Antibiotic prophylaxis approaches for urinary tract infections

Trained Immunity-Based Vaccine in B Cell Hematological Malignancies With Recurrent Infections: A New Therapeutic Approach

Infectious complications are a major cause of morbidity and mortality in B-cell hematological malignancies (HM). Prophylaxis for recurrent infections in HM patients with antibody deficiency consists of first-line antibiotics and when unsuccessful, gammaglobulin replacement therapy (IgRT). Recent knowledge of trained immunity-based vaccines (TIbV), such as the sublingual polybacterial formulation MV130, has shown a promising strategy in the management of patients with recurrent infections. We sought to determine the clinical benefit of MV130 in a cohort of HM patients with recurrent respiratory tract infections (RRTIs) who underwent immunization with MV130 for 3 months. Clinical information included the frequency of infections, antibiotic use, number of visits to the GP and hospitalizations previous and after MV130 immunotherapy. Improvement on infection rate was classified as: clear (>60% reduction of infection), partial (26%-60%) and low (≤25%) improvement. Fifteen HM patients (aged 42 to 80 years; nine females) were included in the study. All patients reduced their infection rate. Analysis of paired data revealed that the median (range, min - max) of respiratory infectious rate significantly decreased from 4.0 (8.0-3.0) to 2.0 (4.0-0.0) (p<0.001) at 12 months of MV130. A clear clinical improvement was observed in 53% (n = 8) of patients, partial improvement in 40% (n = 6) and low improvement in 7% (n = 1). These data correlated with a decrease on antibiotic consumption from 3.0 (8.0-1.0) to 1.0 (2.0-0.0) (p = 0.002) during 12 months after initiation of treatment with MV130. The number of infectious-related GP or emergency room visits declined from 4.0 (8.0-2.0) to 2.0 (3.0-0.0) (p<0.001), in parallel with a reduction in hospital admissions due to infections (p = 0.032). Regarding safety, no adverse events were observed. On the other hand, immunological assessment of serum IgA and IgG levels demonstrated an increase in specific antibodies to MV130-contained bacteria following MV130 immunotherapy. In conclusion, MV130 may add clinical benefit reducing the rate of infections and enhancing humoral immune responses in these vulnerable patients.

In Vitro Antioxidant and Bactericidal Efficacy of 15 Common Spices: Novel Therapeutics for Urinary Tract Infections?

Background and Objectives: Bacterial urinary tract infection (UTI) is the most common ailment affecting all age groups in males and females. The commercial antibiotics usage augments antibiotics resistance and creates higher recurrence rates of such communal infections. Hence, this study is aimed at investigating the antibacterial and antioxidant potentials of 15 common spices against 11 UTI-causing bacterial pathogens. Materials and Methods: The antioxidant potential of the methanolic extracts was analyzed as contents of total phenols and flavonoids; radical scavenging, total reducing power, the ferric reducing power assay. Urinary pathogens were subjected to spice extracts to investigate antibacterial assays. Results: Preliminary phytochemical study of spices was performed to find those containing alkaloids, flavonoids, phenolic compounds, and steroids that can be recognized for their noteworthy bactericidal effects. The outcome of the antioxidative potential from the four methods demonstrated the sequence of potent antioxidant activity: Acorus calamus >Alpinia galanga > Armoracia rusticana > Capparis spinosa > Aframomum melegueta. The total polyphenols and flavonoids in the studied species positively correlated with their antioxidant properties. The four most effective spices (A. calamus, A. galanga, A. rusticana, and C. spinosa) had a zone of inhibition of at least 22 mm. A. calamus, A. melegueta, and C. spinosa had the lowest minimum inhibitory concentration (MIC) value against Enterobacter aerogenes, Staphylococcus aureus and Proteus mirabilis. All 15 spices had the lowest minimum bactericidal concentration (MBC) value against most of the pathogenic bacteria. Conclusion: The four highly potent and unique spices noted for the in vitro control of UTI-causing pathogens could be pursued further in the development of complementary and alternative medicine against UTI-causing pathogens.