CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / A maioria dos micro-organismos encontra-se integrados em comunidades denominadas âbiofilmeâ. Dentre estes se destaca a Pseudomonas aeruginosa, um patÃgeno oportunista de vegetais, animais e humanos, frequentemente associado à infecÃÃes nosocomiais difÃceis de serem erradicadas devido à presenÃa de biofilme. Os antibiÃticos fluoroquinolonas, tais como a ciprofloxacina (CIP), sÃo utilizados contra esta bactÃria, entretanto, mecanismos de resistÃncia vem sendo desenvolvidos por este micro-organismo. Assim, novas formas de controle microbiano tÃm sido alvo de inÃmeras pesquisas a fim de substituir ou potencializar os mÃtodos convencionais. Para esse fim, peptÃdeos antimicrobianos (AMPs) obtidos de diversos seres vivos representam uma alternativa para o desenvolvimento de novas drogas. Formas sintÃticas anÃlogas ao AMP Hilina a1 (Hy-a1), isolado da espÃcie Hypsiboas albopunctatus, tem demonstrado excelente eficÃcia antimicrobiana, dentre os quais se destacam o peptÃdeo Lys-[Trp6]hy-a1 (Lys-a1). Dessa forma, o objetivo deste trabalho foi verificar a influÃncia do peptÃdeo Lys-a1 na atividade antimicrobiana de CIP contra o micro-organismo patogÃnico Pseudomonas aeruginosa ATCC 9027. A concentraÃÃo inibitÃria mÃnima (CIM), a concentraÃÃo bactericida mÃnima (CBM) e a curva de morte foram determinadas para a CIP e a Lys-a1, separadamente. A influÃncia da Lys-a1 na atividade antimicrobiana da CIP foi verificada pela metodologia checkerboard com quantificaÃÃo da biomassa e do nÃmero de cÃlulas viÃveis do biofilme atravÃs da coloraÃÃo pelo cristal violeta e contagem de unidades formadoras de colÃnia (UFC), respectivamente. Os valores de CIM e CBM da Lys-a1 foi de 125 μg.mL-1, e para a CIP foi de 0,24 e 0,48 μg.mL-1, respectivamente. Os dados mostraram que tanto a CIP quanto a Lys-a1 sÃo potentes antimicrobianos contra P. aeruginosa, sendo capazes de inibir tanto o crescimento planctÃnico como o desenvolvimento do biofilme. A interaÃÃo das substÃncias foi interpretada pelo Ãndice de concentraÃÃo inibitÃria fracional (ICIF) e mostrou um efeito aditivo, estabelecendo uma diminuiÃÃo de 16 vezes da CIM e da CBM da CIP, quando combinada com a Lys-a1. Esta influÃncia foi observada tambÃm na cinÃtica de morte e na atividade antibiofilme. Em conclusÃo, o efeito aditivo entre a Lys-a1 e a CIP na atividade antimicrobiana sugere que o peptÃdeo tem potencial como um agente terapÃutico e adjuvante para o tratamento de doenÃas infecciosas causadas por P. aeruginosa, podendo habilitar o uso de concentraÃÃes menores do antibiÃtico. / Most microorganism lies embedded in communities called "biofilms". Among these stand out Pseudomonas aeruginosa, an opportunistic pathogen of plants, animals and humans, frequently associated with nosocomial infections difficult to be eradicated due to the presence of biofilm. The fluoroquinolone antibiotics such as ciprofloxacin (CIP) against this bacterium are used, however, the mechanism of resistance has been developed for this microorganism. Thus, new forms of microbial control have been the subject of numerous studies in order to replace or enhance conventional methods. For this purpose, antimicrobial peptides (AMPs) obtained from various living beings represent an alternative to the development of new drugs. Synthetic forms analogous to Hylin a1 AMP (Hy-a1), isolated from species Hypsiboas albopunctatus, has shown excellent antimicrobial efficacy, among which stand out the peptide Lys-[Trp6]hy-a1 (Lys-a1). Thus, the aim of this work was to verify the influence of the peptide Lys-a1 in antimicrobial activity of CIP against pathogenic microorganism Pseudomonas aeruginosa ATCC 9027. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and the curve death were determined to CIP and Lys-a1 separately. The influence of Lys-a1 in the antimicrobial activity of the CIP has been verified by the checkerboard method to quantify the biomass and the number of viable cells in biofilms by crystal violet staining and counting of colony forming units (CFU), respectively. The MIC and MBC values of Lys-a1 was 125 μg.mL-1 and the CIP was 0.24 and 0.48 μg.mL-1, respectively. The data showed that both the CIP as Lys-a1 are potent antibiotics against P. aeruginosa is able to inhibit both the planktonic growth and biofilm development. The interaction of substances interpreted by the fractional inhibitory concentration index (FICI) and showed an additive effect, establishing a decrease of 16 times the MIC and MBC of the CIP, when combined with the Lys-a1. This effect was also observed in the kinetics of death and antibiofilm activity. In conclusion, the additive effect of the Lys-a1 and CIP in antimicrobial activity suggests that the peptide has potential as a therapeutic agent and an adjuvant for the treatment of infectious diseases caused by P. aeruginosa can enable the use of lower concentrations of the antibiotic.

Micropartícula de quitosana complexada com íons metálicos [Fe(II), Fe(III), Zn(II)] foram preparadas e caracterizadas a fim de se obter sistemas microparticulados para a adsorção de substâncias. A técnica de preparo utilizada foi a secagem por aspersão, através da qual se obteve micropartículas esféricas colapsadas e com superfície rugosa. O tamanho de partícula foi influenciado tanto pela reação de reticulação com glutaraldeído como pela presença e tipo do metal utilizado para a formação do complexo. A adsorção do ciprofloxacino pelas micropartículas desenvolvidas foi estudada em meio aquoso, O estado de equilíbrio foi influenciado pelo tipo de metal presente na micropartícula e pela concentração inicial de ciprofloxacino na solução. Com o intuito de descrever o mecanismo de adsorção, foram utilizados modelos matemáticos de isotermas de Langmuir e Freundlich, sendo que os dados apresentaram um melhor ajuste para a isoterma de Freundlich. Através da análise de modelos de cinética de pesudo-primeira-ordem e pseudo-segunda-ordem, verificou-se que os dados melhor se ajustaram ao modelo de pseudo-segunda-ordem, indicando que o mecanismo de adsorção do ciprofloxacino pelas micropartículas é através de quimissorção. A determinação da capacidade de adsorção do ciprofloxacino, conduzido in vitro, demonstrou que as micropartículas de quitosana-Fe(III) e quitosana-Zn(II) apresentam efetividade de adsorção. Com isso as micropartículas de quitosana-Fe(III) foram encapsuladas por uma matriz de pectina, sendo este utilizado para a adsorção de antimicrobianos residuais presentes no cólon. A estabilidade das esferas foi determinada em meios digestivos simulados, onde se verificou uma estabilidade de 1 h e 5 h nos meios gástricos e intestinal, respectivamente. Quando as esferas foram incubadas no meio colônico, observou-se uma degradação dependente da concentração de pectina. Com o intuito de evitar a adsorção do ciprofloxacino no meio intestinal, as esferas foram revestidas com Eudragit RS. Estudos de adsorção em meio colônico simulado demonstrou que a capacidade de adsorção das micropartículas de quitosana-Fe(III) não é afeta pela encapsulação na matriz de pectina. O sistema desenvolvido demonstra ser promissor para a extração do ciprofloxacino presente no meio colônico simulado. / The aim of this work was to develop, characterize chitosan- metal ion [Fe(II), Fe(III), Zn(II)] microparticle, and evaluate the adsorption capacities of ciprofloxacin by these complexes. The microparticles were prepared by a spray drying method. They showed good sphericity and a roughness surface morphology. The particle size was influenced by crosslinking reaction and by the kind of metal ion onto the microparticle. A batch adsorption system was applied to study the adsorption of ciprofloxacin from aqueous solution by chitosan-metal ion crosslinked microparticle. The adsorption process was fast, and the equilibrium contact times were influenced by the kind of metal ion onto microparticle. The Langmuir and Freundlich adsorption models were used for mathematical description of the adsorption equilibrium, and it was found that experimental data fitted well to Freundlich model. Adsorption models, based on the assumption of the pseudo-first-order and pseudo-second-order mechanism showed that the pseudo-second-order adsorption mechanism is predominant, and the adsorption process appears to be controlled by the chemical reaction. Chitosan-Fe(III) and chitosan-Zn(II) microparticle demonstrated the highest adsorption of ciprofloxacin. Chitosan-Fe(III) microparticle was encapsulated in a pectin matrix. The system was used for the adsorption of colonic residual antibiotics responsible by the emergence of resistance. The stability of the beads was carried out on simulated digestive media. Beads incubated in simulated gastric and intestinal medium were stable for 1 h and 5 h, respectively. When incubated in simulated colonic medium, beads were then degraded by pectinases contained in the medium. Coating with Eudragit RS was needed to prevent the early adsorption of antibiotics in intestinal medium. Adsorption studies in simulated colonic medium show that the adsorption capacity of chitosan-Fe(III) is not modified after encapsulation within pectin beads making the elimination reaching the colon clinically feasible.

Objetivo: O objetivo geral deste trabalho foi avaliar o perfil farmacocinético para os compostos enrofloxacino (ENRO) e seu principal metabólito, ciprofloxacino (CIPRO), e cloranfenicol (CAP) em frangos de corte visando subsidiar a tomada de ações para controle de resíduos de medicamentos veterinários em produtos de origem animal e a produção de materiais de referência para fins de controle de qualidade analítica. Métodos: Frangos machos da linhagem Cobb-Vantress foram utilizados nos experimentos para determinação da farmacocinética plasmática e níveis teciduais para os compostos ENRO/CIPRO (10 mg/kg), CAP (100 mg/kg) após administração em dose única oral e administração contínua através da água de consumo simulando as condições reais de produção. As concentrações plasmáticas e teciduais foram determinadas utilizando a técnica de cromatografia líquida acoplada à espectrometria de massas em tandem (LC-MS/MS) através de métodos desenvolvidos e validados in house. Análise farmacocinética nãocompartimental e modelagem compartimental dos dados foram realizadas utilizando o software WinNonlin e NONMEM v.6, respectivamente. Para determinação das concentrações teciduais os animais foram sacrificados em tempos pré-definidos e amostras de plasma, músculo e fígado coletadas para os compostos ENRO/CIPRO e plasma e músculo para CAP. Resultados e Discussão: Três métodos multirresíduos para determinação de medicamentos veterinários incluindo diferentes compostos pertencentes às classes químicas ou terapêuticas previstas nesse projeto foram desenvolvidos utilizando LCMS/ MS com limites de quantificação (LOQ) em acordo com os propósitos de aplicação das metodologias. Além disso, métodos específicos para a análise dos compostos individuais nas amostras de plasma foram desenvolvidos para a determinação dos perfis farmacocinéticos em plasma. Conclusões: com base nos dados gerados foi possível implementar novas metodologias para o controle de resíduos de medicamentos veterinários relevantes na produção de aves de corte, bem como o estudo dos perfis farmacocinéticos e depleção tecidual permitiram o delineamento correto das etapas de planejamento e predição de valores encontrados em amostras experimentais. De forma complementar, os dados gerados permitirão a produção de amostras naturalmente contaminadas contendo os fármacos em questão para a produção de materiais de referência com o objetivo de serem utilizados para controle de qualidade analítico. / Objective: The aim of this study was to evaluate the pharmacokinetic profile for compounds enrofloxacin (ENRO) and its major metabolite, ciprofloxacin (CIPRO), and chloramphenicol (CAP) in broilers in order to support the actions taken to vet drugs residues control in animal products and production of reference materials for purposes of analytical quality control. Methods: Cobb- Vantress male broilers were used in experiments to determine the plasma pharmacokinetics and tissue levels to ENRO / CIPRO (10 mg / kg) and CAP (100 mg / kg) after single oral dose administration and continuous administration compounds through drinking water simulating the production conditions. Plasma and tissue concentrations were determined using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) using inhouse developed and validated methods. The non-compartmental and compartmental pharmacokinetic data modeling was performed using WinNonlin software and NONMEM v.6, respectively. For determination of tissue concentrations, animals were sacrificed at predefined times and plasma, muscle and liver samples collected for ENRO/ CIPRO and plasma and muscle samples to CAP. Results and Discussion: Three mutiresidue methods for determination of veterinary drugs including compounds belonging to same chemical and therapeutic classes in this project were developed using LCMS/ MS with limits of quantification (LOQ) in accordance with the purposes of application of methodologies. Furthermore, specific for analyzing individual compounds in the plasma samples methods have been developed for determination of plasma pharmacokinetic profiles. Conclusions: Based on the data generated was possible to implement new methodologies for control of veterinary drug residues relevant in broiler production, as well as the study of pharmacokinetic profiles and tissue depletion allowed the correct delineation of planning and predicting values found in experimental samples. As a complement, the data generated will enable the production incurred samples containing the drugs for production of reference materials for analytical quality control purposes.

A diferenciação entre processos infecciosos e inflamatórios representa um grande desafio na área de diagnóstico. A complexação do antimicrobiano ciprofloxacino (CIP) com o tecnécio (99mTc-CIP) vem sendo estudada com objetivo de desenvolver um radiofármaco com alta especificidade no diagnóstico de infecções, baseado em seu amplo espectro de atividade antibacteriana. O mecanismo de ação do fármaco consiste na ligação deste com a enzima ADN-girase da bactéria, permitindo sua ligação à bactéria ativa e a obtenção de imagens devido a fótons emitidos pelo 99mTc. Tendo em vista que o local de formação do complexo envolve os mesmos grupos funcionais responsáveis pela ligação do fármaco à enzima, sua eficácia pode ser prejudicada. A diferenciação entre processos infecciosos e inflamatórios representa um grande desafio na área de diagnóstico. A complexação do antimicrobiano ciprofloxacino (CIP) com o tecnécio (99mTc-CIP) vem sendo estudada com objetivo de desenvolver um radiofármaco com alta especificidade no diagnóstico de infecções, baseado em seu amplo espectro de atividade antibacteriana. O mecanismo de ação do fármaco consiste na ligação deste com a enzima ADN-girase da bactéria, permitindo sua ligação à bactéria ativa e a obtenção de imagens devido a fótons emitidos pelo 99mTc. Tendo em vista que o local de formação do complexo envolve os mesmos grupos funcionais responsáveis pela ligação do fármaco à enzima, sua eficácia pode ser prejudicada. O objetivo deste trabalho foi avaliar as condições ideais para ligação do 99mTc a duas quinolonas (CIP e pefloxacino), utilizando diferentes agentes redutores (SnCl2 e FSA), pH da solução e temperatura de incubação. A complexação dos fármacos ao radioisótopo 99mTc foi avaliada através do controle radioquímico, utilizando cromatografia em camada delgada. Posteriormente, testou-se sua atividade antimicrobiana in vitro utilizando diferentes microorganismos. O agente redutor FSA não foi eficiente na formação do complexo, resultando em uma concentração alta de Tc livre (37%). A formulação com Sn aumentou a formação de colóide com aquecimento (100 ºC). A complexação dos antimicrobianos ao Tc impediu sua ligação à ADN-girase. A taxa de ligação variou de 10% (filtração) a 16% (centrigugação). Além disso, verificou-se boa correlação entre a formação de colóide e quantidade de radiação ligada à bactéria em ambos os testes. Esta perda de atividade vem de encontro a alguns estudos clínicos relatados na literatura, que revelam a não diferenciação entre processos infecciosos e processos inflamatórios pelas quinolonas marcadas com 99mTc. / Differentiation between inflammation and infection represents a major challenge in clinical diagnostics. Several studies using ciprofloxacin (CIP), a broad spectrum antimicrobial agent, complexed with technetium (99mTc) have been reported in order to evaluate its capacity to diagnose infections. CIP mechanism of action involves its binding with bacterial DNA-gyrase during the growth phase and the acquisition of images due to 99mTc radioactivity. The fact that the sites of complexation are the same as those involved in bacterial binding it may affect its antimicrobial activity. The objective of the present work was to evaluate the ideal conditions for the complexation of CIP and pefloxacin with 99mTc using stannous chloride and formamidinesulfinic acid (FSA) as reducing agents, different pH and temperatures. The efficiency of complexation was monitored using radiochemical control as well as thin layer chromatography. Furthermore the antimicrobial activity of both complexes was evaluated in vitro. FSA was not adequate as a reducing agent and SnCl2 was better at room temperature than using heat (100 oC). The complexes did not bound well to the bacterias with binding efficiencies ranging from 10 (filtration method) to 16% (centrifugation method). Besides that, a good correlation between colloid formation (impurity) and radioactivity bound to bacterias was found. This decrease in bacterial activity was previously reported in some articles suggesting that quinolones complexed with 99mTc are not suitable to diagnose infections in the presence of inflammation.

Introduktion: Extrapyramidala systemet är ett nätverk i det centrala nervsystemet(CNS) som har en viktig roll i att samordna kroppsrörelser. De komponenter somtillhör det extrapyramidala systemet är basala ganglier, cerebellum och flera olikaledningsbanor och bland dessa har basala ganglier störst betydelse. Extrapyramidalasymtom, även kallade EPS, är ett samlingsbegrepp för motoriska biverkningar,exempelvis muskelkramper, muskelstelhet och skakningar, som uppkommer omextrapyramidala systemet i hjärnan utsätts för störningar. Vissa läkemedelsgrupper,såsom äldre antipsykotiska och antidepressiva läkemedel, är kända för att orsaka EPSgenom sin påverkan på det extrapyramidala systemet. Det finns även andra läkemedelsom också kan orsaka EPS, vilket inte är lika välkänt. Ett exempel på detta ärciprofloxacin, ett ofta förskrivet antibiotikum. Trots att extrapyramidala symtom kanupplevas besvärliga för patienter och trots att ciprofloxacin är ett mycket välanväntläkemedel, finns det inte mycket publicerad/beskriven information om risken attdrabbas av EPS vid användning av ciprofloxacin. Därför är det värdefullt att ta reda påom ciprofloxacin kan ge EPS och hur detta läkemedel kan påverka nervsystemet. Syfte: Syftet med denna studie är att ta reda på eventuellt samband mellan intag avciprofloxacin och EPS. Syftet är även att undersöka möjliga mekanismer bakom dessasymtom. Metod: Detta är en litteraturstudie som baseras på fallstudier inhämtade fråndatabasen PubMed samt inkomna biverkningsrapporter i Läkemedelsverkets databas,Biverkningsrapportering och Signaldetektion (BiSi), och den amerikanskaläkemedelsmyndighetens (The Food and Drug Administration) databas, FDA AdverseEvent Reporting System (FAERS). Resultat/Diskussion/Slutsats: Denna studie visar att det, trots att frekvensen avEPS är låg, är troligt att användning av ciprofloxacin kan utlösa EPS, framförallttremor, muskelkramper och muskuloskeletal stelhet. Detta resultat kan dock, på grundav det begränsade materialet, inte generaliseras till att omfatta alla patienter. Det äroklart om ciprofloxacin, även hos en frisk person, kan orsaka EPS och om andrafysiologiska faktorer såsom lever- eller njurfunktion hos patienten har betydelse förframkallande av EPS eftersom nedsatt lever- eller njurfunktion ökar toxiciteten avläkemedlet. Det går heller inte att utesluta påverkan av läkemedelsinteraktion medsamtidigt intagna läkemedel. För att kunna ge ett svar med högre tillförlitlighetangående frågeställningen: eventuellt samband mellan intag av ciprofloxacin ochextrapyramidala symtom, krävs det vidare forskning, exempelvis genom att studerasamtliga biverkningsrapporter som innehåller information om patientens profil,dosering av ciprofloxacin och samtidig medicinering. Möjliga mekanismer bakomuppkomsten av EPS vid användning av ciprofloxacin anses vara att ciprofloxacinfungerar som en GABA-A-antagonist i basala ganglier och den förändrade GABA-ergahämningen, på grund av antagonismen, stör den normala rörelsereglerande funktionenhos de basala ganglierna. Avslutningsvis, baserat på resultatet av denna studie kan detvara av värde att iaktta försiktighet vid förskrivning av ciprofloxacin till patienter somhar nedsatt njur- eller leverfunktion och till patienter som har samtidig medicinering,särskilt med läkemedel som är kända för benägenhet att orsaka EPS såsomantipsykotiska och antidepressiva läkemedel.

Biofilms are surface-bound bacterial colonies that are held together by a self-produced extracellular polymeric matrix. They are highly resistant to antibiotics and host defence mechanisms, and are known to be the cause of persistent infections. Biofilm-degrading enzymes have been shown to prevent biofilm formation, remove mature biofilm, and enhance the efficacy of antibiotics. This study investigated the antibacterial and antibiofilm actions of the commercial enzyme Pectinex Ultra SP-L (Pectinex), alone and in combination with antibiotics, on standard and clinical cultures of Staphylococcus aureus and Pseudomonas aeruginosa. The cytotoxicity of Pectinex was determined on human cell cultures in vitro. Pectinex (7.42 – 950 PGU/ml) was not bactericidal, and had no effect on the antibacterial efficacy of amoxicillin-clavulanate and ciprofloxacin in cultures of S. aureus (ATCC 12600) and P. aeruginosa (ATCC 9027), respectively. However, in clinical cultures of P. aeruginosa, Pectinex caused an 89.0% (from 1.0 to 1.89 μg/ml) and 92.8% (from 1.67 to 3.22 μg/ml) increase in the MIC and MBC of ciprofloxacin, respectively. In clinical cultures of S. aureus, both bactericidal indices of amoxicillin-clavulanate were increased by 28.0% (from 2.0 to 2.56 μg/ml). In all bacterial cultures, low concentrations of Pectinex (≤ 118.75 PGU/ml) and prolonged incubation periods (≥ 6 h) were both associated with increased viability and biofilm biomass. Over a short incubation period (≤ 6 h), higher concentrations of Pectinex (237.5 – 950 PGU/ml) effectively inhibited biofilm formation in P. aeruginosa ATCC (237.5 – 950 PGU/ml) and clinical (950 PGU/ml) strains but not in S. aureus cultures. Pectinex (237.5 – 950 PGU/ml) was cytotoxic to HeLa cells, lymphocytes and neutrophils, and induced morphological features that included shrunken rounded cells, blebs, apoptotic bodies, cytoplasmic vacuoles and cell debris. The effects at 475 and 950 PGU/ml were comparable to mitomycin C 10 μg/ml and staurosporine 1 μg/ml. Pectinex was shown to either enhance or reduce biofilm biomass and cell viability in cultures of S. aureus and P. aeruginosa. The manifested effects depended on the concentration of the enzyme, the specific bacterial species and strain, and the maturity of the biofilms. Further studies are still needed in order to determine the actions of Pectinex on other clinical pathogens. / Thesis (PhD)--University of Pretoria, 2014. / lk2014 / Pharmacology / PhD / Unrestricted

ESKAPE pathogens are notorious in causing nosocomial infections and escaping current antibiotic treatments. There has been a dramatic increase in nosocomial infections accompanied with a decrease in the number of antibiotics developed, leading to significant increase in morbidity and mortality among patients. In an attempt to combat this problem, derivatives of ciprofloxacin, rifabutin and beta-lactam antibiotics were synthesized and tested against the ESKAPE pathogens. From minimum inhibitory concentration assays, 4 ciprofloxacin analogs and 8 beta-lactam analogs were found to be effective against multiple bacterial species. Additionally, 12 rifabutin analogs and 23 beta-lactam analogs were potent against single bacterial species, primarily toward methicillin-resistant Staphylococcus aureus (MRSA) at a concentration of ≤ 25 µg mL-1. Based on the effectiveness against methicillin-resistant Staphylococcus aureus (MRSA), three rifabutin analogs were selected for further testing. Two rifabutin analogs (DU644 and DU645) were found to possess between a one to twofold mean increase of inhibitory activities, while the other rifabutin analogs (DU650) demonstrated up to a twofold decrease of inhibitory activity when compared to the parent drug. These compounds were then examined for their bactericidal and antibiofilm activities against MRSA. From these assays, we found that DU644 and DU645 were 4 times more bactericidal and antibiofilm against MRSA when compared to the parent drug. In addition, rpoB mutation validation results confirmed that modification of these rifabutin derivatives at the C3 and C4 positions, and bearing an imidazolyl ring carrying substituted spiropiperidyl ring, did not change their mechanism of action towards the beta-subunit of RNA polymerase. Cytotoxicity testing performed using human hepatocellular carcinoma epithelial cells (hepG2) showed that at concentrations ranged from 1.25 µg mL-1 to 25 µg mL-1, DU644 and DU645 showed very low toxicity. Collectively, structural drugs modifications of these obsolete drugs are able to restore their antibacterial activities against MRSA, which is notable as the most infectious nosocomial pathogen. Therefore, further development and application of rifabutin analogs might be beneficial for medical use to combat MRSA infections.

Introduction: Infections caused by bacteria can be treated with antibiotics. One type of antibiotic used to fight bacteria is ciprofloxacin, a group of fluoroquinolones. To prevent this, bacteria have developed resistance by mutating in various ways. Negative bacterial cultures, short- and long-term treatments, all favor the progression of bacterial resistance to antibiotics, as a consequence of mutation. Compared to other antibiotics, the resistance development has increased more extensively for ciprofloxacin. Also, ciprofloxacin is incorrectly prescribed in primary care, which contributes to the increase in resistance development. Because of this, doctors wish to be more restrictive with the prescription of ciprofloxacin. Aim: This study aimed to determine if ciprofloxacin in primary care in Sörmland is prescribed correctly by examining whether the prescriptions are in compliance with the treatment recommendations in Sweden. Methods: The study was conducted as a survey research and executed under two months; from start of February to middle of April. The inclusion criteria were the primary care in Sörmland and the prescribers who prescribed ciprofloxacin with ATC code J01MA02 from January 2020. Firstly, the head of the care unit was contacted. Prescribers were then contacted individually to take part in a phone interview. The collection of data was compiled and compared to the treatment recommendations in Sweden to determine if the prescriptions were correct, regarding indication, dosage, and treatment time. Results: A total of 236 prescriptions were obtained, of which 89 were included in this study. Out of these, 32 prescriptions (36%) were in accordance with the correct choice of preparation regarding indication, dosage and treatment time and were, therefore, considered to be correct. Prescriptions that were not in accordance with the Swedish treatment recommendations, regarding the use of correct preparation for a single indication, dosage or treatment time, amounted to 57 prescriptions (64%). These prescriptions were, thereby, considered incorrect. Conclusion: This study concludes that it appears that less than half of the prescriptions of ciprofloxacin in the primary care in Sörmland were correct during this time period.

Bacteremia initiated by Staphylococcus aureus infections can be a serious medical problem. Although a number of different antibiotics are used to combat staphylococcal infections, resistance has continued to develop. Combination therapy for certain infections has been used to reduce the emergence of resistance when a single agent has become ineffective. We hypothesize that the use of rifampicin and ciprofloxacin in combination with azithromycin, known for its inhibitory effects on the bacterial ribosome, can create potential synergistic effects resulting from indirect effects on ribosomal subunit synthesis. To determine this we measured the effects of single and multiple antibiotics on cell growth rates, cell viability, and synthesis rates for DNA, RNA, and protein. We then measured synthesis rates of ribosomal subunits and the amounts of gyrase and RNAP. Effects of the antibiotic combinations on 70S ribosomes was assayed and the amounts of RNA and degradation was measured. We lastly studied the effects of these antibiotic combinations on mutation frequency in Staphylococcus aureus. Our data have shown support not only for the use of antibiotic combination therapy but have provided strong evidence of an increase in the inhibition of bacterial ribosome assembly in Staphylococcus aureus. The reduction of 50S ribosomal subunit synthesis and 23S ribosomal RNA in cells grown in the presence of azithromycin, already known for it’s inhibitory effects on the 50S subunit synthesis, in combination with rifampicin or in combination with rifampicin and ciprofloxacin was observed. This also resulted in a reduction or elimination in the frequency of resistant cells when grown in the presence of these combinations. These studies have shed light on the mechanism of action involved and synergistic effects occurring in combination antibiotic treatments and how ribosomal subunit assembly is affected. The insights gained through this research provide necessary information needed for the design of more potent antibiotic combinations. This will create a better understanding and new methods for eliminating the spread of harmful pathogens such as Staphylococcus aureus.

Yes / Ciprofloxacin (CIP) is a poorly soluble drug that also displays poor permeability. Attempts to improve the solubility of this drug to date have largely focused on the formation of crystalline salts and metal complexes. The aim of this study was to prepare amorphous solid dispersions (ASDs) by ball milling CIP with various polymers. Following examination of their solid state characteristics and physical stability, the solubility advantage of these ASDs was studied, and their permeability was investigated via parallel artificial membrane permeability assay (PAMPA). Finally, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the ASDs were compared to those of CIP. It was discovered that acidic polymers, such as Eudragit L100, Eudragit L100C==, Carbopol and HPMCAS, were necessary for the amorphization of CIP. In each case, the positively charged secondary amine of CIP was found to interact with carboxylate groups in the polymers, forming amorphous polymeric drug salts. Although the ASDs began to crystallize within days under accelerated stability conditions, they remained fully XCray amorphous following exposure to 90% RH at 25 oC, and demonstrated higher than predicted glass transition temperatures. The solubility of CIP in water and simulated intestinal fluid was also increased by all of the ASDs studied. Unlike a number of other solubility enhancing formulations, the ASDs did not decrease the permeability of the drug. Similarly, no decrease in antibiotic efficacy was observed, and significant improvements in the MIC and MBC of CIP were obtained with ASDs containing HPMCASC") and HPMCASCMG. Therefore, ASDs may be a viable alternative for formulating CIP with improved solubility, bioavailability and antimicrobial activity.