We studied the basic and clinical effects of norfloxacin (NFLX) in 120 patients with gonococcal infections (110 men with urethritis and 10 women with cervicitis)--all residents at Sapporo City; and epidemiologically analyzed the sources of their infections. The male patients were between 16 and 67 years old and the female patients were between 20 and 61 years old, with a peak in the early 20s both for sexes. 70.6% of the male patients in their 10s were infected from their girl friends or so-called pick-up friends and 50% of the female patients from their husbands. The other half of the female were workers serving at so-called special massage parlors. The minimum inhibitory concentration (MIC) of NFLX against N. gonorrhoeae distributed was 0.0125 approximately 3.13 micrograms/ml, with a peak at 0.025 micrograms/ml. NFLX inhibited 93.3% of the clinical strains of this species at less than 0.1 microgram/ml and 96.2% at less than 1 microgram/ml, where the inoculation was 10(6) CFU/ml. Twenty one (20.2%) of the 104 N. gonorrhoeae strains were penicillinase-producing one (PPNG). NFLX inhibited 18 of these PPNG (85.7%) at less than 0.1 microgram/ml and the other 3 strains at 1.56 approximately 3.13 micrograms/ml. Oral administration of 200 mg NFLX showed the average peak serum level of 0.72 micrograms/microliter in 2 hours and the average peak level in the urethral secretions of 0.5 micrograms/ml in one hour. These two concentrations of NFLX covered 95.2% of the MIC distribution against N. gonorrhoeae. The clinical efficacy of 600 mg NFLX (peros) was 97.4 and 93.1% for a 3-and 7-day treatment for male urethritis; and 100% for both 3-and 7-day treatment for female cervicitis. Complicated urethritis with C. trachomatis was noticed in 32.7% of the male urethritis and in 20% of the female cervicitis cases. Urethral secretions among about half of these patients were observed even after treatment with NFLX. As a subsequent treatment, another effective chemotherapeutic is required against C. trachomatis. No adverse reactions were detected with NFLX. All the above results demonstrate that NFLX is a highly effective and safe chemotherapeutic agent for treatment of gonorrhoea.
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Uncomplicated lower urinary tract infection (LUTI) is one of the most common infections treated in general practice. Although nationwide treatment guidelines for LUTI are increasingly available, most European countries, including Slovenia, have not yet set such guidelines.
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A total 72 drinking water sample were collected and analyzed by membrane filtration method during 1 year study from various points in Khairpur City. Out of these 58 (80.55%) samples were found to be contaminated with thermo-tolerant Escherichia coli 2. The susceptibility of these isolates to 35 antibiotics was studied by disc diffusion method and the organism was highly sensitive to levoflaxin, cefipime, enoxobid, noroxin, tarivid, ciproxin, avelox, amikacin, kanamycin, rocifin, pipenedic acid and slightly sensitive to cravit, naladixic acid, neomycin, cefizox, fortum cefotaxime, cefizox, fortum, tobramycin and cefoperoxone. The resistance against 16 antibiotics such as meropenem, linkomycin, fusidic acid, orbenin, penicillin, streptomycin, bacitracin, minocin, zinacef, amoxil, ceclor, claracid, cephalexin, augmentin, cephradin and dalacin was shown by these isolates. We report the presence of multi-drug resistance in thermo-tolerant Escherichia coli isolated in municipal water with different levels of prevalence in Khairpur City. In this study a higher number of positive results were obtained in all sampling points indicating the more fecally polluted municipal water.
A retrospective analysis was done over a period of 3 years (January 2010- December 2012) in a tertiary care hospital, Pune, to note the changes in the prevalence and distribution of biotypes, serotypes, antibiotic susceptibility pattern and phage types of Vibrio cholerae isolates from clinical samples so as to be vigilant and curtail major outbreak in future. Vibrio cholerae isolates were obtained from 4.4% of the 1126 fecal specimens processed from cases of acute watery diarrhea. Majority of the isolates were identified as V. cholerae O1 biotype El Tor serotype Ogawa (98%); Phage 27 was the predominant type (77.5%). Majority of the cases were encountered during the months June-August (68%). Antibiogram over a period of 3 years showed that isolates were consistently resistant to Ampicillin (90%) and Furazolidone (88%). Low level of resistance was seen with Norfloxacin (8%), Gentamicin (8%) and Tetracycline (6%). All isolates were susceptible to Chloramphenicol.
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The acid-base equilibria of several diprotic amphoteric drugs, namely, niflumic acid, norfloxacin, piroxicam, pyridoxine and 2-methyl-4-oxo-3H-quinazoline-3-acetic acid have been characterized in terms of microconstants and tautomeric ratios. A multiwavelength spectrophotometric (WApH) titration method for determination of acid dissociation constants (pKa values) of ionizable compounds developed previously was applied for this purpose. Microspeciation was investigated by three approaches: (1) selective monitoring of ionizable group by spectrophotometry, (2) deductive method and (3) k(z) method for determination of tautomeric ratio from co-solvent mixtures. The formulation for (3) has been derived and found to invoke fewer assumptions than a reported procedure (K. Takács-Novák, A. Avdeef, K.J Box, B. Podányi, G. Szász, J. Pharm. Biomed. Anal., 12 (1994) 1369-1377). It has been shown that the WApH technique, for such types of ampholytes, is able to deduce the microconstants and tautomeric ratios which are in good agreement with literature data.
A mass screening of 600 diabetic revealed 240 (190 female and 50 male) with urinary infections. The comparative antibiotic efficacy (elimination) and tolerability of Cinoxacin and Norfloxacin were assessed in the treatment of these patients. The traditional protocol (2 daily doses for 10-20 days) was supplemented in every case by chronic prophylaxis (a single daily dose for 10 days each month for 6 months) that was designed to prevent recurrences and the development of chronic urinary infections. Cinoxacin was always found to be faster acting in antibacterial terms than Norfloxacin (at 10 days x2 = p less than 0.01; at 2 degrees, 4 degrees, and 6 degrees month x2 = p less than 0.05) providing a more complete and faster remission of the subjective symptoms, as well as being considerably better tolerated a both locally and systematically than Norfloxacin.
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Ion mobility spectrometry-mass spectrometry (IMS-MS) offers an opportunity to combine measurements and/or calculations of the collision cross-sections and subsequent mass spectra with computational modelling in order to derive the three-dimensional structure of ions. IMS-MS has previously been reported to separate two components for the compound norfloxacin, explained by protonation on two different sites, enabling the separation of protonated isomers (protomers) using ion mobility with distinguishable tandem mass spectrometric (MS/MS) data. This study reveals further insights into the specific example of norfloxacin and wider implications for ion mobility mass spectrometry.
The MIC of azithromycin to all 135 isolates ranged from 0.078 to 0.25 microgram/ml with the agar dilution method and from 0.016 to 0.50 microgram/ml with the E-test. The MIC50 and MIC90 of azithromycin were 0.064 microgram/ml and 0.125 microgram/ml, respectively, by the agar dilution method, whereas they are slightly higher by the E-test method. Seventy-six of the isolates were beta-lactamase producers and 69 were high-level tetracycline-resistant N. gonorrhoeae. There was no difference in the MIC50 and MIC90 of azithromycin in these groups of isolates. The percentage agreement within the acceptable +/-1 log2 dilution difference between MICs obtained by E-test and those obtained by the agar dilution method was 97.8%.
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OBJECTIVE: To evaluate the potential spectrum of activity of two novel dual-action compounds with carboxamido bonds (CQ-397 and CQ-414; Laboratorios Aranda, San Rafael, Mexico) against human pathogens. METHODS: Approximately 800 Gram-positive and Gram-negative aerobic clinical bacteria were tested in vitro using the Mueller-Hinton broth microdilution method of the National Committee of Clinical Laboratory Standards. RESULTS: CQ-397 (cefamandole+enrofloxacin) and CQ-414 (cefamandole+norfloxacin) were equally potent against Enterobacteriaceae (MIC90 range, 0.06--0.5 microg/mL and 0.06--1 microg/mL, respectively). Citrobacter freundii (MIC90, 4 microg/mL) and Providencia spp. (MIC90, >32 microg/mL) exhibited elevated study drug MICs. Enterobacteriaceae resistant to fluoroquinolones generally remained resistant. CQ-397 and CQ-414 were active against Stenotrophomonas maltophilia (MIC90, 4 microg/mL) and oxacillin-susceptible staphylococci (MIC90, 0.25 microg/mL), but not oxacillin-resistant Staphylococcus aureus (MIC90, >32 microg/mL), Staphylococcus epidermidis (MIC90, 8 microg/mL), and enterococci (MIC90s, 8 to >32 microg/mL). There was no difference in the dual-action drug activity (MIC90, 2 microg/mL) between penicillin-susceptible and -resistant pneumococci. Haemophilus influenzae and Moraxella catarrhalis were very susceptible (MIC range, less-than-or-equal0.015--0.06 microg/mL) to both compounds. CONCLUSIONS: The activity of these novel dual-action compounds, formed from the bonding of older antimicrobials, warrants further investigation for potential human and/or animal health use, including toxicology and pharmacokinetics.
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Clostridium difficile has been shown to be a nosocomial pathogen associated with diarrhoea and pseudomembranous colitis in hospitalised patients and the infection is believed to be acquired nosocomially. Community-acquired C. difficile-associated diarrhoea has also been reported. Recent studies have shown the occurrence of C. difficile in food animals which may act as a source of infection to humans. The aim of this study was to determine the occurrence of C. difficile in broiler chickens sold at market places in an urban area in Zimbabwe. Faeces of broiler chickens were collected from the cages at the market places and soils were collected from areas around the market places. The chicken faeces and soil samples were cultured for C. difficile. The C. difficile isolates were tested for toxins A or B production as well as for their susceptibility to antimicrobial drugs. C. difficile was isolated from 29.0% of 100 chicken faeces samples and 22.0% of 100 soil samples. Some of the C. difficile isolates from chickens (89.7%) and soils (95.5%) were toxigenic. All the isolates were susceptible to metronidazole, vancomycin, doxycycline, chloramphenicol and tetracycline. Over 70% of the isolates were susceptible to erythromycin, co-trimoxazole and ampicillin. They were all resistant to cefotaxime, gentamicin, ciprofloxacin, norfloxacin and nalidixic acid. The results of the present study suggest that broiler chickens sold at market places in the urban area are an important source of C. difficile, which may infect humans through consumption of chicken meat.
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The concentration of norfloxacin in serum and urine was measured in five healthy volunteers and eleven patients with renal impairment following a 400 mg oral dose of norfloxacin. In impaired renal function the elimination rate of norfloxacin is decreased considerably whereupon the area under the curve (AUC) rises rapidly. The urinary concentration of norfloxacin decreases with renal function but therapeutic levels are still obtained for sensitive organisms. Patients with a glomerular filtration rate of less than 30 ml/min require dosage reduction and we would recommend a reduction to half the usual dosage.
A total of 817 blood cultures from patients, comprising 469 and 348 males and females respectively. There were no records of the underlying clinical conditions of the patients.
An open, prospective, randomized study was performed to investigate the effect of norfloxacin prophylaxis on stricture formation and operative outcome after transurethral resection of the prostate. After resection, the 359 patients studied were randomly divided into 2 groups: 1) those given norfloxacin as prophylaxis for 15 days following removal of the catheter (norfloxacin group) and 2) those given no antimicrobial prophylaxis during the same period (control group). Of the patients 94 were excluded. At followup 6 to 12 months postoperatively, the number of strictures in the anterior urethra was 2 of 135 in the norfloxacin group and 22 of 130 in the control group (p < 0.01). Strictures in the bladder neck developed in 3 of 135 and 4 of 130 patients, respectively (not significant). As a consequence of a lower structure incidence in the anterior urethra in the norfloxacin group, fewer patients in that group were dissatisfied with the operative outcome. The results suggest that norfloxacin provides effective prophylaxis against stricture formation after transurethral resection of the prostate.
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To compare CCFA (cycloserine, cefoxitin fructose agar) with a new selective medium CDMN (containing cysteine hydrochloride, norfloxacin, and moxalactam) for the isolation of Clostridium difficile after direct faecal culture.
The purpose of the present study was to detect bacterial strains and antibiotic susceptibility in chronic tonsillitis patients with IgA nephropathy (IgAN) and without nephritis, in order to provide evidence for clinical therapy and pathogenesis of IgAN.
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Millions of assays are performed each year to monitor for substance abuse in various settings. When common medications cross-react with frequently used testing assays, false-positive results can lead to invalid conclusions.
Translocation of intestinal bacteria to ascitic fluid is, probably, the first step in the development of spontaneous bacterial peritonitis in patients with cirrhosis. Proteins of the complement system are soluble mediators implicated in the host immune response to bacterial infections and its activation has been traditionally considered to be an endotoxin-induced phenomenon. The aim of this study was to compare the modulation of these proteins in response to the presence of bacterial DNA and/or endotoxin in patients with advanced cirrhosis and ascites in different clinical conditions. Groups I and II consisted of patients without/with bacterial DNA. Group III included patients with spontaneous bacterial peritonitis and Group IV with patients receiving norfloxacin as secondary long-term prophylaxis of spontaneous bacterial peritonitis. Serum and ascitic fluid levels of endotoxin and truncated residues of the complement system were measured by ELISA. The complement system is triggered in response to bacterial DNA, as evidenced by significantly increased levels of C3b, membrane attack complex, and C5a in patients from Groups II and III compared with patients without bacterial DNA (Group I) and those receiving norfloxacin (Group IV). Gram classification did not further differentiate the immune response between patients within groups II and III, even though endotoxin levels were, as expected, significantly higher in patients with bacterial DNA from gram-negative microorganisms. The complement protein activation observed in patients with bacterial DNA in blood and ascitic fluid is indistinguishable from that observed in patients with spontaneous bacterial peritonitis and may occur in an endotoxin-independent manner.
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To determine the fundamental photochemical properties of new quinolones that can induce photosensitivity, the in vitro phototoxicity of these drugs (enoxacin, norfloxacin, ofloxacin, ciprofloxacin, and lomefloxacin) was examined with respect to photosensitizing ability to peroxidize unsaturated lipid squalene in ethanol solution. Lomefloxacin and ciprofloxacin showed the highest efficiency in sensitization of peroxidation of the lipid. Moderate repression of peroxidation occurred by addition of sodium azide (a quencher of singlet molecular oxygen), suggesting that the nonsinglet oxygen mechanism is operative in addition to the singlet oxygen mechanism.
A sample preparation method was developed for determination of quinolones in honey using immunoaffinity resin. For this purpose, an immunoaffinity resin for quinolones was prepared by coupling a quinolone-specific monoclonal antibody to agarose resin. Honey samples diluted with phosphate buffer were reacted with immunoaffinity resin. After the resin was washed, quinolones were eluted with glycine-HCl. Quinolones in the eluate were determined by HPLC with fluorescence detection. No interfering peak was found on the chromatograms of honey samples. The recoveries of quinolones from samples were over 70% at fortification levels of 20 ng/g (for norfloxacin, ciprofloxacin and enrofloxacin) and 10 ng/g (for danofloxacin). The quantification limits of quinolones were 2 ng/g. This sample preprocessing method using immunoaffinity resin was found to be effective and suitable for determining residual quinolones in honey.
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A prospective epidemiological study of the spectrum of causative agents (CA) of uncomplicated urinary tract infections (UTI) in adult patients and CA resistance to antimicrobial drugs was conducted in nine cities of the Russian Federation in 2004-2005. Minimum inhibiting concentrations were ascertained by dilution in agar according to NCCLS (2000-2002) recommendations. The study has found that uncomplicated UTI are most frequently caused by E.coli (73.9%). Other CA occur much less frequently: K.pneumoniae--6.4%, E. faecalis--4.4%, S. epidermidis--4.1%, Staphylococcus spp--3.4%, others--2% patients. E. coli demonstrated high resistance to ampicilline (33.1%), co-trimoxasol (19.4%). Most active against E. coli were fluoroquinolones (norfloxacin, ciprofloxacin, levofloxacine), the resistance being 4.8%; cefalosporins of the second and third generation (cefuroxim, ceftibuten), nitrofurantoin, no resistant strains were found.