Comparative in-vitro activity of erythromycin, vancomycin and pristinamycin

Preparation and evaluation in vitro and in vivo of pristinamycin enteric-coated granules based on albumin nanoparticles

CONTEXT

The purpose of this study was to prepare enteric-coated particles based on albumin nanoparticles (NPs) using a mixture of PI_A albumin NPs freeze-dried powder (PA-PI_A) and PII_A albumin NPs freeze-dried powder (PA-PII_A) to improve the bioavailability effect of pristinamycin.

OBJECTIVE

This is the first study on the preparation of pristinamycin into enteric-coated granules based on albumin NPs, and our study has effectively improved the bioavailability of pristinamycin and ensured its safety.

METHODS

Pristinamycin albumin enteric-coated granules (PAEGs) were prepared by hybrid wet granulation. The characterizations of albumin NPs were performed by in vitro and in vivo studies of PAEGs. The assays were analyzed using zeta-sizer, transmission electron microscopy, high-performance liquid chromatography, and a fully automated biochemical index analyzer.

RESULTS

The morphology of NPs was close to spherical. PI_A-NPs and PII_A-NPs respectively had a zeta potential of (-24.33 ± 0.75) mV and (+7.30 ± 0.27) mV and mean size of (251.91 ± 19.64) nm and (232.83 ± 22.61) nm. The release of PI_A and PII_A from PAEGs in the artificial gastrointestinal fluid was as high as 58.46% and 87.79%. In the experimental group of oral PAEGs, PI_A and PII_A were AUC_(0-t) (3.68 ± 0.58) mg·L^-1·h^-1 and (2.81 ± 1.06) mg·L^-1·h^-1. The results of aspartate aminotransferase and alanine aminotransferase biochemical indices showed that there was no significant difference between the experimental and normal groups of oral PAEGs.

CONCLUSION

The PAEGs significantly increased the release of PI_A and PII_A in simulated intestinal fluid and improved the bioavailability. The oral administration of PAEGs may not damage the liver of rats. We hope that our study will promote its industrial development or clinical application.

Oral pristinamycin for the treatment of resistant Gram-positive infections in patients with cancer: Evaluation of clinical outcomes

Pristinamycin has been used to treat a range of Gram-positive infections, but reported experience in patients with malignancy is limited. This study aimed to evaluate the use of pristinamycin in patients with cancer at an Australian centre. All patients commenced on oral pristinamycin therapy at the Peter MacCallum Cancer Centre between January 2005 and December 2014 were identified using the hospital pharmacy dispensing system. Information on demographics, co-morbidities, cancer diagnosis, infection characteristics, pristinamycin regimen, pristinamycin tolerability and outcomes was collected. The median duration of follow-up was 398 days. In total, 26 patients received pristinamycin, with median age of 61 years and a male predominance (65%). Underlying diagnoses were haematological malignancies (50%) and solid tumours (50%). Pathogens included 13 meticillin-resistant Staphylococcus aureus, 6 vancomycin-resistant Enterococcus faecium, 4 meticillin-resistant Staphylococcus epidermidis, 2 meticillin-susceptible S. aureus and 1 vancomycin-susceptible E. faecium. Infection sites were osteomyelitis (6), skin and soft-tissue (4), intra-abdominal/pelvic abscess (4), bloodstream (3), empyema (3), endocarditis/endovascular (3), prosthesis-related infection (2) and epididymo-orchitis (1). One patient ceased pristinamycin due to nausea. Regarding outcome, 13 patients (50%) were cured of infection, 8 (31%) had suppression and 5 (19%) had relapse. Relapses included 1 endovascular infection, 2 episodes of osteomyelitis, 1 pelvic abscess and 1 skin and soft-tissue infection. Overall, 81% of patients achieved cure or suppression of antibiotic-resistant or complex Gram-positive infections, consistent with published experience in non-cancer populations. A favourable tolerability profile makes oral pristinamycin a viable treatment option, particularly in settings where outpatient management of cancer is the objective.

Use of pristinamycin for infections by gram-positive bacteria: clinical experience at an Australian hospital

Thirty-six patients were treated with pristinamycin for 46 different microbiological isolates between April 2007 and July 2009. Pathogens included 9 methicillin-resistant Staphylococcus aureus isolates, 13 methicillin-resistant coagulase negative staphylococci, and 9 vancomycin-resistant enterococci. Sites of infections included 12 osteomyelitis cases, 10 prosthetic joints, 4 other prostheses, and 1 epidural abscess. Five patients ceased treatment due to side effects. Ten patients were cured of their infections, and 21 patients had infections successfully suppressed.

Nonsense mutations in the lsa-like gene in Enterococcus faecalis isolates susceptible to lincosamides and Streptogramins A

The lsa gene confers intrinsic resistance to lincosamides and streptogramins A in Enterococcus faecalis, probably by active efflux. The lsa-like genes of two clinical isolates of E. faecalis susceptible to lincosamides and dalfopristin contained mutations that produced premature termination codons. Revertant mutants were obtained by selection on agar plates containing clindamycin.

In vitro activity of RP 74501-RP 74502, a novel streptogramin antimicrobial mixture, against clinical isolates of Legionella species

Agar and broth microdilution MICs of RP 74501-RP 74502, a mixture of streptogramin antimicrobial agents that inhibited 90% of 22 Legionella strains tested, were 0.64 and 0.08 microgram/ml, respectively; respective erythromycin values were 1.0 and 0.12 microgram/ml. RP 74501-RP 74502 at 1 microgram/ml was more active than the same erythromycin concentration in a macrophage system for both L. pneumophila strains studied but at a lower concentration (0.25 microgram/ml) was much less active than erythromycin.