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Yuan R, Wen J, Xing Q, Chao L, Hu C, Ren J, Meng F. Efficacy of pretreatment with remimazolam on prevention of propofol-induced injection pain in patients undergoing gastroscopy. Sci Rep 2023; 13:19683. [PMID: 37951978 PMCID: PMC10640606 DOI: 10.1038/s41598-023-47151-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023] Open
Abstract
To evaluate the efficacy of remimazolam pretreatment in preventing propofol-induced injection pain (PIP) in patients undergoing gastroscopy. One hundred and forty patients (ASA I-II, aged 18-65 years, BMI 18-28 kg/m2) who were to undergo gastroscopy were randomized into either a saline group (group S) or a remimazolam group (group R) (n = 70 for each) on a computer-generated random number basis. The patients in group S received normal saline (0.1 ml/kg) and those in group R were administered remimazolam (0.1 mg/kg) via intravenous infusion for 60 s. 30 s after the injection of normal saline or remimazolam, patients received intravenously propofol (0.5 ml/s) until loss of consciousness. A different anesthesiologist who was unaware of the pretreatment was responsible for maintaining the outcome. The primary endpoint of our study was the incidence of PIP, which was measured using a 4-point scale. Secondary endpoints include the intensity of PIP, vital signs, characteristics of surgery and recovery, and adverse events. The incidence of PIP was significantly lower in group R than in group S (13 vs 51%, p < 0.001), and a lower percentage of patients presented with moderate PIP (3 vs 20%, p < 0.001). Moreover, lower consumption of propofol, shorter recovery time, and greater patient satisfaction were observed in group R than in group S. Pretreatment with remimazolam can effectively reduce the incidence and intensity of PIP in gastroscopy and shorten the recovery time without severe adverse effects.Clinical Trials Registration: Trial Registration: Chinese Clinical Trial Registry (identifier: ChiCTR2200063793). Registry time: 16/09/2022. Registry name: Efficacy of Pre-Treatment with Remimazolam on Prevention of Propofol-Induced Injection Pain in Patients Undergoing Gastroscopy. The date of patient enrollment began from 2022-9-17 to 2022-10-10. The link to the registration: https://www.chictr.org.cn/showproj.html?proj=176004 .
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Affiliation(s)
- Ruimei Yuan
- Department of Anesthesiology, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jing Wen
- Department of Urology, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, No.105 JieFang Road, Jinan, 250013, Shandong, China
| | - Qingfei Xing
- Department of Urology, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, No.105 JieFang Road, Jinan, 250013, Shandong, China
| | - Lei Chao
- Department of Anesthesiology, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chunhai Hu
- Department of Urology, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, No.105 JieFang Road, Jinan, 250013, Shandong, China.
| | - Jie Ren
- Department of Anesthesiology, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Fanjun Meng
- Department of Anesthesiology, Jinan Central Hospital, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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2
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Faustova M, Nazarchuk O, Dmytriiev D, Babina Y, Nazarchuk H, Dudar A. The effect of local anesthetics against planktonic forms and film formation of S. aureus strains and its dependence on antiseptics activity. Front Microbiol 2023; 14:1199899. [PMID: 37720142 PMCID: PMC10499629 DOI: 10.3389/fmicb.2023.1199899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
Today surgical site infections (SSIs) remain the second among hospital acquired infections in Europe and the USA. Staphylococcus aureus as a pathogen of nosocomial infections occur more frequently in surgical hospitals. The work was aimed to establish the effect of local anesthetics against planktonic forms and biofilm-formation of S. aureus clinical strains and the relationship between the sensitivity of S. aureus strains to local anesthetics and antiseptics in vitro. The antimicrobial activity of local anesthetics (0.5%, bupivacaine, 2.0% lidocaine, 0.375% ropivacaine) and antiseptics (decamethoxine 0.02%, chlorhexidine 0.05%) against clinical strains of S. aureus was observed and studied their ability to produce biofilms. The antimicrobial effect of local anesthetics was lower compared to antiseptics, but we observed inhibition of growth and reproduction of S. aureus in their presence. The ropivacaine solution and the lidocaine solution demonstrated almost the same activity against the studied microorganism isolates. Along with this, bupivacaine solution had the highest activity against the studied microorganisms. The minimal inhibitory concentration of bupivacaine for S. aureus was 2.2 times lower than the minimal inhibitory concentration of lidocaine and 2.1 times lower than the minimal inhibitory concentration of ropivacaine significantly (p < 0.05). Scientific research on various aspects of the formation of bacterial biofilms is a relevant area that will change approaches to the prophylaxis and treatment of a number of infections, including SSIs.
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Affiliation(s)
- Mariia Faustova
- Department of Microbiology, Virology and Immunology, Poltava State Medical University, Poltava, Ukraine
| | - Oleksandr Nazarchuk
- Department of Microbiology, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Dmytro Dmytriiev
- Department of Anaesthesiology and Intensive Care, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Yuliana Babina
- Department of Microbiology, Virology and Immunology, Poltava State Medical University, Poltava, Ukraine
| | - Halyna Nazarchuk
- Department of Ophthalmology, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Alina Dudar
- Department of Microbiology, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
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3
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Cervicovaginal microbiota isolated from healthy women exhibit probiotic properties and antimicrobial activity against pathogens isolated from cervical cancer patients. Arch Microbiol 2022; 204:491. [PMID: 35840844 DOI: 10.1007/s00203-022-03103-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/04/2022] [Accepted: 06/27/2022] [Indexed: 01/10/2023]
Abstract
Abnormal cervicovaginal microbiota play an important role in HPV persistence and progression to cervical cancer. The present study aimed at isolating and identifying potential probiotics from vaginal swabs of healthy women and evaluating their activity against vaginal pathogens isolated from cervical cancer patients. Based on probiotic, acid-bile tolerance and antimicrobial properties, 13 lactic acid bacteria (LAB) from the healthy group were identified by MALDI TOF MS (Matrix Assisted Laser Desorption and Ionisation, Time Of Flight Mass Spectrometry). Among these, four strains, Lactobacillus gasseri P36Mops, Limosilactobacillus fermentum P37Mws, Lactobacillus delbrueckii P31Mcs and Enterococcus faecium P26Mcm, exhibited significant antimicrobial activity against 8 vaginal pathogens (Staphylococcus haemolyticus P41Tcs, Escherichia coli P30Tcs, E. coli P79Bcm, Enterococus faecalis P29Mops, E. faecalis P50Tws, E. faecalis P68Tcb, S. haemolyticus P48Bcb and S. haemolyticus P58Bcb) isolated from precancerous and cervical cancer patients. 16S rRNA sequencing of four potential probiotics revealed congruency with the MALDI-TOF MS identification and phylogenetic analysis showed genetic relationship with previously reported LAB strains. The selected LAB showed strain specific hydrophobicity (35.88-56.70%), auto-aggregation (35.26-61.39%) and antibiotic susceptibility. Interestingly, L. gasseri P36Mops was resistant to five standard antibiotics routinely used against urogenital or vaginal infections. LCMS (Liquid Chromatography Mass Spectrometry) analyses of the CFS (cell-free supernatant) of the four potential probiotics revealed the presence of metabolites such as N-(1-deoxy-1-fructosyl)valine, hygroline, acetoxy-2-hydroxy-16-heptadecen-4-one, avocadyne 4-acetate, avocadyne 2-acetate, taraxinic acid glucosyl ester, 6-hydroxypentadecanedioic acid, with reported antimicrobial activity. The overall data suggest the bio-therapeutic potential of the identified vaginal probiotics against cervical cancer-associated pathogens.
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4
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Leal ALAB, Bezerra CF, Confortin C, da Silva LE, Marinho EM, Marinho MM, Vasconcelos MA, da Silva TG, Marinho ES, Teixeira AMR, Coutinho HDM, Barreto HM, Dos Santos HS. Chemical composition and potentiating action of Norfloxacin mediated by the essential oil of Piper caldense C.D.C. against Staphylococcus aureus strains overexpressing efflux pump genes. Arch Microbiol 2021; 203:4727-4736. [PMID: 34052872 PMCID: PMC8164493 DOI: 10.1007/s00203-021-02393-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 02/08/2023]
Abstract
Infectious diseases caused by multidrug-resistant microorganisms has increased in the last years. Piper species have been reported as a natural source of phytochemicals that can help in combating fungal and bacterial infections. This study had as objectives characterize the chemical composition of the essential oil from Piper caldense (EOPC), evaluate its potential antimicrobial activity, and investigate the synergistic effect with Norfloxacin against multidrug-resistant S. aureus overproducing efflux pumps, as well as, verify the EOPC ability to inhibit the Candida albicans filamentation. EOPC was extracted by hydrodistillation, and the chemical constituents were identified by gas chromatography, allowing the identification of 24 compounds (91.9%) classified as hydrocarbon sesquiterpenes (49.6%) and oxygenated sesquiterpenes (39.5%). Antimicrobial tests were performed using a 96-well plate microdilution method against C. albicans ATCC 10231, Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 25923 standard strains, as well as against multidrug-resistant strains S. aureus SA1199B (overexpressing norA gene), S. aureus K2068 (overexpressing mepA gene) and S. aureus K4100 (overexpressing qacC gene). The oil showed activity against C. albicans ATCC 10231 (≥ 512 µg/mL) and was able to inhibit hyphae formation, an important mechanism of virulence of C. albicans. On the other hand, EOPC was inactive against all bacterial strains tested (≤ 1,024 µg mL). However, when combined with Norfloxacin at subinhibitory concentration EOPC reduced the Norfloxacin and Ethidium bromide MIC values against S. aureus strains SA1199B, K2068 and K4100. These results indicate that EOPC is a source of phytochemicals acting as NorA, MepA and QacC inhibitors.
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Affiliation(s)
- Antonio Linkoln Alves Borges Leal
- Department of Biological Chemistry, Regional University of Cariri, Crato, CE, Brazil
- Department of Microbiology and Parasitolog, Federal University of Piaui, Teresina, PI, Brazil
| | - Camila Fonseca Bezerra
- Department of Pharmaceutical Sciences, Federal University of Pernambuco, Recife, PE, Brazil
| | - Camila Confortin
- Postgraduate Programme in Sustainable Territorial, Federal University of Paraná, Curitiba, PR, Brazil
| | - Luiz Everson da Silva
- Postgraduate Programme in Sustainable Territorial, Federal University of Paraná, Curitiba, PR, Brazil
| | - Emanuelle Machado Marinho
- Department of Analytical Chemistry and Physical Chemistry, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Márcia Machado Marinho
- Faculty of Education, Science and Letters of Iguatu, State University of Ceará, Iguatu, CE, Brazil
| | | | - Terezinha Gonçalves da Silva
- Department of Antibiotics, Drug Planning and Synthesis Laboratory-LPSF, Federal University of Pernambuco, Cidade Universitária, Recife, PE, Brazil
| | - Emmanuel Silva Marinho
- Group of Theoretical Chemistry and Electrochemistry, State University of Ceará, Campus FAFIDAM, Limoeiro do Norte, Fortaleza, CE, Brazil
| | | | | | | | - Hélcio Silva Dos Santos
- Department of Biological Chemistry, Regional University of Cariri, Crato, CE, Brazil.
- Center for Exact Sciences and Technology, Vale do Acarau State University, Sobral, CE, Brazil.
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Av Sá LGD, Silva CRD, de A Neto JB, Cândido TM, de Oliveira LC, do Nascimento FB, Barroso FD, da Silva LJ, de Mesquita JR, de Moraes MO, Cavalcanti BC, Júnior HV. Etomidate inhibits the growth of MRSA and exhibits synergism with oxacillin. Future Microbiol 2020; 15:1611-1619. [PMID: 33215536 DOI: 10.2217/fmb-2020-0078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Aim: The purpose of this study was to evaluate the antimicrobial activity of the anesthetic etomidate against strains of MRSA and biofilms. Materials & methods: The antibacterial effect of etomidate was assessed by the broth microdilution method. To investigate the probable action mechanism of the compound flow cytometry techniques were used. Results: MRSA strains showed MIC equal to 500 and 1000 μg/ml of etomidate. Four-fifths (80%) of the tested MRSA strains demonstrated synergistic effect with oxacillin. Etomidate also showed activity against MRSA biofilm at concentration of 250 μg/ml. Cytometric analysis revealed that the cells treated with etomidate leading to cell death, probably by apoptosis. Conclusion: Etomidate showed antibacterial activity against MRSA.
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Affiliation(s)
- Lívia G do Av Sá
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Cecília R da Silva
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - João B de A Neto
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil.,University Center Christus, Fortaleza, CE, Brazil
| | - Thiago M Cândido
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Leilson C de Oliveira
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Francisca Bsa do Nascimento
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Fátima Dd Barroso
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Lisandra J da Silva
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Manoel O de Moraes
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Bruno C Cavalcanti
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Hélio Vn Júnior
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE, Brazil.,Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE, Brazil
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6
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do AV Sá LG, da Silva CR, S Campos RD, de A Neto JB, Sampaio LS, do Nascimento FBSA, Barroso FDD, da Silva LJ, Queiroz HA, Cândido TM, Rodrigues DS, Leitão AC, de Moraes MO, Cavalcanti BC, Júnior HVN. Synergistic anticandidal activity of etomidate and azoles against clinical fluconazole-resistant Candida isolates. Future Microbiol 2019; 14:1477-1488. [DOI: 10.2217/fmb-2019-0075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: The purpose of this study was to evaluate the effect of etomidate alone and in combination with azoles on resistant strains of Candida spp. in both planktonic cells and biofilms. Materials & methods: The antifungal activity of etomidate was assessed by the broth microdilution test; flow cytometric procedures to measure fungal viability, mitochondrial transmembrane potential, free radical generation and cell death; as well detection of DNA damage using the comet assay. The interaction between etomidate and antifungal drugs (itraconazole and fluconazole) was evaluated by the checkerboard assay. Results: Etomidate showed antifungal activity against resistant strains of Candida spp. in planktonic cells and biofilms. Etomidate also presented synergism with fluconazole and itraconazole in planktonic cells and biofilms. Conclusion: Etomidate showed antifungal activity against Candida spp., indicating that it is a possible therapeutic alternative.
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Affiliation(s)
- Lívia G do AV Sá
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Cecília R da Silva
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Rosana de S Campos
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
- University Center Christus, Fortaleza, CE 60160-230, Brazil
| | - João B de A Neto
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
- University Center Christus, Fortaleza, CE 60160-230, Brazil
| | - Letícia S Sampaio
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Francisca BSA do Nascimento
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Fátima DD Barroso
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Lisandra J da Silva
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Helaine A Queiroz
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Thiago M Cândido
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
- University Center Christus, Fortaleza, CE 60160-230, Brazil
| | - Daniel S Rodrigues
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Amanda C Leitão
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Manoel O de Moraes
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Bruno C Cavalcanti
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
| | - Hélio VN Júnior
- Department of Clinical & Toxicological Analysis, School of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, CE 60430-1160, Brazil
- Drug Research & Development Center, Federal University of Ceará, Fortaleza, CE 60430-276, Brazil
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7
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Kesici U, Demirci M, Kesici S. Antimicrobial effects of local anaesthetics. Int Wound J 2019; 16:1029-1033. [PMID: 31148374 DOI: 10.1111/iwj.13153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/11/2019] [Accepted: 05/12/2019] [Indexed: 12/26/2022] Open
Abstract
After the introduction of cocaine to the medical practice, local anaesthetics (LA) became essential in pain control. LA infiltration along the incision may be used to provide surgical anaesthesia or postoperative analgesia. This study aimed to compare the antimicrobial effects of the topical antimicrobial agent mupirocine with those of the LA lidocaine and the combination of lidocaine and adrenalin. In our study, the in vitro antimicrobial effects of 1 mL sterile saline, 20 mg/mL mupirocine, 20 mg/mL Lidocaine, and 20 mg/mL Lidocaine and Adrenaline were tested against Staphylococcus aureus American type culture collection (ATCC) 29213, Pseudomonas aeruginosa ATCC 27853, and Escherichia coli ATCC 25922 as Group C (Control), Group M (Mupirocine), Group L (Lidocaine), and Group LA (Lidocaine + adrenaline), respectively. S aureus ATCC 29213, P aeruginosa ATCC 27853, and E coli ATCC 25922 were cultured onto Mueller-Hinton agar (Oxoid, UK) plates for 18 to 24 hours at 37°C. Colonies from these plates were suspended in sterile saline and a 0.5 McFarland turbidity standard suspension (corresponding to 1.5 × 108 CFU/mL) of each isolate was prepared. S Aureus ATCC 29213 inhibition zone diameter values of Group M, Group LA, and Group L were significantly higher compared with the group C (P ˂ 0.05). P aeruginosa ATCC 27853 inhibition zone diameter values of Group M and Group LA were significantly higher compared with the group C (P ˂ 0.05). E coli ATCC 25922 inhibition zone diameter values of Group M, Group LA, and Group L were significantly higher compared to the group C (P ˂ 0.05). LA infiltration along the incision may be used to provide surgical anaesthesia or postoperative analgesia. Considering that LAs show antimicrobial effects besides their analgesic effects, they may contribute to preventing the development and reducing the rate of surgical infections, decreasing the requirement to administer antibiotics. However, caution should be exercised not to antagonise the effective treatment of surgical infections, remembering that controversy on the antimicrobial effects of LAs remains in the literature. Therefore, further comprehensive studies with larger patient populations are warranted to demonstrate the antimicrobial effects of LAs.
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Affiliation(s)
- Ugur Kesici
- Faculty of Medicine, Department of General Surgery, University of Beykent, Istanbul, Turkey
| | - Mehmet Demirci
- Faculty of Medicine, Department of Microbiology, University of Beykent, Istanbul, Turkey
| | - Sevgi Kesici
- Department of Anesthesiology and Reanimation, Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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