Journal of Antimicrobial Agents

Characterization of impurities present in generic antimicrobial agents is not required according to the approval criteria for their sale worldwide. To assess the safety of generics, we conducted a structural estimation of impurities in six piperacillin/tazobactam generics and carried out an in silico analysis. Namely, these generics were compared with the brand name drug by HPLC and LC-MS. The mutagen that in silico analysis showed alert was detected in five of six generic products. It was estimated that this mutagen was an azido group of the precursor used in the synthesis process of tazobactam whose patent has expired. With regards to this mutagenic substance, pharmaceutical companies marketing a generic Piperacillin/Tazobactam product will have to check presence or absence of this mutagen before introducing the product to the market.

Introduction: Antibiotic resistance is a global healthcare problem, strongly connected to hospital acquired infections. The aim of the study was to imprint doctors' perceptions and beliefs regarding antibiotics use and resistance, and infection prevention and control measures as well.

Material and Methods: The current study was conducted in Messolonghi hospital and in Agioi Anargiroi hospital. A specific questionnaire was administered to 123 clinicians of varying specialties, mostly interns.

Results: Drawbacks were detected in staff training in terms of proper antibiotic prescription. Their prescribing decisions were mainly affected by their knowledge, training and their previous experience. The vast majority of the participants consider antibiotic resistance as a serious national problem, driven by antibiotic overprescribing. They also believe hospital acquired infections are a serious health problem, with major effects on healthcare quality and cost. However, few successfully responded in the relative questionnaire regarding patient colonization from nosocomial pathogens and although they were informed about Personal Protective Measures, few had knowledge of their proper use.

Discussion: This study indicates that the application of coordinated antimicrobial programs (antibiotic stewardship) as well as clinician training in infection prevention and control is imperative for Public Hospitals in Greece.

The purpose of this study is to prove the potential safe use of AKWATON as a new antimicrobial product. Many service products are often removed from the market due to their toxic effects on the human body or to their aggressiveness towards the environment. Antimicrobial products such as disinfectants may contain harmful ingredients that can cause disease. Some disinfecting products are corrosive or irritating; others produce strong odors, which in the long run can cause real health problems. AKWATON is a new disinfectant, member of the family of guanidine polymers.

Its bactericidal, fungicidal and sporicidal properties have been demonstrated and widely documented. In this study, the toxic effects of AKWATON and of three well known commercial antimicrobial products currently on market, were evaluated and compared on various human tissues including eyes, lung, skin and liver cells. The testing were performed using the TB (Trypan blue) and MTT (3-(4,5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) methods. Cell-cultures and the different tests done, showed that the AKWATON based-disinfectant was much less toxic, killing many fewer cells than the commercial disinfectants. It spared more than 64% of skin cells; 65% of lung cells; 66% of eye cells and 64% of liver cells while some well-known disinfectants currently marketed killed 100% of cells. This study demonstrated that AKWATON can be used as an odorless, colorless, non-corrosive and harmless disinfectant for hospital, agriculture industry, farming, food service and household facilities or as antiseptic.

Ceragenins are small molecule mimics of endogenous antimicrobial peptides (AMPs), and as such display broadspectrum antimicrobial activity. These molecules are derived from a common bile acid and can be prepared at a large scale. Because ceragenins are not peptide based, they are not substrates for proteases. Gram-negative and positive bacteria are susceptible to ceragenins, including drug resistant organisms. Although ceragenins and colistin have common features, ceragenins retain full antibacterial activity against colistin-resistant Gram-negative bacteria. Bactericidal activity of ceragenins involves selective association with bacterial membranes followed by membrane depolarization. Due to this mechanism of action, which provides bactericidal activity against sessile bacteria, ceragenins eradicate established biofilms. Lipid-enveloped viruses (e.g. vaccinia) are deactivated by ceragenins, and topical application of a lead ceragenin decreases transmission of the virus in skin in a murine model. More recently, the activities of ceragenins against fungal pathogens have been reported, with minimum inhibition concentrations comparable to clinically used anti-fungal agents. In addition to antimicrobial activities, ceragenins have been shown to display some of the “secondary” activities attributed to AMPs. In vivo use of ceragenins to eradicate biofilms, prevent infection and accelerate bone growth demonstrate some of the types of applications in which ceragenins may be used to augment or replace activities of endogenous AMPs.

Congenital asplenia is a rare life-threatening condition, often presenting with sepsis caused by encapsulated pathogens. It may arise as part of situs abnormalities or result from an unrelated specific defect of spleen development. Isolated congenital asplenia is a very rare condition. We report a case of asplenia revealed by severe sepsis and multi-organ failure in a previously healthy 25-year-old male how had never undergone any surgical procedures. Blood cultures grew Streptococcus oralis four days after admission. Computed tomography revealed pneumonia and asplenia. The patient was finally diagnosed as Streptococcal sepsis revealing isolated congenital asplenia. Cephalosporin and levofloxacin were administered and the patient died following cardiopulmonary arrests. No family history for this condition was reported. Clinicians should pay attention to the congenital asplenia in Streptococcal disease, particularly in the event of overwhelming sepsis. In affected individuals, the use of appropriate antibiotic prophylaxis and immunisations could save lives.

Today more than past we need to improve clinical outcomes in the management of infectious disease related to patient in critical conditions (septic shock, sepsis, MOF, invasive fungal infections, HIV, peritonitis, meningitis, endocarditis, osteomyelitis, pneumonia, severe UTI, proteases infections and other). The same way we can see the high efficacy of some new drugs in eradicate severe infectious (as CEPAT), saving cost for transplant. This condition needs today an active role and permanent presence of clinical pharmacist in medical team because these therapies highly involved in patient’s health. The objective of this work is to analyze the role of clinical pharmacist in infectious disease medical team observing some in our opinion relevant publication and the positive effect on clinical outcomes. Infectious disease needs today new management systems to contain the increase of antimicrobial resistance in an era of few new and innovative drug discovered by pharmaceutical industries. Clinical pharmacist can give to the physicians a great help in this field to improve clinical outcomes, reducing toxicity, containing costs but also to preserve the antimicrobial potential of the antimicrobials (as safe-life drugs). These are only some of the many reason to apply the clinical pharmacist competence in patient medical team.

Misuse and overdose of antibiotics in agriculture and human disease lead to a worldwide problem of resistant bacteria. In 2012, 10,000 metric tons of antibiotics in the US and 8,000 in Europe were used in animals for the food industry. Resistance can be transferred within and between bacteria species, but also spread easily over to humans by contact with contaminated food, soil or infected animals and patients. To find a successful therapy against resistant microbes is extremely difficult due to the high cost of developing next generation antibiotics and its production, but also because of bacteria ability of developing new mechanisms against these drugs. Therefore, technology based on avian antibodies IgYs can be a strong alternative for antibiotic therapy. Advantages of IgYs include: low costs, effective and non-harmful method of production. But the strongest argument is that they cannot be affected by bacterial resistance. IgYs can be used not only as a preventative or therapeutic but also as growth promoters in food production. In this review we present the reasons for antibiotic resistance in bacteria and its consequences in the field of farming and human medicine, including molecular biology mechanisms and statistics. Furthermore we introduce IgYs as a promising and potential candidate for the replacement of antibiotics in the near future.

Production of antitumor agent(s) from alternative natural marine microbial resources may decrease or avoid the bad side effects of the used anti-tumour chemotherapeutic agents and may increase the specificity of the antitumor agents to be safer for human application. So, this study aimed to search for new alternative antitumor agent producers using two recommended bioassays (Red Potato Disc Bioassay and Sulforhodamine B Bioassay). The obtained results indicated the isolation of three new marine actinomycetes strains from the western harbor of Alexandria, they identified using the 16S rRNA gene sequence as Streptomyces sp. strain AMS11, Nocardiopsis halotolerans strain AMS10b and Nocardiopsis halotolerans strain AMS10a. The bio-toxicity test was carried out using the biomarker Artemia salina, they showed a moderate toxicity level (LC50< 1000 ppm). The antitumor activities of their supernatants against the colon cancer cell line (HCT116) and the liver cancer cell line (HEPG2) showed promising results in comparison to the recommended chemotherapeutic drug 5-flourouracil used for the treatment of both liver and colon cancer cells. The optimization for antitumor activity was performed using the Plackett –Burman experimental design.