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Costa FMS, Granja A, Pérez RL, Warner IM, Reis S, Passos MLC, Saraiva MLMFS. Fluoroquinolone-Based Organic Salts (GUMBOS) with Antibacterial Potential. Int J Mol Sci 2023; 24:15714. [PMID: 37958698 PMCID: PMC10650486 DOI: 10.3390/ijms242115714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/25/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Antimicrobial resistance is a silent pandemic considered a public health concern worldwide. Strategic therapies are needed to replace antibacterials that are now ineffective. One approach entails the use of well-known antibacterials along with adjuvants that possess non-antibiotic properties but can extend the lifespan and enhance the effectiveness of the treatment, while also improving the suppression of resistance. In this regard, a group of uniform materials based on organic salts (GUMBOS) presents an alternative to this problem allowing the combination of antibacterials with adjuvants. Fluoroquinolones are a family of antibacterials used to treat respiratory and urinary tract infections with broad-spectrum activity. Ciprofloxacin and moxifloxacin-based GUMBOS were synthesized via anion exchange reactions with lithium and sodium salts. Structural characterization, thermal stability and octanol/water partition ratios were evaluated. The antibacterial profiles of most GUMBOS were comparable to their cationic counterparts when tested against Gram-positive S. aureus and Gram-negative E. coli, except for deoxycholate anion, which demonstrated the least effective antibacterial activity. Additionally, some GUMBOS were less cytotoxic to L929 fibroblast cells and non-hemolytic to red blood cells. Therefore, these agents exhibit promise as an alternative approach to combining drugs for treating infections caused by resistant bacteria.
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Affiliation(s)
- Fábio M. S. Costa
- LAQV, REQUIMTE, Laboratory of Applied Pharmacy, Department of Chemical Sciences, Faculty of Pharmacy, Porto University, Rua de Jorge Viterbo Ferreira, 4050-313 Porto, Portugal; (F.M.S.C.); (A.G.); (S.R.)
| | - Andreia Granja
- LAQV, REQUIMTE, Laboratory of Applied Pharmacy, Department of Chemical Sciences, Faculty of Pharmacy, Porto University, Rua de Jorge Viterbo Ferreira, 4050-313 Porto, Portugal; (F.M.S.C.); (A.G.); (S.R.)
| | - Rocío L. Pérez
- Department of Chemistry, Louisiana State University, Baton Rouge, LA 70803, USA; (R.L.P.); (I.M.W.)
- Department of Chemistry and Biochemistry, Georgia Southern University, Statesboro, GA 30458, USA
| | - Isiah M. Warner
- Department of Chemistry, Louisiana State University, Baton Rouge, LA 70803, USA; (R.L.P.); (I.M.W.)
- Department of Chemistry, Cincinnati University, Cincinnati, OH 45221, USA
| | - Salette Reis
- LAQV, REQUIMTE, Laboratory of Applied Pharmacy, Department of Chemical Sciences, Faculty of Pharmacy, Porto University, Rua de Jorge Viterbo Ferreira, 4050-313 Porto, Portugal; (F.M.S.C.); (A.G.); (S.R.)
| | - Marieta L. C. Passos
- LAQV, REQUIMTE, Laboratory of Applied Pharmacy, Department of Chemical Sciences, Faculty of Pharmacy, Porto University, Rua de Jorge Viterbo Ferreira, 4050-313 Porto, Portugal; (F.M.S.C.); (A.G.); (S.R.)
| | - M. Lúcia M. F. S. Saraiva
- LAQV, REQUIMTE, Laboratory of Applied Pharmacy, Department of Chemical Sciences, Faculty of Pharmacy, Porto University, Rua de Jorge Viterbo Ferreira, 4050-313 Porto, Portugal; (F.M.S.C.); (A.G.); (S.R.)
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Kambale-Kombi P, Marini Djang'eing'a R, Alworong'a Opara JP, Minon JM, Atoba Bokele C, Bours V, Azerad MA, Tonen-Wolyec S, Kayembe Tshilumba C, Batina-Agasa S. Does glucose-6-phosphate dehydrogenase deficiency worsen the clinical features of sickle cell disease? A multi-hospital-based cross-sectional study. Hematology 2022; 27:590-595. [PMID: 35617172 DOI: 10.1080/16078454.2022.2074715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The impact of glucose-6-phosphate dehydrogenase deficiency(G-6-PD) on the clinical course of sickle cell disease(SCD) is still controversial. The objectives of this study were to determine the prevalence of G-6-PD deficiency in patients with SCD and its effect on their clinical course. METHODS A cross-sectional study of 122 SCD patients and 211 healthy blood donors was conducted in Kisangani city. Data were collected through clinical examination supplemented by patient medical records, and laboratory tests based on a survey form. G-6-PD activity was measured by spectrophotometry and the screening for SCD by the HemoTypeSC® rapid test. Statistical analysis was done using SPSS ver. 20.0. RESULTS The prevalence of G-6-PD deficiency did not differ between SCD and non-SCD subjects, 35.2% vs. 33.6% respectively(p = .767). When comparing the hemoglobin level between SCD patients with and without G-6-PD deficiency, no significant difference was observed. However, in the 6 months prior to the study, SCD patients with G-6-PD deficiency had on average more transfusions than non-deficient SCD patients, 0.64 ± 0.897 vs. 0.24 ± 0.486(p = .004). Similarly, considering the clinical events of the last 12 months prior to the study, there were more hospitalizations, major vaso-occlusive crises and anemia requiring blood transfusion among G-6-PD deficient SCD patients compared to no-deficient, respectively 1.42 ± 1.451vs. 0.76 ± 1.112(p = .007); 1.37 ± 1.092 vs. 0.85 ± 1.014(p = .005); 0.74 ± 0.902 vs. 0.38 ± 0.739 (p = .007). CONCLUSION The prevalence of G-6-PD deficiency in SCD patients was high but did not differ from that observed in controls. In addition, G-6-PD deficiency appeared to worsen the clinical features of SCD. Nevertheless, prospective studies further clarifying this observation are needed.
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Affiliation(s)
- Paul Kambale-Kombi
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Roland Marini Djang'eing'a
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo.,Department of Pharmaceutical Sciences, Laboratory of Analytical Chemistry, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Jean-Pierre Alworong'a Opara
- Department of Pediatrics, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Jean-Marc Minon
- Department of Laboratory Medicine, Transfusion and Thrombosis-Haemostasis Unit, Centre Hospitalier Régional de la Citadelle, Liège, Belgium
| | - Camille Atoba Bokele
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Vincent Bours
- Department of Human Genetics, CHU of Liège, University of Liège, Liège, Belgium
| | - Marie-Agnès Azerad
- Department of Haematology, CHU of Liège at Site CHR Citadelle, Liège, Belgium
| | - Serge Tonen-Wolyec
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Charles Kayembe Tshilumba
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Salomon Batina-Agasa
- Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
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Parikh M, Shah M, Hirapara J, Soni S, Vaishnav B, Ghosh L. Ofloxacin Induced Hemolysis in G6PD-deficient Patient: A Rare Cause of Pigment Nephropathy. Indian J Nephrol 2021; 31:410-413. [PMID: 34584362 PMCID: PMC8443095 DOI: 10.4103/ijn.ijn_138_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/23/2020] [Accepted: 08/29/2020] [Indexed: 11/04/2022] Open
Abstract
Thrombotic microangiopathy (TMA) commonly presents as a triad of acute kidney injury (AKI), jaundice, and hemolysis; however, tropical infections such as malaria, dengue, leptospira, and drugs like antimalarials can also have a similar presentation. They can cause AKI for many reasons including pre-renal causes but an important yet not relatively uncommon genetic cause of hemolytic anemia, that is, glucose 6-phosphate deficiency (G6PD) manifesting as jaundice, hemolysis, and AKI secondary to pigment nephropathy after receiving offending drugs needs to be worked up while evaluating such patients. Ofloxacin is not usually included in the lists of unsafe drugs in G6PD deficiency. Herein, we report a patient developing intravascular hemolysis secondary to G6PD deficiency associated with ofloxacin administration presenting as a rare cause for pigment nephropathy.
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Affiliation(s)
- Mital Parikh
- Consultant Nephrologist, Department of Medicine, Shree Krishna Hospital, Karamsad, India
| | - Maulin Shah
- Consultant Nephrologist, Department of Medicine, Shree Krishna Hospital, Karamsad, India
| | - Jekishan Hirapara
- Resident in Medicine, Department of Medicine, Shree Krishna Hospital, Karamsad, India
| | - Shailesh Soni
- Consultant Pathologist, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India
| | - Bhalendu Vaishnav
- Professor and Head, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India
| | - Labani Ghosh
- Assistant Professor, Department of Medicine, Shree Krishna Hospital, Karamsad, India
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Bancone G, Chu CS. G6PD Variants and Haemolytic Sensitivity to Primaquine and Other Drugs. Front Pharmacol 2021; 12:638885. [PMID: 33790795 PMCID: PMC8005603 DOI: 10.3389/fphar.2021.638885] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/01/2021] [Indexed: 02/04/2023] Open
Abstract
Restrictions on the cultivation and ingestion of fava beans were first reported as early as the fifth century BC. Not until the late 19th century were clinical descriptions of fava-induced disease reported and soon after characterised as “favism” in the early 20th century. It is now well known that favism as well as drug-induced haemolysis is caused by a deficiency of the glucose-6-phosphate dehydrogenase (G6PD) enzyme, one of the most common enzyme deficiency in humans. Interest about the interaction between G6PD deficiency and therapeutics has increased recently because mass treatment with oxidative 8-aminoquinolines is necessary for malaria elimination. Historically, assessments of haemolytic risk have focused on the clinical outcomes (e.g., haemolysis) associated with either a simplified phenotypic G6PD characterisation (deficient or normal) or an ill-fitting classification of G6PD genetic variants. It is increasingly apparent that detailed knowledge of both aspects is required for a complete understanding of haemolytic risk. While more attention has been devoted recently to better phenotypic characterisation of G6PD activity (including the development of new point-of care tests), the classification of G6PD variants should be revised to be clinically useful in malaria eliminating countries and in populations with prevalent G6PD deficiency. The scope of this work is to summarize available literature on drug-induced haemolysis among individuals with different G6PD variants and to highlight knowledge gaps that could be filled with further clinical and laboratory research.
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Affiliation(s)
- Germana Bancone
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Cindy S Chu
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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CYP2C9, CYP2D6, G6PD, GCLC, GSTM1 and NAT2 gene polymorphisms and risk of adverse reactions to sulfamethoxazole and ciprofloxacin in San Luis Potosí, Mexico. Meta Gene 2019. [DOI: 10.1016/j.mgene.2019.100574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Mukherjee I, Ghosh A, Bhadury P, De P. Matrix assisted antibacterial activity of polymer conjugates with pendant antibiotics, and bioactive and biopassive moieties. J Mater Chem B 2019. [DOI: 10.1039/c9tb00328b] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We report the comparative antibacterial activity of a polymer–antibiotic conjugate with coupled bioactive (cationic) and biopassive (zwitterionic) functionalities against several biofilm and nonbiofilm forming bacterial species in both liquid and solid matrices.
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Affiliation(s)
| | - Anwesha Ghosh
- Integrative Taxonomy and Microbial Ecology Research Group
- Department of Biological Sciences
- India
| | - Punyasloke Bhadury
- Integrative Taxonomy and Microbial Ecology Research Group
- Department of Biological Sciences
- India
- Centre for Advanced Functional Materials
- Indian Institute of Science Education and Research Kolkata
| | - Priyadarsi De
- Polymer Research Centre
- Department of Chemical Sciences
- India
- Centre for Advanced Functional Materials
- Indian Institute of Science Education and Research Kolkata
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Sanna M, Caocci G, Orrù F, Ledda A, Vacca A, Piras E, Fozza C, Deias P, Tidore G, Dore F, La Nasa G. Safe fluoroquinolones prophylaxis in blood cancer patients with chemotherapy-induced neutropenia and Glucose-6-Phosphate-Dehydrogenase deficiency. J Clin Pharm Ther 2017; 42:733-737. [DOI: 10.1111/jcpt.12571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/09/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Sanna
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - G. Caocci
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - F. Orrù
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - A. Ledda
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - A. Vacca
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - E. Piras
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - C. Fozza
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari Italy
| | - P. Deias
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
| | - G. Tidore
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari Italy
| | - F. Dore
- Department of Clinical and Experimental Medicine; University of Sassari; Sassari Italy
| | - G. La Nasa
- Hematology Unit; Department of Medical Sciences and Public Health; Bone Marrow Transplant Center; R. Binaghi Hospital; University of Cagliari; Cagliari Italy
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Kheng S, Muth S, Taylor WRJ, Tops N, Kosal K, Sothea K, Souy P, Kim S, Char CM, Vanna C, Ly P, Ringwald P, Khieu V, Kerleguer A, Tor P, Baird JK, Bjorge S, Menard D, Christophel E. Tolerability and safety of weekly primaquine against relapse of Plasmodium vivax in Cambodians with glucose-6-phosphate dehydrogenase deficiency. BMC Med 2015; 13:203. [PMID: 26303162 PMCID: PMC4549079 DOI: 10.1186/s12916-015-0441-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 07/29/2015] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Primaquine is used to prevent Plasmodium vivax relapse; however, it is not implemented in many malaria-endemic countries, including Cambodia, for fear of precipitating primaquine-induced acute haemolytic anaemia in patients with glucose-6-phosphate dehydrogenase deficiency (G6PDd). Reluctance to use primaquine is reinforced by a lack of quality safety data. This study was conducted to assess the tolerability of a primaquine regimen in Cambodian severely deficient G6PD variants to ascertain whether a weekly primaquine could be given without testing for G6PDd. METHODS From January 2013 to January 2014, Cambodians with acute vivax malaria were treated with dihydroartemisinin/piperaquine on days (D) 0, 1 and 2 with weekly doses of primaquine 0.75 mg/kg for 8 weeks (starting on D0, last dose on D49), and followed until D56. Participants' G6PD status was confirmed by G6PD genotype and measured G6PD activity. The primary outcome was treatment completion without primaquine toxicity defined as any one of: (1) severe anaemia (haemoglobin [Hb] <7 g/dL), (2) a >25 % fractional fall in Hb from D0, (3) the need for a blood transfusion, (4) haemoglobinuria, (5) acute kidney injury (an increase in baseline serum creatinine >50 %) or (6) methaemoglobinaemia >20 %. RESULTS We enrolled 75 patients with a median age of 24 years (range 5-63); 63 patients (84 %) were male. Eighteen patients were G6PDd (17/18 had the Viangchan variant) and had D0 G6PD activity ranging from 0.1 to 1.5 U/g Hb (median 0.85 U/g Hb). In the 57 patients with normal G6PD (G6PDn), D0 G6PD activity ranged from 6.9 to 18.5 U/g Hb (median 12 U/g Hb). Median D0 Hb concentrations were similar (P = 0.46) between G6PDd (13 g/dL, range 9.6-16) and G6PDn (13.5 g/dL, range 9-16.3) and reached a nadir on D2 in both groups: 10.8 g/dL (8.2-15.3) versus 12.4 g/dL (8.8-15.2) (P = 0.006), respectively. By D7, five G6PDd patients (27.7 %) had a >25 % fall in Hb, compared to 0 G6PDn patients (P = 0.00049). One of these G6PDd patients required a blood transfusion (D0-D5 Hb, 10.0-7.2 g/dL). No patients developed severe anaemia, haemoglobinuria, a methaemoglobin concentration >4.9 %, or acute kidney injury. CONCLUSIONS Vivax-infected G6PDd Cambodian patients demonstrated significant, mostly transient, falls in Hb and one received a blood transfusion. Weekly primaquine in G6PDd patients mandates medical supervision and pre-treatment screening for G6PD status. The feasibility of implementing a package of G6PDd testing and supervised primaquine should be explored. TRIAL REGISTRATION The trial was registered on 3/1/2013 and the registration number is ACTRN12613000003774.
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Affiliation(s)
- Sim Kheng
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
| | - Sinoun Muth
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
| | - Walter R J Taylor
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
- Service de Médecine Tropicale et Humanitaire, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
- Mahidol Oxford Tropical Medicine Research Unit, 420/60 Rajvithi Road, Bangkok, 10400, Thailand.
| | - Narann Tops
- WHO Cambodia Country Office, Pasteur Street, Phnom Penh, Cambodia.
| | - Khem Kosal
- Pailin Referral Hospital, Pailin, Cambodia.
| | | | - Phum Souy
- Anlong Veng Referral Hospital, Anlong Venh, Oddar Meanchey, Cambodia.
| | - Saorin Kim
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia.
| | - Chuor Meng Char
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
| | - Chan Vanna
- Pramoy Health Centre, Veal Veng, Pursat, Cambodia.
| | - Po Ly
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
| | | | - Virak Khieu
- National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia.
| | | | - Pety Tor
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia.
| | - John K Baird
- Eijkman Oxford Clinical Research Unit, Jakarta, Indonesia.
- Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Steven Bjorge
- WHO Cambodia Country Office, Pasteur Street, Phnom Penh, Cambodia.
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Luzzatto L, Seneca E. G6PD deficiency: a classic example of pharmacogenetics with on-going clinical implications. Br J Haematol 2014; 164:469-80. [PMID: 24372186 PMCID: PMC4153881 DOI: 10.1111/bjh.12665] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
That primaquine and other drugs can trigger acute haemolytic anaemia in subjects who have an inherited mutation of the glucose 6-phosphate dehydrogenase (G6PD) gene has been known for over half a century: however, these events still occur, because when giving the drug either the G6PD status of a person is not known, or the risk of this potentially life-threatening complication is under-estimated. Here we review briefly the genetic basis of G6PD deficiency, and then the pathophysiology and the clinical features of drug-induced haemolysis; we also update the list of potentially haemolytic drugs (which includes rasburicase). It is now clear that it is not good practice to give one of these drugs before testing a person for his/her G6PD status, especially in populations in whom G6PD deficiency is common. We discuss therefore how G6PD testing can be done reconciling safety with cost; this is once again becoming of public health importance, as more countries are moving along the pathway of malaria elimination, that might require mass administration of primaquine. Finally, we sketch the triangular relationship between malaria, antimalarials such as primaquine, and G6PD deficiency: which is to some extent protective against malaria, but also a genetically determined hazard when taking primaquine.
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Affiliation(s)
- Lucio Luzzatto
- Istituto Toscano Tumori and Department of Haematology, University of FlorenceFirenze, Italy
| | - Elisa Seneca
- Department of Haematology, University of Naples Federico IINapoli, Italy
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Harthan AA, Heger ML. Stenotrophomonas infection in a patient with glucose-6-phosphate dehydrogenase deficiency. J Pediatr Pharmacol Ther 2013; 18:137-41. [PMID: 23798908 DOI: 10.5863/1551-6776-18.2.137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The drug of choice for treatment of Stenotrophomonas maltophilia is sulfamethoxazole/trimethoprim, and second-line therapy usually consists of a fluoroquinolone. However, in patients with glucose-6-phosphate dehydrogenase deficiency, neither sulfamethoxazole/trimethoprim nor a fluoroquinolone is a preferred option as it may result in hemolysis. Currently, there is a paucity of data regarding treatment of S maltophilia infection in these patients. This case report presents a patient who was successfully treated with doxycycline and inhaled colistimethate.
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Affiliation(s)
- Aaron A Harthan
- Department of Pharmacy, Children's Hospital of Illinois, Peoria, Illinois
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