minocycline and Bacteroidaceae-Infections

In this study, a thermoresponsive gel for minocycline (MCL) with chitosan/β-glycerophosphate (C/β-GP) was formulated and its characterization, in vitro release, stability, toxicity and pharmacodynamics were investigated. The formulation containing MCL was prepared by pouring the chitosan solution directly onto the sterilized drug powder and stirring before mixing with the β-glycerophosphate (β-GP) solution. The final preparations contained 0.5% (w/v) chitosan, 1.8% (w/v) β-GP and 2% (w/v) MCL. The drug content of prepared gels was in the range of 92-99%, and the pH value of the optimized formulation was found to be 5.6-6.2. The gelation temperature of the prepared C/β-GP thermogelling solutions was 37 °C. Color, consistency, pH, viscosity and drug content of the in situ gels were found to be consistent, and no signs of separation and deterioration were observed over a period of 90 d. In vivo studies showed that rats' liver and kidney tissue sections were normal, with no structural damage. The constituents of the in situ gels formulation had a well-sustained release efficacy on the animal model of periodontitis.

Topics: Administration, Oral; Animals; Anti-Bacterial Agents; Bacteroidaceae Infections; Chitosan; Delayed-Action Preparations; Disease Models, Animal; Drug Carriers; Drug Compounding; Drug Stability; Female; Gels; Glycerophosphates; Hydrogen-Ion Concentration; Kinetics; Male; Minocycline; Periodontal Pocket; Periodontitis; Porphyromonas gingivalis; Rats, Sprague-Dawley; Solubility; Technology, Pharmaceutical; Temperature; Viscosity

We report a first human case of Porphyromonas pogonae causing soft tissue infection in a patient with open fracture. Strong β-hemolytic, aerotolerant, and non-pigmented gram-negative coccobacilli which matched Porphyromonas pogonae by PCR for 16S rRNA genes were identified from the pus specimen. The clinical course of the patient improved with repeated surgical drainage and tigecycline administration.

Topics: Adult; Anti-Bacterial Agents; Bacteroidaceae Infections; Ciprofloxacin; DNA, Bacterial; Fractures, Bone; Humans; Male; Minocycline; Porphyromonas; Rifampin; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Soft Tissue Infections; Suppuration; Tigecycline

Aplastic anemia (AA) is a rare hematologic disease characterized by hypo-cellular bone marrow. The clinical features include fatigue, increased bruising, and gingival bleeding caused by anemia, leukopenia, and thrombocytopenia. A patient with AA is at high risk for infection because of leukopenia. The risk of systemic infection is especially high in AA patients with severe local infections, including periodontitis. Accordingly, periodontal treatment should include antibiotic prophylaxis to reduce the risk of systemic infection. However, treatment of periodontitis in the AA patient is significantly complicated by the bleeding disorder. We present a case report of the successful periodontal treatment of an AA patient with spontaneous gingival bleeding.. The patient was closely monitored for platelet and neutrophil counts before every treatment. The patient's platelet count was always under 10,000/microl. Therefore, it was necessary to increase platelet counts to over 25,000/microl by transfusion, after which subgingival scaling with anesthesia was performed. When the neutrophil count was less than 2,000/microl, local minocycline chemotherapy was applied to the pockets. Periodontal infection was monitored by detection of bacterial DNA and measurement of serum immunoglobulin (Ig) G titer against periodontal bacteria.. Following the physical and chemical treatment, the gingival appearance improved dramatically and the spontaneous gingival bleeding disappeared. Moreover, the IgG titer against periodontal bacteria decreased to normal range and specific periodontal pathogens were no longer detectable in the tested pockets.. We believe that the treatment strategy in the present report provides new sight into treatment planning for severely medically compromised patients.

Topics: Adult; Anemia, Aplastic; Anti-Bacterial Agents; Antibodies, Bacterial; Bacteroidaceae Infections; Dental Care for Chronically Ill; Dental Scaling; Gingival Hemorrhage; Humans; Male; Minocycline; Periodontitis; Platelet Transfusion; Prevotella intermedia

The incidence of beta-lactamase production in anaerobic gram-negative rods isolated from 93 pus specimens of orofacial odontogenic infections and the antimicrobial susceptibility of these isolates against 11 antibiotics were determined. A total of 191 anaerobic gram-negative rods were isolated from the specimens. Beta-lactamase was detected in 35.6% of the black-pigmented Prevotella and 31.9% of the nonpigmented Prevotella. However, no strains among the other species isolated produced beta-lactamase. Ampicillin, cefazolin and cefotaxime showed decreased activity as regards beta-lactamase-positive Prevotella strains, whereas the activity of ampicillin/sulbactam, cefmetazole, and imipenem continued to be effective against such strains. All tested beta-lactam antibiotics were effective against Porphyromonas and Fusobacterium. Erythromycin showed decreased activity against nonpigmented Prevotella and Fusobacterium. Clindamycin, minocycline and metronidazole were powerful antibiotics against which anaerobic gram-negative rods could be tested. The present study showed that beta-lactamase-positive strains were found more frequently in the Prevotella strains than in any of the other species of anaerobic gram-negative rods. The effectiveness of adding sulbactam to ampicillin was demonstrated, as well as the difference in cephalosporin activity against beta-lactamase-positive strains.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Ampicillin Resistance; Anti-Bacterial Agents; Bacteroidaceae Infections; beta-Lactam Resistance; beta-Lactamases; Cefmetazole; Cephalosporin Resistance; Cephamycins; Chi-Square Distribution; Clindamycin; Erythromycin; Fusobacterium; Gram-Negative Anaerobic Straight, Curved, and Helical Rods; Gram-Negative Bacterial Infections; Humans; Imipenem; Metronidazole; Middle Aged; Minocycline; Periodontal Diseases; Porphyromonas; Prevotella; Sulbactam; Thienamycins; Tooth Diseases