state using the lyophilization method and diagnosing them using scanning electron microscopy. A mixture of the three nano-antibiotics was prepared in the form of a nano-medicine, which was used to treat bacteria in cultures and determine the effectiveness of nano-antibiotics and nano-medicine on these bacteria. The findings showed that nano-medicine was highly effective in inhibiting these bacteria at the lowest concentration (OD=0.042) and the highest concentration (OD=0.038), compared to the three micro-antibiotics individually. The OD values of amoxicillin, azithromycin, and metronidazole were 0.523, 0.521, and 0.453, respectively. The OD values of the three nano-antibiotics, including nano-amoxicillin, nano-azithromycin, and nano-metronidazole, were 0.386, 0.258, and 0.167, respectively. It was observed that the percentage of inhibition in each of the nano-antibiotics was higher than the inhibition in micro-antibiotics and that the nano-medicine had much higher inhibition than each of the three micro- and nano-antibiotics alike. The safety of using nano-antibiotics in the prepared medicine was confirmed using electrochemical technology and cyclic voltammetry to identify the electrochemical properties through oxidation and reduction in blood media. Based on the findings, only reduction peaks appeared, and there were no oxidation peaks in the prepared kit or for each of the three nano-antibiotics. It was found that they were all non-oxidants and could be used safely as good antioxidants in treatments. However, the same three micro treatments showed blood oxidation due to the appearance of oxidation peaks in all of them. The study proved that all isolates are resistant to usable antibiotics. All of the antibiotics in the nano-medicine had an anti-bacterial effect, and the effect of the new form of antibiotic was proportional to the concentration of the antibiotic.
Topics: Animals; Helicobacter Infections; Metronidazole; Helicobacter pylori; Anti-Bacterial Agents; Amoxicillin; Azithromycin
PubMed: 38226381
DOI: 10.32592/ARI.2023.78.4.1313 -
Clinical Oral Investigations Mar 2020Gingival recessions inevitably occur during healing after scaling and root planing, but synoptic data on this topic is still lacking. This review compared the recession... (Review)
Review
BACKGROUND
Gingival recessions inevitably occur during healing after scaling and root planing, but synoptic data on this topic is still lacking. This review compared the recession formation with and without the administration of systemic antibiotics.
OBJECTIVES
To evaluate the formation of recession with and without the administration of antibiotics during the healing after scaling and root planing.
MATERIALS AND METHODS
This study re-analyzed publications that reported clinical attachment levels (CAL) and probing pocket depths (PD) up to January 2019, including the pivotal review by Zandbergen and co-workers (2013). Whereas these studies traditionally focused on PD and CAL, the present analysis compared recession formation (ΔREC) after adjunctive systemic administration of amoxicillin (amx) and metronidazole (met) during scaling and root planing (SRP) and SRP alone. The mean increase in ΔREC, if not reported, was calculated from CAL and PD values and statistically analyzed. Recession formation was compared after 3 and 6 months after therapy. Results were separately reported for chronic periodontitis (CP) as well as aggressive periodontitis (AP) cases.
RESULTS
Recessions increased consistently between baseline and follow-up. In the AP group, median ΔREC was 0.20 mm after 3 months, irrespective of whether antibiotics were administered or not. After 6 months, median ΔREC increased to 0.35 mm after AB and remained stable at 0.20 mm with SRP alone. In the CP group, after 3 months with and without antibiotics, median ΔREC accounted for 0.30 mm and 0.14 mm, respectively. After 6 months, median ΔREC accounted for 0.28 mm (with AB) and 0.20 mm (without AB). The quantitative assessment by meta-analyses also yielded small values (≤ 0.25 mm) for the estimated differences in recession formation between AB and noAB; however, none of them reached statistical significance.
CONCLUSIONS
Although a slight tendency towards higher recession formation after SRP in combination with AB could be observed in many studies, quantitative meta-analyses showed no clinically relevant difference in recession formation due to the administration of AB. In general, the description and discussion of recessions in the literature seems not to be a major focus so far.
CLINICAL RELEVANCE
Since the preservation of gingival tissues is important by preventive and therapeutic means, e.g., when avoiding postoperative root sensitivity or performing regenerative surgery, these aspects should not be neglected. We thus suggest to report REC measurements along with PD and CAL values for more direct recession formation (ΔREC) assessments in the future.
Topics: Amoxicillin; Anti-Bacterial Agents; Dental Scaling; Gingival Recession; Humans; Metronidazole; Root Planing
PubMed: 31938962
DOI: 10.1007/s00784-020-03198-4 -
Frontiers in Cellular and Infection... 2021Current treatments for giardiasis include drugs with undesirable side effects, which increase the levels of therapeutic desertion and promote drug resistance in the...
Current treatments for giardiasis include drugs with undesirable side effects, which increase the levels of therapeutic desertion and promote drug resistance in the parasites. Herein, we describe the antigiardiasic evaluation on Giardia lamblia trophozoites of a structurally diverse collection of 74 molecules. Among these scaffolds, we discovered a benzopyrrolizidine derivative with higher antigiardiasic activity (IC = 11 µM) and lower cytotoxicity in human cell cultures (IC = 130 µM) than those displayed by the current gold-standard drugs (metronidazole and tinidazole). Furthermore, this compound produced morphologic modifications of trophozoites, with occasional loss of one of the nuclei, among other changes not observed with standard giardicidal drugs, suggesting that it might act through a novel mechanism of action.
Topics: Animals; Antiprotozoal Agents; Giardia lamblia; Giardiasis; Humans; Metronidazole; Trophozoites
PubMed: 35096662
DOI: 10.3389/fcimb.2021.828100 -
PloS One 2023Helicobacter pylori treatment failure remains a challenging problem. This study aimed to identify predictive factors for successful eradication in patients following... (Clinical Trial)
Clinical Trial
BACKGROUND
Helicobacter pylori treatment failure remains a challenging problem. This study aimed to identify predictive factors for successful eradication in patients following treatment failures.
METHODS
This was a retrospective cohort study. This study included 1,050 dyspeptic patients diagnosed with H. pylori infection at tertiary care center in Thailand between March 2014 and October 2021. Patients' demographic data, endoscopic findings, H. pylori culture, antimicrobial susceptibility testing (AST), treatment regimens and outcomes were analysed.
RESULTS
Of 1,050 patients with H. pylori infections, 302 (28.7%) experienced treatment failure (mean age 58.4 years; 44.7% males). AST was performed in 192. Resistance was observed for metronidazole (43.2%), levofloxacin (33.9%), clarithromycin (24%), and amoxicillin (2.1%). There was no tetracycline resistance. Multidrug-resistance (MDR) was significantly more common following treatment failure (45.5% vs. 15.7%, p<0.001). Baseline characteristics were similar between treatment successes and failures. Eradication rates after first-line and second-line regimens were 71.2% and 54.5%, respectively. Medication nonadherence [OR 36.6 (95%CI 8.65-155.03, p<0.001)] and MDR [OR 4.49 (95%CI 2.29-8.81, p<0.001)] were associated with treatment failure. Over time, resistance increased for metronidazole, levofloxacin, and clarithromycin, while eradication rates with triple therapy declined. Tailored antibiotic therapy [OR 4.92 (95%CI 1.61-14.99, p = 0.005)] and a regimen including 4-times-daily dosing of amoxicillin (2 grams/day) [OR 3.05 (95%CI 1.10-8.41, p = 0.032)] were significantly associated with treatment success after first-line failure. Eradication rates when using tailored therapy and 4-times-daily dosing of amoxicillin (2 grams/day) were 91.1% and 89.4%, respectively. Performing AST before first-line therapy resulted in the highest cure rates. AST performed after multiple treatment failures was also associated with higher eradication rates compared with the group without AST (94.4% vs. 50%,p = 0.008).
CONCLUSIONS
AST either before or after treatment failure correlated with a higher proportion of successful eradication. Nonadherence and the MDR infections predicted treatment failure. Tailored therapy and 4-times-daily dosing of amoxicillin after treatment failure were likely to be successful.
Topics: Female; Humans; Male; Middle Aged; Amoxicillin; Anti-Bacterial Agents; Clarithromycin; Drug Therapy, Combination; Helicobacter Infections; Helicobacter pylori; Levofloxacin; Metronidazole; Retrospective Studies; Treatment Failure
PubMed: 38033026
DOI: 10.1371/journal.pone.0294403 -
Molecules (Basel, Switzerland) Dec 2021Metronidazole (MET) is a commonly detected contaminant in the environment. The compound is classified as poorly biodegradable and highly soluble in water. Heterogeneous...
Metronidazole (MET) is a commonly detected contaminant in the environment. The compound is classified as poorly biodegradable and highly soluble in water. Heterogeneous photocatalysis is the most promoted water purification method due to the possibility of using sunlight and small amounts of a catalyst needed for the process. The aim of this study was to select conditions for photocatalytic removal of metronidazole from aquatic samples. The effect of catalyst type, mass, and irradiance intensity on the efficiency of metronidazole removal was determined. For this purpose, TiO, ZnO, ZrO, WO, PbS, and their mixtures in a mass ratio of 1:1 were used. In this study, the transformation products formed were identified, and the mineralization degree of compound was determined. The efficiency of metronidazole removal depending on the type of catalyst was in the range of 50-95%. The highest MET conversion (95%) combined with a high degree of mineralization (70.3%) was obtained by using a mixture of 12.5 g TiO-P25 + PbS (1:1; /) and running the process for 60 min at an irradiance of 1000 W m. Four MET degradation products were identified by untargeted analysis, formed by the rearrangement of the metronidazole and the C-C bond breaking.
Topics: Catalysis; Metronidazole; Photochemical Processes; Water Purification
PubMed: 34946687
DOI: 10.3390/molecules26247612