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Rawat R, Chouhan RS, Sadhu V, Sharma M. Clarithromycin-Loaded Submicron-Sized Carriers: Pharmacokinetics and Pharmacodynamic Evaluation. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16093593. [PMID: 37176475 PMCID: PMC10179782 DOI: 10.3390/ma16093593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023]
Abstract
The current study aims to improve clarithromycin bioavailability and effectiveness in complicated intra-abdominal infection management. Therefore, clarithromycin-loaded submicron dual lipid carriers (CLA-DLCs) were developed via hot high shear homogenization technique and evaluated for colloidal parameters, release behavior, stability study, and in-vitro antibiofilm activity. Bioavailability and therapeutic efficacy of optimized formulation on hampering cytokines storm induction was determined in E. coli-induced peritonitis. The developed CLA-DLCs (particle size 326.19 ± 24.14 nm, zeta potential -31.34 ± 2.81 mV, and entrapment efficiency 85.78 ± 4.01%) exhibited smooth spherical shapes and sustained in vitro release profiles. Long-term stability study of optimized CLA-DLCs ensured maintenance of colloidal parameters for 1 year at room temperature. In vitro antimicrobial studies revealed 3.43-fold higher anti-biofilm activity of CLA-DLCs compared with clarithromycin. In addition, the relative bioavailability of CLA-DLCs was enhanced 5.89-fold compared to pure drug in rats. The remarkable decrease in microbial burden in blood as well as tissues, along with oxidative stress markers (lipid peroxidation, myeloperoxidase activity, and carbonylated protein level) and immunological markers (total leukocyte count, neutrophil migration, NO, TNF-, and IL-6) on treatment with CLA-DLCs enhanced the survival in a rat model of peritonitis compared with the pure drug and untreated groups. In conclusion, CLA-DLCs hold promising potential in management of intra-abdominal infections and prevention of associated complications.
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Affiliation(s)
- Reetika Rawat
- Department of Pharmacy, Banasthali Vidyapith, Banasthali 304022, Rajasthan, India
| | - Raghuraj Singh Chouhan
- Department of Environmental Sciences, Institute "Jožef Stefan", Jamova 39, 1000 Ljubljana, Slovenia
| | - Veera Sadhu
- Centre for Advanced Materials Application, Slovak Academy of Sciences, Dubravskaesta 9, 84511 Bratislava, Slovakia
- Polymer Institute, Slovak Academy of Sciences, Dúbravská Cesta 9, 84541 Bratislava, Slovakia
| | - Manu Sharma
- Department of Pharmacy, Banasthali Vidyapith, Banasthali 304022, Rajasthan, India
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Scutera S, Sparti R, Comini S, Menotti F, Musso T, Cuffini AM, Allizond V, Banche G. Dalbavancin Boosts the Ability of Neutrophils to Fight Methicillin-Resistant Staphylococcus aureus. Int J Mol Sci 2023; 24:ijms24032541. [PMID: 36768864 PMCID: PMC9917267 DOI: 10.3390/ijms24032541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
Polymorphonuclear leukocytes (PMNs) are the most important cell type involved in the early nonspecific host response to bacterial pathogens. Staphylococcus aureus has evolved mechanisms to evade immune responses that contribute to its persistence in PMNs, and acquired resistance to several antimicrobials. Additionally, methicillin-resistant S. aureus (MRSA) is one of the most common causes of acute bacterial skin and skin-structure infections (ABSSSIs). Dalbavancin (DBV), a lipoglycopeptide, is indicated for the treatment of ABSSSIs, and has a broad spectrum of action against most microorganisms. Here, we sought to determine the effect of DBV on the neutrophil killing of MRSA and its potential immunomodulating activity. Our results revealed that DBV boosts MRSA killing by acting on both bacteria and PMNs. DBV pre-treatment of PMNs did not change the respiratory burst or degranulation, while an increased trend in neutrophil extracellular traps-associated elastase and in the production of TNFα and CXCL8 was revealed. In parallel, DBV caused a delay in the apoptosis of MRSA-infected neutrophils. In conclusion, we demonstrated a cooperative effect between the antimicrobial properties of PMNs and DBV, thus owing to their immunomodulatory activity. In the choice of the treatment management of serious S. aureus infections, DBV should be considered as an outstanding option since it reinforces PMNs pathogen clearance capability by exerting its effect directly, not only on MRSA but also on neutrophils.
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Serbanescu MA, Oveisi M, Sun C, Fine N, Bosy A, Glogauer M. Metronidazole enhances killing of Porphyromonas gingivalis by human PMNs. FRONTIERS IN ORAL HEALTH 2022; 3:933997. [PMID: 36105174 PMCID: PMC9464935 DOI: 10.3389/froh.2022.933997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background and objectivesPeriodontitis affects the supporting structures of the teeth as a result of the interactions between the subgingival biofilm and the host immune system. Periodontal therapy in severe forms of periodontitis often utilizes antimicrobial agents with some potential to improve host defense responses. In the present study, we investigated the in vitro effect of metronidazole (MTZ) at concentrations achievable in the periodontal pocket on PMN activation and PMN mediated killing of Porphyromonas gingivalis.Materials and methodsFlow cytometry based assays were used to measure the impact of MTZ on PMN degranulation, neutrophil extracellular trap (NET) formation and myeloperoxidase (MPO) release and phagocytosis in response to the keystone oral pathogen P. gingivalis. Functional assays for PMN mediated killing of P. gingivalis and reactive oxygen species (ROS) production in PMN were also carried out.ResultsWe demonstrate that PMNs pretreated with MTZ (2 μg/ml or 50 μg/ml) displayed enhanced killing of P. gingivalis compared to untreated PMNs. At concentrations achieved physiologically in the periodontal pocket, MTZ induced PMN surface expression of two activation markers (CD66 and CD63). MTZ did not alter P. gingivalis-induced NETosis, but suppressed P. gingivalis-induced ROS production and phagocytosis.ConclusionMTZ displays a positive interaction with PMNs to potentiate PMN mediated killing of P. gingivalis and may therefore contribute to its beneficial effects in the treatment of periodontitis initiated by P. gingivalis infections including those refractory to conventional treatment.
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Affiliation(s)
| | - Morvarid Oveisi
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Chunxiang Sun
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Noah Fine
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | | | - Michael Glogauer
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- Department of Dental Oncology and Maxillofacial Prosthetics, Princess Margaret Cancer Centre, Toronto, ON, Canada
- *Correspondence: Michael Glogauer
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A rabbit model to study antibiotic penetration at the site of infection for non-tuberculous mycobacterial lung disease: macrolide case study. Antimicrob Agents Chemother 2022; 66:e0221221. [PMID: 35099272 DOI: 10.1128/aac.02212-21] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Nontuberculous mycobacterial pulmonary disease (NTM-PD) is a potentially fatal infectious disease requiring long treatment duration with multiple antibiotics and against which there is no reliable cure. Among the factors that have hampered the development of adequate drug regimens is the lack of an animal model that reproduces the NTM lung pathology required for studying antibiotic penetration and efficacy. Given the documented similarities between tuberculosis and NTM immunopathology in patients, we first determined that the rabbit model of active tuberculosis reproduces key features of human NTM-PD and provides an acceptable surrogate model to study lesion penetration. We focused on clarithromycin, a macrolide and pillar of NTM-PD treatment, and explored the underlying causes of the disconnect between its favorable potency and pharmacokinetics, and inconsistent clinical outcome. To quantify pharmacokinetic-pharmacodynamic target attainment at the site of disease, we developed a translational model describing clarithromycin distribution from plasma to lung lesions, including the spatial quantitation of clarithromycin and azithromycin in mycobacterial lesions of two patients on long-term macrolide therapy. Through clinical simulations, we visualized the coverage of clarithromycin in plasma and four disease compartments, revealing heterogeneous bacteriostatic and bactericidal target attainment depending on the compartment and the corresponding potency against nontuberculous mycobacteria in clinically relevant assays. Overall, clarithromycin's favorable tissue penetration and lack of bactericidal activity indicated that its clinical activity is limited by pharmacodynamic rather than pharmacokinetic factors. Our results pave the way towards the simulation of lesion pharmacokinetic-pharmacodynamic coverage by multi-drug combinations, to enable the prioritization of promising regimens for clinical trials.
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Suryaprasanna J, Radhika PL, Karunakar P, Rekharani K, Faizuddin U, Manojkumar MG, Jammula S. Evaluating the effectiveness of clarithromycin as an adjunct to scaling and root planing: A randomized clinical trial. J Indian Soc Periodontol 2018; 22:529-534. [PMID: 30631232 PMCID: PMC6305085 DOI: 10.4103/jisp.jisp_254_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Administration of systemic antibiotics may implement persuasive treatment effect for chronic periodontitis by intending tissue-invasive bacteria in addition to accustomed nonsurgical periodontal therapy (NSPT). Aims The aim of this study was to assess the ancillary effects of oral clarithromycin (CLM) along with NSPT for chronic periodontitis. Materials and Methods Thirty periodontitis patients were randomly divided into two equal groups in this double-blind, randomized, parallel group, and active-controlled trial: test group - scaling and root planning (SRP) plus CLM (500 mg thrice daily for 7 days, orally) was given, and control group - only SRP was done. Clinical analysis, such as gingival index (GI), probing depth (PD), and clinical attachment loss (CAL), were taken at baseline, 3 months, and 6-month intervals for both groups. Subgingival plaque samples were cultured for periodontopathic organisms. Immunological parameter C-reactive protein (CRP) levels were estimated. Results SPSS version 14 was used for statistical analysis. The intragroup comparison showed a significant reduction in the mean scores of all the parameters from baseline to 6 months. The intergroup comparison showed a statistically significant reduction of PD from baseline to 3 months (P < 0.001). GI, CAL, and CRP levels were also reduced but not statistically significant. The mean colony-forming units (CFU) of Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) showed a statistically significant reduction from baseline to 3 months only in the test group (P = 0.042) and (P = 0.046), respectively. There was no statistically significant reduction of Aa and Pg at 6 months. Conclusions CLM conceivably accepted as an addendum to NSPT for a shorter period.
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Affiliation(s)
- Jammula Suryaprasanna
- Department of Periodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Potini Lakshmi Radhika
- Department of Periodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Parupalli Karunakar
- Department of Conservative and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Koduganti Rekharani
- Department of Periodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Umrana Faizuddin
- Department of Conservative and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Mallela George Manojkumar
- Department of Pediatric Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Suribabu Jammula
- Department of R&D, Pulse Pharma Ceutical Pvt. Ltd., Hyderabad, Telangana, India
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Lai PC, Schibler MR, Walters JD. Azithromycin enhances phagocytic killing of Aggregatibacter actinomycetemcomitans Y4 by human neutrophils. J Periodontol 2016; 86:155-61. [PMID: 25186779 DOI: 10.1902/jop.2014.140183] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Aggregatibacter actinomycetemcomitans resists killing by neutrophils and is inhibited by azithromycin (AZM) and amoxicillin (AMX). AZM actively concentrates inside host cells, whereas AMX enters by diffusion. The present study is conducted to determine whether AZM is more effective than AMX at enhancing phagocytic killing of A. actinomycetemcomitans by neutrophils. METHODS Killing assays were conducted in the presence of either 2 μg/mL AZM or 16 μg/mL AMX (equipotent against A. actinomycetemcomitans). Neutrophils were loaded by incubation with the appropriate antibiotic. Opsonized A. actinomycetemcomitans strain Y4 was incubated with the indicated antibiotic alone, with loaded neutrophils and antibiotic, or with control neutrophils (without antibiotic) at multiplicities of infection (MOIs) of 30 and 90 bacteria per neutrophil. RESULTS Neutrophil incubation with 2 μg/mL AZM yielded an intracellular concentration of 10 μg/mL. At an MOI of 30, neutrophils loaded with AZM failed to kill significantly more bacteria than control neutrophils during the 60- and 90-minute assay periods. At an MOI of 90, neutrophils loaded with AZM killed significantly more bacteria than either AZM alone or control neutrophils during 60- and 90-minute incubations (P < 0.05), and killed significantly more bacteria after 90 minutes than the sum of the killing produced by AZM alone or neutrophils alone. Neutrophils incubated with AMX under identical conditions also killed significantly more bacteria than either AMX alone or control neutrophils, but there was no evidence of synergism between AMX and neutrophils. CONCLUSIONS Neutrophils possess a concentrative transport system for AZM that may enhance killing of A. actinomycetemcomitans. Its effects are most pronounced when neutrophils are greatly outnumbered by bacteria.
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Affiliation(s)
- Pin-Chuang Lai
- Division of Periodontology, College of Dentistry, The Ohio State University Wexner Medical Center, Columbus, OH
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Konstantinidis T, Kambas K, Mitsios A, Panopoulou M, Tsironidou V, Dellaporta E, Kouklakis G, Arampatzioglou A, Angelidou I, Mitroulis I, Skendros P, Ritis K. Immunomodulatory Role of Clarithromycin in Acinetobacter baumannii Infection via Formation of Neutrophil Extracellular Traps. Antimicrob Agents Chemother 2016; 60:1040-8. [PMID: 26643338 PMCID: PMC4750671 DOI: 10.1128/aac.02063-15] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/23/2015] [Indexed: 12/29/2022] Open
Abstract
Macrolide antibiotics have been shown to act as immunomodulatory molecules in various immune cells. However, their effect on neutrophils has not been extensively investigated. In this study, we investigated the role of macrolide antibiotics in the generation of neutrophil extracellular traps (NETs). By assessing ex vivo and in vivo NET formation, we demonstrated that clarithromycin is able to induce NET generation both in vitro and in vivo. Clarithromycin utilizes autophagy in order to form NETs, and these NETs are decorated with antimicrobial peptide LL-37. Clarithromycin-induced NETs are able to inhibit Acinetobacter baumannii growth and biofilm formation in an LL-37-dependent manner. Additionally, LL-37 antimicrobial function depends on NET scaffold integrity. Collectively, these data expand the knowledge on the immunomodulatory role of macrolide antibiotics via the generation of LL-37-bearing NETs, which demonstrate LL-37-dependent antimicrobial activity and biofilm inhibition against A. baumannii.
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Affiliation(s)
- Theocharis Konstantinidis
- Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Kambas
- Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Alexandros Mitsios
- Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Maria Panopoulou
- Laboratory of Microbiology, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Victoria Tsironidou
- Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Erminia Dellaporta
- Gastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Georgios Kouklakis
- Gastrointestinal Endoscopy Unit, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Athanasios Arampatzioglou
- Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Iliana Angelidou
- Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioannis Mitroulis
- Department of Clinical Pathobiochemistry and Institute for Clinical Chemistry and Laboratory Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Panagiotis Skendros
- Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece First Department of Internal Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Konstantinos Ritis
- Laboratory of Molecular Hematology, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece First Department of Internal Medicine, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis, Greece
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Fujise O, Miura M, Hamachi T, Aida Y, Nishimura F. Regenerative effect of azithromycin on periodontitis with different levels of gingival inflammation: three case reports. Aust Dent J 2014; 59:245-51. [DOI: 10.1111/adj.12177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2013] [Indexed: 11/29/2022]
Affiliation(s)
- O Fujise
- Section of Periodontology; Division of Oral Rehabilitation; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - M Miura
- Section of Periodontology; Division of Oral Rehabilitation; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - T Hamachi
- Section of Periodontology; Division of Oral Rehabilitation; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - Y Aida
- Section of Periodontology; Division of Oral Rehabilitation; Faculty of Dental Science; Kyushu University; Fukuoka Japan
| | - F Nishimura
- Section of Periodontology; Division of Oral Rehabilitation; Faculty of Dental Science; Kyushu University; Fukuoka Japan
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Raghunatha K, George JP. Periodontal tissue and serum concentration of clarithromycin after systemic administration in patients affected by chronic periodontitis. J Periodontol 2013; 84:e17-22. [PMID: 23451987 DOI: 10.1902/jop.2013.120521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND During the past two decades, dentists and microbiologists have relied on periodontal antibiotic therapy in the management of periodontitis. This association has accumulated and strengthened exponentially. Macrolides attain high therapeutic concentrations in infected tissue, so they are potentially a good choice for inhibiting invasive periodontal pathogens. Clarithromycin accumulates in phagocytes, monocytes, fibroblasts, polymorphonuclear cells, macrophages, and lymphocytes. These cells are more numerous at inflamed sites, so it is reasonable to expect clarithromycin levels to be higher in periodontally diseased sites. This study determines the distribution profile of clarithromycin in the gingiva of patients with periodontitis compared to serum after systemic administration of clarithromycin. METHODS Twenty patients (14 males and six females, aged 25 to 45 years) with chronic periodontitis were enrolled in the study. Gingival index and plaque index were recorded at baseline and 3 days after administration of 500 mg clarithromycin, twice daily, for 3 days. Intravenous blood and biopsy of periodontal tissue samples were taken on the third day. These samples were analyzed for detection of clarithromycin concentration using high-performance liquid chromatography. RESULTS Approximately 6 hours after the last dose of clarithromycin, mean clarithromycin concentrations in serum and periodontal tissue were 0.465 μg/mL and 2.61 μg/g, respectively, and the difference was statistically significant. CONCLUSIONS Clarithromycin can attain higher levels in gingiva than serum of patients with periodontitis. This distribution profile of clarithromycin can thus be advantageous in the management of periodontal lesions.
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Affiliation(s)
- K Raghunatha
- Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
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Azithromycin kills invasive Aggregatibacter actinomycetemcomitans in gingival epithelial cells. Antimicrob Agents Chemother 2012; 57:1347-51. [PMID: 23274657 DOI: 10.1128/aac.02558-12] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aggregatibacter actinomycetemcomitans invades periodontal pocket epithelium and is therefore difficult to eliminate by periodontal scaling and root planing. It is susceptible to azithromycin, which is taken up by many types of mammalian cells. This led us to hypothesize that azithromycin accumulation by gingival epithelium could enhance the killing of intraepithelial A. actinomycetemcomitans. [(3)H]azithromycin transport by Smulow-Glickman gingival epithelial cells and SCC-25 oral epithelial cells was characterized. To test our hypothesis, we infected cultured Smulow-Glickman cell monolayers with A. actinomycetemcomitans (Y4 or SUNY 465 strain) for 2 h, treated them with gentamicin to eliminate extracellular bacteria, and then incubated them with azithromycin for 1 to 4 h. Viable intracellular bacteria were released, plated, and enumerated. Azithromycin transport by both cell lines exhibited Michaelis-Menten kinetics and was competitively inhibited by l-carnitine and several other organic cations. Cell incubation in medium containing 5 μg/ml azithromycin yielded steady-state intracellular concentrations of 144 μg/ml in SCC-25 cells and 118 μg/ml in Smulow-Glickman cells. Azithromycin induced dose- and time-dependent intraepithelial killing of both A. actinomycetemcomitans strains. Treatment of infected Smulow-Glickman cells with 0.125 μg/ml azithromycin killed approximately 29% of the intraepithelial CFU of both strains within 4 h, while treatment with 8 μg/ml azithromycin killed ≥82% of the CFU of both strains (P < 0.05). Addition of carnitine inhibited the killing of intracellular bacteria by azithromycin (P < 0.05). Thus, human gingival epithelial cells actively accumulate azithromycin through a transport system that facilitates the killing of intraepithelial A. actinomycetemcomitans and is shared with organic cations.
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Jain N, Lai PC, Walters JD. Effect of gingivitis on azithromycin concentrations in gingival crevicular fluid. J Periodontol 2012; 83:1122-8. [PMID: 22220766 DOI: 10.1902/jop.2012.110558] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Macrolide antibiotics yield high concentrations in inflamed tissue, suggesting that their levels in gingival crevicular fluid (GCF) could be increased at gingivitis sites. However, the increased volume of GCF associated with gingivitis could potentially dilute macrolides. To determine whether these assumptions are correct, the bioavailability of systemically administered azithromycin was compared in GCF from healthy and gingivitis sites. METHODS Experimental gingivitis was induced in one maxillary posterior sextant in nine healthy individuals. Contralateral healthy sextants served as controls. Participants ingested 500 mg azithromycin, followed by a 250-mg dose 24 hours later. Four hours after the second dose, plaque was removed from experimental sites. GCF was collected from eight surfaces in both the experimental and control sextants and pooled separately. GCF samples were subsequently collected on days 2, 3, 8, and 15, and azithromycin content was determined by agar diffusion bioassay. RESULTS On days 2 and 3, the pooled GCF volume at experimental sites was significantly higher than at control sites (P <0.01), and the total azithromycin mass in 30-second GCF samples pooled from experimental sites was significantly higher than at control sites (P <0.02). However, there were no significant differences in azithromycin concentration between the experimental and control pools at any point. Concentrations exceeded 7.3 μg/mL on day 2 and 2.5 μg/mL on day 15. CONCLUSION Azithromycin concentrations are similar in GCF from gingivitis sites and healthy sites, suggesting that the processes that regulate GCF azithromycin concentration can compensate for local inflammatory changes.
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Affiliation(s)
- Nidhi Jain
- Division of Periodontology, College of Dentistry, The Ohio State University Health Sciences Center, Columbus, OH, USA
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Bogdanovska L, Kukeska S, Popovska M, Petkovska R, Goracinova K. Therapeutic strategies in the treatment of periodontitis. MAKEDONSKO FARMACEVTSKI BILTEN 2012. [DOI: 10.33320/maced.pharm.bull.2012.58.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Periodontitis is a chronic inflammatory process which affects the tooth - supporting structures of the teeth. The disease is initiated by subgingival periopathogenic bacteria in susceptible periodontal sites. The host immune response towards periodontal pathogens helps to sustain periodontal disease and eventual alveolar bone loss. Although scaling and root planing is the standard treatment modality for periodontitis, it suffers from several drawbacks such as the inability to reach the base of deep pockets and doesn’t arrest migration of periodontal pathogens from other sites in the oral cavity. In order to overcome the limitations of scaling and root planning, adjunctive chemotherapeutics and host modulatory agents to the treatment are used. These therapeutic agents show substantial beneficial effects when compared to scaling and root planning alone. This review will cover an update on chemotherapeutic and past and future host immune modulatory agents used adjunctively to treat and manage periodontal diseases.
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