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Roy N, Oleru O, Amakiri U, Stratis C, Kwon D, Wang A, Akhavan A, Henderson PW. Outcomes After Implant-Based Breast Reconstruction Following the National Institution of a Ban on Bacitracin Irrigation. Ann Plast Surg 2024; 92:S191-S195. [PMID: 38319958 PMCID: PMC10984754 DOI: 10.1097/sap.0000000000003794] [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] [Indexed: 02/08/2024]
Abstract
BACKGROUND The use of irrigation with bacitracin-containing solution is common among surgeons, as it was widely thought to have antibacterial properties and prevent postoperative infection. Current literature, however, suggests that antibiotic-containing irrigation confers little added benefit. On January 31, 2020, the Food and Drug Administration instituted a ban on bacitracin-containing irrigation for operative use. This study aimed to determine whether bacitracin has a beneficial effect on postoperative infection rates by analyzing infection rates before and after the Food and Drug Administration ban on bacitracin irrigation. METHODS A single-institution retrospective chart review was conducted. Eligible patients underwent implant-based breast reconstruction after mastectomy from October 1, 2016, to July 31, 2022. Procedure date, reconstruction type, patient comorbidities, use of bacitracin irrigation, postoperative infection, and secondary outcomes were collected. Univariate and multivariable logistic regression analyses were performed. RESULTS A total of 188 female patients were included in the study. Bacitracin use did not protect against infection in univariate or multivariable analysis. Age greater than 50 years was associated with an increased risk of postoperative infection ( P = 0.0366). The presence of comorbidities, smoker status, neoadjuvant therapy treatment before surgery, implant placement, and laterality were all not significantly associated with postoperative infection development. CONCLUSIONS The results of this study demonstrate a lack of association between bacitracin use and postoperative infection. Additional research into the optimal antibiotic for perioperative irrigation is needed, as bacitracin is not encouraged for use.
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Affiliation(s)
- Nikita Roy
- Department of Surgery, Icahn School of Medicine at Mount Sinai
| | - Olachi Oleru
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - Daniel Kwon
- Department of Surgery, Icahn School of Medicine at Mount Sinai
| | - Anya Wang
- Department of Surgery, Icahn School of Medicine at Mount Sinai
| | - Arya Akhavan
- Department of Surgery, Icahn School of Medicine at Mount Sinai
| | - Peter W. Henderson
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
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So JY, Suzuki N, Chen JK, Pugliese S, Kwong BY, Meng L, Honari G. Association of Intraoperative Antibiotic Irrigation With Systemic Contact Dermatitis. JAMA Dermatol 2023; 159:106-109. [PMID: 36383358 PMCID: PMC9669923 DOI: 10.1001/jamadermatol.2022.4458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022]
Abstract
This case series describes the development of morbilliform drug eruption after breast surgery.
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Affiliation(s)
- Jodi Y. So
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Nathalie Suzuki
- Dermatologic Clinic, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
| | - Jennifer K. Chen
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Silvina Pugliese
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Bernice Y. Kwong
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
| | - Lina Meng
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California
| | - Golara Honari
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California
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Khattak RZ, Nawaz A, Alnuwaiser MA, Latif MS, Rashid SA, Khan AA, Alamoudi SA. Formulation, In Vitro Characterization and Antibacterial Activity of Chitosan-Decorated Cream Containing Bacitracin for Topical Delivery. Antibiotics (Basel) 2022; 11:antibiotics11091151. [PMID: 36139931 PMCID: PMC9495230 DOI: 10.3390/antibiotics11091151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Bacitracin is a broad spectrum antibiotic that is used against various microorganisms. Chitosan is a natural polymer that has been widely investigated as an antimicrobial agent for preventing and treating infections owing to its intrinsic antimicrobial properties, as well as its ability to effectively deliver extrinsic antimicrobial compounds to infected areas. Topical drug delivery offers important benefits for improving the therapeutic effect and reducing systemic side effects of administered compounds/drugs. The topical use of chitosan-decorated bacitracin-loaded cream improves the permeation of the drug across the skin and enhances the drug bioavailability by prolonging the residence time of the drug when applied topically, as well as producing synergistic effects and reducing the side effects of the drug. Topical chitosan-decorated cream can be a promising approach to administer the drug more efficiently and enhance the efficacy of treatment in wound healing and antibacterial activity. (2) Methods: This study was conducted to prepare, assess and investigate the synergistic antibacterial activity of a chitosan-coated bacitracin cream. The results were compared to the antibacterial activity of simple bacitracin-loaded cream. The prepared cream was evaluated for various in vitro characteristics such as rheology, pH, viscosity, drug content and antibacterial activity studies. (3) Result: The formulations were found to be stable regarding color, liquefaction and phase separation at all accelerated conditions. It was observed that with time, substantial variations in the pH of the preparations were found. The introduction of chitosan results in controlled release of the drug from the formulations. The antibacterial activity of the formulated creams was assessed with the disc diffusion method against Staphylococcus aureus(ATCC),Escherichiacoli (STCC),Pseudomonas aeruginosa(ATCC) and Bacillus cereus(ATCC). The strains, E. coli, S. aureus, P. aeruginosa and B. cereus were susceptible to 50 µg chitosan-decorated bacitracin cream, showing inhibition zones of 10 ± 0.6, 34 ± 1.5, 31 ± 0.76 and 21 ± 2.02 mm, respectively. The zones of inhibition for simple bacitracin-loaded cream were significantly smaller than chitosan-decorated cream, at 2 ± 0.2, 28 ± 0.92, 15 ± 0.5 and 11 ± 1.25 mm (ANOVA; p < 0.05), respectively. (4) Conclusion: It was observed that the zones of inhibition of simple bacitracin-loaded cream were significantly smaller than those of chitosan-decorated bacitracin-loaded cream. Chitosan synergistically improves the antimicrobial activity of bacitracin. Hence, the developed formulation was effective and should be considered as a suitable candidate for topical management of skin infections and wound healing.
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Affiliation(s)
- Rumana Zaib Khattak
- Advanced Drug Delivery Lab, Gomal Centre of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan 29050, Pakistan
| | - Asif Nawaz
- Advanced Drug Delivery Lab, Gomal Centre of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan 29050, Pakistan
- Correspondence:
| | - Maha Abdallah Alnuwaiser
- Department of Chemistry, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Muhammad Shahid Latif
- Advanced Drug Delivery Lab, Gomal Centre of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan 29050, Pakistan
| | - Sheikh Abdur Rashid
- Advanced Drug Delivery Lab, Gomal Centre of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan 29050, Pakistan
| | - Asghar Ali Khan
- Department of Agronomy, Faculty of Agriculture, Gomal University, Dera Ismail Khan 29050, Pakistan
| | - Soha A. Alamoudi
- Biological Sciences Department, College of Science and Arts, King Abdulaziz University, Rabigh 21911, Saudi Arabia
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Aslanli A, Domnin M, Stepanov N, Efremenko E. "Universal" Antimicrobial Combination of Bacitracin and His 6-OPH with Lactonase Activity, Acting against Various Bacterial and Yeast Cells. Int J Mol Sci 2022; 23:ijms23169400. [PMID: 36012663 PMCID: PMC9409362 DOI: 10.3390/ijms23169400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
The effect of Bacitracin as an antibiotic acting against Gram-positive bacterial cells was evaluated in combination with hexahistidine-containing organophosphate hydrolase (His6-OPH), possessing lactonase activity against various N-acylhomoserine lactones produced by most Gram-negative bacteria as quorum-sensing molecules. The molecular docking technique was used to obtain in silico confirmation of possible interactions between molecules of His6-OPH and Bacitracin as well as the absence of a significant influence of such interactions on the enzymatic catalysis. The in vitro experiments showed a sufficient catalytic efficiency of action of the His6-OPH/Bacitracin combination as compared to the native enzyme. The notable improvement (up to 3.3 times) of antibacterial efficiency of Bacitracin was revealed in relation to Gram-negative bacteria when it was used in combination with His6-OPH. For the first time, the action of the Bacitracin with and without His6-OPH was shown to be effective against various yeast strains, and the presence of the enzyme increased the antibiotic effect up to 8.5 times. To estimate the role of the enzyme in the success of His6-OPH/Bacitracin with yeast, in silico experiments (molecular docking) with various fungous lactone-containing molecules were undertaken, and the opportunity of their enzymatic hydrolysis by His6-OPH was revealed in the presence and absence of Bacitracin.
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Affiliation(s)
| | | | | | - Elena Efremenko
- Correspondence: ; Tel.: +7-495-939-3170; Fax: +7-495-939-5417
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Bellotto O, Semeraro S, Bandiera A, Tramer F, Pavan N, Marchesan S. Polymer Conjugates of Antimicrobial Peptides (AMPs) with d-Amino Acids (d-aa): State of the Art and Future Opportunities. Pharmaceutics 2022; 14:pharmaceutics14020446. [PMID: 35214178 PMCID: PMC8879212 DOI: 10.3390/pharmaceutics14020446] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 12/15/2022] Open
Abstract
In recent years, antimicrobial peptides (AMPs) have enjoyed a renaissance, as the world is currently facing an emergency in terms of severe infections that evade antibiotics’ treatment. This is due to the increasing emergence and spread of resistance mechanisms. Covalent conjugation with polymers is an interesting strategy to modulate the pharmacokinetic profile of AMPs and enhance their biocompatibility profile. It can also be an effective approach to develop active coatings for medical implants and devices, and to avoid biofilm formation on their surface. In this concise review, we focus on the last 5 years’ progress in this area, pertaining in particular to AMPs that contain d-amino acids, as well as their role, and the advantages that may arise from their introduction into AMPs.
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Affiliation(s)
- Ottavia Bellotto
- Chemical and Pharmaceutical Sciences Department, University of Trieste, 34127 Trieste, Italy; (O.B.); (S.S.)
| | - Sabrina Semeraro
- Chemical and Pharmaceutical Sciences Department, University of Trieste, 34127 Trieste, Italy; (O.B.); (S.S.)
| | - Antonella Bandiera
- Life Sciences Department, University of Trieste, 34127 Trieste, Italy; (A.B.); (F.T.)
| | - Federica Tramer
- Life Sciences Department, University of Trieste, 34127 Trieste, Italy; (A.B.); (F.T.)
| | - Nicola Pavan
- Medical, Surgical and Health Sciences Department, University of Trieste, 34127 Trieste, Italy;
| | - Silvia Marchesan
- Chemical and Pharmaceutical Sciences Department, University of Trieste, 34127 Trieste, Italy; (O.B.); (S.S.)
- Correspondence:
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Duquette E, Bhatti P, Sur S, Felbaum DR, Dowlati E. The History and Use of Antibiotic Irrigation for Preventing Surgical Site Infection in Neurosurgery: A Scoping Review. World Neurosurg 2022; 160:76-83. [DOI: 10.1016/j.wneu.2022.01.098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/23/2022] [Accepted: 01/23/2022] [Indexed: 11/28/2022]
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Intraoperative bacitracin irrigations for the prevention of surgical site infections-Consider the alternatives - CORRIGENDUM. Infect Control Hosp Epidemiol 2021; 42:252. [PMID: 33570483 DOI: 10.1017/ice.2020.1382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Wood A. Clinical Issues-February 2021. AORN J 2021; 113:197-205. [PMID: 33534165 DOI: 10.1002/aorn.13319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 11/07/2022]
Abstract
Moving the surgical lights over a sterile field Key words: surgical lights, light handles, sterile field contamination, surgical site infection (SSI). Transport stretchers in the OR Key words: transport stretcher, bed linens, cross-contamination, sterile field, infectious disease. Using positive-pressure ORs for patients who require airborne precautions Key words: airborne precautions, positive-pressure airflow, positive-pressure OR, anteroom. Discontinuing the use of intraoperative bacitracin irrigation Key words: bacitracin for injection, antibiotic irrigation, antimicrobial irrigation, surgical site infection (SSI).
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