minocycline and tosufloxacin

The importance of macrolide-resistant (MR) Mycoplasma pneumoniae has become much more apparent in the past decade. We investigated differences in the therapeutic efficacies of macrolides, minocycline, and tosufloxacin against MR M. pneumoniae. A total of 188 children with M. pneumoniae pneumonia confirmed by culture and PCR were analyzed. Of these, 150 patients had a strain with an MR gene and 134 had one with an A-to-G mutation at position 2063 of M. pneumoniae 23S rRNA domain V. Azithromycin (n = 27), clarithromycin (n = 23), tosufloxacin (n = 62), or minocycline (n = 38) was used for definitive treatment of patients with MR M. pneumoniae. Defervescence within 48 h after the initiation of antibiotic therapy was observed in 41% of the patients in the azithromycin group, 48% of those in the clarithromycin group, 69% of those in the tosufloxacin group, and 87% of those in the minocycline group. The average number of days of fever after the administration of antibiotic treatment was lower in the minocycline and tosufloxacin groups than in the macrolide groups. The decrease in the M. pneumoniae burden, as estimated by the number of DNA copies, after 48 to 96 h of treatment was more rapid in patients receiving minocycline (P = 0.016) than in those receiving tosufloxacin (P = 0.049), azithromycin (P = 0.273), or clarithromycin (P = 0.107). We found that the clinical and bacteriological efficacies of macrolides against MR M. pneumoniae pneumonia was low. Our results indicated that minocycline rather than tosufloxacin can be considered the first-choice drug for the treatment of M. pneumoniae pneumonia in children aged ≥ 8 years.

Topics: Adolescent; Anti-Bacterial Agents; Azithromycin; Child; Child, Preschool; Clarithromycin; Drug Resistance, Bacterial; Fluoroquinolones; Humans; Infant; Infant, Newborn; Male; Minocycline; Mutation; Mycoplasma pneumoniae; Naphthyridines; Pneumonia, Mycoplasma; RNA, Bacterial; RNA, Ribosomal, 23S; Treatment Outcome

To clarify therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia and against macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia in pediatric patients.. A prospective, multicenter observational study was conducted from July 2013 to August 2015. The therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin were evaluated in 59 patients with pneumonia caused by MRMP and in 50 patients with pneumonia caused by MSMP. In vitro activities of antimicrobial agents against isolates of Mycoplasma pneumoniae were also measured.. Mean durations of fever following commencement of treatment in patients infected with MRMP and MSMP were 5.2 and 1.9 days, respectively (log-rank test, P < 0.0001). Among patients infected with MRMP, mean durations of fever were 4.6, 5.5, 1.0 and 7.5 days for patients treated with azithromycin, clarithromycin, minocycline and tosufloxacin, respectively (log-rank test, P < 0.0001). Among patients infected with MSMP, mean durations of fever were 2.5, 1.7, 0.9 and 4.3 days for patients treated with azithromycin, clarithromycin, minocycline and tosufloxacin, respectively (log-rank test, P = 0.0162). The MIC90s of azithromycin and clarithromycin among the 27 isolates of MRMP were 64 and 256 μg/ml, respectively, and those among the 23 isolates of MSMP were <0.000125 and 0.001 μg/ml, respectively. The MIC90s of minocycline and tosufloxacin among the 27 isolates of MRMP were 1.0 and 0.25 μg/ml, respectively, and those among the 23 isolates of MSMP were 1.0 and 0.5 μg/ml, respectively.. Both minocycline and tosufloxacin showed good in vitro activities against MRMP. Minocycline, but not tosufloxacin, shortened the duration of fever in pediatric patients infected with MRMP compared to the duration of fever in patients treated with macrolides.

Topics: Adolescent; Anti-Bacterial Agents; Azithromycin; Child; Clarithromycin; Drug Resistance, Bacterial; Female; Fluoroquinolones; Humans; Male; Microbial Sensitivity Tests; Minocycline; Mycoplasma pneumoniae; Naphthyridines; Pneumonia, Mycoplasma; Treatment Outcome

We studied 181 patients diagnosed with male urethritis at Oogaki Municipal Hospital from April 2002 to March 2004. Twenty-two out of 92 patients diagnosed with gonococcal urethritis (GU) and 52 out of 89 patients diagnosed with non-gonococcal urethritis (NGU) were positive for Chlamidia trichomatis by polymerase chain reaction (PCR). Most patients of male urethritis were in their twenties. Of GU patients, 39 (67%) were infected from commercial sex workers (CSWs). Of NGU patients, 12 (30%) were infected from CSWs, 24 (40%) from girl friends and 4 (10%) from their Twenty-eight (48%) out of GU patients were infected through oral sex. spouse. Eighty-three GU patients were treated with SPCM (2 g, one shot). Fifty-five patients could be evaluated for the efficacy of treatment. Elimination rate of Neisseria gonorrhoeae was 100% and 14 out of 18 patients with persisting urethritis had C. trichomatis. Eighty-two NGU patients were treated with minocycline, tosufloxacin, levofloxacin, gatiflixacin or clarithromycine. Sixty-six patients could be evaluated for the efficacy of treatment. Forty-one patients were diagnosed with non-gonococcal chlamydial urethritis (NGCU) and 25 patients were diagnosed with non-gonococcal, non-chlamydial urethritis (NGNCU). The clinical curative rate of NGCU and NGNCU was 93% (38/41) and 80% (20/25), respectively.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Chlamydia Infections; Fluoroquinolones; Gonorrhea; Hospitals, Municipal; Humans; Japan; Levofloxacin; Male; Middle Aged; Minocycline; Naphthyridines; Ofloxacin; Sexual Partners; Sexually Transmitted Diseases, Bacterial; Spectinomycin; Urethritis

Chlamydia pneumoniae infection of lymphocytes in blood has been well documented, and it is apparent that control of this pathogen in these cells may be critical in the development of chronic inflammatory diseases associated with infection by this bacterium. The activity of antibiotics against C. pneumoniae in lymphocytes was assessed in this study by utilizing an in vitro infection model with lymphoid cells. The results obtained indicated that although all of the antibiotics tested showed remarkable activity against bacterial growth in epithelial cells, C. pneumoniae in lymphocytes was less susceptible to antibiotics than was bacterial growth in epithelial cells, which are widely used for the evaluation of anti-C. pneumoniae antibiotics.

Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents; Azithromycin; Cells, Cultured; Chlamydia Infections; Chlamydophila pneumoniae; Clarithromycin; Female; Fluoroquinolones; Humans; Lymphocytes; Mice; Mice, Inbred BALB C; Microbial Sensitivity Tests; Minocycline; Naphthyridines; Reverse Transcriptase Polymerase Chain Reaction; RNA, Bacterial

Regarding Neisseria gonorrhoeae, the National Committee for Clinical Laboratory Standards (NCCLS) has not defined the breakpoint minimum inhibitory concentration (MIC) for expanded spectrum cephems such as cefpodoxime and ceftizoxime, because of the absence of resistant strains to these antibiotics. To date, in gonococcal urethritis, after treatment with third generation cephems and aztreonam, clinical failures caused by resistant N. gonorrhoeae strains have not been reported. However, we experienced two clinical failures in patients with gonococcal urethritis treated with cefdinir and aztreonam. N. gonorrhoeae isolates from these two patients showed high-level MICs to these agents. The MIC of cefdinir was 1 microg/ml for both strains and that of aztreonam was 8 microg/ml for both strains, while the MICs of other beta-lactams were also higher than the NCCLS value, except for ceftriaxone, for which the MIC was 0.125 microg/ml for both strains. Moreover, the MICs of fluoroquinolones, tetracyclines, and erythromycin against these two isolates were higher than the NCCLS susceptibility value. These isolates were susceptible to spectinomycin. In N. gonorrhoeae, the emergence of these beta-lactam-resistant isolates is of serious concern. However, a more serious problem is that these isolates were already resistant to non-beta-lactam antimicrobials. In Japan, ceftriaxone has not been permitted for clinical use against gonococcal infections. Therefore, in Japan, patients with gonococcal urethritis caused by these resistant N. gonorrhoeae strains should be treated with cefodizime or spectinomycin.

Topics: Adult; Anti-Infective Agents; Aztreonam; Cefdinir; Ceftriaxone; Cephalosporins; Drug Resistance, Microbial; Drug Resistance, Multiple; Drug Therapy, Combination; Fluoroquinolones; Gonorrhea; Humans; Japan; Male; Microbial Sensitivity Tests; Minocycline; Naphthyridines; Neisseria gonorrhoeae; Roxithromycin; Spectinomycin; Urethritis

The frequency and the antibacterial sensitivity of Streptococcus pneumoniae strains isolated from 6 key hospitals (in 5 areas) and 1 otorhinolaryngology clinic in Gifu Prefecture from February to March, 1999, were investigated with several antibiotics. A total of 128 strains of Streptococcus pneumoniae were isolated throughout the study: 47 strains (36.7%) of penicillin-susceptible S. pneumoniae (PSSP), 51 strains (39.8%) of penicillin-intermediate S. pneumoniae (PISP), and 30 strains (23.4%) of penicillin-resistant S. pneumoniae (PRSP); the resistant bacteria being relatively prominent. In these hospitals, PSSP was isolated by 38.8% in all the key hospitals and by 30% in the otolaryngology clinic with almost no discernible difference. PISP was isolated by 63.3%, higher in the otolaryngology clinic and PRSP by 28.6%, higher in the key hospitals conversely. The MIC90s in PISP and PRSP were determined with the antibiotics. In result, only cefditoren (CDTR) showed favorable antibacterial activities with the MIC90 of 0.78 microgram/ml among penicillins or oral cephems. The MIC90s of carbapenems such as imipenem (IPM), meropenem (MEPM), and panipenem (PAPM) were less than 0.39 microgram/ml; particularly, PAPM showed the highest antibacterial activities. Among new quinolones such as tosufloxacin (TFLX), levofloxacin (LVFX), sparfloxacin (SPFX), and ciprofloxacin (CPFX), TFLX showed the highest antibacterial activities with the MIC90 of 0.39 microgram/ml. Other agents showed very low antibacterial activities as the MIC90s were 25 micrograms/ml in minocycline (MINO) and more than 100 micrograms/ml in clarithromycin (CAM) and clindamycin (CLDM).

Topics: Amoxicillin; Anti-Bacterial Agents; Cefaclor; Cefdinir; Cefixime; Cefmenoxime; Cefpodoxime; Ceftizoxime; Cephalosporins; Ciprofloxacin; Clarithromycin; Clindamycin; Drug Resistance, Microbial; Fluoroquinolones; Humans; Imipenem; Japan; Levofloxacin; Meropenem; Microbial Sensitivity Tests; Minocycline; Naphthyridines; Ofloxacin; Penicillin G; Penicillins; Streptococcus pneumoniae; Thienamycins

We isolated 73 streptococcus strains (41 from infections, and 32 from colonization) from various skin diseases between March, 1994, and June, 1998. In 29 out of 41 cases of infective origin, Staphylococcus aureus strains were simultaneously isolated. Twenty-four out of 28 patients with impetigo were suffering from atopic dermatitis. We confirmed that impetigo lesions where Streptococcus pyogenes was dominant in number always showed thick-walled pustules on an erythematous base; these skin lesions were considered to be an early manifestation of streptococcal impetigo. We further confirmed that thick-crusted lesions in streptococcal impetigo, where S. aureus exceeded S. pyogenes in number, were a late manifestation. Antimicrobial agents such as minocycline, fusidic acid, ofloxacin and tosufloxacin, were more effective against S. aureus strains than against beta-hemolytic streptococcal strains. In contrast, ampicillin, cefdinir, imipenem, erythromycin and vancomycin were more effective against beta-hemolytic streptococcal strains.

Topics: Ampicillin; Anti-Bacterial Agents; Anti-Infective Agents; Cephalosporins; Erythromycin; Fluoroquinolones; Fusidic Acid; Humans; Imipenem; Microbial Sensitivity Tests; Minocycline; Naphthyridines; Ofloxacin; Penicillins; Skin Diseases, Bacterial; Species Specificity; Streptococcal Infections; Streptococcus; Vancomycin

We re-evaluated several antibiotics including newer ones, for their in vitro killing activity, as well as their inhibitory activity, against clinical isolates of periodontopathic bacteria. Tetracyclines were active against Porphyromonas gingivalis, and were highly active against Prevotella intermedia, but demonstrated only a low killing activity against Actinobacillus actinomycetemcomitans. Rokitamycin, a new macrolide, and clindamycin were highly active against P. gingivalis and P. intermedia, but showed very weak killing activity against A. actinomycetemcomitans. Quinolones demonstrated excellent bactericidal activity against A. actinomycetemcomitans, and good inhibitory and bactericidal activity against P. gingivalis and P. intermedia. Metronidazole had an activity almost equivalent to quinolones against P. gingivalis and P. intermedia; but it was the least active against A. actinomycetemcomitans.

Topics: Aggregatibacter actinomycetemcomitans; Anti-Bacterial Agents; Anti-Infective Agents; Antitrichomonal Agents; Clindamycin; Erythromycin; Fluoroquinolones; Metronidazole; Microbial Sensitivity Tests; Minocycline; Miocamycin; Naphthyridines; Ofloxacin; Porphyromonas gingivalis; Prevotella intermedia; Quinolones; Tetracycline