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We wanted to ascertain how Helicobacter pylori infection is managed in Scandinavia.
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We successfully visualized the antibacterial behavior of biodegradable polymeric nanoparticles (NPs) on a biofilm formed by Staphylococcus epidermidis using field emission scanning electron microscopy (FE-SEM). A hydrophilic ionic liquid, 1-butyl-3-methylimidazolium tetrafluoroborate ([BMIM][BF4]), was applied for observation using FE-SEM. The differences in adherence and penetration behavior of three types of NPs were revealed using this method and confocal laser scanning microscopy. Biodegradable poly(dl-lactide-co-glycolide) (PLGA) NPs were prepared by the emulsion solvent diffusion method. In this study, we treated the biofilm with three PLGA NPs: unmodified PLGA, PLGA modified with chitosan (CS) and clarithromycin (CAM)-loaded + CS-modified PLGA. The viability of S. epidermidis cells treated with PLGA NPs was estimated using the LIVE/DEAD BacLight kit to understand the antibacterial ability of each NP sample in a quantitative way. The results confirmed that CAM-loaded + CS-modified PLGA had high antibacterial ability on the biofilm. This novel observation technique would be useful in the development of drug formations and medical agents.
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Infection caused by Mycobacterium avium complex (MAC) is common in patients with immunosuppression, such as AIDS, and deficiencies of gamma interferon and interleukin-12, as well as patients with chronic lung diseases. Treatment of MAC disease is limited since few drugs show in vivo activity. We tested a new bridged bicyclic macrolide, EDP-420, against MAC in vitro and in beige mice. EDP-420 was inhibitory in vitro at a concentration ranging from 2 to 8 microg/ml (MIC(50) of 4 microg/ml and MIC(90) of 8 microg/ml). In macrophages, EDP-420 was inhibitory at 0.5 microg/ml, suggesting that the drug concentrates intracellularly. Mice infected with macrolide-susceptible MAC strain 101 were given 100 mg of EDP-420/kg of body weight daily for 4 weeks and showed a significant reduction in the number of bacteria in both liver and spleen which was greater than the reduction observed with clarithromycin treatment at the same dose (P < 0.05). However, macrolide-resistant MAC 101 did not respond to EDP-420 treatment. A combination of EDP-420 with mefloquine was shown to be indifferent; mefloquine alone was active against macrolide-resistant MAC. The frequency of resistance to EDP-420 in MAC 101 was 10(-9), which is significantly less than the emergence of resistance to clarithromycin, approximately 10(-7) (P < 0.05). Further evaluation of EDP-420 in the treatment of MAC disease is warranted.
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One-hundred and two studies were accepted comprising 25,644 cases and 398 treatment arms. The eradication rate of proton pump inhibitor-based first line triple therapies was 80.4% (confidence interval: 78.9-81.8); no difference was observed between the five proton pump inhibitors (p > 0.05). Ranitidine bismuth citrate based regimens were efficient in 79.9% (75.7-84.0) (p = 0.95 vs PPI). H2 blockers-based therapies achieved 68.6% (59.0-78.1) (p = 0.0007 vs proton pump inhibitor and p = 0.005 vs ranitidine bismuth citrate-based regimens). Proton pump inhibitor-based double combinations were efficient in 47.1 (31.9-62.4) (p = 0.001 vs triple regimens). Clarithromycin+amoxicillin/nitroimidazole combinations achieved rates of 79.6% and 84.1%, respectively, while amoxicillin-nitroimidazole regimens were less efficient (72.5%, 66.6-78.5) (p = 0.006). The pooled eradication rate of second-line triple regimens was 75.5% (69.9-86.4)(p = 0.08 vs primary treatment). Quadruple therapies were successful in 81.1% (76.6-85.6) of cases as first-line and 73.8% (61.2-86.4) as second-line regimens (p = 0.77 and p = 0.02 vs triple regimens). The pooled eradication rates varied from 58% to 92% in the European countries.
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Treatment-naive H pylori-positive individuals were randomly assigned to a 10-day regimen (oral twice-daily doses) with rabeprazole (20 mg): standard triple therapy (proton pump inhibitor, added clarithromycin [500 mg] and amoxicillin [1 g] [PPI-CA]); sequential therapy (ST) added amoxicillin (1 g) on days 1 to 5, and metronidazole (500 mg) and clarithromycin (500 mg) on days 6 to 10. Participants with clarithromycin-resistant H pylori were randomly assigned to ST or quadruple therapy. Treatment effectiveness was estimated as per cent (95% CI) with a negative urea breath test at least 10 weeks after treatment.
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Mycobacterial granulomas of the skin and subcutis can be caused by one of a number of pathogens. This review concentrates on noncultivable species that cause diseases characterized by focal granuloma(s), namely leproid granuloma (in dogs) and feline leprosy (in cats). Clinically indistinguishable lesions can be caused by tuberculous organisms (Mycobacterium bovis and Mycobacterium microti) and members of the Mycobacterium avium complex. Rapidly growing mycobacterial species that cause infection of the subcutaneous panniculus associated with draining tracts are not discussed. Disease caused by Mycobacterium ulcerans is an important emerging differential diagnosis for ulcerated cutaneous nodules in certain localized regions. CLINICAL LESIONS: Lesions comprise one or multiple nodules in the skin/subcutis. These are generally firm and well circumscribed, and typically become denuded of hair. They may or may not ulcerate, depending on the virulence of the causal organisms and the immune response of the host.
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This study aimed to investigate the antibiotic concentration at each stage of treatment and to evaluate the removal efficiency of antibiotics in different types of secondary and advanced treatment, as well as the effects of the location of their discharge points on the occurrence of antibiotics in surface water. Eight target antibiotics and four hospital wastewater treatment plants in Bangkok with different conventional and advanced treatment options were investigated. Antibiotics were extracted by solid phase extraction and analysed by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The antibiotic with the highest concentration at influent was cefazolin at 13,166 ng/L, while the antibiotic with the highest concentration at effluent was sulfamethoxazole at 1,499 ng/L. The removal efficiency of antibiotics from lowest to highest was sulfamethoxazole, piperacillin, clarithromycin, metronidazole, dicloxacillin, ciprofloxacin, cefazolin, and cefalexin. The adopted conventional treatment systems could not completely remove all antibiotics from wastewater. However, using advanced treatments or disinfection units such as chlorination and UV could increase the antibiotic removal efficiency. Chlorination was more effective than UV, ciprofloxacin and sulfamethoxazole concentration fluctuated during the treatment process, and sulfamethoxazole was the most difficult to remove. Both these antibiotics should be studied further regarding their contamination in sludge and suitable treatment options for their removal.
Five patients had clarithromycin-sensitive H. pylori before eradication therapy and gained H. pylori-resistant to clarithromycin after eradication therapy. The sensitive and resistant colonies of each of the H. pylori populations, taken from patients before/after antibiotic therapy, had identical sequence types (ST) obtained with MLST.
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The crystal structures of the commercially available form of erythromycin A dihydrate and clarithromycin anhydrate, in addition to the structure of erythromycin B dihydrate, are reported in this paper. In light of the crystallographic data, analysis of the structural information provides insight into the physical properties of these pharmaceuticals. The propensity of these pharmaceuticals to form solvated structures is discussed and the hygroscopicity of erythromycin A dihydrate is investigated. Solid-state 13C NMR was used to monitor changes that occur when the dihydrate form of erythromycin A is stored under conditions of low relative humidity. Although erythromycin A dihydrate retains its crystallographic order at low humidity, as indicated by its X-ray powder diffraction pattern, the local chemical environment is dramatically influenced by the loss of the water molecules and results in dramatic changes in its solid-state 13C NMR spectrum.
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Medication errors may occur at any point during patient care in the health care system. Drug interaction in known with macrolide antibiotics and ranolazine and is primarily related to effects on the cytochrome P4503A (CYP3A) metabolic pathway. This case highlights medication errors that resulted in rare debilitating neurological adverse effects of ranolazine in an elderly due to drug interaction with clarithromycin.