ABSTRACT
Background: Diabetic foot ulcers (DFUs) remain difficult to treat with likely incriminating risk factors involving Methicillinresistant Staphylococcus aureus (MRSA). Linezolid offers complimentary consistent action against MSSA and MRSApathogens making it an ideal choice for inpatient, switch or outpatient therapy for complicated skin and skin structureinfections.Objective: The objective of the study was to compare the efficacy of injectable versus oral linezolid in the management ofpost-operative DFUs.Materials and Methods: Retrospective analyses of 100 cases receiving oral or injectable linezolid. A total of 100 subjectswere enrolled in this study. Two groups were made of 50 patients each and labeled as Group A and Group B. In Group A,tablet linezolid was given in a dose of 600 mg BD for 7 days. In Group B, injectable linezolid was given in a dose of 600 mgintravenous (IV) BD for 7 days. Clinical and bacteriological improvement was documented. In both groups tablet cefuroxime,500 mg BD was given for 7 days in conjunction with linezolid.Results: We found 90–100% improvement in wound infections and in culture reports. Results in both the groups receivingoral or IV linezolid for post-operative DFU healing were comparable when administered for 7 days. Linezolid offered hightherapeutic success rates (75–100%) against the incriminated pathogens of S. aureus with little action against Acinetobacteror Pseudomonas aeruginosa.Conclusion: These results suggest that linezolid given empirically is highly effective in the treatment of DFUs. The equivocalclinical and microbiological eradication rates for oral and injectable formulations with 7 days therapy makes them less liable forresistance induction or development.
ABSTRACT
Background: Inhalation therapy involving nebulization remains important modality of therapy for severe or high-risk obstructive airwaydiseases including bronchial asthma. The likely incremental factors for the translational impact of this delivery strategy includes fine particledose (FPD), fine particle fraction (FPF), mass median aerodynamic diameter (MMAD), and respirable fraction (RF) of the pharmaceuticalaerosols playing a key role in site-specific delivery to the lungs. The new generation active vibrating mesh nebulizers (VMNs) offer aconvenient, portable strategy in above clinical cases without compromising the delivery efficiency for improved therapeutic outcomes.Aim: This in vitro study was conducted to validate the improved efficiency and aerodynamic effect of glycopyrronium solutionnebulization with novel patented active and passive VMN devices.Materials and Methods: A in vitro lung deposition study was conducted using drug samples of glycopyrronium bromide(25 mcg/2 ml and 1 ml) using new generation cascade impactor at a flow rate of 15 L/min at Glenmark R&D Center, Sinnar, India.Results: Three samples of glycopyrronium nebulizing solution were analyzed using next generation impactor at a flow rate of15 L/min for aerodynamic aerosol parameters (FPF and RF) and total/active substance delivered (FPD and delivered dose) whenloaded with active (NEBZMART*, 2 ml) and passive (E-flow*, 1 ml) VMN. The results demonstrated comparable aerodynamicaerosol, particle size, and total delivered dose as FPF (64.9% vs. 72.8%), FPD (16.4 vs. 14.2 mcg), MMAD (3.9 vs. 3.2), andGSD (1.8 vs. 1.62) for active and passive VMN, respectively. The nebulization time was observed as 3–5 min for both thedevices demonstrating higher efficiency for active VMN.Conclusion: The results showed comparable aerodynamic aerosol, particle size, and total delivered dose or RF forglycopyrronium nebulizing solution delivered by the VMNs.