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Li Q, Zhang Y, Liu P, Zhong J, Gong B, Yao H, Lin A. Pd-Catalyzed Asymmetric 5-exo-trig Cyclization/Cyclopropanation/Carbonylation of 1,6-Enynes for the Construction of Chiral 3-Azabicyclo[3.1.0]hexanes. Angew Chem Int Ed Engl 2023; 62:e202211988. [PMID: 36426561 DOI: 10.1002/anie.202211988] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 11/01/2022] [Accepted: 11/23/2022] [Indexed: 11/26/2022]
Abstract
We herein disclose a mild and efficient access to chiral 3-azabicyclo[3.1.0]hexanes via a Pd-catalyzed asymmetric 5-exo-trig cyclization/cyclopropanation/carbonylation of 1,6-enynes. Various nucleophiles, such as alcohols, phenols, amines and water, are well compatible with the reaction system. This reaction forms three C-C bonds, two rings, two adjacent quaternary carbon stereocenters as well as one C-O/C-N bond with excellent regio- and enantioselectivities. The products could be further functionalized to generate a library of 3-azabicyclo[3.1.0]hexane frameworks.
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Affiliation(s)
- Qiuyu Li
- State Key Laboratory of Natural Medicines (SKLNM) and Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, P. R. China
| | - Yunchu Zhang
- State Key Laboratory of Natural Medicines (SKLNM) and Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, P. R. China
| | - Pengyun Liu
- State Key Laboratory of Natural Medicines (SKLNM) and Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, P. R. China
| | - Jing Zhong
- State Key Laboratory of Natural Medicines (SKLNM) and Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, P. R. China
| | - Baihui Gong
- State Key Laboratory of Natural Medicines (SKLNM) and Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, P. R. China
| | - Hequan Yao
- State Key Laboratory of Natural Medicines (SKLNM) and Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, P. R. China
| | - Aijun Lin
- State Key Laboratory of Natural Medicines (SKLNM) and Department of Medicinal Chemistry, School of Pharmacy, China Pharmaceutical University, Nanjing, 210009, P. R. China
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Ayodele O, Khanye S, Mothibe M, Sibiya N. Fluoroquinolone-induced Glycaemic Aberrations: Could Quinolones be Repurposed to Serve as New Antidiabetic Agents? Curr Rev Clin Exp Pharmacol 2023; 18:12-21. [PMID: 35184708 DOI: 10.2174/2772432817666220218101050] [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: 11/01/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 02/08/2023]
Abstract
Nalidixic acid is a synthetic antibiotic discovered in the 1960s during the synthesis of chloroquine, an effective drug for treating malaria. Nalidixic acid became the backbone for developing quinolones that are now widely used clinically for the treatment of various bacterial infections. The mechanism of action of quinolone involves the inhibition of topoisomerase II and topoisomerase IV. In attempts to improve the potency of fluoroquinolones, modifications were made; these modifications resulted in the emergence of newer generations of fluoroquinolones. Also, due to these modifications, several side effects were noted, including blood glucose control aberrations. Among fluoroquinolones that disrupt glucose homeostasis is gatifloxacin, which is in the third-generation category. Fluoroquinolones have been demonstrated to induce glycaemic aberrations by enhancing pancreatic cells' insulin secretion and interaction with antidiabetic agents via inhibition of cytochrome P450 enzymes. Considering their ability to induce hypoglycaemia, few studies have reported repurposing of quinolones as antidiabetic agents. Hyperglycaemia has also been reported to often precede hypoglycaemia. Due to the ability to decrease blood glucose, it is not surprising that some authors have reported novel quinolone derivates with antidiabetic properties in experimental studies. However, there is still a paucity of data regarding the effect of quinolones derivatives on glycaemic control. Understanding how fluoroquinolones lower blood glucose concentration could serve as the basis for developing novel quinolone derivatives with the sole purpose of lowering blood glucose concentrations. Although there are various conventional anti-hyperglycaemic agents, due to their associated shortfalls as well as an increase in the prevalence of diabetes, the discovery and development of new antidiabetics are warranted.
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Affiliation(s)
- Omobonlale Ayodele
- Division of Pharmacology, Faculty of Pharmacy, Rhodes University, Makhanda 6140, South Africa
| | - Setshaba Khanye
- Division of Pharmaceutical Chemistry, Faculty of Pharmacy, Rhodes University, Makhanda 6140, South Africa
| | - Mamosheledi Mothibe
- Division of Pharmacology, Faculty of Pharmacy, Rhodes University, Makhanda 6140, South Africa
| | - Ntethelelo Sibiya
- Division of Pharmacology, Faculty of Pharmacy, Rhodes University, Makhanda 6140, South Africa
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3
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Refat MS, Saad HA, Gobouri AA, Alsawat M, Belgacem K, Majrashi BM, Adam AMA. RuO2 Nanostructures from Ru(III) Complexes As a New Smart Nanomaterials for Using in the Recycling and Sustainable Wastewater Treatment: Synthesis, Characterization, and Catalytic Activity in the Hydrogen Peroxide Decomposition. RUSSIAN JOURNAL OF PHYSICAL CHEMISTRY A 2022. [DOI: 10.1134/s0036024421150218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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4
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Han J, Kiss L, Mei H, Remete AM, Ponikvar-Svet M, Sedgwick DM, Roman R, Fustero S, Moriwaki H, Soloshonok VA. Chemical Aspects of Human and Environmental Overload with Fluorine. Chem Rev 2021; 121:4678-4742. [PMID: 33723999 PMCID: PMC8945431 DOI: 10.1021/acs.chemrev.0c01263] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Indexed: 12/24/2022]
Abstract
Over the last 100-120 years, due to the ever-increasing importance of fluorine-containing compounds in modern technology and daily life, the explosive development of the fluorochemical industry led to an enormous increase of emission of fluoride ions into the biosphere. This made it more and more important to understand the biological activities, metabolism, degradation, and possible environmental hazards of such substances. This comprehensive and critical review focuses on the effects of fluoride ions and organofluorine compounds (mainly pharmaceuticals and agrochemicals) on human health and the environment. To give a better overview, various connected topics are also discussed: reasons and trends of the advance of fluorine-containing pharmaceuticals and agrochemicals, metabolism of fluorinated drugs, withdrawn fluorinated drugs, natural sources of organic and inorganic fluorine compounds in the environment (including the biosphere), sources of fluoride intake, and finally biomarkers of fluoride exposure.
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Affiliation(s)
- Jianlin Han
- Jiangsu
Co-Innovation Center of Efficient Processing and Utilization of Forest
Resources, College of Chemical Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Loránd Kiss
- University
of Szeged, Institute of Pharmaceutical Chemistry
and Interdisciplinary Excellence Centre, Eötvös u. 6, 6720 Szeged, Hungary
| | - Haibo Mei
- Jiangsu
Co-Innovation Center of Efficient Processing and Utilization of Forest
Resources, College of Chemical Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Attila Márió Remete
- University
of Szeged, Institute of Pharmaceutical Chemistry
and Interdisciplinary Excellence Centre, Eötvös u. 6, 6720 Szeged, Hungary
| | - Maja Ponikvar-Svet
- Department
of Inorganic Chemistry and Technology, Jožef
Stefan Institute, Jamova
cesta 39, 1000 Ljubljana, Slovenia
| | - Daniel Mark Sedgwick
- Departamento
de Química Orgánica, Universidad
de Valencia, 46100 Burjassot, Valencia Spain
| | - Raquel Roman
- Departamento
de Química Orgánica, Universidad
de Valencia, 46100 Burjassot, Valencia Spain
| | - Santos Fustero
- Departamento
de Química Orgánica, Universidad
de Valencia, 46100 Burjassot, Valencia Spain
| | - Hiroki Moriwaki
- Hamari
Chemicals Ltd., 1-19-40, Nankokita, Suminoe-ku, Osaka 559-0034, Japan
| | - Vadim A. Soloshonok
- Department
of Organic Chemistry I, Faculty of Chemistry, University of the Basque Country UPV/EHU, 20018 San Sebastian, Spain
- IKERBASQUE,
Basque Foundation for Science, 48011 Bilbao, Spain
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5
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Mutant Prevention Concentration of Ciprofloxacin against Klebsiella pneumoniae Clinical Isolates: An Ideal Prognosticator in Treating Multidrug-Resistant Strains. Int J Microbiol 2019; 2019:6850108. [PMID: 31772582 PMCID: PMC6855012 DOI: 10.1155/2019/6850108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/11/2019] [Indexed: 11/17/2022] Open
Abstract
Background Fluoroquinolone-resistant Klebsiella pneumoniae poses a therapeutic challenge when implicated in urinary tract infections, pyelonephritis, pneumonia, skin infections, osteomyelitis, and respiratory infections. The mutant prevention concentration (MPC) represents a concentration threshold above which increase of resistant mutants occurs rarely. The aim of the present study is to determine the MPC among ciprofloxacin-resistant K. pneumoniae clinical isolates. Materials and Methods A total of 240 clinical isolates of K. pneumoniae were collected from a tertiary care hospital. The MPCs were determined for 24 selected strains using an inoculum of 1010 CFU/ml in Müller-Hinton agar plates with serial/various concentrations (0.003-100 μg) of ciprofloxacin. In addition to the MPC, phenotypic screening for ESBL, AmpC, and carbapenemase was performed. The detection of qnr genes for 24 isolates and DNA sequencing for six isolates were performed. Results Ciprofloxacin resistance was observed in 19.6% of the K. pneumoniae clinical isolates. Among the ciprofloxacin-resistant isolates, 14 isolates showed an MPC value of more than 100 μg. The MPC ranged between 100 μg and 20 μg for ciprofloxacin-resistant isolates. ESBL producers and qnr gene-producing strains had a high MPC. 11 isolates showed the presence of either qnrB or qnrS genes. None of the samples showed the presence of the qnrA gene. Conclusion From our study, we infer that ESBL producers and qnr gene-possessing strains are frequently resistant to ciprofloxacin. Estimation of the MPC in the case of multidrug-resistant isolates in the clinical setup may help in treating these drug-resistant strains.
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Chierentin L, Salgado HRN. Review of Properties and Analytical Methods for the Determination of Norfloxacin. Crit Rev Anal Chem 2016; 46:22-39. [PMID: 26398574 DOI: 10.1080/10408347.2014.941456] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The first-generation quinolones have their greatest potency against Gram-negative bacteria, but newly developed molecules have exhibited increased potency against Gram-positive bacteria, and existing agents are available with additional activity against anaerobic microorganisms. Norfloxacin is a broad-spectrum antimicrobial fluoroquinolone used against Gram-positive and Gram-negative organisms (aerobic organisms). There are different analytical methods available to determine norfloxacin applied in quality control of this medicine in order to ensure its effectiveness and safety. The authors present an overview of the fourth generation of quinolones, followed by the properties, applications, and analytical methods of norfloxacin. These results show several existing analytical techniques that are flexible and broad-based methods of analysis in different matrices. This article focuses on bionalytical and pharmaceutical quality-control applications, such as thin-layer chromatography, microbiological assay, spectrophotometry, capillary electrophoresis (CE), and high-performance liquid chromatography (HPLC).
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Affiliation(s)
- Lucas Chierentin
- a School of Pharmaceutical Sciences, São Paulo State University , Araraquara , São Paulo , Brazil
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7
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Sampathkumar N, Murugesh A, Rajendran SP. A Facile Synthesis of 5-Phenyl-Dibenzo[ b, g][1,8]Napthyridines. J Heterocycl Chem 2016. [DOI: 10.1002/jhet.2256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Arumugam Murugesh
- School of Chemical Sciences; Bharathiar University; Coimbatore 641 046 Tamil Nadu India
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8
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Pola S, Bhongiri Y, Jadhav R, Ch P, G. V. Synthesis of new fused heterocyclic aromatic hydrocarbons via C–S and C–C bond formation by C–H bond activation in the presence of new Pd(ii) Schiff's base complexes. RSC Adv 2016. [DOI: 10.1039/c6ra15609f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Pd(ii) Schiff base macrocyclic complexes are used as photocatalysts with high stability, C–S bond and intramolecular C–H bond activation under visible light irradiation.
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Affiliation(s)
- Someshwar Pola
- Department of Chemistry
- Nizam College
- Osmania University
- Hyderabad
- India
| | - Yadagiri Bhongiri
- Department of Chemistry
- Nizam College
- Osmania University
- Hyderabad
- India
| | - Ramchander Jadhav
- Department of Chemistry
- Nizam College
- Osmania University
- Hyderabad
- India
| | - Prabhakar Ch
- Department of Chemistry
- National Institute of Technology
- Kurukshetra
- India
| | - Venkanna G.
- Department of Chemistry
- Nizam College
- Osmania University
- Hyderabad
- India
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Stine JG, Lewis JH. Hepatotoxicity of antibiotics: a review and update for the clinician. Clin Liver Dis 2013; 17:609-42, ix. [PMID: 24099021 DOI: 10.1016/j.cld.2013.07.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Collectively, the various classes of antibiotics are a leading cause of drug-induced liver injury (DILI). However, acute antibiotic-associated DILI can be difficult to diagnose, as the course of therapy is usually brief, and other confounding factors are often present. In addition to the broad clinicopathologic spectrum of hepatotoxicity associated with the antimicrobials, the underlying infectious disease being treated may itself be associated with hepatic dysfunction and jaundice. This review provides summarized information on several classes of antimicrobial agents, highlighting new agents causing DILI and updating information on older agents.
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Affiliation(s)
- Jonathan G Stine
- Division of Gastroenterology and Hepatology, Department of Medicine, Georgetown University Medical Center, 3800 Reservoir Road, NW Room M2408, Washington, DC 20007, USA
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10
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Efficient synthesis of novel benzo[b][1,8]naphthyridin-4(1H)-ones and pyrido[2,3-b]quinoxalin-4(1H)-ones from alkynones and primary amines. Tetrahedron 2013. [DOI: 10.1016/j.tet.2013.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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12
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13
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Preheim LC, Olsen KM, Yue M, Snitily MU, Gentry-Nielsen MJ. Effect of cirrhosis on antibiotic efficacy in a rat model of pneumococcal pneumonia. Diagn Microbiol Infect Dis 2005; 51:103-11. [PMID: 15698715 DOI: 10.1016/j.diagmicrobio.2004.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2004] [Accepted: 09/13/2004] [Indexed: 11/30/2022]
Abstract
A rat model was used to study the effects of cirrhosis on antibiotic therapy of pneumococcal pneumonia. Cirrhotic and control male Sprague-Dawley rats were infected transtracheally with type 3 Streptococcus pneumoniae. Treatment began 18 h later with phosphate-buffered saline (PBS), azithromycin (50 mg/kg), trovafloxacin (50 mg/kg), or ceftriaxone (100 mg/kg) injected subcutaneously twice daily for 5 days. Antibiotic concentrations were measured by high-performance liquid chromatography. Azithromycin, trovafloxacin, and ceftriaxone were all equally effective at preventing mortality in both cirrhotic and normal rats. Free fraction area under the curve to minimum inhibitory concentration ratio (AUC/MIC) and maximum calculated serum concentration to MIC ratio (C(max)/MIC) and percent time that the serum concentration exceeded the MIC (%T > MIC) were greater for ceftriaxone compared with azithromycin or trovafloxacin. Azithromycin achieved higher concentrations in bronchoalveolar lavage fluid (BALF), epithelial lining fluid (ELF), and BAL white blood cells than ceftriaxone or trovafloxacin in cirrhotic rats. Macrolide, beta-lactam, or fluoroquinolone antibiotic efficacy in a pneumococcal pneumonia model does not appear to be affected by hepatic cirrhosis.
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Affiliation(s)
- Laurel C Preheim
- Infectious Diseases Section, Veterans Affairs Medical Center, Omaha, NE 68105, USA.
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14
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Stein GE, Schooley S, Tyrrell KL, Citron DM, Goldstein EJC. Bactericidal activities of methoxyfluoroquinolones gatifloxacin and moxifloxacin against aerobic and anaerobic respiratory pathogens in serum. Antimicrob Agents Chemother 2003; 47:1308-12. [PMID: 12654663 PMCID: PMC152495 DOI: 10.1128/aac.47.4.1308-1312.2003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Gatifloxacin (Bristol-Myers Squibb) and moxifloxacin (Bayer) are new methoxyfluoroquinolones with broad-spectrum activity against aerobic and anaerobic pathogens of the respiratory tract. In this investigation, we analyzed the bactericidal activity in serum over time of these antimicrobials against three aerobic (Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus) and four anaerobic (Peptostreptococcus micros, Peptostreptococcus magnus, Fusobacterium nucleatum, and Prevotella melaninogenica) bacteria associated with respiratory tract infections. Serum samples were obtained from 11 healthy male subjects following a single 400-mg oral dose of gatifloxacin and moxifloxacin. These samples were collected prior to and at 2, 6, 12, and 24 h after the dose of each drug. Gatifloxacin exhibited bactericidal activity for a median of 12 h against Streptococcus pneumoniae (MIC = 0.5 micro g/ml), Peptostreptococcus micros (MIC = 0.25 micro g/ml), and F. nucleatum (MIC = 0.5 micro g/ml) and 24 h against H. influenzae (MIC = 0.03 micro g/ml), Staphylococcus aureus (MIC = 0.125 micro g/ml), Peptostreptococcus magnus (MIC = 0.125 micro g/ml), and Prevotella melaninogenica (MIC = 0.5 micro g/ml). Moxifloxacin exhibited bactericidal activity for a median of 24 h against Streptococcus pneumoniae (MIC = 0.125 micro g/ml), H. influenzae (MIC = 0.015 micro g/ml), Staphylococcus aureus (MIC = 0.06 micro g/ml), F. nucleatum (MIC = 0.5 micro g/ml), Prevotella melaninogenica (MIC =0.5 micro g/ml), Peptostreptococcus magnus (MIC = 0.125 micro g/ml), and Peptostreptococcus micros (MIC = 0.25 micro g/ml). The results from this pharmacodynamic study suggest that these fluoroquinolones would have prolonged killing activity against these organisms in vivo and may have clinical utility in the treatment of mixed aerobic-anaerobic respiratory tract infections.
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Affiliation(s)
- Gary E Stein
- Michigan State University, East Lansing, Michigan 48824. R. M. Alden Research Lab, Santa Monica, California 90404, USA.
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15
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Léophonte P. Nouvelles fluoroquinolones et pneumonies communautaires chez l'adulte. Med Mal Infect 2001. [DOI: 10.1016/s0399-077x(01)80108-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Extensive pharmacologic and clinical development of quinolone antimicrobial agents has resulted in improved antimicrobial activity, pharmacokinetic features, toxicity, and drug-drug interaction profiles. Nalidixic acid and other early quinolones had limited use due to poor pharmacokinetics, relatively narrow antimicrobial spectrum of activity, and frequent adverse effects. Beginning with the development of fluoroquinolones, such as norfloxacin and ciprofloxacin, in the 1980s, the agents assumed a greatly expanded clinical role because of their broad antimicrobial spectrum of action, improved pharmacokinetic properties, and more acceptable safety profile. Although the pharmacokinetics and efficacy of the drugs have improved significantly, a major area of continued emphasis is to further reduce the frequency and severity of adverse events and drug-drug interactions. Older agents such as ciprofloxacin and ofloxacin are still extensively prescribed, but the focus of this article is on the newer fluoroquinolones (levofloxacin and other drugs that have been approved or have been under investigation since approximately 1997).
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Affiliation(s)
- D N Fish
- Department of Pharmacy Practice, School of Pharmacy, University of Colorado Health Sciences Center, Denver 80262, USA
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18
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Abstract
This year's review is divided into several sections: the first describes drug withdrawals and new general reviews of drug-induced liver disease (DILD), including a review of a classification of drug injury. We review agents newly described as causing DILD, and new reports of DILD from established agents appearing in the year 2000. New aspects regarding the treatment of acetaminophen toxicity are included, and in the final section we deal with prevention of DILD as well as issues surrounding the use of potentially hepatotoxic medications in patients with underlying chronic disease.
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Affiliation(s)
- G Marino
- Division of Gastroenterology, Section of Hepatology, Georgetown University Medical Center, Washington, District of Columbia 20007, USA
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19
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Stearne LE, Kooi C, Goessens WH, Bakker-Woudenberg IA, Gyssens IC. In vitro activity of trovafloxacin against Bacteroides fragilis in mixed culture with either Escherichia coli or a vancomycin- resistant strain of Enterococcus faecium determined by an anaerobic time-kill technique. Antimicrob Agents Chemother 2001; 45:243-51. [PMID: 11120973 PMCID: PMC90268 DOI: 10.1128/aac.45.1.243-251.2001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To determine the efficacy of trovafloxacin as a possible treatment for intra-abdominal abscesses, we have developed an anaerobic time-kill technique using different inocula to study the in vitro killing of Bacteroides fragilis in pure culture or in mixed culture with either Escherichia coli or a vancomycin-resistant strain of Enterococcus faecium (VREF). With inocula of 5 x 10(5) CFU/ml and trovafloxacin concentrations of </=2 microg/ml, a maximum observed effect (E(max)) of >/=6.1 (log(10) CFU/ml) was attained with all pure and mixed cultures within 24 h. With inocula of 10(8) CFU/ml, a similar E(max) and a similar concentration to produce 50% of E(max) (EC(50)) for B. fragilis were found in both pure cultures and mixed cultures with E. coli. However, to produce a similar killing of B. fragilis in the mixed cultures with VREF, a 14-fold increase in the concentration of trovafloxacin was required. A vancomycin-susceptible strain of E. faecium and a trovafloxacin-resistant strain of E. coli were also found to confer a similar "protective" effect on B. fragilis against the activity of trovafloxacin. Using inocula of 10(9) CFU/ml, the activity of trovafloxacin was retained for E. coli and B. fragilis and was negligible against VREF. We conclude that this is a useful technique to study the anaerobic killing of mixed cultures in vitro and may be of value in predicting the killing of mixed infections in vivo. The importance of using mixed cultures and not pure cultures is clearly shown by the difference in the killing of B. fragilis in the mixed cultures tested. Trovafloxacin will probably be ineffective in the treatment of infections involving large numbers of enterococci. However, due to its ability to retain activity against large cultures of B. fragilis and E. coli, trovafloxacin could be beneficial in the treatment of intra-abdominal abscesses.
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Affiliation(s)
- L E Stearne
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
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20
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Pai MP, IV JB, Amsden GW. Plasma Pharmacokinetics and Tissue Penetration of Alatrofloxacin in Morbidly Obese Individuals. Clin Drug Investig 2001; 21:219-24. [DOI: 10.2165/00044011-200121030-00008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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21
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Stass H, Schühly U, Möller JG, Delesen H. Effects of Sucralfate on the Oral Bioavailability of Moxifloxacin, a Novel 8-Methoxyfluoroquinolone, in Healthy Volunteers. Clin Pharmacokinet 2001; 40 Suppl 1:49-55. [PMID: 11352442 DOI: 10.2165/00003088-200140001-00007] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To investigate the effect of concomitant Al3+ (sucralfate) administration on the pharmacokinetics and tolerability of moxifloxacin. DESIGN This was a single-centre, randomised, nonblinded, 2-way crossover study in healthy volunteers. PARTICIPANTS 12 healthy men (age 21 to 41 years) were enrolled in the study. METHODS The plasma and urinary pharmacokinetics of moxifloxacin were characterised up to 72 hours after single doses of moxifloxacin 400mg administered orally either alone or together with 190mg of Al3+ (Sucralfat-Ratiopharm 1000) given immediately before and at 5, 10, 15 and 24 hours after the dose of moxifloxacin. There was a 2-week washout phase between the treatments. RESULTS The treatments were well tolerated. The concomitant administration of Al3+ reduced the bioavailability of moxifloxacin [geometric mean area under the concentration-time curve from zero to infinity (AUCinfinity) 12.9 versus 32.2 mg/L x h; relative bioavailability 40%, 90% confidence interval (CI) 33 to 49%] and slowed down the absorption rate [median time to maximum concentration (tmax) 3.5 versus 1.0 hours], with a reduction of the maximum plasma concentration (Cmax) fgeometric mean Cmax0.82 versus 2.83 mg/L; estimated true ratio of Cmax 29%, 90% CI 20 to 42%]. CONCLUSIONS Concomitant ingestion with sucralfate and/or oral Al3+-containing antacids significantly reduces the bioavailability of moxifloxacin. This is compatible with reduced solubilisation as a consequence of a chelation reaction with polyvalent cations, a common finding for quinolones. Therefore, staggered administration of moxifloxacin and Al3+-containing or related cationic interactants should be considered to avoid a loss of therapeutic efficacy due to subtherapeutic plasma concentrations of the quinolone.
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Affiliation(s)
- H Stass
- Pharma Research Centre, Institute of Clinical Pharmacology, Bayer AG, Wuppertal, Germany.
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22
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Abstract
BACKGROUND Premarketing trials showed the fluoroquinolone agents to have a favorable side-effect profile, with treatment-related adverse events comprising gastrointestinal, central nervous system, and dermatologic effects that were generally mild and reversible on cessation of treatment. However, postmarketing surveillance studies have identified severe adverse events, including severe anaphylaxis, QTc-interval prolongation, and potential cardiotoxicity, associated with 3 quinolone agents that either resulted in the removal of the agent from the market (temafloxacin and grepafloxacin) or significantly restricted its use due to substantial mortality and morbidity associated with liver toxicity (trovafloxacin). To date, there have been no such significant adverse events associated with the older fluoroquinolone agents, including ciprofloxacin, ofloxacin, norfloxacin, and levofloxacin. However, there are fewer data from postmarketing surveillance studies on the most recently approved agents, such as moxifloxacin and gatifloxacin, or agents awaiting approval, such as gemifloxacin. OBJECTIVE This paper examines safety data from the premarketing trials and postmarketing surveillance studies of fluoroquinolones available in the United States. METHODS A MEDLINE search was performed to identify all English-language studies published since 1980 concerning the safety profiles of the fluoroquinolones. CONCLUSIONS The fluoroquinolone antibacterial agents offer broad-spectrum therapy in patients with a variety of infections. Given similar spectra of activity, the choice between quinolones may be based on differences in efficacy and safety or tolerability profiles. Most drug reactions involving these agents are minor and reversible on discontinuing treatment, but adverse effects can be associated with significant mortality and morbidity, as was seen in the case of trovafloxacin and temafloxacin.
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Affiliation(s)
- J Bertino
- Bassett Healthcare, Clinical Pharmacology Research Center, Cooperstown, New York 13326, USA
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23
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Boccumini LE, Fowler CL, Campbell TA, Puertolas LF, Kaidbey KH. Photoreaction potential of orally administered levofloxacin in healthy subjects. Ann Pharmacother 2000; 34:453-8. [PMID: 10772429 DOI: 10.1345/aph.18134] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To evaluate the photoreaction potential of levofloxacin on exposure to solar-simulating radiation. Solar-simulating is ultraviolet (UV) light, defined as UVA in the 320-400 nm range and UVB in the 290-320 nm range. DESIGN In a single-center, double-blind, randomized study, 30 adults (20 men, 10 women) received oral levofloxacin (500 mg qd x 5 d) or placebo. At baseline photoexposure prior to drug administration, each subject was exposed to UVB light at 0.75, 1.0, and 2.0 times the minimal erythema dose and to UVA light (25 J/cm2). Photoexposure was repeated on day 5, two hours following final drug administration, and response was determined using both a photoreaction rating scale and investigator assessment. RESULTS Using the photoreaction rating scale, following UVB exposure on day 5, no abnormal photoreactions were observed among levofloxacin recipients. UVA exposure was associated with mild reactions in 20 of 24 levofloxacin-treated and three of six placebo-treated subjects, with no associated symptoms. By investigator assessment, all subjects had a negative reaction to UVB photoexposure, and 10 of 24 levofloxacin-treated and three of six placebo-treated subjects had a photoreaction following UVA photoexposure. Dermal reactions were mild and similar for both treatment groups. No subject experienced an immediate wheal-and-flare reaction. There were no statistically significant differences between treatment groups for any of the comparisons. CONCLUSIONS Levofloxacin has a low photosensitizing potential when administered to healthy subjects.
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Affiliation(s)
- L E Boccumini
- The RW Johnson Pharmaceutical Research Institute, Raritan, NJ 08869, USA
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24
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Lucena MI, Andrade RJ, Rodrigo L, Salmerón J, Alvarez A, Lopez-Garrido MJ, Camargo R, Alcantára R. Trovafloxacin-induced acute hepatitis. Clin Infect Dis 2000; 30:400-1. [PMID: 10671353 DOI: 10.1086/313680] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- M I Lucena
- Servicio de Farmacología Clínica, Facultad de Medicina, Campus Universitario de Teatinos s/n, 29071 Málaga, Spain.
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