Investigating the effect of intracameral cefuroxime on oxidative stress and apoptosis in the rat cornea / Investigando o efeito de cefuroxima intracameral sobre o estresse oxidativo e a apoptose na córnea de ratos

ABSTRACT PURPOSE: We examined the effect of intracameral administration of cefuroxime on oxidative stress and endothelial apoptosis in rat corneal tissue. METHODS: In total, 30 rats were divided into 3 groups of 10 rats each (intracameral administration of cefuroxime 0.1 mg/0.01 mL (cefuroxime group); intracameral administration of balanced salt solution 0.01 mL (control group); or absence of intracameral injection (sham group). Corneal endothelial apoptosis was assessed by immunohistochemical analysis using caspase-3 and caspase-8. Total oxidant status, total antioxidant status, oxidative stress index, and paraoxonase and arylesterase levels were examined in corneal endothelial tissue and serum. RESULTS: Paraoxonase levels in the serum were significantly different between the sham and cefuroxime groups (p=0.027). A significant difference was also observed in total oxidant status levels between the cefuroxime and balanced salt solution groups (p=0.023). In addition, there were significant differences in total antioxidant status levels in corneal tissue between the cefuroxime and sham groups (p<0.001) and between the cefuroxime and balanced salt solution groups (p<0.001). Furthermore, significant differences were also observed in oxidative stress index levels between the cefuroxime and balanced salt solution groups (p=0.001) and between the cefuroxime and sham groups (p=0.026). According to the immunohistochemical staining results, a significant association with caspase-3 activity existed between the cefuroxime and balanced salt solution groups (p=0.007), while no significant difference was found with caspase-8 activity (p=0.541). Caspase-3 activity exhibited a significant relationship between the sham and balanced salt solution groups (p=0.018), but no relationship was found with caspase-8 activity (p=0.623). CONCLUSION: Immunohistochemical examination revealed that intracameral cefuroxime increased apoptosis when compared to the sham and balanced salt solution groups. Moreover, intracameral cefuroxime increased oxidative stress in the cornea and simultaneously induced apoptosis.

RESUMO OBJETIVO: Examinamos o efeito da administração intracameral da cefuroxima sobre o estresse oxidativo e a apoptose endotelial no tecido corneano de ratos. MÉTODOS: No total, 30 ratos foram divididos em 3 grupos de 10 ratos cada (administração intracameral de cefuroxima 0,1 mg/0,01 mL (grupo cefuroxima), administração intracameral de solução salina balanceada 0,01 mL (grupo controle) ou ausência de injeção intracameral (grupo sham)). A apoptose endotelial da córnea foi avaliada por análise imuno-histoquimica usando caspase-3 e -8. O status oxidante total, o status antioxidante total, o índice de estresse oxidativo e os níveis de a paraoxonase e arilesterase foram investigados no tecido endotelial da córnea e no soro. RESULTADOS: Os níveis de paraoxonase no soro foram significativamente diferentes entre os grupos sham e cefuroxima (p=0,027). Foi também observada uma diferença significativa nos níveis de estado oxidante total entre os grupos cefuroxima e solução salina balanceada (p=0,023). Além disso, houve diferenças significativas nos níveis de status antioxidante total no tecido da córnea entre os grupos cefuroxima e sham (p<0,001) e entre os grupos cefuroxima e solução salina balanceada (p<0,001). Diferenças significativas também foram observadas nos níveis do índice de estresse oxidativo entre os grupos cefuroxima e solução salina balanceada (p=0,001) e entre os grupos cefuroxima e sham (p=0,026). De acordo com os resultados de coloração imuno-histoquimica, houve associação significativa com a atividade da caspase-3 entre os grupos cefuroxima e solução salina balanceada (p=0,007), enquanto não houve diferença significativa com a atividade da caspase-8 (p=0,541). A atividade da caspase-3 exibiu uma relação significativa entre os grupos sham e solução salina balanceada (p=0,018), mas nenhuma relação foi encontrada com a atividade da caspase-8 (p=0,623). CONCLUSÃO: O exame imuno-histoquímico revelou que a cefuroxima intracameral aumentou a apoptose quando comparada com os grupos sham e solução salina balanceada. Além disso, a cefuroxima intracameral aumentou o estresse oxidativo na córnea e induziu simultaneamente a apoptose.

Antibióticos profilácticos en cirugía urológica / Prophylactics antibiotics in urologic surgery

La infección es la complicación más temida de las cirugías, si bien éstas pueden presentarse en sitios alejados al operado, como el caso de las neumonías, lo más frecuente es que se relacione con la zona intervenida y en particular con la herida operatoria. Se prefiere hablar de Infección del Sitio Operatorio (ISO) en forma técnica para referirnos a esta afección. Se define como ISO: Infecciones que ocurren dentro de los 30 días después de la cirugía si no hay un implante o dentro de un año si hay un implante in situ. Además la infección parece, clínicamente, estar relacionada con la cirugía.

Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo / Efficacy, safety and cost of cefuroxime compared with cephradine in the treatment of acute pyelonephritis during pregnancy

Background: Second generation cephalosporins (CFPs) are more active in the treatment of acute pyelonephritis during pregnancy but their cost is considerably higher than their predecessors. Cefuroxime, a second generation CFP with oral and parenteral presentations, might offer significant advantages and become a first choice antimicrobial in this setting. Aim: To compare the efficacy, safety and cost of cefuroxime and cephradine in the treatment of acute pyelonephritis in pregnancy. Patients and methods: Hospitalized women with 12 to 34 weeks of pregnancy, with clinical and bacteriological diagnosis of acute pyelonephritis, were randomly assigned to receive cefuroxime (Curocef (r), GlaxoWellcome) 750 mg t.i.d, i.v or cephradine 1 g q.i.d., i.v. If the isolated organism was resistant to the assigned drug the patient was excluded. Once patients were afebrile, they were switched to an oral form of the same antimicrobial. They were discharged according to the clinical status and treated for a total of 14 days. Laboratory tests, including urine culture were requested during controls and at the end of follow-up at 28 days. Results: One hundred and one patients were randomized: 49 to receive cephradine and 52 to receive cefuroxime. Patients in the cefuroxime group had fewer febrile days (mean 1.7 vs 2.2, p<0.05), faster clinical recovery (mean 2.7 vs 3.1 days, p<0.05), a higher rate of bacteriological cure at 28 days (78.8 percent and 59.2 percent, p<0.05) and lower rate of failure (21.2 percent vs 40.8 percent p<0.05). The rate of resistance of isolated uropathogens was l4 percent to cephradine and 1 percent to cefuroxime. Conclusions: Cefuroxime can be considered as a first choice option in the treatment of acute pyelonephritis during pregnancy due to its tolerance, microbiological activity and efficacy

Agar diffusion tests with cefuroxime disks for predicting ceftriaxone susceptibility among isolates of "Streptococcus pneumoniae"

The performance of agar diffusion tests using disks of cefuroxine (30 micrograms) for predicting ceftriaxone susceptibility in 33 isolates of "Streptococcus pneumoniae"was studied. All 7 resistant isolates to ceftriaxone (MIC>= 1.0 microgram/ml) exhibited zones of inhibition < 28 mm. The procedure can be easily adapted to clinical laboratories.

Streptococcus pyogenes: susceptibilidad in vitro a diversos antimicrobianos en dos períodos / Streptococcus pyogenes: in vitro susceptibility to several antimicrobials in 2 periods

The frequency of Streptococcus pyogenes infections with deep tissue and toxic shock syndrome has increased in the last decade throughout the world. Aim: to compare antimicrobial susceptibility of S. pyogenes strains isolated during 1986 and 1994-95. Eighty two S. pyogenes strains isolated in 1986 and 67 strains isolated in 1994-1995, were studied. MIC 50 and 90 were determined by an agar dilution method for penicillin, ampicillin, cefazolin, cefuroxime, erythromicin. roxithromycin and miocamycin. Eighty eight strains came from skin of soft tissues, 19 from surgical wounds, 18 from invasive infections, 15 from pharyngeal swabs and 9 from other locations. All strains were susceptible to penicillin, ampicillin, cefazolin, cefuroxime, roxithromycin and miocamycin. Ninety nine percent of strains were susceptibel to erythromycin. Strains isolated in 1994-95 had a higher MIC 50 and 90 for erythromycin than those isolated in 1986. The changes in susceptibility to erythromycin of recently isolated strains could be due to the widespread use of macrolides in Chile

Susceptibilidad de escherichia coli frente a 13 drogas antimicrobiana / Susceptibility of escherichia coli against 13 antimicrobial drugs

Escherichia coli es uno de los bacilos gram negativos más aislados en nuestras clínicas, provocando diversos cuadros de tipo infeccioso. Por este motivo es importante conocer la susceptibilidad antimicrobiana de esta especie, con el fin de poder administrar drogas antimicrobianas realmente efectivas. Este trabajo determina la sensibilidad cuantitativa "in vitro" de 245 cepas de Escherichia coli, aisladas de diversas muestras clínicas frente a 13 drogas antimicrobianas para lo cual se utilizó el método de dilución en agar de Ericsson y Sherris. Los resultados obtenidos muestran que alrededor del 90 por ciento de las cepas fueron sensibles a Enoxacino, Cefotaxima, Aztreonam, Gentamicina, Ceftriaxzona, Amikacina, Cefuroximo, Cefoperazona y Nitrofurantoina y alrededor del 50 por ciento de las cepas fueron sensibles a Cefradina. Frente a los restantes antimicrobianos-Cloramfenicol, Cotrimoxazol y Ampicilina- se obtuvo un alto nivel de resistencia