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The present experimental in vitro study was carried out to evaluate the anti-brucella activities of essential oils of Rosmarinus officinalis L., Origanum syriacum, Thymus syriacus, Salvia palaestina Benth, Mentha piperia, and Lavandula stoechas L., alone and in combination with some antibiotics. The activity against 16 tetracycline-resistant B. melitensis isolates was determined by disc diffusion method incorporating a concentration of 5%. Antibiotic discs were also used as a control. Microdilution brucella broth susceptibility assay was used in order to determine the MICs of essential oils and five antibiotics.
In this work, a method for the analysis of fluoroquinolone antibiotics using microwave-assisted micellar extraction combined with liquid chromatography-mass spectrometry detection has been developed. Different surfactants were tested for use as extractants in the isolation of the analytes from solid samples, and several experimental designs were evaluated for the determination and optimization of the variables that affect recovery from the matrix. Under optimal conditions, we obtained recoveries greater than 73% with relative standard deviations below 8%. Compounds were detected by liquid chromatography-electrospray ionization tandem mass spectrometry with detection limits between 0.15 and 0.55 ng g(-1) and quantification limits between 0.49 and 1.85 ng g(-1) . Finally, the optimized method was applied in the determination of antibiotics in real solid samples. Four fluoroquinolones (levofloxacin, norfloxacin, ciprofloxacin and enrofloxacin) were found in coastal marine sediments taken close to a marine outfall and in sewage sludge samples from a wastewater treatment plant. Concentrations ranged between 0.81 and 34.3 ng g(-1) in the sediments and 3.43 and 206.1 ng g(-1) in the sludge.
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Antibiotics are commonly used to combat infections and could be used in treating some connective diseases. They are not without side effects especially when used without regard to age, gender, diseases and their severity, comorbidity, and idiosyncrasies. This is more likely to occur when dispensed by unqualified persons to selves or others. Consequences of inappropriate use include various morbidities and in some instances death. This is a report of a middle-aged man with several risk factors for cardiovascular disease, who on the side had chronic osteomyelitis. Wound swab grew organisms sensitive to levofloxacin, and he had the drug prescribed to him by the attending orthopedic surgeon. With reduction in discharge to the point that he no longer bound his foot in bandage, he went on using the drug beyond the duration of prescription without reverting to his orthopedic surgeon until he developed sudden onset palpitation and shortness of breath. With this was an unusual tachyarrhythmia which defied initial measures. This prompted further review of his drug history when he admitted to taking levofloxacin for up to 3 months. Suspecting it to be the culprit, he was advised to discontinue it. With this, his symptoms started to abate, alongside gradual improvement in electrocardiograms till eventual normalization. This report is made to highlight the possibility that some antibiotics have the propensity to induce arrhythmias that can be very serious especially in cardiovascular disease-burdened patients. Such patients then go into heart failure and it becomes difficult to tell which came first, the arrhythmia or the heart failure. Resolving the order of onset assists in proper management. As a result, it is being recommended that patients with unexplained arrhythmias with or without heart failure should have their drug histories evaluated. Uncontrolled prescription and use of antibiotics should also be discouraged.
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Acinetobacter baumannii, an aerobic, non-motile, gram-negative bacterium is an important nosocomial pathogen which shows resistance to the most antibiotics. Carbapenems are the most commonly used antibiotics for the treatment of infections caused by this pathogen. However the emergence of resistance against carbapenems in an increasing rate generates serious problems for antimicrobial therapy. The aims of this study were to detect the antibiotic susceptibility, and the presence of blaOXA resistance genes of clinical A.baumannii isolates and to determine the clonal relationship between these isolates. A total of 79 A.baumannii strains isolated from various clinical specimens (37 respiratory tract samples, 11 wound, 10 blood, 8 catheters, 6 tissue, 5 urine, 2 abscess) of the patients admitted to Mersin University Medical School Hospital between May 2012-January 2013, were included in the study. The isolates were identified by conventional methods and Vitek®2 Compact automated system. Antibiotic susceptibilities of the isolates were determined by Kirby-Bauer disk diffusion method and evaluated according to CLSI criteria. The presence of blaOXA-51, blaOXA-23, blaOXA-24, blaOXA-48 and blaOXA-58 genes were detected by an in-house polymerase chain reaction (PCR), and the clonal relationship between the isolates were identified by pulsed-field gel electroforesis (PFGE) using the ApaI restriction enzyme. In our study, all of the isolates were susceptible to colistin, while the resistance rates against piperacillin-tazobactam, ciprofloxacin, imipenem, meropenem, cefoperazone/sulbactam, trimethoprim-sulfamethoxazole, ceftazidime, levofloxacin, gentamicin, tetracycline, ampicillin-sulbactam, amikacin, netilmicin and tigecycline were 97.5%, 96.2%, 94.9%, 94.9%, 93.6%, 91.1%, 88.6%, 86%, 83.6%, 77.2%, 69.6%, 55.7%, 27.8% and 3.8%, respectively. All the isolates were identified as A.baumannii with the OXA-specific PCR and OXA16S rDNA sequence analysis. All of the isolates (100%) harboured blaOXA-51 and 71 (89.9%) harboured blaOXA-23 gene, however they were all negative for blaOXA-24, blaOXA-48 and blaOXA-58 genes. According to PFGE results 10 pulsotypes were identified, of these eight pulsotypes formed 77 (97.5%) similar strains with indistinguishable PFGE profiles ranging between 3-30 [A (n= 30), B (n= 20), C (n= 9), D (n= 5), E (n= 4), F (n= 3), G (n= 3), H (n= 3)]. When compared with the other clones, clones A and B were dominant among the samples and they have exhibited high level of antibiotic resistance. The rest two pulsotypes [I (n= 1), J (n= 1)] were in close relation with the main cluster. No common outbreak isolate was detected, but the relationship between the majority of the strains pointed out that there was a cross contamination problem in our hospital. In conclusion blaOXA-51 and blaOXA-23 were detected as predominant genes responsible from carbapenem resistance in our clinical A.baumannii strains, and it was considered that the high prevalence of clones A and B may constitute a threat in terms of hospitalized patients.
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Clostridium difficile isolates from a 2004 outbreak in Québec, Canada, were all found to be susceptible to metronidazole, vancomycin, rifampin, and meropenem but resistant to bacitracin, cefotaxime, ciprofloxacin, and levofloxacin, and most (>80%) were resistant to ceftriaxone, clarithromycin, gatifloxacin, and moxifloxacin. The predominant NAP1 isolates were susceptible to clindamycin, while the NAP2 isolates were resistant.
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For MICs <1 mg/L, all simulated patients reach the efficacy target. However, with higher values of MIC, the proposed regimens were inefficient for patients with moderate or severe renal impairment: 3.4% and 30.2% of patients with moderate renal impairment reached the efficacy target for ciprofloxacin and ofloxacin, respectively, for an MIC of 2 mg/L. For ciprofloxacin, more than 80% of patients with severe renal impairment were unable to reach the target fAUC/MIC with an MIC as low as 1 mg/L, whereas for levofloxacin, all simulated patients reached the efficacy target until an MIC of 4 mg/L.
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Community-acquired pneumonia is the seventh leading cause of death in Canada. Previous studies have shown reductions in both mortality rate and length of hospital stay with the use of guideline-concordant empiric therapy and standardized preprinted orders.
The 2007 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines recommend that community-acquired pneumonia (CAP) patients admitted to hospital wards initially receive respiratory fluoroquinolone monotherapy or beta-lactam plus macrolide combination therapy. There is little evidence as to which regimen is preferred, or if differences in medical resource utilization exist between therapies. Thus, the authors compared length of hospital stay (LOS) and length of intravenous antibiotic therapy (LOIV) for patients who received initial levofloxacin 750 mg daily versus ceftriaxone 1000 mg plus azithromycin 500 mg daily ('combination therapy').