ABSTRACT
OBJECTIVE@#To assess the activities of biapenem against multidrug-resistant and extensively drug-resistant Mycobacterium tuberculosis.@*METHODS@#Biapenem/clavulanate (BP/CL) was evaluated for in vitro activity against Mycobacterium tuberculosis (Mtb) multidrug-resistant (MDR) isolates, extensively drug-resistant (XDR) isolates, and the H37RV strain. BP/CL activity against the H37Rv strain was assessed in liquid cultures, in macrophages, and in mice..@*RESULTS@#BP/CL exhibited activity against MDR and XDR Mtb isolates in liquid cultures. BP/CL treatment significantly reduced the number of colony forming units (CFU) of Mtb within macrophages compared with control untreated infected macrophages. Notably, BP/CL synergized in pairwise combinations with protionamide, aminosalicylate, and capreomycin to achieve a fractional inhibitory concentration for each pairing of 0.375 in vitro. In a mouse tuberculosis infection model, the efficacy of a cocktail of levofloxacin + pyrazinamide + protionamide + aminosalicylate against Mtb increased when the cocktail was combined with BP/CL, achieving efficacy similar to that of the positive control treatment (isoniazid + rifampin + pyrazinamide) after 2 months of treatment.@*CONCLUSION@#BP/CL may provide a new option to clinically treat MDR tuberculosis.
Subject(s)
Animals , Mice , Anti-Infective Agents , Pharmacology , Therapeutic Uses , Cell Line , Drug Evaluation, Preclinical , Macrophages , Mycobacterium tuberculosis , Thienamycins , Pharmacology , Therapeutic Uses , Tuberculosis, Multidrug-Resistant , Drug TherapyABSTRACT
Objective To investigate the clinical effect of biapenem and levofloxacin in the treatment of pulmonary infection caused by extensive drug resistant bacillus.Methods 182 patients with pulmonary infection caused by extensive drug resistant bacillus from the department of respiratory in our hospital were selected and divided into two groups, 91 cases in the control group were given cefoperazone sodium and sulbactam sodium +levofloxacin treatment, 91 cases in the experiment group received biapenem +levofloxacin treatment, serum levels of white blood cell count(WBC), high sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),serum amyloid A(SAA), recovery time of clinical symptoms, signs and laboratory examination, the clinical effect, bacteriological effect and incidence of adverse reactions were compared after treatment.Results The effective rate in the control group(74.72%)was lower than the experiment group(86.81%), with significant difference (P<0.05); compared with the control group, the bacterial clearance rate was higher, bacterial unclearance rate, partial clearance rate, replacement rate were higher in the experiment group after treatment, serum levels of WBC,hs-CRP,PCT,SAA were lower after treatment, recovery time of body temperature, pulmonary signs, abnormal shadow of chest X-ray, WBC, hs-CRP were shorter, with significant difference ( P<0.05 ); there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The clinical effect of biapenem and levofloxacin in the treatment of pulmonary infection caused by extensive drug resistant bacillus was exactly, can effectively remove bacteria, control infection, shorten the treatment time, and the safety was high.
ABSTRACT
Objective To observe the results of broth dilution method and disc diffusion method to test the synergistic effect of Reduning and cefoperazone sodium / sulbactam sodium(SCF) on extensive drug resistant Acinetobacter bauman (XDR-AB) in vitro environment ,and compare their compliance to guide the clinical medication .Methods A total of 12 strains of XDR-AB from infec-tion patients in our hospital in 2015 were collected ,the strain was sub cultured .Firstly ,observe the minimum inhibitory concentra-tion (MIC) of SCF and Reduning on XDR-AB alone and in combination by broth dilution method .And then judge the synergy effects through calculation .Secondly ,the inhibition ring diameter and the synergy effects was detected using the disc diffusion meth-od .Results The MIC of Reduning and SCF in combination on XDR-AB was declined compared with them alone .The Fractional in-hibitory concentration of Reduning and SCF in combination on XDR-AB were equal or less than 0 .5 ,they had synergistic effect on XDR-AB .The inhibition ring diameter of Reduning was 10 mm tested by disk diffusion method .Different strains of XDR-AB on SCF bacteriostatic annulus diameter difference ,5 strains were 15 mm ,3 strains were 16 mm ,and 4 strains were 17 mm .Reduning and SCF appeared synergistic effect according to the inhibition ring diameter expanded when they effected on XDR -AB in combina-tion .Conclusion In vitro ,Reduning combined with SCF on XDR-AB has good synergistic effect .Compared with broth microdilution checkerboard dilution method ,disk diffusion method is more simple and convenient ,but it has a certain subjective on judging re-sults ,which is better to operate by experienced person .
ABSTRACT
PURPOSE: To report a case of secondary pigmentary glaucoma due to clofazimine treatment for extensive drug-resistant tuberculosis. CASE SUMMARY: A 23-year-old man presented with blurred vision in both eyes. The patient started to take clofazimine for extensive drug-resistant tuberculosis six months prior, after which his facial skin color changed to a dark-brown. Intraocular pressure (IOP) was 50 mm Hg in the right eye and 48 mm Hg in the left eye. Slit lamp examination revealed corneal edema, opacity, and flare in the anterior chamber in both eyes. A color vision test revealed a mild color defect in both eyes. Visual field (VF) test revealed superior temporal VF loss in the left eye. Gonioscopy revealed open angles with high pigmentation in the trabecular meshwork in both eyes. The patient was diagnosed with pigmentary glaucoma, and maximum tolerated medical therapy was performed. However, the IOP was uncontrolled. Trabeculectomy was performed in both eyes. Postoperative IOP was measured to be 12 mm Hg in both eyes without medication, and visual acuity measured 20/22 in the right eye and 20/17 in the left eye. CONCLUSIONS: To the best of our knowledge, this report is the first case of clofazimine being a possible cause of pigmentary glaucoma in a patient with extensive drug-resistant tuberculosis.