The aim of the present work was to prepare and evaluate the oral mucoadhesive sustained release nanoparticles of clarithromycin and omeprazole in order to improve patient compliance by improving its therapeutic effect and reducing its dose-related side effects. The clarithromycin- and omeprazole-containing gliadin nanoparticles were prepared by the desolvation method using Pluronic F-68 as a stabilizing agent. The results showed that this method is reproducible, easy, and leads to the efficient entrapment of drug as well as formation of spherical particles ranging from 400 to 650 nm. The maximum percentage of drug entrapment for clarithromycin and omeprazole was 81.7 +/- 2.2 and 73.7 +/- 3.9%, respectively, whereas the percentage of yield of the system was 85.1 +/- 1.9%. The sustained release behavior of gliadin nanoparticles was evaluated in phosphate-buffered saline (pH 7.4) and simulated gastric fluid (pH 1.2), at 37 +/- 1 degrees C. Their mucoadhesive properties were determined by in vitro and in vivo methods. In vitro antibacterial activity of the formulations was performed on isolated culture of Helicobacter pylori, which showed greater eradication effect of dual therapy entrapped formulations when compared with single therapy containing formulations and plain drugs.
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With the changing face of modern medicine and increased use of new antimicrobial compounds against Streptococcus pyogenes, as macrolides, in recent years more strains developed new resistance to macrolides and lincosamides. This is of interest because some scientists believe that the new antibiotics policies possibly influence the rate of resistance in Streptococcus pyogenes: the pattern of resistance to macrolides is complex and involving cross or co-resistance with chemically unrelated or related agents, as lincosamides. To obtain current epidemiological data on antimicrobial resistance of Streptococcus pyogenes, we performed an year surveillance study: the rate of resistance to erythromycin was from 4% in October 1994 to 55% in December 1995, and in the same time clarithromycin was from 0% to 46% and clindamycin from 0% to 32%.
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Patient clinic, screened for non-bleeding gastrointestinal conditions including celiac disease (antiendomysial antibodies), autoimmune atrophic gastritis (hypergastrinemia with strongly positive antiparietal cell antibodies) and H. pylori infection (IgG antibodies confirmed by urease breath test).
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Collective evidences suggest the causal association of Helicobacter pylori infection with iron deficiency anemia. Generation of free radicals against this bacterium can lead to turbulence in oxidative-antioxidative system. This study was undertaken to evaluate the marker of oxidative protein injury, protein carbonylation, and total antioxidant status in anemic H. pylori-infected patients and to observe the alteration in them after treatment for 1 month with oral ferrous sulfate and anti-H. pylori therapy. Twenty anemic H. pylori-infected patients were randomly divided into 2 groups. The H. pylori-infected patients in Group I received both iron supplementation and anti-H pylori therapy, whereas patients in Group II received only the iron supplementation. Fifteen healthy volunteers served as controls. All the study parameters were estimated after 1 month of the treatment.
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Pharmaceutical and personal care products (PPCPs) residues are being highlighted around the world as of emerging concern in surface waters. Here the occurrence of PPCPs in the central and lower Yangtze River, along with four large freshwater lakes within the river basin (Dongting, Poyang, Tai, and Chao) was reported. Fifteen out of twenty selected PPCPs were detected in the collected surface water samples. Caffeine, paraxanthine, sulfamethazine, and clindamycin were detected with 100 percent frequency in the Yangtze River. In the river, the highest average concentration was observed for erythromycin (296 ng L(-1)), followed by caffeine (142 ng L(-1)) and paraxanthine (41 ng L(-1)). In the four lakes, total PPCP concentrations were much higher in the Chao (1547 ng L(-1)) and Tai (1087 ng L(-1)) lakes compared to the Poyang (108 ng L(-1)) and Dongting (137 ng L(-1)) lakes. Lincomycin and clindamycin were most abundant in the lakes, especially in the Tai Lake. Environmental risk assessment for the worst case scenario was assessed using calculated risk quotients, and indicates a high environmental risk of erythromycin and clarithromycin in the Yangtze River, clarithromycin in the Chao Lake, and clindamycin in the Tai Lake.
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The patient was a 67-year-old man with diabetes mellitus who had been to a hot spring spa a few days before his admission. The diagnosis of Legionella pneumonia was made using a urinary antigen assay. Intravenous pazufloxacin and oral clarithromycin were started. However, despite these treatments, he developed acute respiratory distress syndrome (ARDS). He was administered the combination of intravenous pazufloxacin and erythromycin, corticosteroid, and sivelestat for two weeks. Then he was successfully recovered. The outcome suggests that treatment with corticosteroid and sivelestat, in addition to a combination of appropriate anti-Legionella antibiotics, should be considered for patients with severe Legionella pneumonia with ARDS.
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Therapeutic drug monitoring (TDM) of anti-tuberculosis (TB) drugs is beneficial for patients responding slowly to treatment and those with multidrug-resistant TB. We used ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) to develop a rapid method for simultaneously measuring the blood concentrations of nine second-line anti-TB drugs: streptomycin, kanamycin, clarithromycin, cycloserine, moxifloxacin, levofloxacin, para-aminosalicylic acid, prothionamide and linezolid.