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Bedoya-Agudelo JP, López-Carvajal JE, Quiguanás-Guarín ES, Cardona N, Padilla-Sanabria L, Castaño-Osorio JC. Assessment of Antimicrobial and Cytotoxic Activities of Liposomes Loaded with Curcumin and Lippia origanoides Essential Oil. Biomolecules 2024; 14:851. [PMID: 39062565 PMCID: PMC11275147 DOI: 10.3390/biom14070851] [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] [Received: 06/13/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
(1) Introduction: Curcumin and Lippia origanoides essential oils have a broad spectrum of biological activities; however, their physicochemical instability, low solubility, and high volatility limit their therapeutic use. Encapsulation in liposomes has been reported as a feasible approach to increase the physicochemical stability of active substances, protect them from interactions with the environment, modulate their release, reduce their volatility, improve their bioactivity, and reduce their toxicity. To date, there are no reports on the co-encapsulation of curcumin and Lippia origanoides essential oils in liposomes. Therefore, the objective of this work is to prepare and physiochemical characterize liposomes loaded with the mixture of these compounds and to evaluate different in vitro biological activities. (2) Methods: Liposomes were produced using the thin-layer method and physiochemical characteristics were calculated. The antimicrobial and cytotoxic activities of both encapsulated and non-encapsulated compounds were evaluated. (3) Results: Empty and loaded nanometric-sized liposomes were obtained that are monodisperse and have a negative zeta potential. They inhibited the growth of Staphylococcus aureus and did not exhibit cytotoxic activity against mammalian cells. (4) Conclusions: Encapsulation in liposomes was demonstrated to be a promising strategy for natural compounds possessing antimicrobial activity.
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Affiliation(s)
- Juan Pablo Bedoya-Agudelo
- Molecular Immunology Group (GYMOL), Center of Biomedical Research, Faculty of Health Sciences, Quindío University, Armenia 630003, Colombia; (J.P.B.-A.); (J.E.L.-C.); (E.S.Q.-G.); (J.C.C.-O.)
| | - Jhon Esteban López-Carvajal
- Molecular Immunology Group (GYMOL), Center of Biomedical Research, Faculty of Health Sciences, Quindío University, Armenia 630003, Colombia; (J.P.B.-A.); (J.E.L.-C.); (E.S.Q.-G.); (J.C.C.-O.)
| | - Edwin Stiven Quiguanás-Guarín
- Molecular Immunology Group (GYMOL), Center of Biomedical Research, Faculty of Health Sciences, Quindío University, Armenia 630003, Colombia; (J.P.B.-A.); (J.E.L.-C.); (E.S.Q.-G.); (J.C.C.-O.)
| | - Nestor Cardona
- Group of Investigation in Oral Health, Faculty of Dentistry, Antonio Nariño University, Armenia 630001, Colombia;
| | - Leonardo Padilla-Sanabria
- Molecular Immunology Group (GYMOL), Center of Biomedical Research, Faculty of Health Sciences, Quindío University, Armenia 630003, Colombia; (J.P.B.-A.); (J.E.L.-C.); (E.S.Q.-G.); (J.C.C.-O.)
| | - Jhon Carlos Castaño-Osorio
- Molecular Immunology Group (GYMOL), Center of Biomedical Research, Faculty of Health Sciences, Quindío University, Armenia 630003, Colombia; (J.P.B.-A.); (J.E.L.-C.); (E.S.Q.-G.); (J.C.C.-O.)
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Lemos-Luengas EV, Rentería-Valoyes S, Muñoz DMA, Gonzalez CKG, Guerrón-Gómez G, Ramos-Castaneda JA. In vitro activity of ceftazidime-avibactam against gram-negative bacteria in patients with bacteremia and skin and soft-tissue infections in Colombia 2019-2021. Diagn Microbiol Infect Dis 2024; 109:116235. [PMID: 38458096 DOI: 10.1016/j.diagmicrobio.2024.116235] [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: 11/09/2023] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVES Ceftazidime-avibactam (CAZ-AVI) is an option for infections caused by MDR gram-negative bacilli. In this study, we aimed to analyze the in vitro antimicrobial activity of CAZ-AVI and other antimicrobial agents against gram-negative bacilli that were collected in Colombia between 2019 and 2021 from patients with bacteremia and skin and soft-tissue infections (SSTIs). METHODS A total of 600 Enterobacterales and 259 P. aeruginosa strains were analyzed. The phenotypic resistance of isolates, particularly non-susceptibility to meropenem, multidrug-resistant (MDR) isolates, and difficult-to-treat (DTR) P. aeruginosa, was evaluated according to CLSI breakpoints. RESULTS Enterobacterales had the most susceptibility to CAZ-AVI (96.5 %) and tigecycline (95 %). Tigecycline and CAZ-AVI were the antimicrobial agents with the most in vitro activity against carbapenem-resistant Enterobacterales (CRE). CAZ-AVI was the antimicrobial treatment with the most activity against P. aeruginosa. CONCLUSIONS Tigecycline and CAZ-AVI were the antimicrobial agents with the most activity against CRE and MDR Enterobacterales. For P. aeruginosa, CAZ-AVI was the antimicrobial treatment with the most in vitro activity.
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Affiliation(s)
- Elkin Vladimir Lemos-Luengas
- Medical Affairs Pfizer Colombia, Colombia; Foundation For Development And Support In International Health (FUDASAI), Miami, FL, USA.
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Valladales-Restrepo LF, Aristizábal-Carmona BS, Giraldo-Correa JA, Acevedo-Medina LF, Valencia-Sánchez L, Acevedo-López DT, Gaviria-Mendoza A, Machado-Duque ME, Machado-Alba JE. Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World. Microorganisms 2023; 11:1369. [PMID: 37374871 DOI: 10.3390/microorganisms11061369] [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: 04/23/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Skin and soft tissue infections are one of the main causes of consultations worldwide. The objective was to determine the treatment of a group of patients with uncomplicated skin and soft tissue infections in Colombia. Methods: Follow-up study of a cohort of patients with skin infections who were treated in the Colombian Health System. Sociodemographic, clinical and pharmacological variables were identified. Treatments were evaluated using clinical practice guidelines for skin infections. Results: A total of 400 patients were analyzed. They had a median age of 38.0 years and 52.3% were men. The most commonly used antibiotics were cephalexin (39.0%), dicloxacillin (28.0%) and clindamycin (18.0%). A total of 49.8% of the subjects received inappropriate antibiotics, especially those with purulent infections (82.0%). Being cared for in an outpatient clinic (OR: 2.09; 95% CI: 1.06-4.12), presenting pain (OR: 3.72; 95% CI: 1.41-9.78) and having a purulent infection (OR: 25.71; 95% CI: 14.52-45.52) were associated with a higher probability of receiving inappropriate antibiotics. Conclusions: Half of patients with uncomplicated skin and soft tissue infections were treated with antibiotics that were not recommended by clinical practice guidelines. This inappropriate use of antibiotics occurred in the vast majority of patients with purulent infections because the antimicrobials used had no effect on methicillin-resistant Staphylococcus aureus.
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Affiliation(s)
- Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S. A, Pereira 660003, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
- Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
| | - Brayan Stiven Aristizábal-Carmona
- Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
| | - Jaime Andrés Giraldo-Correa
- Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
| | - Luis Felipe Acevedo-Medina
- Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
| | - Laura Valencia-Sánchez
- Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
| | - Doménica Tatiana Acevedo-López
- Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
| | - Andrés Gaviria-Mendoza
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S. A, Pereira 660003, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
| | - Manuel Enrique Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S. A, Pereira 660003, Colombia
- Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660003, Colombia
| | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S. A, Pereira 660003, Colombia
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Valderrama-Rios MC, Álvarez-Moreno CA, Cortes JA. Interventions to Improve Antibiotic Use in Hospitals with Different Levels of Complexity in Colombia: Findings from a Before-and-After Study and Suggestions for the Future. Antibiotics (Basel) 2023; 12:antibiotics12050867. [PMID: 37237770 DOI: 10.3390/antibiotics12050867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/27/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND In the collaborative efforts to control bacterial antimicrobial resistance (AMR), the challenge for many low- and middle-income countries currently lies in the adequate design and successful implementation and operation of different strategies aimed at improving antibiotic use during hospital care. This study aims to provide data on these different strategies in three hospitals with different levels of complexity and geographic locations in Colombia. METHODS This before-and-after study describes and analyzes the development and implementation of clinical practice guidelines (CPGs), continuing education courses, quick consultation tools, and antimicrobial stewardship programs (ASPs) with the use of telemedicine. This includes measuring indicators in the ASP framework such as adherence to CPGs and antibiotic consumption. RESULTS We used five CPGs developed in the Colombian context. We designed and developed a Massive Open Online Course (MOOC) and a mobile application (app) as strategies for dissemination and implementation. The ASP was designed and implemented according to each institution's level of complexity. In the three hospitals, a progressive increase in adherence to the antibiotic recommendations proposed in the CPGs was observed, and there was a lower use of antibiotics with the ASPs, both in the general wards and ICUs. CONCLUSIONS We concluded that in medium-complexity hospitals located in small rural cities, successful development of ASPs is possible when they are well-planned, implemented, and supported by the organization. It is necessary that Colombia and other Latin American countries continue activities that reduce AMR by designing, implementing, and improving these interventions throughout the national territory.
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Affiliation(s)
| | - Carlos Arturo Álvarez-Moreno
- Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá 111321, Colombia
- Clínica Universitaria Colombia, Clínica Colsanitas Grupo Keralty, Bogotá 111321, Colombia
| | - Jorge Alberto Cortes
- Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá 111321, Colombia
- Unidad de Enfermedades Infecciosas, Hospital Universitario Nacional de Colombia, Bogotá 111321, Colombia
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Valladales-Restrepo LF, Constain-Mosquera CA, Hoyos-Guapacha MA, Hoyos-Guapacha KL, Gaviria-Mendoza A, Machado-Duque ME, Machado-Alba JE. Study of the indications for macrolide prescriptions in a Colombian population. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2022; 42:302-314. [PMID: 35867923 PMCID: PMC9433087 DOI: 10.7705/biomedica.6116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
Introduction The inappropriate use of antibiotics is associated with a greater risk for antimicrobial resistance, high health care costs, adverse events, and worse clinical outcomes. Objective To determine the prescription patterns and approved and nonapproved indications for macrolides in a group of patients from Colombia. Materials and methods This was a cross-sectional study on the indications for the use of macrolides in outpatients registered in a drug-dispensing database of approximately 8.5 million people affiliated with the Colombian health system. Sociodemographic, pharmacological, and clinical variables were considered. Results A total of 9.344 patients had received a macrolide prescription; their median age was 40.1 years (interquartile range: 27.1-53.3 years) and 58.3% were women. The most commonly prescribed macrolide was azithromycin (38.8%) most frequently for Helicobacter pylori infection (15.9%) and pneumonia treatment (15.8%). A total of 31.3% of the prescriptions were used for unapproved indications: common cold (7.8%), COVID-19 (4.0%), and acute bronchitis (3.5%). Residence in the Caribbean region (OR=1.17; 95%CI 1.05-1.31), dental prescriptions (OR=2.75; 95%CI 1.91-3.96), presence of chronic respiratory comorbidities (OR=1.30; 95%CI 1.08-1.56), and prescription of erythromycin (OR=3.66; 95%CI 3.24-4.14) or azithromycin (OR=2.15; 95%CI 1,92-2.41) were associated with a higher probability of macrolide use for unapproved indications while being 18-64 years old (OR=0.81; 95%CI 0.71-0.93) or 65 years or older (OR=0.77; 95%CI 0.63-0.94) and residing in Bogotá-Cundinamarca (OR=0.74; 95%CI 0.65-0.85) were associated with reduced risk. Conclusions Most patients received macrolides for respiratory tract infections; erythromycin and azithromycin were used for unapproved indications in people under 18 years of age and those with chronic respiratory diseases.
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Affiliation(s)
- Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia; Grupo de Investigación en Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia; Semillero de Investigación en Farmacología Geriátrica, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
| | - Camilo Alexander Constain-Mosquera
- Semillero de Investigación en Farmacología Geriátrica, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colo.
| | - María Alejandra Hoyos-Guapacha
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.
| | - Karol Liceth Hoyos-Guapacha
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.
| | - Andrés Gaviria-Mendoza
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia; Grupo de Investigación en Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
| | - Manuel Enrique Machado-Duque
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia; Grupo de Investigación en Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia.
| | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.
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Valladales-Restrepo LF, Constain-Mosquera CA, Álvarez-Amaya V, Machado-Alba JE. Study of prescription-indication of tetracyclines in a population in Colombia. Fundam Clin Pharmacol 2021; 36:390-396. [PMID: 34481423 DOI: 10.1111/fcp.12724] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/30/2022]
Abstract
The inappropriate use of antibiotics is associated with increased antimicrobial resistance, adverse reactions, medical care costs, and worse clinical outcomes. The objective of this study is to determine the prescription patterns and approved and unapproved indications for tetracyclines in a group of patients in Colombia. This was a cross-sectional study, based on a database of medication dispensing of approximately 8.5 million people affiliated with the Colombian Health System, of the indications for the use of tetracyclines in outpatients. Sociodemographic, pharmacological, and comorbidity variables were considered. A total of 20 699 patients with a prescription of tetracyclines were identified, with a median age of 26.1 years; 65.0% were women. The most prescribed tetracycline was doxycycline (95.1%), especially for the treatment of acne (55.3%). A total of 23.5% of the prescriptions was used for unapproved indications, for example, vaginitis-vulvitis-vulvovaginitis (8.1%). Increasing age, prescriptions of doxycycline made by general physician, and woman attended by general physician were associated with a greater probability that a tetracycline was used for unapproved indications. Residing in Bogota-Cundinamarca Region and woman that residing in Bogota-Cundinamarca reduced this risk. A high proportion of patients received tetracyclines for dermatological conditions, with a lower proportion of use for gynecological and respiratory infections. For approximately one quarter of the cases, tetracyclines were prescribed for indications not approved by regulatory agencies, especially in those over 18 years and when the prescriptions of doxycycline was made by a general practitioners.
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Affiliation(s)
- Luis Fernando Valladales-Restrepo
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S. A., Pereira, Risaralda, Colombia.,Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | - Camilo Alexander Constain-Mosquera
- Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | - Valeria Álvarez-Amaya
- Semillero de Investigación en Farmacología Geriátrica, Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | - Jorge Enrique Machado-Alba
- Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S. A., Pereira, Risaralda, Colombia
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Enfrentamiento de las infecciones de piel en el adulto. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Real-World Evidence: Pharmacoepidemiology for Daily Clinical Practice—An Experience from Colombia. Drugs Real World Outcomes 2020; 7:257-259. [PMID: 32754866 PMCID: PMC7581657 DOI: 10.1007/s40801-020-00208-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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