Eucalyptus essential oils inhibit the lipopolysaccharide-induced inflammatory response in RAW264.7 macrophages through reducing MAPK and NF-κB pathways.

BACKGROUND: Eucalyptus essential oils have been used in traditional medicine for centuries. It was reported that Eucalyptus leaves possess antioxidant and antimicrobial effects. Here, we investigated the anti-inflammatory activity of the essential oils extracted from the leaves of four different Eucalyptus species in RAW264.7 macrophages. METHODS: Lipopolysaccharide (LPS)-activated RAW264.7 macrophages were used to evaluate the anti-inflammatory activity of the leaf essential oils of Eucalyptus. The cell survival was quantified by an Alamar Blue assay. Nitric oxide (NO) production was assessed by Griess reaction. TNF-α and IL-6 production were measured by enzyme-linked immunosorbent assay (ELISA). Nuclear factor-κB (NF-κB) transcriptional activity was measured by NF-κB reporter assay. Intracellular protein expression levels were determined by Western blot. The expression levels of inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), mitogen-activated protein kinase (MAPK), protein kinase C (PKC) and NF-κB pathway were measured by western blot in LPS-activated RAW 264.7 macrophage. RESULTS: The essential oils extracted from Eucalyptus citriodora leaf exert the best NO inhibitory activity in LPS-activated RAW264.7 macrophages. The essential oils were fractionated into fractions A-H, and fraction F has been demonstrated to inhibit the expression levels of TNF-α, IL-6, NO, iNOS and COX-2 in LPS-activated RAW264.7 macrophages. Mechanistic analysis revealed that fraction F reduced the phosphorylation levels of ERK1/2, p38, PKC-α, PKC-ε and PKC-δ, and inhibited the NF-κB transcriptional activity. The chemical composition of Fraction F was determined by GC-MS. CONCLUSIONS: The discoveries made herein could help develop innovative nonsteroidal anti-inflammatory drugs with minimal side effects and strong efficacy. Clinical trials on these Eucalyptus leaf essential oils will help customize and optimize their therapeutic administration.

Implementation and outcomes of an antimicrobial stewardship program: Effectiveness of education.

BACKGROUND: Unnecessary use of antibiotics is a common occurrence in hospitals. Implementation of antibiotic stewardship programs (ASPs) has been shown to reduce both unnecessary antibiotic use and drug-resistant bacteria. Education is a fundamental component of an ASP. However, the effectiveness of proper uses of antibiotics education has not been clearly analyzed. METHODS: In a 520-bed university hospital located in northeastern Taiwan, a significantly increasing prescription of carbapenems, specifically imipenem and meropenem, was observed. An educational program highlighting the judicious use of carbapenems was started, beginning in October 2013. A multidisciplinary ASP was implemented starting in January 2014. The consumption of antibiotics, measured by defined daily dose per 1000 occupied bed-days, was compared among the pre-educational, posteducational, and post-ASP periods. RESULTS: Compared with the pre-educational period, there was a significant reduction in antibiotics consumption of 13% total inpatient antibiotics (p = 0.008), 29.8% carbapenems (p = 0.001), 34.9% imipenem and meropenem (p < 0.001), and 27% glycopeptides (p = 0.015), in the posteducational and post-ASP periods. The major reduction emerged during the posteducational period and was sustained after the ASP. The percentage of inpatients prescribed with antibiotics was significantly decreased (16.2%; p < 0.001). The rate of carbapenem-resistant Acinetobacter baumannii decreased from 70.8% to 29.6% within 7 months. CONCLUSION: A focused educational program is effective in controlling the prescription of specific antibiotic classes in the early phase of a multidisciplinary ASP.