Ciprofloxacin

Initial hazard screening for genotoxicity of photo-transformation products of ciprofloxacin by applying a combination of experimental and in-silico testing

Ciprofloxacin (CIP) is a broad-spectrum antibiotic found within μg/L concentration range in the aquatic environment. It is a known contributor of umuC induction in hospital wastewater samples. CIP can undergo photolysis to result in many transformation products (TPs) of mostly unknown toxicity. The aims of this study were to determine the genotoxicity of the UV mixtures and to understand the possible genotoxic role of the stable TPs. As such, CIP and its UV-irradiated mixtures were investigated in a battery of genotoxicity and cytotoxicity in vitro assays. The combination index (CI) analysis of residual CIP in the irradiated mixtures was performed for the umu assay. Further, Quantitative Structure-Activity Relationships (QSARs) predicted selected genotoxicity endpoints of the identified TPs. CIP achieved primary elimination after 128 min of irradiation but was not completely mineralized. Nine photo-TPs were identified. The irradiated mixtures were neither mutagenic in the Ames test nor genotoxic in the in vitro micronucleus (MN) test. Like CIP, the irradiated mixtures were umuC inducing. The CI analysis revealed that the irradiated mixtures and the corresponding CIP concentration in the mixtures shared similar umuC potentials. QSAR predictions suggested that the TPs may be capable of inducing chromosome aberration, MN in vivo, bacterial mutation and mammalian mutation. However, the experimental testing for a few genotoxic endpoints did not show significant genotoxic activity for the TPs present as a component of the whole mixture analysis and therefore, further genotoxic endpoints may need to be investigated to fully confirm this.

Transformation products of antibiotic and cytostatic drugs in the aquatic cycle that result from effluent treatment and abiotic/biotic reactions in the environment: an increasing challenge calling for higher emphasis on measures at the beginning of the pipe

Pharmaceuticals may undergo transformation into new products during almost all possible processes along their life-cycle. This could either take place in the natural water environment and/or during water treatment processes. Numerous studies that address the issue of such transformation products (TPs) have been published, describing selected aspects of TPs in the environment and their formation within effluent and water treatment processes. In order to exemplify the number and quality of information published on TPs, we selected 21 active pharmaceutical ingredients from the groups of antibiotics and antineoplastics, and assessed the knowledge about their TPs that has been published until the end of May 2012. The goal of this work was to demonstrate, that the quality of data on pharmaceutical TPs greatly differs in terms of the availability of chemical structures for each TP, rather than to provide an exhaustive database of available TPs. The aim was to point out the challenge going along with so many TPs formed under different treatment and environmental conditions. An extensive review in the form of a table showing the existing data on 158 TPs for 15 compounds, out of 21 investigated, was presented. Numerous TPs are the result of different treatments and environmental processes. However, also numerous different TPs may be formed within only one type of treatment, applied under sometimes even very similar treatment conditions and treatments times. In general, the growing number of elucidated TPs is rationalized by ineffective removal treatments. Our results demonstrate a severe risk of drowning in much unrelated and non-assessable data, both from a scientific and from a technical treatment-related point of view. Therefore, limiting the input of pharmaceuticals into effluents as well as improving their (bio) degradability and elimination behavior, instead of only relying on advanced effluent treatments, is urgently needed. Solutions that focus on this "beginning of the pipe" approach should minimize the adverse effects of parent compounds by reducing and formation of TPs and their entrance into the natural environment.

Tipagem molecular e resistência aos antimicrobianos em isolados de Escherichia coli de frangos de corte e de tratadores na Região Metropolitana de Curitiba, Paraná

Este estudo verificou o perfil de resistência aos antimicrobianos entre isolados de Escherichia coli de frangos de corte de criação intensiva e de subsistência e dos respectivos tratadores e a similaridade genotípica entre isolados de E.coli de frangos de corte de criação intensiva e isolados de E. coli de tratadores de frangos de criação intensiva pela técnica de Eletroforese em Gel de Campo Pulsado (PFGE). 60 amostras de fezes de frangos de criação intensiva, 60 de frangos de corte de criação de subsistência (caipira) e 20 amostras dos tratadores de frangos de criação intensiva e 20 de tratadores de frangos de criação de subsistência. E. coli foram isoladas, identificadas e submetidas ao teste de suscetibilidade a 12 antimicrobianos. Pela PFGE foram analisados 24 isolados de E. coli de frangos de corte de criação intensiva e oito de tratadores. Em isolados E. coli de frangos de criação intensiva a resistência para a ampicilina foi de 100%, cefotaxima 43%, ceftriaxona 48%, ácido nalidíxico 62%, enrofloxacina 23%, ciprofloxacina 23%, tetraciclina 83% e 45% para trimetoprim-sulfametoxazol. Nos isolados de frangos de criação de subsistência foi de 20%, 0%, 0%, 5%, 2%, 4%, 33% e 8%, respectivamente. Resistência à fosfomicina e à nitrofurantoína foi encontrada em isolados de frangos de criação de subsistência. Em isolados de E. coli de tratadores de frangos de corte de criação intensiva a resistência para ampicilina foi de 60%, para ciprofloxacina 25% e para tetraciclina 45%, enquanto nos tratadores de subsistência foram de 20%, 5% e 30%, respectivamente. Isolados de E. coli de frangos em criação de subsistência apresentaram 46,6%(28/60) de suscetibilidade a todos os antimicrobianos testados enquanto que na criação intensiva 81%(49/60) foram multirresistentes. Sete clusters de isolados de E. coli de frangos de diferentes aviários apresentaram similaridade acima de 80%, e dois destes foram superiores a 95%. Três clusters de isolados de frangos e de tratadores apresentaram similaridade superior a 80%. Somente um destes clusters foi de isolado de tratador e de frango do mesmo aviário.

Poly[LA-(Glc-Leu)] copolymer as a carrier for ocular delivery of ciprofloxacin: formulation, characterization and in vivo biocompatibility study

Background: Ciprofloxacin hydrochloride-encapsulated poly[LA-(Glc-Leu)] copolymeric nanoparticles were prepared to provide sustained release and ameliorate shortcomings associated with eye drops. Methods: Poly[LA-(Glc-Leu)] copolymer was synthesized by ring opening copolymerization of l-lactide with a cyclodepsipetide. Ciprofloxacin hydrochloride-loaded polymeric nanoparticles were prepared by double emulsification-solvent evaporation technique with emphasis on optimization of different process and formulation variables. Results: Optimized formulation showed encapsulation efficiency of approximately 63.08 ± 5.88% and a positive zeta potential of +17.46 mV. Scanning electron microscope study revealed the spherical shape of the nanoparticles with a particle size 300–400 nm. In vitro drug-release studies showed sustained release for 24 h with biphasic release pattern. In vivo ocular tolerability study in rabbits demonstrated no signs of toxicity or irritation parallel to the results obtained with the marketed formulation. Conclusion: Poly[LA-(Glc-Leu)] copolymer can be used as an efficient carrier for nanoparticle preparation of ciprofloxacin.

Treatment of acute otitis externa with ciprofloxacin otic 0.2% antibiotic ear solution

Background/objective

An inflammation of the cutis and subcutis of the external auditory canal is a primary symptom in cases of acute otitis externa. It is usually treated locally, since this type of therapy ensures a high concentration of the drug and interacts at the site of inflammation with no systemic effects. This systematic review compares the efficacy of treatment using a ciprofloxacin 0.2% solution with other therapeutic options.

Methods

After compiling a catalog of search terms, medical databases were searched systematically for randomized, controlled studies. This search initially yielded a total of 38 studies which were then evaluated by three independent reviewers. The number of studies was subsequently reduced to 14: six studies using a ciprofloxacin 0.2% solution, and eight studies using both 0.2% and 0.3% solutions.

Results

The studies included in the review demonstrate the statistical equivalence between the ciprofloxacin solution (0.2%) and the reference products PNH (a combination of polymyxin B, neomycin sulfate and hydrocortisone), auriculum powder, and a ciprofloxacin foam with respect to the cure rate. The research groups consistently observed high in vitro activity of ciprofloxacin against Pseudomonas aeruginosa.

Conclusion

This systematic review confirms the hypothesis of ciprofloxacin’s noninferiority in the treatment of otitis externa, in terms of the cure rate and microbiological eradication.

Newer concepts in antimicrobial therapy

Antimicrobial agents continue to play a significant role in clinical practice not only due to their active role in the treatment of bacterially induced infections. The accompanying anti-inflammatory characteristics and their antagonism against superantigens add to their importance. The practitioner must also be aware of both overt and covert unwanted effects. During the past decade, the new quinolones, advanced macrolides, and better cephalosporins have been introduced. The staid penicillins have been up-graded with the addition of a beta-lactamase inhibitor. Many antibiotics have been available for several decades but new uses for them and their derivatives permit the dermatologist to have a more versatile armamentarium. Rifamycin has been shown to be effective in the treatment of leishmaniasis. The new macrolide, clarithromycin, will reduce the lesions of acne vulgaris and acne rosacea. Although phototoxicity was well recognised in the sulfonomides, several quinolones can create similar light-induced problems. Bullous diseases are known to be instigated by the penicillins, while vasculitis may be caused by a quinolone. Even porphyria has been reported to be induced by a tetracycline. Antimicrobial therapy has been an integral part of dermatologic practice since the introduction of the sulfa drugs six decades ago. Whether skin is affronted by more pathogenic bacteria than any other organ or whether the percentage of infectious etiologies is greater for cutaneous maladies than for other organ afflictions is not germane to this presentation. The facts remain that signs and symptoms of many dermatitides are diminished or even eliminated by antimicrobials [1, 2, 3, 4].