MedWorm: Clarithromycin

[Correspondence] Treatment of Helicobacter pylori in Latin America

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

In their multisite study, Robert Greenberg and colleagues attempted to identify a reliably effective treatment for Helicobacter pylori for use in Latin America. Each study site used locally available drugs and the regimens all contained clarithromycin or clarithromycin–metronidazole, despite the unacceptably low success of triple therapies elsewhere and a high expected prevalence of metronidazole resistance. The success of treatments for infectious diseases is mainly related to the absence of antimicrobial resistance and is predictable if one knows the pattern of resistance and the effect of resistance on the regimens tested. (Source: LANCET)

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clarithromycin, Biaxin, Biaxin XL

MedicineNet Hearing General — Fri, 03 Feb 2012 07:00:00 +0100

Title: clarithromycin, Biaxin, Biaxin XLCategory: MedicationsCreated: 12/31/1997Last Editorial Review: 2/3/2012 (Source: MedicineNet Hearing General)

Comparison of levofloxacin-containing sequential and standard triple therapies for the eradication of Helicobacter pylori.

European Journal of Internal Medicine — Fri, 03 Feb 2012 00:26:41 +0100

CONCLUSION: The levofloxacin-containing sequential therapy is a significantly better strategy than the standard triple treatment for H. pylori eradication. Standard triple treatment is no more effective for H. pylori in our population and levofloxacin-containing sequential regimen might be used as a first-line eradication option. PMID: 22284248 [PubMed - in process] (Source: European Journal of Internal Medicine)

Clarithromycin therapy for patients with cystic fibrosis: A randomized controlled trial

Pediatric Pulmonology — Sat, 21 Jan 2012 09:32:09 +0100

AbstractThe clinically significant actions of oral azithromycin in modifying progressive cystic fibrosis (CF) lung disease have been well documented. In vitro and clinical data suggests that clarithromycin has immunomodulatory properties similar to other 14‐member macrolides, however two previously reported short term, open label trials of clairthromycin in small numbers of patients with CF failed to show significant benefits in modifying lung function or inflammation. We performed an international double blind, cross‐over trial in which 63 subjects with CF were studied while receiving either placeo or 500 mg oral clarithromycin twice daily for 5 months, with a 1‐month wash‐out. The primary efficacy end point was the change in lung function (FEV1 and FVC) during the clarithromyci...

Clarithromycin/digoxin interaction: Digoxin toxicity in an elderly patient: case report

Reactions — Tue, 17 Jan 2012 19:08:18 +0100

(Source: Reactions)

Lansoprazole‐based sequential and concomitant therapy for the first‐line Helicobacter pylori eradication

Chinese Journal of Digestive Diseases — Mon, 09 Jan 2012 05:00:00 +0100

CONCLUSION: The first‐line lansoprazole‐based sequential therapy and concomitant therapy were well‐tolerated and comparable in terms of H. pylori eradication rate.© 2012 The Author. Journal of Digestive Diseases © 2012 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd. (Source: Chinese Journal of Digestive Diseases)

Efficacy of combined treatment with S-carboxymethylcysteine (carbocisteine) and clarithromycin in chronic rhinosinusitis patients without nasal polyp or with small nasal polyp

Auris, Nasus, Larynx — Sun, 08 Jan 2012 20:04:34 +0100

Abstract: Objective: In Japan, fourteen-membered ring macrolides, antibacterial agents, and S-carboxymethylcysteine (SCMC; carbocisteine), a mucolytic, are commonly used to treat chronic rhinosinusitis (CRS), and they are also used in combination. However, no large-scale randomized study has examined the effects of these pharmacotherapies. The aim of this study is to evaluate the effect of combined administration of clarithromycin (CAM), a fourteen-membered ring macrolide, and SCMC, compared with CAM single therapy.Methods: Patients with CRS were centrally registered and randomly assigned to treatment with CAM (200mg/day) alone (monotherapy group) or CAM (200mg/day) in combination with SCMC (1500mg/day; combination group) for 12 weeks. We assessed the clinical efficacy of the treatments us...

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Clarithromycin form I determined by synchrotron X-ray powder diffraction

Acta Crystallographica Section C — Fri, 06 Jan 2012 05:00:00 +0100

The structure of the metastable form I polymorph of the macrolide antibiotic clarithromycin, C38H69NO13, was determined by a powder diffraction method using synchrotron radiation. The space group of form I is P21212. The initial model was determined by a molecular replacement method using the structure of clarithromycin form 0 as a search model, and the final structure was obtained through Rietveld refinements. In the form I crystal structure, the clarithromycin molecules are aligned parallel along the a axis in a head-to-tail manner with intermolecular hydrogen bonds between the hydroxy O atoms. The dimethylamine groups of the clarithromycin molecule interdigitate between neighbouring head-to-tail clarithromycin alignments. The novel crystal packing found in form I provides a mechanism th...

Evaluation of a Four‐drug, Three‐antibiotic, Nonbismuth–containing “Concomitant” Therapy as First‐line Helicobacter pylori Eradication Regimen in Greece

Helicobacter — Thu, 05 Jan 2012 16:46:02 +0100

Conclusion: A 10‐day concomitant regimen appears to be an effective, safe, and well‐tolerated treatment option for first‐line H. pylori eradication in Greece. (Source: Helicobacter)

A Comparison between Sequential Therapy and a Modified Bismuth‐based Quadruple Therapy for Helicobacter pylori Eradication in Iran: A Randomized Clinical Trial

Helicobacter — Thu, 05 Jan 2012 16:46:00 +0100

Conclusion: Because the two regimens showed acceptable and similar abilities in H. pylori eradication and because of much higher cost of clarithromycin in Iran, the furazolidone containing regimen seems to be superior. Further modifications of sequential therapies are needed to make them ideal regimens in developing countries. (Source: Helicobacter)

Relationship between clinical efficacy for pulmonary MAC and drug-sensitivity test for isolated MAC in a recent 6-year period

Journal of Infection and Chemotherapy — Wed, 28 Dec 2011 16:53:04 +0100

Abstract There are a few recent reports about the relationship between the clinical effect and drug-sensitivity test. We investigated the relationship between the clinical efficacy of treatment for pulmonary Mycobacterium avium complex (MAC) and drug-sensitivity test for isolated MAC by comparison between data from 2005 to 2007 and from 2008 to 2010. We studied 60 patients who satisfied diagnostic criteria of nontuberculous mycobacterial infection established by the American Thoracic Society in 2007 and who received combination therapy using rifampicin (RFP), ethambutol (EB), streptomycin (SM), and clarithromycin (CAM). Average CAM dosage was increased from the early (517 mg/day) to the later (800 mg/day) period. Sputum conversion rate increased from 63% in the ea...

Efficacy of sitafloxacin-based rescue therapy for Helicobacter pylori after failures of first- and second-line therapies.

Antimicrobial Agents and Chemotherapy — Tue, 27 Dec 2011 05:00:00 +0100

Authors: Matsuzaki J, Suzuki H, Nishizawa T, Hirata K, Tsugawa H, Saito Y, Okada S, Fukuhara S, Hibi T Abstract Sitafloxacin-based triple therapy achieved 83.6% (per-protocol) and 78.2% (intention-to-treat) success in eradicating Helicobacter pylori among 78 Japanese patients after clarithromycin-based first-line and metronidazole-based second-line triple therapies failed. Eradication succeeded in 32 out of 43 patients even with gyrA mutation-positive Helicobacter pylori (per-protocol). The position of the gyrA mutation (N87 or D91) was determined to be a better marker than minimum inhibitory concentration levels for predicting outcomes of sitafloxacin-based treatment. PMID: 22203601 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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Valosin containing protein (VCP) interacts with macrolide antibiotics without mediating their anti-inflammatory activities.

European Journal of Pharmacology — Fri, 23 Dec 2011 05:00:00 +0100

Authors: Nujić K, Smith M, Lee M, Belamarić D, Tomašković L, Alihodžić S, Malnar I, Polančec D, Schneider K, Haber VE Abstract In addition to antibacterial activity, some macrolide antibiotics, such as azithromycin and clarithromycin, also exhibit anti-inflammatory properties in vitro and in vivo, although the targets and mechanism(s) of action remain unknown. The aim of the present study was to identify protein targets of azithromycin and clarithromycin which could potentially explain their anti-inflammatory effects. Using chemical proteomics approach, based on compound-immobilized affinity chromatography, valosin containing protein (VCP) was identified as a potential target of the macrolides. Validation studies confirmed the interaction of macrolides and VCP and gave some ...

Risk Factors That Affect the Surgical Outcome in the Management of Focal Bronchiectasis in a Developed Country [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Wed, 21 Dec 2011 05:00:00 +0100

Conclusions Complete resection of bronchiectasis while the disease is localized and is free from Pseudomonas aeruginosa infection is the key for a success. Also, immunocompromised status was suggested to be a risk factor. (Source: The Annals of Thoracic Surgery)

Detecting H. Pylori and its Resistance to ClarithromycinDetecting H. Pylori and its Resistance to Clarithromycin

Medscape Today Headlines — Tue, 20 Dec 2011 04:00:00 +0100

Is there a certain laboratory test that best detects proton pump inhibitor resistant H. pylori disease? BMC Gastroenterology (Source: Medscape Today Headlines)

Epidemiological, clinical, and therapeutic pattern of Mycobacterium marinum infection: A retrospective series of 35 cases from southern France

Journal of the American Academy of Dermatology — Mon, 19 Dec 2011 05:52:16 +0100

To the Editor: Despite some data favoring clarithromycin, there is still considerable variation in the antibiotic regimens used to treat Mycobacterium marinum Data from 35 consecutive individuals, including 4 immunosuppressed patients with primary infection by M marinum identified in our institution from January 1994 to December 2007 were retrospectively investigated for the results of empiric antibiotic treatment. (Source: Journal of the American Academy of Dermatology)

Clarithromycin suppresses the periodontal bacteria‐accelerated abdominal aortic aneurysms in mice

Journal of Periodontal Research — Mon, 19 Dec 2011 05:00:00 +0100

Conclusion: These findings suggest that CAM administration is useful to suppress periodontal bacteria‐accelerated abdominal aortic aneurysms via MMP regulation. (Source: Journal of Periodontal Research)

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Malaria therapy in HIV: drug interactions between nevirapine and quinine

International Journal of STD and AIDS — Thu, 15 Dec 2011 05:00:00 +0100

We report the case of an HIV-positive Nigerian man on antiretroviral therapy (ART) with an undetectable viral load who presented with rigors, fever and back pain after returning to the UK from a three-week trip to Nigeria. Infection with Plasmodium falciparum malaria was confirmed and treatment with quinine commenced together with amoxicillin/clavulanic acid and clarithromycin for possible respiratory infection. At the time of admission the patient could not remember the names of his ART medications. After 24 hours his parasitaemia had increased from 1% to 2.5% and his clinical condition had deteriorated. At this point, his ART was identified as abacavir, lamivudine and nevirapine. The Liverpool HIV-drug interactions website was checked for drug interactions. It recommends caution in the c...

Antimicrobial susceptibility of Helicobacter pylori to six antibiotics currently used in Spain

Journal of Antimicrobial Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions Our study confirms an increasing rate of resistance to levofloxacin that equals that of clarithromycin in our healthcare area. This fact may reflect a wide and indiscriminate use of the former antibiotic and could account for a loss of clinical effectiveness of levofloxacin-containing regimens. Moreover, clarithromycin resistance rates remain stable, which could allow us to maintain its use in our area. (Source: Journal of Antimicrobial Chemotherapy)

CNS infections caused by Mycobacterium abscessus complex: clinical features and antimicrobial susceptibilities of isolates

Journal of Antimicrobial Chemotherapy — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions Our study revealed that M. abscessus complex isolates, particularly M. massiliense, should be considered potential pathogens causing CNS infections. Long-duration clarithromycin-based combination therapy plus surgical intervention may provide the best chance of cure. (Source: Journal of Antimicrobial Chemotherapy)

Effectiveness of three times daily lansoprazole/amoxicillin dual therapy for Helicobacter pylori infection in Korea

British Journal of Clinical Pharmacology — Sat, 10 Dec 2011 06:49:14 +0100

CONCLUSIONSBecause dual therapy had fewer side effects than triple therapy and a similar eradication rate, dual therapy may provide an acceptable alternative first line therapy for H. pylori eradication in Korea. (Source: British Journal of Clinical Pharmacology)

Predominant Dissemination of PVL-Negative CC89 MRSA with SCCmec Type II in Children with Impetigo in Japan

Interdisciplinary Perspectives on Infectious Diseases — Wed, 07 Dec 2011 11:14:21 +0100

Conclusions. PVL-negative CC89-SCCmec type II strains are the most predominant strains among the CA-MRSA strains circulating in the community in Japan. (Source: Interdisciplinary Perspectives on Infectious Diseases)

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Helicobacter pylori antibiotic resistance in Brazil: clarithromycin is still a good option

Arquivos de Gastroenterologia — Sun, 04 Dec 2011 09:45:50 +0100

CONCLUSION: Due to the low amoxicillin and clarithromycin resistance observed in this study, therapies using these antimicrobials remain appropriated first-line H. pylori therapy.CONTEXTO: A susceptibilidade aos antibióticos é a pedra fundamental dos tratamentos de erradicação do Helicobacter pylori. OBJETIVO: Avaliar a prevalência da resistência primária do H. pylori aos antibióticos em uma população urbana do Brasil. MÉTODOS: As cepas do H. pylori foram obtidas de pacientes submetidos a endoscopia digestiva para avaliação de sintomas dispépticos. Biopsias do antro, corpo e fundo gástrico foram realizadas para determinar a susceptibilidade das cepas do H. pylori aos antibióticos. A concentração inibitória mínima da furazolidona e do bismuto foram determinadas rotineira...

Review article: rifabutin in the treatment of refractory Helicobacter pylori infection

Alimentary Pharmacology and Therapeutics — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion Rifabutin‐containing rescue therapy constitutes an encouraging strategy after multiple (usually three) previous eradication failures with key antibiotics such as amoxicillin, clarithromycin, metronidazole, tetracycline and levofloxacin. (Source: Alimentary Pharmacology and Therapeutics)

Clarithromycin in Preventing Bronchopulmonary Dysplasia in Ureaplasma urealyticum-Positive Preterm Infants

PEDIATRICS — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS: Clarithromycin treatment prevents development of BPD in preterm infants who are born at 750 to 1250 g and colonized with U urealyticum. (Source: PEDIATRICS)

Novel Effects of Macrolide Antibiotics on Cardiovascular Diseases

Cardiovascular Therapeutics — Thu, 01 Dec 2011 05:00:00 +0100

SUMMARYMacrolide antibiotics are broadly used for the treatment of various microbial infections. However, they are also known to have multiple biologic effects, such as alteration of inflammatory factors and matrix metalloproteinases (MMPs). Because of controversial results in clinical trials, the effects of macrolides on cardiovascular diseases are still to be elucidated. It has been reported that MMP activity is upregulated in various cardiovascular diseases, such as myocarditis, cardiac transplant rejection and myocardial infarction. However, little is known about the effects of macrolides on cardiovascular diseases. We have reported that clarithromycin suppressed the development of myocarditis, cardiac rejection and myocardial ischemia using animal models. In this article, we reviewed ...

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Otomastoiditis with acute left facial nerve paralysis caused by Mycobacterium chelonae.

Ear, Nose and Throat Journal — Thu, 01 Dec 2011 05:00:00 +0100

We describe a case of left-sided otomastoiditis with acute facial nerve paralysis caused by this organism in a previously well middle-aged woman. Her facial palsy totally resolved after tympanomastoidectomy plus a 7-week regimen of clarithromycin and moxifloxacin. To our knowledge, a case of otomastoiditis with acute facial nerve paralysis caused by M chelonae has not been reported previously. PMID: 22180118 [PubMed - in process] (Source: Ear, Nose and Throat Journal)

Virulence genotypes and drug resistance of Helicobacter pylori from Vladivostok, Russia: another feature in the Far East

Microbiology and Immunology — Thu, 01 Dec 2011 05:00:00 +0100

ABSTRACTHelicobacter pylori in Vladivostok, Far Eastern Russia, were investigated during 2004–2009. The genotype cagA+vacA+ (s1/m1 or m2) accounted for 74.7%, with cagA−vacA+ (s2/m2) in 11.2%. The CagA EPIYA type was mainly Western ABC, with minor types (ABCCC and novel AAABC) or non‐Western/non‐East Asia type (AB). Regarding drug resistance, metronidazole resistance was the highest, with marked decrease in six years (from 71.4% to 30.8%); in stead, levofloxacin and clarithromycin resistance increased. The data indicate that in Vladivostok, H. pylori was mainly the Western (not East Asian) type and dynamic changes in drug resistance occurred during six years. (Source: Microbiology and Immunology)

Helicobacter pylori Eradication in Functional Dyspepsia: HEROES Trial [Original Investigation]

Archives of Internal Medicine — Mon, 28 Nov 2011 05:00:00 +0100

Conclusion Helicobacter pylori eradication provided significant benefits to primary care patients with functional dyspepsia. Trial Registration clinicaltrials.gov Identifier: NCT00404534 (Source: Archives of Internal Medicine)

An audit of clinical outcome for patients with community-acquired pneumonia treated with combinations of benzylpenicillin, chloramphenicol and doxycycline: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

An update to the British Thoracic Society (BTS) national guideline for the management of community-acquired pneumonia (CAP) was published in 2009. The BTS guideline recommends preferred treatment with amoxicillin for low severity CAP, a beta-lactam (amoxicillin or benzylpenicillin) with clarithromycin for moderate severity CAP and co-amoxiclav with clarithromycin for severe CAP. The BTS made a standard data collection template available to UK hospitals to audit adherence to selected elements of the CAP guideline. First-line empirical antibiotic treatment recommendations for CAP in our 1,000-bed university hospital differ from those of the BTS guideline in an effort to mitigate the risk of Clostridium difficile superinfection. This non-randomised prospective observational study was carried ...

Laboratory aspects of clinically significant rapidly growing mycobacteria

Indian Journal of Medical Microbiology — Thu, 24 Nov 2011 05:00:00 +0100

R Set, J ShastriIndian Journal of Medical Microbiology 2011 29(4):343-352The pathogenic potential of the rapidly growing mycobacteria (RGM) has started being recognized. This is due to more sensitive and specific techniques in the laboratory. The RGM are generally defined as nontuberculous species of mycobacteria that show visible growth on agar media within 7 days. RGM are widely distributed in nature and have been isolated from natural water, tap water, and soil. Several biochemical tests, high performance liquid chromatography, and molecular techniques have been developed for rapid identification of these species. The American Thoracic Society and the Infectious Disease Society of America recommend that RGM should be identified to the species level using a recognized acceptable methodol...

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Successfully treated Mycobacterium abscessus mastitis: A rare cause of breast masses

Indian Journal of Medical Microbiology — Thu, 24 Nov 2011 05:00:00 +0100

We describe a patient with Mycobacterium abscessus mastitis that presented as a mass lesion and haemorrhagical discharge. It was initially diagnosed and treated as fibrocystic disease and non-specific abscess. Full recovery was obtained with combination therapy of clarithromycin, linezolid and amikacin without surgical debridement followed by several abscess aspirations. Atypical mycobacteria should be considered in diagnosis of chronic breast lesions in endemic areas. This is the first reported case of mastitis due to M. abscessus in Turkey. (Source: Indian Journal of Medical Microbiology)

BIAXIN (Clarithromycin) Tablet, Film Coated BIAXIN (Clarithromycin) Tablet, Film Coated, Extended Release BIAXIN (Clarithromycin) Granule, For Suspension [Abbott Laboratories]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 23 Nov 2011 05:00:00 +0100

Updated Date: Nov 23, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Role of gastritis pattern on Helicobacter pylori eradication

Internal and Emergency Medicine — Mon, 21 Nov 2011 18:10:17 +0100

This study aimed to evaluate the role of different gastritis patterns on the efficacy of the currently suggested 14-day triple therapy regimen. One-hundred and seventeen, consecutive, non-ulcer dyspeptic patients, with H. pylori infection diagnosed at endoscopy, were enrolled. All patients received a 14-day, triple therapy with lansoprazole 30 mg, clarithromycin 500 mg and amoxicillin 1 g, all given twice daily. Bacterial eradication was assessed with 13C-urea breath test 4–6 weeks after completion of therapy. H. pylori infection was cured in 70.1% at ITT analysis and 83.7% at PP analysis. The eradication rate tended to be lower in patients with corpus-predominant gastritis as compared to those with antral-predominant gastritis at both ITT (66.1 vs 74.5%) and PP (...

Macrolides: from in vitro anti-inflammatory and immunomodulatory properties to clinical practice in respiratory diseases

European Journal of Clinical Pharmacology — Mon, 21 Nov 2011 18:03:38 +0100

Conclusion This review provides an overview on the properties of macrolides (erythromycin, clarithromycin, roxithromycin, azithromycin), their efficacy in various respiratory diseases and their adverse effects. Content Type Journal ArticleCategory Review ArticlePages 1-25DOI 10.1007/s00228-011-1161-xAuthors P. Zarogoulidis, Pulmonary Department, “G. Papanikolaou” Hospital, Aristotle University of Thessaloniki, Thessaloniki, 57010 GreeceN. Papanas, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, GreeceI. Kioumis, Pulmonary Department, “G. Papanikolaou” Hospital, Aristotle University of Thessaloniki, Thessaloniki, 57010 GreeceE. Chatzaki, Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexa...

[Department of Error] Department of Error

LANCET — Sat, 19 Nov 2011 05:00:00 +0100

Malfertheiner P, Bazzoli F, Delchier JC, et al. Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial. Lancet 2011;377: 905–13—In this Article (March 12), the fourth sentence of the third paragraph in the Procedures section (p 906) should have read: “In the 7-day standard regimen, one capsule of omeprazole, two of amoxicillin, and one of clarithromycin were taken twice daily (before morning and evening meals). (Source: LANCET)

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Effect of Pretreatment with Lactobacillus gasseri OLL2716 on First‐line Helicobacter pylori Eradication Therapy

Journal of Gastroenterology and Hepatology — Fri, 18 Nov 2011 05:00:00 +0100

Conclusion: This study confirmed that the major cause of treatment failure is resistance to clarithromycin. A 4‐week treatment with L. gasseri‐containing yogurt improves the efficacy of triple therapy in patients with H. pylori infection. (Source: Journal of Gastroenterology and Hepatology)

Wild-type MIC distribution and epidemiological cut-off values in clinical Legionella pneumophila serogroup 1 isolates

Diagnostic Microbiology and Infectious Disease — Fri, 18 Nov 2011 05:00:00 +0100

Conclusion: All isolates were inhibited by low concentrations of the fluoroquinolones and macrolides tested, with somewhat higher MICs for the fluoroquinolones. Rifampicin was found to be the most active against L. pneumophila isolates in vitro. These data can be used as a reference for the detection of resistance in clinical L. pneumophila isolates and as a setting of clinical breakpoints. (Source: Diagnostic Microbiology and Infectious Disease)

Drug susceptibility testing and pharmacokinetics question current treatment regimens in Mycobacterium simiae complex disease

International Journal of Antimicrobial Agents — Fri, 18 Nov 2011 05:00:00 +0100

Abstract: The Mycobacterium simiae complex bacteria can cause opportunistic infections in humans. In the case of definite disease, there are no evidence-based treatment regimens and outcomes are very disappointing. To increase the evidence base underpinning treatment regimens for M. simiae complex disease, drug susceptibility patterns and rifampicin/ethambutol synergy were assessed retrospectively in 69 clinical M. simiae complex isolates from 60 patients (22 patients with M. simiae, 24 with Mycobacterium lentiflavum, 8 with Mycobacterium triplex, 5 with Mycobacterium parascrofulaceum and 1 with Mycobacterium stomatepiae) submitted to the mycobacteriology laboratory at National Jewish Health (Denver, CO). Quantitative drug susceptibility testing (DST) was performed using the radiometric Ba...

Effect of amphotericin B alone or in combination with rifampicin or clarithromycin against Candida species biofilms.

The International Journal of Artificial Organs — Thu, 17 Nov 2011 05:00:00 +0100

Authors: Del Pozo JL, Francés ML, Hernáez S, Serrera A, Alonso M, Rubio MF Abstract Effectiveness of amphotericin B alone or in combination with rifampicin or clarithromycin on the killing of Candida species biofilms was investigated in vitro. Amphotericin B was assayed at 0.005 to 10 mg/ml. Rifampin and clarithromycin were assayed at 10 mg/ml. We studied 7 Candida albicans, 3 Candida parapsilosis, 3 Candida glabrata, 3 Candida krusei and 2 Candida tropicalis strains. Biofilms were developed in 96-well, flat-bottomed microtiter plates for 48 hours. A synergistic effect between amphotericin B and clarithromycin was demonstrated against 66.6% of C. parapsilosis, 66.6% of C. glabrata, and 42.8% of C. albicans biofilms. A synergistic effect between amphotericin B and rifampin was dem...

Randomized Trial on 14 versus 7 days of Esomeprazole, Moxifloxacin, and Amoxicillin for Second‐line or Rescue Treatment of Helicobacter pylori Infection

Helicobacter — Thu, 10 Nov 2011 10:20:41 +0100

Conclusion: Second‐line/rescue H. pylori eradication therapy with esomeprazole, moxifloxacin, and amoxicillin is very effective and well tolerated. Fourteen days of treatment significantly increase the eradication rate but also the rate of adverse events. (Source: Helicobacter)

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A large-scale nationwide multicenter prospective observational study of triple therapy using rabeprazole, amoxicillin, and clarithromycin for Helicobacter pylori eradication in Japan

Journal of Gastroenterology — Tue, 08 Nov 2011 06:48:06 +0100

Conclusion In a large-scale nationwide study of use in clinical practice, RAC therapy was confirmed to be effective and safe. Content Type Journal ArticleCategory Original Article—Alimentary TractPages 1-8DOI 10.1007/s00535-011-0487-6Authors Toshio Fujioka, Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, JapanNobuo Aoyama, GI Endoscopy and IBD Center, Aoyama Clinic, Kobe, JapanKyoko Sakai, Center for Digestive and Liver Diseases, Nara City Hospital, Nara, JapanYoshiyuki Miwa, Miwa Clinic, Gifu, JapanMineo Kudo, Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, JapanJunichi Kawashima, Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, ...

Randomised clinical trial: comparative study of 10‐day sequential therapy with 7‐day standard triple therapy for Helicobacter pylori infection in naïve patients

Alimentary Pharmacology and Therapeutics — Tue, 08 Nov 2011 05:00:00 +0100

Conclusions Ten‐day sequential therapy is more effective and equally tolerated for eradication of H. pylori infection compared with standard triple therapy. Sequential therapy may have a role as first‐line treatment for H. pylori infection. (Source: Alimentary Pharmacology and Therapeutics)

High frequency of A2143G mutation in clarithromycin-resistant Helicobacter pylori isolates recovered from dyspeptic patients in Iran

The Saudi Journal of Gastroenterology — Sat, 05 Nov 2011 04:00:00 +0100

Conclusion: The important findings in our study indicate that A2143G is the most prevalent point mutation (30/32: 93.7%) attributed in clarithromycin resistance among the H. pylori strains. The current study concluded that clarithromycin could still be involved in the empirical treatment of H. pylori infection, although a high frequency of A2143G mutation may increase the concerns regarding treatment failure. (Source: The Saudi Journal of Gastroenterology)

Mycobacterium genavense as a cause of subacute pneumonia in patients with severe cellular immunodeficiency

BMC Infectious Diseases — Sat, 05 Nov 2011 04:00:00 +0100

Conclusion: Clinicians should be aware that M. genavense could be the etiologic agent of sub-acute pneumonia mimicking tuberculosis in patients with cellular immunodeficiency status. (Source: BMC Infectious Diseases)

Comparison of efficacy of mometasone furoate versus clarithromycin in the treatment of chronic rhinosinusitis without nasal polyps in Chinese adults.

American Journal of Rhinology and Allergy — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSION: Mometasone furoate and clarithromycin show a comparable clinical effect for CRSsNPs in Chinese adults. Mometasone furoate is more effective in improving edema and secretion for CRSsNP patients with concomitant AR. PMID: 22185725 [PubMed - in process] (Source: American Journal of Rhinology and Allergy)

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Detection of clarithromycin resistance in Helicobacter pylori following noncryogenic storage of rapid urease tests for 30 days

Chinese Journal of Digestive Diseases — Mon, 31 Oct 2011 04:00:00 +0100

Conclusion: Gastric biopsy specimens stored within the gel of an RUT for 30 days can be used to for molecular testing confirm the diagnosis of H. pylori infection and test for clarithromycin susceptibility. (Source: Chinese Journal of Digestive Diseases)

Review article: the effectiveness of standard triple therapy for Helicobacter pylori has not changed over the last decade, but it is not good enough

Alimentary Pharmacology and Therapeutics — Sat, 22 Oct 2011 05:34:27 +0100

Conclusion Although a decrease in the H. pylori eradication rate after triple therapy has been suggested in recent years, cure rates with this regimen did not change in Spain between 1997 and 2008. However, this by no means indicates that the efficacy of standard triple therapy in Spain is acceptable, as it has been calculated to be around only 80%. Therefore, it is evident that new strategies to improve first‐line treatment are urgently needed. (Source: Alimentary Pharmacology and Therapeutics)

Antimicrobial efficacies of several antibiotics against uterine cervicitis caused by Mycoplasma genitalium

Journal of Infection and Chemotherapy — Fri, 21 Oct 2011 16:01:27 +0100

In conclusion, AZM-SR 2 g single dose, MFLX 400 mg/day for 14 days, and STFX 200 mg/day for 14 days would each be an effective treatment for M. genitalium infection. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s10156-011-0329-8Authors Michinori Terada, Department of Infection Control and Prevention, Aichi Medical University, 21 Karimata, Yazako, Nagakute-cho, Aichi-gun, Aichi, 480-1195 JapanKoji Izumi, Department of Obstetrics and Gynecology, Izumi Ladies Clinic, Gifu, JapanEmiko Ohki, Department of Infection Control and Prevention, Aichi Medical University, 21 Karimata, Yazako, Nagakute-cho, Aichi-gun, Aichi, 480-1195 JapanYuka Yamagishi, Department of Infection Control and Prevention, Aichi Medical University, 21 Karimata, Ya...

DPO multiplex PCR as an alternative to culture and susceptibility testing to detect Helicobacter pylori and its resistance to clarithromycin.

BMC Gastroenterology — Mon, 17 Oct 2011 04:00:00 +0100

Conclusion: The DPO-PCR is an interesting tool to detect H. pylori on gastric biopsies and to study its susceptibility to clarithromycin in laboratories that cannot perform real-time PCR assays. (Source: BMC Gastroenterology)

Outbreak of a cutaneous Mycobacterium marinum infection in Jiangsu Haian, China

Diagnostic Microbiology and Infectious Disease — Thu, 13 Oct 2011 16:14:17 +0100

Abstract: Mycobacterium marinum is a slow-growing mycobacterium. In November 2008, we diagnosed a patient with M. marinum infection who worked at a fish farm in Jiangsu Haian, China. We conducted an investigation and found 18 patients with the same infection. In suspected cases, complete data were collected including medical history, clinical manifestations, laboratory features, and responses to treatment. Therapeutic regimens, including clarithromycin monotherapy or combined treatment with clarithromycin, rifampicin, and ethambutol, were prescribed. A total of 18 patients with M. marinum infection were found. All patients showed only skin lesions. Biopsies were performed and 16 patients showed infective granulomas. Acid-fast bacilli stain (Ziehl-Neelson stain) for cutaneous samples were p...

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Atypical Mycobacterial Infection Presenting as Persistent Skin Lesion in a Patient with Ulcerative Colitis

Clinical and Developmental Immunology — Wed, 05 Oct 2011 22:54:55 +0100

We present a case of skin infection with Mycobacterium chelonae in a 60-year-old Caucasian woman with ulcerative colitis who had been treated with corticosteroids and azathioprine. The disease manifested with fever and rash involving the right leg. Infliximab was administered due to a presumptive diagnosis of pyoderma gangrenosum, leading to worsening of the clinical syndrome and admission to our hospital. Routine cultures from various sites were all negative. However, Ziehl-Neelsen staining of pus from the lesions revealed acid-fast bacilli, and culture yielded a rapidly growing mycobacterium further identified as M. chelonae. The patient responded to a clarithromycin-based regimen. Clinicians should be aware of skin lesions caused by atypical mycobacteria in immunocompromised patients wi...

Clarithromycin, as an adjunct to non surgical periodontal therapy for chronic periodontitis: A double blinded, placebo controlled, randomized clinical trial

Archives of Oral Biology — Sat, 01 Oct 2011 04:00:00 +0100

Abstract: Objective: Along with conventional non-surgical periodontal therapy (NSPT) systemic antimicrobials may provide more effective treatment for chronic periodontitis by targeting tissue-invasive bacteria. The aim of this randomized, placebo-controlled, double-masked clinical trial was to evaluate the adjunctive effects of oral clarithromycin (CLM) to non-surgical periodontal therapy for chronic periodontitis.Methods: 40 patients were categorized into two groups: test group – scaling and root planing (SRP) plus CLM (500mg b.i.d. for 3 days) and control group – SRP plus placebo. Clinical parameters were recorded at baseline and at 1, 3, 6, and 9 months. They included gingival index (GI), probing depth (PD), and clinical attachment level (CAL). Also microbial analysis of dental plaq...

Symbicort Turbohaler 100/6, 200/6, 400/12 Inhalation powder (budesonide/formoterol fumarate dihydrate) - Revised SPC

NeLM - SPC Changes — Fri, 30 Sep 2011 04:00:00 +0100

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes The SPC has been updated with regards to an amendment to the interactions section as follows: Section 4.5 Amended to Pharmacokinetic interactions Potent inhibitors of CYP3A4 (eg, ketoconazole, itraconazole, voriconazole, posaconazole, clarithromycin, telithromycin, nefazodone and HIV protease inhibitors) are likely to markedly increase plasma levels of budesonide and concomitant use should be avoided. If this is not possible the time interval between administration of the inhibitor and budesonide should be as long as possible (see section 4.4). The potent CYP3A4 inhibitor ketoconazole, 200 mg once daily, increased plasma levels of concomitantly orally admi...

Sequential therapy for Helicobacter pylori eradication: is levofloxacin better?

Gut — Fri, 30 Sep 2011 04:00:00 +0100

We read with great interest the study by Romano et al on a modified sequential therapy regimen for Helicobacter pylori eradication.1 Basically, the trial showed that a novel levofloxacin-based regimen was more effective than the standard, clarithromycin-based sequential regimen, irrespective of levofloxacin dose used (250 mg or 500 mg twice daily). We thank the authors for seeking to improve the efficacy of sequential therapy. However, a note of caution is probably required when the authors suggest that ‘the levofloxacin-based regimen might be used as first-line therapy in those geographical areas where primary clarithromycin resistance is >15%’.1 Indeed, the high efficacy of such a therapy could depend on the very low prevalence (3.7%) of primary levofloxacin resi...

Levofloxacin in first-line eradication regimens for Helicobacter pylori: better test antibiotic susceptibility before treating

Gut — Fri, 30 Sep 2011 04:00:00 +0100

We sincerely congratulate Romano et al1 for their recent manuscript in Gut showing that levofloxacin-containing sequential therapy can overcome suboptimal cure rates of clarithromycin-containing sequential therapy (≤80% in the intention-to-treat analysis), in a setting with a high clarithromycin resistance rate (20%) but a low levofloxacin resistance rate (3%). Interestingly, we failed to replicate their results in a prior trial with quite a similar design,2 even though the fluoroquinolone resistance rate in Spain has been reported to be as low as 6%.3 In our trial, intention-to-treat eradication rates for clarithromycin-containing (76%) and levofloxacin-containing (82%) 10-day sequential therapies were suboptimal. These poor results are likely related to a higher prevalence of levoflox...

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The Authors' reply

Gut — Fri, 30 Sep 2011 04:00:00 +0100

We thank Drs Molina-Infante and Gisbert1 for their letter and for their appreciation of our study.2 We completely agree that the discrepancy between their study and our study as to the efficacy of levofloxacin-containing sequential treatment in Helicobacter pylori eradication might be at least in part due to the very low (ie, 3%) prevalence of H pylori strains resistant to this antimicrobial in our region compared with their geographical area. We also agree that clarithromycin-containing sequential treatment is achieving disappointing results in areas with a high prevalence of clarithromycin and/or dual (ie, metronidazole + clarithromycin) resistance and that, therefore, its role in this setting should be critically reconsidered. Recently, a study by Hsu et al has demonstrated high efficac...

The Prevalence and Incidence of Helicobacter pylori–Associated Peptic Ulcer Disease and Upper Gastrointestinal Bleeding Throughout the World

Gastrointestinal Endoscopy Clinics of North America — Thu, 29 Sep 2011 08:28:07 +0100

Due to heightened awareness regarding testing for and eradication of infection, the prevalence and incidence of H pylori infection (and by extension the prevalence and incidence of peptic ulcer disease) appear to have declined in recent years. However, antimicrobial resistance is mounting and traditional clarithromycin- or metronidazole-containing triple therapies may no longer be highly effective at eradicating the infection. Combined bismuth- and metronidazole-containing quadruple therapy or sequential 4-drug therapy may be better choices for first-line treatment against this unique pathogen that is ideally suited to survive in the human stomach. (Source: Gastrointestinal Endoscopy Clinics of North America)

Primary Antibiotic Resistance of Helicobacter pylori Isolated from Beijing Children

Helicobacter — Thu, 22 Sep 2011 10:04:26 +0100

Conclusion: The high prevalence of primary antibiotic resistance was out of expectation in H. pylori strains isolated from the children in Beijing. Antibiotic susceptibility should be made clear before the antibiotic was used in the anti‐H. pylori therapy in this population. The A2143G was the most populated mutation in macrolide‐resistant strains, and Asn87 and Asp91 of GyrA were the most common mutation points in quinolone resistance strains. (Source: Helicobacter)

Clarithromycin/erythromycin: Exanthema and fixed drug eruption: 4 case reports

Reactions — Thu, 22 Sep 2011 07:55:36 +0100

(Source: Reactions)

A new look at anti-Helicobacter pylori therapy.

World Journal of Gastroenterology : WJG — Wed, 21 Sep 2011 04:00:00 +0100

Authors: Chuah SK, Tsay FW, Hsu PI, Wu DC Abstract With the rising prevalence of antimicrobial resistance, the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e., 80% or less) in most countries. Therefore, several treatment regimens have emerged to cure Helicobacter pylori (H. pylori) infection. Novel first-line anti-H. pylori therapies in 2011 include sequential therapy, concomitant quadruple therapy, hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy. After the failure of standard triple therapy, a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI), bismuth, tetracycline and metronidazole can be employed as rescue treatment. Recently, triple therapy combining a PPI, levofloxacin and am...

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Randomised clinical trial: the efficacy of a 10‐day sequential therapy vs. a 14‐day standard proton pump inhibitor‐based triple therapy for Helicobacter pylori in Korea

Alimentary Pharmacology and Therapeutics — Mon, 19 Sep 2011 04:00:00 +0100

Conclusion The 10‐day sequential therapy achieved significantly higher eradication rates than the 14‐day standard PPI‐based triple therapy in Korea. (Source: Alimentary Pharmacology and Therapeutics)

The clinical efficacy and safety of a fluoroquinolone-containing regimen for pulmonary MAC disease

Journal of Infection and Chemotherapy — Fri, 16 Sep 2011 16:43:38 +0100

Abstract Despite recent advances in chemotherapy, the treatment of pulmonary Mycobacterium avium complex (MAC) disease remains unsatisfactory. Judging from its MIC, fluoroquinolones including gatifloxacin (GFLX) are expected to demonstrate efficacy against MAC disease. However, there have been few clinical studies using fluoroquinolones. Therefore, a prospective study to evaluate the clinical efficacy and safety of a fluoroquinolone-containing regimen for the treatment of pulmonary MAC disease was conducted. In this trial, patients with pulmonary MAC disease received protocol-guided combined chemotherapy with rifampin (RFP) and ethambutol (EB) plus either GFLX or clarithromycin (CAM). Adult patients who fulfilled the criteria of the ATS definition of pulmonary MAC disease w...

Sequential therapy for H. pylori eradication

NeLM - Disease Focused Reviews — Thu, 15 Sep 2011 04:00:00 +0100

Source: Drug and Therapeutics Bulletin (DTB) Area: Evidence > Disease Focused Reviews This review in the Drug and Therapeutics Bulletin (DTB) assesses the efficacy and safety of sequential H. pylori eradication therapy. It found that: Sequential therapy, typically comprising a proton pump inhibitor (PPI) plus amoxicillin given for the first 5 days, followed by the same PPI plus clarithromycin and either metrondiazole or tinidazole for a further 5 days, appears to eradicate infection more effectively than does standard triple therapy, based on systematic reviews of RCTs. The two regimens have similar costs. Sequential therapy is unsuitable for patients allergic to penicillin The relative efficacy of sequential versus triple therapy may be related to ...

Ten‐day sequential therapy is more effective than proton‐pump inhibitor‐based therapy in Korea: a prospective randomized study

Journal of Gastroenterology and Hepatology — Wed, 14 Sep 2011 04:00:00 +0100

Conclusion: The eradication rate of the 10‐day sequential therapy regimen was significantly higher than that of PPI‐based triple therapy in the Korean population. 10‐day sequential therapy may be effective as a first‐line treatment for H. pylori infection in Korea. (Source: Journal of Gastroenterology and Hepatology)

Primary antibiotic resistance of Helicobacter pylori strains isolated from Portuguese children: a prospective multicentre study over a 10 year period

Journal of Antimicrobial Chemotherapy — Tue, 13 Sep 2011 04:00:00 +0100

Conclusions The primary resistance rate of H. pylori strains isolated from Portuguese children to the commonly used anti-H. pylori antibiotics used is high. Additionally, the increasing trend of ciprofloxacin-resistant and double-resistant strains may compromise H. pylori eradication in a high-prevalence population. (Source: Journal of Antimicrobial Chemotherapy)

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Efficacy of increasing dosages of clarithromycin for treatment of experimental Mycoplasma pneumoniae pneumonia

Journal of Antimicrobial Chemotherapy — Tue, 13 Sep 2011 04:00:00 +0100

Conclusions Escalated dosing of clarithromycin resulted in significantly greater therapeutic efficacy in the treatment of experimental M. pneumoniae respiratory infection. (Source: Journal of Antimicrobial Chemotherapy)

A 7-year-old girl with subcutaneous emphysema, pneumomediastinum, pneumothorax, and pneumoretroperitoneum caused by Mycoplasma pneumoniae pneumonia

Journal of Infection and Chemotherapy — Thu, 08 Sep 2011 05:56:42 +0100

Abstract A 7-year-old girl presented with subcutaneous emphysema, pneumomediastinum (PM), pneumoretroperitoneum, and pneumothorax caused by Mycoplasma pneumoniae (MP). The patient had been treated with clarithromycin for pneumonia at another hospital; however, her condition deteriorated and complications developed. Soon after admission to our hospital, we started the patient on minocycline and prednisolone, and the complications improved promptly. Laboratory data showed serum ferritin and urinary beta-2-microglobulin levels were greatly elevated. We therefore speculated that the patient might have underlying hypercytokinemia. Prednisolone is an effective treatment for hypercytokinemia. We therefore recommend prednisolone treatment for cases of severe M. pneumoniae pneumonia...

Ocular infections caused by non‐tuberculous mycobacteria: update on epidemiology and management

Clinical and Experimental Ophthalmology — Thu, 08 Sep 2011 04:00:00 +0100

Conclusions: The incidence of ocular infections caused by non‐tuberculous mycobacteria has increased within the last 8 years, with a high number of biomaterial associated infections among this group. Clinical diagnosis and microbiological confirmation of non‐tuberculous mycobacteria infections remains challenging. Patient outcomes may be improved by early diagnosis, appropriate therapy and removal of biomaterials. (Source: Clinical and Experimental Ophthalmology)

The influence of glycyrrhiza and antibiotics on the purgative action of sennoside a from daiokanzoto in mice.

Biological and Pharmaceutical Bulletin — Tue, 06 Sep 2011 17:16:03 +0100

Authors: Matsui E, Takayama K, Sato E, Okamura N Abstract Daiokanzoto (DKT), a Kampo medicine that includes the combination of two crude drugs (rhubarb and glycyrrhiza), is clinically effective for constipation. The aim of this study is to clarify the influence of glycyrrhiza, three glycyrrhiza constituents (glycyrrhizin, liquiritin, and liquiritin apioside), and eight antibiotics on the purgative action of DKT, rhubarb, or sennoside A, a constituent of rhubarb, in mice. The purgative actions of rhubarb and sennoside A were significantly intensified when glycyrrhiza was co-administered orally to mice. Liquiritin and liquiritin apioside but not glycyrrhizin showed significant amplification of the purgative action in a dose-dependent manner. The purgative actions of DKT and sennoside...

[Helicobacter pylori Eradication Therapy in Korea].

Korean J Gastroenter... — Fri, 02 Sep 2011 01:25:34 +0100

Authors: Kim SY, Jung SW Abstract Helicobacter pylori (H. pylori) is known to be associated with many gastrointestinal diseases including peptic ulcer. In Korea, eradication of H. pylori is recommended for peptic ulcer disease, low grade gastric mucosa-associated lymphoid tissue lymphoma, and early gastric cancer. Standard triple therapy using proton pump inhibitor, clarithromycin, and amoxicillin and bismuth-containing quadruple therapy have been the main first-line and second-line therapy for H. pylori in Korea. Although eradication rate of second-line quadruple therapy remains similar to that of the past, the success rate of eradication with triple therapy has decreased with increasing antimicrobial resistance to H. pylori. There is no standard third-line therapy, and some regim...

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[Primary Antibiotic Resistance of Helicobacter pylori Strains and Eradication Rate according to Gastroduodenal Disease in Korea].

Korean J Gastroenter... — Fri, 02 Sep 2011 01:25:29 +0100

Conclusions: Primary antibiotic resistance and H. pylori eradication rate were not different between cancer and non-cancer patients. PMID: 21873821 [PubMed - in process] (Source: Korean J Gastroenter...)

[Which is the best empirical treatment in patients with urethritis?].

Revista Espanola de Quimioterapia — Thu, 01 Sep 2011 04:00:00 +0100

Conclusions. N. gonorrhoeae showed a level of resistance to tetracycline and ciprofloxacin higher in the second period, being significant for ciprofloxacin. Quinolone resistance was higher in MSM. Haemophilus spp showed a level of resistance to ampicillin, ciprofloxacin and tetracycline higher in the second period, being significant for tetracycline. U.urealyticum showed high level of resistance to ciprofloxacin (80.7%)and ofloxacin (32.4%) and low level of resistance to doxycycline (0.8%) and tetracycline (3.5%). PMID: 21947096 [PubMed - in process] (Source: Revista Espanola de Quimioterapia)

Nodular skin reactions in eyebrow permanent makeup: two case reports and an infection by Mycobacterium haemophilum

Journal of Cosmetic Dermatology — Wed, 31 Aug 2011 23:00:00 +0100

Conclusions Adverse reactions after permanent makeup need a medical evaluation to identify health risks and initiate early treatment. (Source: Journal of Cosmetic Dermatology)

Antimicrobial susceptibility of bacterial pathogens associated with community-acquired respiratory tract infections in Asia: report from the Community-Acquired Respiratory Tract Infection Pathogen Surveillance (CARTIPS) study, 2009–2010

International Journal of Antimicrobial Agents — Wed, 31 Aug 2011 04:00:00 +0100

Abstract: A multicentre resistance surveillance study [Community-Acquired Respiratory Tract Infection Pathogen Surveillance (CARTIPS)] investigating the susceptibilities of 2963 clinical isolates of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella pneumoniae, meticillin-susceptible Staphylococcus aureus (MSSA) and Streptococcus spp. from Asia against 12 antimicrobial agents was undertaken from 2009 to 2010. Based on the breakpoints for oral penicillin V recommended by the Clinical and Laboratory Standards Institute, the prevalence of penicillin-non-susceptible S. pneumoniae (PNSSP) ranged from 46% to 100%. Azithromycin and clarithromycin exhibited variable resistance rates of 0–88% against S. pneumoniae, 0–57% against MSSA and 0–76.5% against Strept...

Clarithromycin: Reversible sensorineural hearing loss: case report

Reactions — Mon, 29 Aug 2011 14:09:06 +0100

(Source: Reactions)

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Modulation of the late sodium current by ATX‐II and ranolazine affects the reverse use‐dependence and proarrhythmic liability of IKr blockade

British Journal of Pharmacology — Sat, 27 Aug 2011 15:22:24 +0100

CONCLUSION AND IMPLICATIONS Modulation of INa,L altered drug‐induced reverse use‐dependence related to QT as well as Tp‐e, indicating that inhibition of INa,L can markedly reduce the TdP liability of agents that prolong QT intervals. (Source: British Journal of Pharmacology)

Numerous risk factors for Helicobacter pylori antibiotic resistance revealed by extended anamnesis. A Bulgarian study.

Journal of Medical Microbiology — Fri, 26 Aug 2011 04:00:00 +0100

In conclusion, the extended anamnesis of H. pylori positive patients should include data on patient age, sex, health-care profession, coinfections and possibly diabetes to improve the choice of empiric therapy. Tailored treatment based on the extended anamnesis is suggested and susceptibility testing of the strains is recommended for patients at risk for antibiotic resistance, especially to clarithromycin, fluoroquinolones or both metronidazole and clarithromycin. PMID: 21873378 [PubMed - as supplied by publisher] (Source: Journal of Medical Microbiology)

Title: Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan

Journal of Gastroenterology and Hepatology — Sun, 21 Aug 2011 23:00:00 +0100

Conclusion: Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan. The novel treatment can be used as a first‐line therapy for H. pylori infection for Taiwanese. (Source: Journal of Gastroenterology and Hepatology)

Colchicine: tips for avoiding fatal in-hospital toxicity

The Poison Review — Sun, 14 Aug 2011 09:13:00 +0100

This article emphasizes that point, and should be read. Related post: Colchicine: be afraid, be very afraid (Source: The Poison Review)

Another cause of ototoxicity: Clarithromycin

International Journal of Pediatric Otorhinolaryngology Extra — Fri, 12 Aug 2011 04:00:00 +0100

Abstract: Reported is a case of cervical atypical mycobacterial infection treated with an extended course of clarithromycin in a 23-month-old child who developed sensorineural hearing loss. While no subjective change in hearing was reported, hearing loss was identified through audiologic ototoxicity monitoring. Audiometric changes encompassing frequency specific threshold shifts and changes in distortion product otoacoustic emissions are shown during the use of and following discontinuation of clarithromycin. Observed hearing loss resolved following termination of clarithromycin. This is believed to be the first report of a pediatric patient on clarithromycin developing reversible sensorineural hearing loss with documented serial audiometric changes. (Source: International Journal of Pedia...

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Efflux inhibition by selective serotonin reuptake inhibitors in Escherichia coli

Journal of Antimicrobial Chemotherapy — Mon, 08 Aug 2011 23:00:00 +0100

Conclusions A possible explanation for the discrepancy between the MIC and real-time efflux assays was that sertraline is a weak inducer of marA and acrB, thereby reducing its initial antibacterial and sensitizing effects over time. The results indicate that sertraline may be useful as a model efflux pump inhibitor for in vitro short-term experiments in E. coli, but is unlikely to be clinically useful as a co-drug against Gram-negative bacteria. (Source: Journal of Antimicrobial Chemotherapy)

Impact of guidelines and enhanced antibiotic stewardship on reducing broad-spectrum antibiotic usage and its effect on incidence of Clostridium difficile infection

Journal of Antimicrobial Chemotherapy — Mon, 08 Aug 2011 23:00:00 +0100

Conclusions Revised antibiotic guidelines and enhanced stewardship was associated with a significant stepwise reduction in the use of cephalosporins and fluoroquinolones and a significant decrease in the incidence of CDI. (Source: Journal of Antimicrobial Chemotherapy)

[Articles] 14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial

LANCET — Fri, 05 Aug 2011 23:00:00 +0100

SummaryBackgroundEvidence from Europe, Asia, and North America suggests that standard three-drug regimens of a proton-pump inhibitor plus amoxicillin and clarithromycin are significantly less effective for eradication of Helicobacter pylori infection than are 5-day concomitant and 10-day sequential four-drug regimens that include a nitroimidazole. These four-drug regimens also entail fewer antibiotic doses than do three-drug regimens and thus could be suitable for eradication programmes in low-resource settings. (Source: LANCET)

Recent Developments in Nongastric Mucosa-Associated Lymphoid Tissue Lymphoma

Current Hematologic Malignancy Reports — Tue, 02 Aug 2011 06:14:18 +0100

Abstract Guidelines and algorithms for the management of gastric mucosa-associated lymphoid tissue (MALT) lymphoma have been developed in the recent past, but the situation regarding nongastric MALT lymphomas is much more complicated. Owing to the heterogeneity of MALT lymphomas arising in various organs, different approaches to treatment have been applied, mostly in an uncontrolled fashion. In the recent past, for example, attempts to use antibiotic therapy in managing ocular adnexal MALT lymphomas have been reported, with response rates varying between 0% and 60% with the use of doxycycline or, more rarely, clarithromycin. Currently, antibiotic therapy remains experimental, with conflicting data and apparent geographic variations. In addition, there is no clear consensus...

Effect of Helicobacter pylori eradication therapy in iron deficiency anaemia of pregnancy - A pilot study.

Indian J Med Res — Mon, 01 Aug 2011 04:00:00 +0100

This study was undertaken to study the effect of eradication therapy in H. pylori infected pregnant women with IDA. Methods: Randomized placebo-controlled double blind clinical trial was done on 40 antenatal women between 14-30 wk gestation, with mild to moderate IDA and having H. pylori infection, as detected by stool antigen test. These women were randomly divided into group I (n=20): H. pylori treatment group (amoxicillin, clarithromycin, omeprazole for 2 wk) and group II (n=20): placebo group. Both groups received therapeutic doses of iron and folic acid. Outcome measures were improvement in haematological parameters and serum iron profile after 6 wk of oral iron therapy. Results: The prevalence of iron deficiency in pregnant women with mild to moderate anaemia was 39.8 per cent (95% C...

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Novel evidence‐based colchicine dose‐reduction algorithm to predict and prevent colchicine toxicity in the presence of cytochrome P450 3A4/P‐glycoprotein inhibitors

Arthritis and Rheumatism — Sun, 31 Jul 2011 23:00:00 +0100

ConclusionThese studies provide quantitative evidence regarding drug interactions and necessary adjustments in the dose of colchicine if colchicine treatment is continued during therapy with multiple CYP3A4/P‐glycoprotein inhibitors. We demonstrated the need for specific reductions in the dose of colchicine when it is used in combination with 2 broadly prescribed calcium channel blockers (verapamil ER and diltiazem ER) and that the dose of colchicine does not need to be adjusted when it is used in combination with azithromycin. (Source: Arthritis and Rheumatism)

[Current Value of Quinolones in Helicobacter pylori Therapy].

Zeitschrift fur Gastroenterologie — Sun, 31 Jul 2011 23:00:00 +0100

Authors: Krasz S, Miehlke S, Berning M, Morgner A, Labenz J Eradication rates in first-line Helicobacter pylori therapy have been declining over the last decades, mainly due to increasing resistance against the recommended antibiotics clarithromycin and metronidazole. Thus, there is a need to evaluate novel regimens and substances to offer effective alternative treatment strategies. New generation quinolones, like levofloxacin and moxifloxacin, exhibit a broad-spectrum activity against various Gram-positive and Gram-negative strains and are mostly well tolerated. Based on a large number of studies, quinolones have been introduced in second-line and rescue treatment and are recommended for these indications in current guidelines. Various studies have investigated alternative strategies ...

Does horny goat weed have any clinically significant interactions?

NeLM - Medicines Q and A — Wed, 27 Jul 2011 23:00:00 +0100

Source: Regional Drug and Therapeutics Centre Area: Evidence > Medicines Q & A Horny goat weed (Epimedium) is a herbal medicine that may comprise mixtures of different related Epimedium species, which contain numerous and varied active constituents. As herbal products are subject to variations in quality, safety and efficacy, their use should not be recommended routinely. There is no published human information on drug interactions with horny goat weed, but the potential for interactions exists, as horny goat weed has been shown in vitro to inhibit a number of cytochrome P450 enzymes. Drugs which may be affected include warfarin, amitriptyline, clarithromycin, erythromycin, ciclosporin, tacrolimus, and phenytoin. This Medicines Q&A explores the possibility ...

Resistance of Helicobacter pylori Strains to Antibiotics in Korea with a Focus on Fluoroquinolone Resistance

Journal of Gastroenterology and Hepatology — Tue, 26 Jul 2011 23:00:00 +0100

Conclusions: Primary H. pylori resistance to ciprofloxacin occurred at a high frequency. The fluoroquinolone resistance is most likely mediated through amino acid point mutation in the gyrA gene at Asn87 and Asp91. (Source: Journal of Gastroenterology and Hepatology)

Clarithromycin: First report of hypersomnia: 2 case reports

Reactions — Sun, 24 Jul 2011 19:59:43 +0100

(Source: Reactions)

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[Correspondence] Helicobacter pylori eradication

LANCET — Fri, 22 Jul 2011 23:00:00 +0100

In a rigorously designed randomised controlled trial, Peter Malfertheiner and colleagues (March 12, p 905) compared 10 days of bismuth-based quadruple therapy with 7 days of clarithromycin-based triple therapy for Helicobacter pylori eradication. There was an impressive benefit of quadruple therapy over triple therapy, with a 25% increase in eradication rates, equating to a number needed to treat to prevent one therapeutic failure of four. (Source: LANCET)

Symptom-based tendencies of Helicobacter pylori eradication in patients with functional dyspepsia.

World Journal of Gastroenterology — Thu, 21 Jul 2011 04:00:00 +0100

CONCLUSION: The efficacy of H. pylori eradication has symptom-based tendencies in FD patients. It may be effective in the subgroup of FD patients with epigastric pain syndrome. PMID: 21912474 [PubMed - in process] (Source: World Journal of Gastroenterology)

Application of Real‐Time PCR Stool Assay for Helicobacter pylori Detection and Clarithromycin Susceptibility Testing in Brazilian Children

Helicobacter — Wed, 20 Jul 2011 17:49:57 +0100

Conclusion: This assay proved to be appropriate for H. pylori clarithromycin susceptibility testing, particularly in children populations where a high prevalence of clarithromycin‐resistant strains is suspected. (Source: Helicobacter)

Ciclosporin/clarithromycin interaction: Acute kidney injury in a child: case report

Reactions — Wed, 20 Jul 2011 16:58:58 +0100

(Source: Reactions)

Trial evaluating 3 different H pylori eradication regimens shows 14-day triple therapy is most effective

NeLM - News — Tue, 19 Jul 2011 23:00:00 +0100

Source: Lancet Area: News The Lancet has featured a study evaluating a 3-drug regimen of a proton-pump inhibitor plus amoxicillin and clarithromycin (commonly used in Europe and North America), with a 5-day concomitant and 10-day sequential four-drug regimens that include a nitroimidazole (commonly used in Latin America), for the treatment of Helicobacter pylori infection. The study, conducted in Latin America involved 1463 patients aged between 21 and 65 years, who tested positive for H pylori infection, and who were randomised to one of the following: . 14 days of lansoprazole, amoxicillin, and clarithromycin (standard therapy) (n=488); . 5 days of lansoprazole, amoxicillin, clarithromycin, and metronidazole (concomitant therapy) (n=489); . 5 days of lans...

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Volatile compounds in the stem bark of Sclerocarya birrea (Anacardiaceae) possess antimicrobial activity against drug-resistant strains of Helicobacter pylori

International Journal of Antimicrobial Agents — Thu, 14 Jul 2011 23:00:00 +0100

Abstract: The aim of this study was to isolate and identify phytochemicals with anti-Helicobacter pylori activity from the stem bark of Sclerocarya birrea. The plant crude extract was fractionated by silica gel column and thin layer chromatography techniques, initially with ethyl acetate (EA) and subsequently with a combination of ethyl acetate/methanol/water (EMW). Further fractionation and identification of the phytoconstituents was achieved by gas chromatography and mass spectrometry (GC/MS) analysis. The antimicrobial activity of the fractions and compounds was evaluated against five metronidazole- and clarithromycin-resistant strains of H. pylori as well as a reference strain ATCC 43526 using the microbroth dilution technique. Amoxicillin was included in the experiments as a positive ...

Review article: non‐bismuth quadruple (concomitant) therapy for eradication of Helicobater pylori

Alimentary Pharmacology and Therapeutics — Wed, 13 Jul 2011 16:42:31 +0100

Conclusions Non‐bismuth quadruple (concomitant) therapy appears to be an effective, safe, and well‐tolerated alternative to triple therapy and is less complex than sequential therapy. Therefore, this regimen appears well suited for use in settings where the efficacy of triple therapy is unacceptably low. (Source: Alimentary Pharmacology and Therapeutics)

Evaluation of Long-Term Clarithromycin Treatment in Adult Chinese Patients with Chronic Rhinosinusitis without Nasal Polyps

Karger Publishers — Wed, 13 Jul 2011 14:41:17 +0100

ORL 2011;73:206–211 (DOI:10.1159/000328342) (Source: Karger Publishers)

Empirical modified sequential therapy containing levofloxacin and high-dose esomeprazole in second-line therapy for Helicobacter pylori infection: a multicentre clinical trial

Journal of Antimicrobial Chemotherapy — Sun, 10 Jul 2011 23:00:00 +0100

Conclusions This modified sequential therapy achieved an excellent eradication rate (>95%) in second-line treatment and the eradication rate appeared to be affected by metronidazole resistance. (Source: Journal of Antimicrobial Chemotherapy)

Supplementing Vitamins C and E to standard triple therapy for the eradication of Helicobacter pylori

Journal of Clinical Pharmacy and Therapeutics — Sun, 10 Jul 2011 23:00:00 +0100

Conclusion: Adding vitamins C and E to standard triple therapy increases the eradication rate of H. pylori. Vitamins C and E may increase the eradication rate via increasing the effectiveness of the antibiotics by decreasing oxidative stress in the gastric mucosa and strengthening the immune system. (Source: Journal of Clinical Pharmacy and Therapeutics)

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In vitro anti-inflammatory and anti-coagulant effects of Antibiotics towards Platelet Activating Factor and Thrombin

Journal of Inflammation — Wed, 06 Jul 2011 23:00:00 +0100

Conclusions: These newly found properties of antibiotics used in sepsis suggest that apart from their general actions, these drugs may present additional beneficial anti-inflammatory and anti-coagulant effects against the onset and establishment of sepsis by inhibiting the PAF/PAF-receptor and/or the thrombin/protease-activated-receptor-1 systems, and/or by reducing PAF-levels through both PAF-biosynthesis inhibition and PAF-catabolism induction. These promising in vitro results need to be further studied and confirmed by in vivo tests, in order to optimize the efficacy of antibiotic treatment in sepsis. (Source: Journal of Inflammation)

Helicobacter pylori Eradication by Sitafloxacin/Lansoprazole Combination and Sitafloxacin Pharmacokinetics in Mongolian Gerbils, and Its In Vitro Activity and Resistance Development.

Antimicrobial Agents and Chemotherapy — Mon, 04 Jul 2011 23:00:00 +0100

Antibiotic susceptibility profile of Helicobacter pylori isolated from the dyspepsia patients in Tehran, Iran

The Saudi Journal of Gastroenterology — Thu, 30 Jun 2011 23:00:00 +0100

Conclusions: These data suggest that metronidazole should be used among Iranian patients in first-line therapy with caution, and ciprofloxacin in association with amoxicillin and a proton pump inhibitor is more recommended. (Source: The Saudi Journal of Gastroenterology)

Cover Picture: Electrophoresis 14'2011

Electrophoresis — Thu, 30 Jun 2011 23:00:00 +0100

AbstractIssue no. 14 is a regular issue consisting of 17 contributions distributed over 3 distinct parts. Part I has 7 articles describing studies on proteins and proteomics including measuring protein mobility using laser Doppler electrophoresis, high sensitivity protein analysis by FESI‐CE‐MALDI‐MS, protocol for SDS‐PAGE separation of myosin heavy chain isoforms, proteomics analysis of a spring wheat cultivar in response to prolonged cold stress, analysis of changes in the 20S proteasome, treatment of acute lymphoblastic leukemia with L‐asparaginase, and improved method for immunostaining of mucin. Part II is on nucleic acids and has 4 contributions on multiplex PCR‐CE analysis, copy number variation, ethnic difference, SNPs, CE‐SSCP, allelic ladder and SNaPshot technique. ...

Evaluation of clarithromycin lactobionate as a novel chiral selector for enantiomeric separation of basic drugs in capillary electrophoresis

Electrophoresis — Thu, 30 Jun 2011 23:00:00 +0100

In this study, clarithromycin lactobionate (CL), belonging to the group of macrolide antibiotics, was first investigated for its potential as a novel chiral selector in CE for enantiomeric separation of several basic drugs. As observed, CL allowed excellent separation of the enantiomers of metoprolol, atenolol, propranolol, bisoprolol, esmolol, ritodrine, and amlodipine, as well as partial enantioresolution of labetalol and nefopam. In addition, CL possesses advantages such as high solubility and low viscosity in the solvent and very weak UV absorption. In the course of this study, it was found that both migration times and enantioseparation of the basic drugs were influenced by several experimental parameters, e.g. selector concentration, the composition and pH of the BGE, the type and co...

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Distribution characteristics of clarithromycin and azithromycin, macrolide antimicrobial agents used for treatment of respiratory infections, in lung epithelial lining fluid and alveolar macrophages

Biopharmaceutics and Drug Disposition — Thu, 30 Jun 2011 23:00:00 +0100

ABSTRACTThe distribution characteristics of clarithromycin (CAM) and azithromycin (AZM), macrolide antimicrobial agents, in lung epithelial lining fluid (ELF) and alveolar macrophages (AMs) were evaluated. In the in vivo animal experiments, the time‐courses of the concentrations of CAM and AZM in ELF and AMs following oral administration (50 mg/kg) to rats were markedly higher than those in plasma, and the area under the drug concentration–time curve (AUC) ratios of ELF/plasma of CAM and AZM were 12 and 2.2, and the AUC ratios of AMs/ELF were 37 and 291, respectively. In the in vitro transport experiments, the basolateral‐to‐apical transport of CAM and AZM through model lung epithelial cell (Calu‐3) monolayers were greater than the apical‐to‐basolateral transport. MDR1 subs...

Review of macrolides (azithromycin, clarithromycin), ketolids (telithromycin) and glycylcyclines (tigecycline).

The Medical Clinics of North America — Wed, 29 Jun 2011 14:45:45 +0100

Authors: Zuckerman JM, Qamar F, Bono BR The advanced macrolides, azithromycin and clarithromycin, and the ketolide, telithromycin, are structural analogs of erythromycin. They have several distinct advantages when compared with erythromycin, including enhanced spectrum of activity, more favorable pharmacokinetics and pharmacodynamics, once-daily administration, and improved tolerability. Clarithromycin and azithromycin are used extensively for the treatment of respiratory tract infections, sexually transmitted diseases, and Helicobacter pylori-associated peptic ulcer disease. Telithromycin is approved for the treatment of community-acquired pneumonia. Severe hepatotoxicity has been reported with the use of telithromycin. PMID: 21679791 [PubMed - in process] (Source: The Medical C...

In vitro activity of azithromycin against Mycoplasma genitalium and its efficacy in the treatment of male Mycoplasma genitalium-positive nongonococcal urethritis

Journal of Infection and Chemotherapy — Mon, 27 Jun 2011 17:48:26 +0100

Abstract Many recent studies have shown that Mycoplasma genitalium is among the pathogens responsible for Chlamydia trachomatis-negative nongonococcal urethritis (NGU). A single 1-g dose of azithromycin (AZM) has been recommended for the treatment of NGU, including M. genitalium-positive NGU, irrespective of whether it is positive or negative for Chlamydia trachomatis. The purpose of this study was to determine the minimal inhibitory concentrations of AZM against Mycoplasma genitalium strains, and to assess its clinical efficacy against Mycoplasma genitalium-positive NGU. Seven Mycoplasma genitalium strains were obtained from the American Type Culture Collection, and susceptibility testing of seven antimicrobial agents was performed using a broth microdilution method. Thirty...

Preemptive Therapy with Steroids but Not Macrolides Improves Gas Exchange in Caustic-Injured Donor Lungs1

Journal of Surgical Research — Sun, 26 Jun 2011 23:00:00 +0100

Conclusion: Preemptive treatment of donors with steroids but not macrolides improves gas exchange in a porcine lung injury model independently from its anti-inflammatory activity. (Source: Journal of Surgical Research)

Benefits of Helicobacter pylori cagE genotyping in addition to cagA genotyping: a Bulgarian study.

Antonie van Leeuwenhoek — Thu, 23 Jun 2011 23:00:00 +0100

In conclusion, use of a second primer pair for the cagA gene can be recommended in countries with common cagA (+) strains. Although both cag genes were linked to severe diseases in Bulgarian patients, the best discrimination of virulent strains was obtained by the cagA/cagE combination or by the cagE gene alone. cagE prevalence increased gradually with patient age, while the cagA (+)/cagE (-) genotype, implying a disrupted cag pathogenicity island, was associated with both younger age and female gender. PMID: 21701821 [PubMed - as supplied by publisher] (Source: Antonie van Leeuwenhoek)

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Practical use of GenoType® HelicoDR, a molecular test for Helicobacter pylori detection and susceptibility testing

Diagnostic Microbiology and Infectious Disease — Wed, 22 Jun 2011 23:00:00 +0100

Abstract: Compared to culture-based method, the sensitivity, specificity, positive, and negative predictive values of the GenoType® HelicoDR for detecting Helicobacter pylori resistance were, respectively, 100, 86.2, 89.7%, and 100% to clarithromycin as well as 82.6, 95.1, 90.5%, and 90.7% to fluoroquinolones. This molecular assay detected a mixture of genotypes and could successfully analyze biopsies without transport/storage limitations. (Source: Diagnostic Microbiology and Infectious Disease)

Effectiveness of Three‐Times Daily Lansoprazole/Amoxicillin Dual therapy for Helicobacter pylori Infection in Korea

British Journal of Clinical Pharmacology — Sun, 19 Jun 2011 23:00:00 +0100

Conclusions: Because dual therapy had fewer side effects than triple therapy and a similar eradication rate, the dual therapy may provide an acceptable alternative first line therapy for H. pylori in Korea. (Source: British Journal of Clinical Pharmacology)

Review of Macrolides (Azithromycin, Clarithromycin), Ketolids (Telithromycin) and Glycylcyclines (Tigecycline)

Medical Clinics of North America — Sat, 18 Jun 2011 23:49:04 +0100

The advanced macrolides, azithromycin and clarithromycin, and the ketolide, telithromycin, are structural analogs of erythromycin. They have several distinct advantages when compared with erythromycin, including enhanced spectrum of activity, more favorable pharmacokinetics and pharmacodynamics, once-daily administration, and improved tolerability. Clarithromycin and azithromycin are used extensively for the treatment of respiratory tract infections, sexually transmitted diseases, and Helicobacter pylori–associated peptic ulcer disease. Telithromycin is approved for the treatment of community-acquired pneumonia. Severe hepatotoxicity has been reported with the use of telithromycin. (Source: Medical Clinics of North America)

Sequential therapy in childhood helicobacter pylori eradication: emphasis on drug compliance

The Journal of Pediatrics — Fri, 17 Jun 2011 04:00:00 +0100

Francavilla et al reported that sequential therapy is better than standard triple therapy to eradicate Helicobacter pylori infection in children, especially to improve the control of clarithromycin-resistant strains. The consensus of North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and Maastricht III recommend 1-week proton pump inhibitor-based triple therapy as the standard first-line choice to achieve eradication rates in the range of 75% to 85% for pediatric H pylori infection. Nevertheless, the eradication rate of such first-line therapy has progressively decreased since the emergence of clarithromycin-resistant strains. In Taiwan, a high rate of H pylori isolates are clarithromycin-resistant. Accordingly, it is promising to apply a new strateg...

Resistance of Helicobacter pylori to quinolones and clarithromycin assessed by genetic testing in Japan

Journal of Gastroenterology and Hepatology — Wed, 15 Jun 2011 23:00:00 +0100

Conclusions: A high incidence of quinolone‐resistance was found in clarithromycin‐resistant strains of H. pylori, particularly in patients with previous eradication failure. Our results suggest that testing for susceptibility of H. pylori to quinolones is useful for determining the optimal rescue eradication regimen. (Source: Journal of Gastroenterology and Hepatology)

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BIAXIN (Clarithromycin) Tablet, Film Coated BIAXIN (Clarithromycin) Tablet, Film Coated, Extended Release BIAXIN (Clarithromycin) Granule, For Suspension [Abbott Laboratories]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 15 Jun 2011 05:00:00 +0100

Updated Date: Jun 15, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Clarithromycin and telithromycin increases interleukin-10 expression in the rat endometriosis model.

Cytokine — Thu, 09 Jun 2011 23:00:00 +0100

Authors: Umezawa M, Tanaka N, Takeda K, Ihara T, Sugamata M Endometriosis is a common gynecological disorder associated with infertility. However, treatment options remain limited at present. Since the pathogenesis involves immune responses, the immunomodulatory effect of macrolide on endometriosis has been the focus of much research. A previous study showed that clarithromycin decreased stromal proliferation and promoted apoptosis of fibroblasts in an endometriosis model in rats; however, the mechanism of the effect remains unknown. The aim of this study is to investigate the effect of clarithromycin, one of the major macrolides, and telithromycin, one of the antibiotics belonging to a macrolide group (ketolide), on IL6, IL10 and Ccl2 expression in a rat endometriosis model induced by...

GI Highlights from the literature

Gut — Sun, 05 Jun 2011 23:00:00 +0100

Further poly- to the pills for Helicobacter pylori eradication? Malfertheiner P, Bazzoli F, Delchier JC, et al. H pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial. Lancet 2011;377:905–13. H pylori is the main cause of peptic ulcer and gastric cancer worldwide. Eradication of the bacterium is therefore advocated in most patients found to be infected with it. Proton pump inhibitor-based triple therapy is the accepted first-line therapy, but their have been concerns about reduced efficacy in recent years. Bismuth-based quadruple therapy is reserved as second-line therapy, due to concerns regarding toler...

Does Long-Term Aspirin Use Have Any Effect On Helicobacter pylori Eradication?

The American Journal of the Medical Sciences — Wed, 01 Jun 2011 23:00:00 +0100

CONCLUSION:: These data suggest that H pylori eradication rate with standard triple eradication regimen is significantly higher among long-term aspirin users than in controls. PMID: 21642817 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

Efficacy of Levofloxacin and Rifaximin based Quadruple Therapy in Helicobacter pylori Associated Gastroduodenal Disease: A Double-Blind, Randomized Controlled Trial.

J Korean Med Sci — Tue, 31 May 2011 23:00:00 +0100

In conclusion, the levofloxacin and rifaximin based regimen comes up to the standard triple therapy, but has a limited efficacy in a Korean cohort. The rifaximin containing regimen has a very high safety profile for H. pylori eradication therapy. PMID: 21655065 [PubMed - in process] (Source: J Korean Med Sci)

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Persistence of CARDS Toxin-producing Mycoplasma pneumoniae in Refractory Asthma.

Chest — Wed, 25 May 2011 23:00:00 +0100

CONCLUSION: Subjects with RA may be chronically infected with Mp. PCR to CARDS Tx appears to be the most sensitive method to identify Mp infection. Despite the persistence of Mp in subjects with RA, some subjects failed to mount an IgG response, and macrolide therapy was insufficient to eradicate Mp. PMID: 21622549 [PubMed - as supplied by publisher] (Source: Chest)

High Helicobacter pylori Resistance to Metronidazole but Zero or Low Resistance to Clarithromycin, Levofloxacin, and Other Antibiotics in Malaysia

Helicobacter — Wed, 18 May 2011 17:55:20 +0100

Conclusions: Although there was high bacterial resistance to metronidazole, the absence of resistance particularly to the key antibiotics used in H. pylori eradication therapy: clarithromycin and levofloxacin is reassuring to note. Continued monitoring of antibiotic resistance should be carried out. (Source: Helicobacter)

Efficacy of 2‐Week, Second‐Line Helicobacter pylori Eradication Therapy Using Rabeprazole, Amoxicillin, and Metronidazole for the Japanese Population

Helicobacter — Wed, 18 May 2011 17:55:19 +0100

Conclusion: This 2‐week metronidazole‐containing second‐line therapy provides high efficacy in Japan where metronidazole resistance is rare. (Source: Helicobacter)

High Eradication Rates of Helicobacter pylori Infection Following Sequential Therapy: The Israeli Experience Treating Naïve Patients

Helicobacter — Wed, 18 May 2011 17:55:17 +0100

Conclusion: The sequential regimen attained significantly higher eradication rates in naïve patients than usually reported for conventional triple therapy. Sequential therapy may be an alternative first‐line therapy in eradicating H. pylori in Israel. (Source: Helicobacter)

A New Modified Concomitant Therapy for Helicobacter pylori Eradication in Turkey

Helicobacter — Wed, 18 May 2011 17:55:16 +0100

Conclusion: Although LAC plus tid metronidazole regimen achieved a much better eradication rate compared with the standard LAC regimen; this is the first study that has a relatively low success with a concomitant therapy. So in areas of high resistance like Turkey, one cannot expect a high success with any clarithromycin containing regimen and those should be avoided. (Source: Helicobacter)

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Clarithromycin: Serum sickness-like reaction: case report

Reactions — Wed, 18 May 2011 17:09:57 +0100

(Source: Reactions)

Stabilization Mechanism of Clarithromycin Tablets under Gastric pH Conditions.

Chemical and Pharmaceutical Bulletin — Sun, 15 May 2011 18:30:03 +0100

Authors: Fujiki S, Iwao Y, Kobayashi M, Miyagishima A, Itai S It has been reported that tablets of clarithromycin (CAM), a 14-membered macrolide antibiotic, are especially stable under low pH conditions such as in gastric fluid, and showed excellent antibacterial efficiency even though CAM molecules themselves are rapidly decomposed. Therefore, we aimed to clarify the stabilization mechanism of CAM tablets under low pH conditions. From the results of stability and dissolution tests, the optimal decomposition rate constant (K(dec)) and dissolution rate constant (K(dis)) at various pH values were calculated by curve-fitting to consecutive reactions. Consequently, log(K(dec)) increased as pH decreased. On the other hand, log(K(dis)) increased as pH decreased from 3.0 to 1.5, but decreased...

PNA-FISH as a new diagnostic method for the determination of clarithromycin resistance of Helicobacter pylori

BMC Microbiology - Latest articles — Fri, 13 May 2011 23:00:00 +0100

Conclusions: The optimized PNA-FISH based diagnostic method to detect H. pylori clarithromycin resistance shown to be a very sensitive and specific method for the detection of clarithromycin resistance in the H. pylori smears and also proved to be a reliable method for the diagnosis of this pathogen in clinical samples and an alternative to existing plating methods. (Source: BMC Microbiology - Latest articles)

Effect of the combination of clarithromycin and amikacin on Pseudomonas aeruginosa biofilm in an animal model of ureteral stent infection

Journal of Antimicrobial Chemotherapy — Tue, 10 May 2011 23:00:00 +0100

Conclusions The prevention of ureteral stent Pseudomonas biofilm infection was enhanced by impregnation of the stent with clarithromycin combined with systemic amikacin. (Source: Journal of Antimicrobial Chemotherapy)

Presumed immune‐mediated hemolytic anemia in two foals with Rhodococcus equi infection

Journal of Veterinary Emergency and Critical Care — Sun, 08 May 2011 23:00:00 +0100

AbstractObjective – To describe the clinical presentation, case management, and outcome in 2 foals with Rhodococcus equi infection associated with presumptive severe immune‐mediated hemolytic anemia.Series Summary – Two foals diagnosed with R. equi pneumonia on the basis of tracheal wash cultures, thoracic radiographs, and thoracic ultrasonography were concurrently diagnosed with hemolytic anemia. Both foals required whole blood transfusions, and were treated with the antimicrobial combination of rifampin and a macrolide (eg, clarithromycin, erythromycin, or azithromycin). Dexamethasone was used to prevent further hemolysis in both foals, and to treat acute lung injury/acute respiratory distress syndrome in 1 of the foals. Both foals survived, and required pro...

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Recurrent Fluctuant Mass of the Wrist and Forearm Associated with Chronic Tenosynovitis by Mycobacterium kansasii.

Orthopedics — Sat, 30 Apr 2011 23:00:00 +0100

This article presents a case of a painless fluctuant mass on the volar aspect of the wrist and forearm of an immunocompetent 45-year-old man with no history of significant underlying disease. This mass proved to be a chronic tenosynovitis associated with Mycobacterium kansasii infection. The patient, who had a history of multiple minor cuts and abrasions plus exposure to an aquatic environment, had a wide resection of the lesion and elective tenosynovectomy. Operative findings revealed a marked tenosynovitis of flexor tendons. Several rice bodies lesions were also observed along the course of the involved flexor tendons.Biopsy showed a granulomatous inflammatory reaction. Specimens of affected tissue were sent to a laboratory for solid (at 30°C and at 37°C) and liquid (at 37°C) mycobact...

Primary and secondary clarithromycin, metronidazole, amoxicillin and levofloxacin resistance to Helicobacter pylori in southern Poland.

Pharmacological Reports — Sat, 30 Apr 2011 23:00:00 +0100

Authors: Karczewska E, Wojtas-Bonior I, Sito E, Zwolińska-Wcisło M, Budak A Abstract The aim of this study was to assess the primary and secondary resistance of H. pylori strains cultured from adult patients of the Małopolska region of Poland, mainly of Kraków and the surrounding areas, to antibacterial agents (amoxicillin, clarithromycin, metronidazole and levofloxacin). In total, 115 H. pylori strains were isolated, of which 90 strains originated from patients who had never been treated for H. pylori infection, while the remaining 25 were isolated from patients in whom eradication of the infection failed after treatment. All tested H. pylori strains were susceptible to amoxicillin. Forty-four percent of strains isolated were resistant to metronidazole. The primary and seconda...

Significant Breakthroughs in Search for Anti-Infectious Agents Derived from Erythromycin A.

Current Medicinal Chemistry — Mon, 25 Apr 2011 23:00:00 +0100

Authors: Ma X, Ma S As a well-established class, macrolide antibiotics continue to enjoy a remarkable interest within pharmaceutical industry. Several stunning breakthroughs in semi-synthetic study of erythromycin A (EMA) contribute to the important role played by the macrolide class in search for new anti-infectious agents. Earlier structural modifications of EMA to address the issue of acid instability resulted in the first breakthrough in search for anti-infectious agents derived from EMA. Clarithromycin (CAM) and azithromycin (AZM) are two representative antibacterials commercialized during this period. Afterwards, continued research on the modifications of EMA to combat bacterial resistance culminated in the second breakthrough in this field. Telithromycin and cethromycin are two ...

[Regional Difference of Antibiotic Resistance of Helicobacter pylori Strains in Korea.]

Korean J Gastroenter... — Sun, 24 Apr 2011 23:00:00 +0100

Conclusions: There was no significant regional difference of the primary antibiotic resistance of H. pylori. However, the included patient number might not be enough for this conclusion demanding further evaluations. PMID: 21519175 [PubMed - as supplied by publisher] (Source: Korean J Gastroenter...)

Med Sci Monit 2011; 17(5):CR235-240 "Influence of pretreatment with H2 receptor antagonists on the cure rates of Helicobacter pylori eradication"

Medical Science Monitor — Sun, 24 Apr 2011 15:52:00 +0100

Conclusions: Pretreatment with H2RA had no significant influence on the efficacy of H. pylori eradication therapy. (Source: Medical Science Monitor)

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Inoculation of Mycobacteria chelonae from a tattoo

Journal of the American Academy of Dermatology — Fri, 15 Apr 2011 17:11:00 +0100

To the Editor: A healthy 41-year-old man presented with a 2-week history of a lower extremity rash within his 2-month-old gray tattoos (). He reported leg pain, myalgia, fatigue, and night sweats. A clinical examination revealed tender erythematous plaques and pustules confined to the tattoos with fever and lymphadenopathy. A white blood cell count was 1200 μL (normal, 3.28-9.29). He denied a similar reaction with previous tattoos. He denied a history of travel, drug use, or high-risk sexual activity. He responded poorly to a 2-week course of doxycycline. A skin biopsy specimen revealed a mixed granulomatous infiltrate with acute and chronic inflammation composed of histiocytes, lymphocytes, neutrophils, and giant cells (). Tissue culture grew Mycobacterium chelonae after 2 weeks. Chest r...

Lysostaphin and clarithromycin: a promising combination for the eradication of Staphylococcus aureus biofilms

International Journal of Antimicrobial Agents — Thu, 14 Apr 2011 23:00:00 +0100

The difficulty of treating biofilm-associated infections has inspired the study of new treatment targets as well as combinations of new substances and antimicrobials with different mechanisms of action. (Source: International Journal of Antimicrobial Agents)

Sequential therapy in clarithromycin‐sensitive and ‐resistant Helicobacter pylori based on polymerase chain reaction molecular test

Journal of Gastroenterology and Hepatology — Wed, 13 Apr 2011 17:03:36 +0100

Conclusion: Genotypic clarithromycin resistance was detected in only 11.3% of H. pylori infections in Thailand. Sequential therapy is highly effective in clarithromycin‐sensitive but is less effective in clarithromycin‐resistant H. pylori. PCR‐molecular test could be a useful tool to identify antimicrobial resistance for optimizing an eradication regimen. (Source: Journal of Gastroenterology and Hepatology)

Enhancement of Amoxicillin Resistance After Unsuccessful Helicobacter pylori Eradication.

Antimicrobial Agents and Chemotherapy — Mon, 11 Apr 2011 23:00:00 +0100

Authors: Nishizawa T, Suzuki H, Tsugawa H, Muraoka H, Matsuzaki J, Hirata K, Ikeda F, Takahashi M, Hibi T A high resistance rate (49.5-72.7%) to amoxicillin (AMX) was observed in Helicobacter pylori (H. pylori) after two or three unsuccessful eradication. Unsuccessful eradication regimens significantly increase resistance to not only clarithromycin (CLR) and metronidazole (MNZ) but also AMX. PMID: 21486961 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

PREVPAC (Lansoprazole, Amoxicillin And Clarithromycin) Kit [Physicians Total Care, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Mon, 11 Apr 2011 05:00:00 +0100

Updated Date: Apr 11, 2011 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Mycobacterium bolletii/Mycobacterium massiliense Furunculosis Associated With Pedicure Footbaths: A Report of 3 Cases [Observation]

Archives of Dermatology — Sun, 10 Apr 2011 23:00:00 +0100

Conclusions Clinicians should elicit a history of pedicure footbaths and maintain a high level of suspicion when faced with skin lesions of the lower extremities that are culture negative or are refractory to conventional antibiotic therapy. Accurate identification and discrimination of M massiliense and M bolletii is difficult and requires sequencing of multiple gene targets beyond their identical 16S rRNA sequences. (Source: Archives of Dermatology)

Effectiveness and safety of macrolides in cystic fibrosis patients: a meta-analysis and systematic review

Journal of Antimicrobial Chemotherapy — Sun, 10 Apr 2011 23:00:00 +0100

Conclusions Long-term use of azithromycin can improve lung function, especially for P. aeruginosa-colonized CF patients. There was no evidence of increased adverse events with azithromycin. More data are needed to verify the best azithromycin regimen and to evaluate other macrolides in CF patients. (Source: Journal of Antimicrobial Chemotherapy)

Drug-drug interaction studies with single-dose colchicine and P-gp/CYP P450 3A4 inhibitors

NeLM - News — Fri, 08 Apr 2011 23:00:00 +0100

In this report, researchers describe their attempt to improve the safety of colchicine dosing algorithms. They conducted seven separate drug-drug interaction (DDI) studies with single-dose colchicine to elucidate in vivo effects of concomitant colchicine and 7 known inhibitors of CYP3A4/P-gp on colchicine pharmacokinetics. . Cyclosporine . Ketoconazole . Ritonavir . Macrolide antibiotics (clarithromycin, azithromycin) . Calcium channel blockers (verapamil, diltiazem) All studies were open label, non-randomised, single-centre, one-sequence, two-period DDI experiments, using two 0.6-mg doses of colchicine, separated by a minimum 14-day wash-out, and followed by the approved dosing regimen of CYP3A4/P-gp inhibitor. Plasma colchicine concentration...

Serum sickness‐like reaction with clarithromycin

Journal of Hospital Medicine — Thu, 31 Mar 2011 23:00:00 +0100

We present a case of serum sickness‐like reaction to clarithromycin, a commonly prescribed drug for the treatment of respiratory tract infections. The patient had been taking this drug for 3 days when she experienced generalized body aches, rash, arthralgia, and shortness of breath, prompting presentation to the emergency department. Laboratory studies showed decreased C4 and total complement with a slightly elevated sedimentation rate. After exclusion of other possible causes, the diagnosis of serum sickness‐like reaction was made. The patient responded well to nonsteroidal antiinflammatory medication, antihistamines, and a short, tapering dose of steroids. To our knowledge, serum sickness‐like reaction to clarithromycin has never been reported previously. This case emphasizes the n...