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Mass drug administration (MDA) of antibiotics is a key component of the so-called "SAFE" strategy for trachoma control, while MDA of anthelminthics provides the cornerstone for control of a number of other neglected tropical diseases (NTDs). Simultaneous delivery of two or more of these drugs, renowned as "integrated NTD control," is being promoted to reduce costs and expand intervention coverage. A cost analysis was conducted alongside an MDA campaign in a remote trachoma endemic area, to inform budgeting for NTD control in South Sudan.
We have developed novel echogenic immunoliposomes (ELIPs) that can be antibody-conjugated for the specific highlighting of atheroma and atheroma components. The utility of these agents for regional drug delivery has not been evaluated previously. We chose to use an antibiotic as the prototype drug. The concept that an infectious agent may affect the development and progression of atherosclerosis has stimulated trials on the use of antibiotics for coronary syndromes. However, these agents are given systemically with concomitant problems. Development of an agent for local drug delivery may obviate adverse effects and improve treatment efficacy. The aim of this study was to evaluate the potential of our ELIPs for drug incorporation and to demonstrate efficient drug delivery to cultured cells.
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The aim of this study was to prepare a microsphere formulation in order to mask the bitter taste of azithromycin.
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Trials were small and methodological quality varied. In adults, fluoroquinolones may be better for reducing clinical relapse rates compared to chloramphenicol. Data are limited for other comparisons, particularly in children.
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As a well-established class, macrolide antibiotics continue to enjoy a remarkable interest within pharmaceutical industry. Several stunning breakthroughs in semi-synthetic study of erythromycin A (EMA) contribute to the important role played by the macrolide class in search for new anti-infectious agents. Earlier structural modifications of EMA to address the issue of acid instability resulted in the first breakthrough in search for anti-infectious agents derived from EMA. Clarithromycin (CAM) and azithromycin (AZM) are two representative antibacterials commercialized during this period. Afterwards, continued research on the modifications of EMA to combat bacterial resistance culminated in the second breakthrough in this field. Telithromycin and cethromycin are two innovative antibacterials discovered in this period for treating community-acquired pneumonia (CAP). Recently, further structural modifications of EMA generate promising antibacterials endlessly, which will hopefully arouse another breakthrough in the near future. In this review, we will give an account of these breakthroughs and discuss the future directions of semi-synthetic research on EMA. In particular, the design and synthesis of some distinguished or promising antibacterials derived from EMA will be highlighted.
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In three male patients with lower respiratory disease, aged 51, 32 and 63 years, Legionnaires' disease was diagnosed by urinary antigen test and culture of the respiratory-tract fluid. In the second patient, the bronchoalveolar fluid also contained Streptococcus pneumoniae and Haemophilus influenzae. All three patients recovered after treatment with azithromycin in the first, cefotaxime, vancomycin and levofloxacin in the second, and erythromycin and ciprofloxacin in the third, respectively. Legionella pneumophila pneumonia is clinically not clearly distinct from other pneumonias and has a high mortality rate when not treated with the proper antibiotics. For that reason, adequate and swift diagnosis is of great importance. The urinary antigen test meets both of these criteria. Still, it is advisable to use culture and serology as well if Legionnaires' disease is suspected in a patient, since the urinary antigen test has limitations. In addition, patient isolates are ofepidemiological importance for public health. By comparing available patient isolates with Legionella strains from water sources, it is possible to identify sources of infection. In 2002, based on this principle, a project was started in The Netherlands aimed at identifying sources of infection, thereby preventing outbreaks of Legionnaires' disease by swift elimination of the source. Since the start of the project, 29 sources have been identified. In the cases described above these were a sauna, a cooling tower and a caravan, respectively. In suspected cases, respiratory-tract fluid must be collected to make possible such a source investigation.
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We studied the effect in vitro of azithromycin on the clinical strain Helicobacter pylori H:72 growing intracellularly in monolayers of HEp-2 epithelial cells. After using gentamicin to eradicate extracellular bacteria, different concentrations of azithromycin were added to the infected cells and samples were taken after 0, 4, 8 and 24 h. Infected cells not exposed to antibiotic were included as controls. The MIC of azithromycin to the H. pylori was 0.25 mg/L and the MBC 0.5 mg/L in a broth dilution plate count method. A bactericidal effect was observed on intracellular H. pylori, with inhibition increasing with increasing azithromycin concentrations. However, extracellular concentrations of 200 x MBC were necessary to achieve intracellular killing. Our results show that azithromycin is active against intracellular H. pylori suggesting that it might be possible to exploit this activity when treating infections due to the organism.
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Bronchoscopy and bronchoalveolar lavage could shorten the course of endogenic foreign body in bronchus; especially it has significance to those cases of respiratory path obstruction with heart and respiratory failure. Plastic bronchitis could be determined by bronchoscopy and a pathologic histologic examination thereafter.
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Adjunct treatment of diarrhea should be routinely undertaken in all calves with systemic signs of illness, manifest as fever, inappetance, or lethargy. Ancillary treatments with documented efficacy in undifferentiated calf diarrhea include parenteral administration of antimicrobials with a predominantly gram negative spectrum of activity, parenteral administration of non-steroidal anti-inflammatory agents such as meloxicam and flunixin meglumine, and continued feeding of cow's milk. Halofuginone and azithromycin have efficacy in calves with diarrhea due to Cryptosporidium parvum, and their administration should be considered in calves documented or suspected to have cryptosporidiosis.
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The characteristics of 29 S. sonnei isolates from Thimphu, Bhutan in June and July, 2011 are identical in PFGE, plasmid and resistance pattern. This study suggests that these recent S. sonnei isolates are clonally related and multidrug-resistant.
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Macrolides are currently used to treat Streptococcus pyogenes infections where allergy or resistance prevents the use of penicillin. However, growing macrolide resistance is now seen worldwide, with rates of 5%-40% being reported. In this context it is therefore important to have other therapeutic options. The aim of this study was to ascertain the potential role of moxifloxacin, a third-generation fluoroquinolone, in the treatment of infections caused by group A S. pyogenes. The antimicrobial susceptibilities of S. pyogenes isolated from 197 adult patients with pharyngotonsillitis were analyzed by the E-test. Twelve percent of the isolates were resistant to macrolides, and 5% showed diminished susceptibility toward penicillin; none of the strains were resistant to cefotaxime or to moxifloxacin (90% minimum inhibitory concentration, 0.25 microg/mL). Therefore, moxifloxacin may be a therapeutic option in the management of S. pyogenes infections when penicillin cannot be used or when macrolide resistance may be a local issue. Clinical studies of moxifloxacin in pharyngotonsillitis are warranted.
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An outbreak investigation included a standardized exposure questionnaire admitted to all patients and medical chart abstraction. Isolates were tested for antimicrobial susceptibility and pulsed-field gel electrophoresis (PFGE).