We report a case of acute hepatotoxicity in a 42-yearold woman after administration of clindamycin for a dental infection. After 6 d of treatment, she had fatigue, nausea, vomiting, anorexia, pruritus and jaundice. He...We report a case of acute hepatotoxicity in a 42-yearold woman after administration of clindamycin for a dental infection. After 6 d of treatment, she had fatigue, nausea, vomiting, anorexia, pruritus and jaundice. Her laboratory analysis showed alanine aminotransferase （ALT）, 1795 IU/L （normal range 0-40）; aspartate aminotransferase （AST）, 1337 IU/L （normal range 5-34）; alkaline phosphatase （ALP）, 339 IU/L （normal range 40-150）; 7-glutamyl transpeptidase （GGT）, 148 IU/L （normal range 9-64 IU/L）; total bilirubin, 4.1 mg/dL; direct bilirubin, 2.9 mg/dL and prothrombin time （PT）, 13.5 s, with international normalized ratio （INR）, 1.04. She was hospitalized, with immediate drug discontinuation. Her liver biopsy specimen showed mixed-type （both hepatocellular and cholestatic） hepatic injury, compatible with a diagnosis of drug-induced hepatitis. An objective causality assessment using the Naranjo probability scale suggested that clindamycin was the probable cause of the acute hepatitis. In susceptible individuals, clindamycin use may lead to acute mixedtype liver toxicity. Complete recovery may be possible if the drug is discontinued before severe liver injury is established.展开更多
In this study, we developed a polymeric nanofiber patch(PNP) for topical disease treatment using electrohydrodynamic atomization(EHDA). The nanofibers were prepared using various concentrations of polyvinyl alcohol(PV...In this study, we developed a polymeric nanofiber patch(PNP) for topical disease treatment using electrohydrodynamic atomization(EHDA). The nanofibers were prepared using various concentrations of polyvinyl alcohol(PVA) and tamarind seed gum and loaded with clindamycin HCl as a model drug. The precursor polymer solutions were sprayed using the EHDA technique; the EHDA processing parameters were optimized to obtain blank and drug-loaded PNPs. The skin adherence, translucence, and ventilation properties of the prepared PNPs indicated that they are appropriate for topical application. The conductivity of the polymer solution increased with increasing PVA and clindamycin concentrations, and increasing the PVA concentration enhanced the solution viscosity. Based on scanning electron microscopy analysis, the PVA concentration had a pronounced effect on the morphology of the sprayed product. Nanofibers were fabricated successfully when the solution PVA concentration was 10%, 13%, or 15%(w/v). The applied voltage significantly affected the diameters of the prepared nanofibers, and the minimum nanofiber diameter was 163.86 nm. Differential scanning calorimetry and X-ray diffraction analyses indicated that the modeldrug was dispersed in PVA in an amorphous form. The PNP prepared with a PVA:gum ratio of 9:1 absorbed water better than the PVA-only PNP and the PNP with a PVA:gum ratio of 9.5:0.5. Moreover, the PNPs loaded with clindamycin at concentrations of 1%–3% prohibited the growth of Staphylococcus aureus more effectively than clindamycin gel, a commercially available product.展开更多
[ Objective] To study the effects of clindamycin on germ cells of male mice. [Method] A total of 48 healthy adult male mice were randomly divided into group A, group B, group C and control group, 12 mice in each group...[ Objective] To study the effects of clindamycin on germ cells of male mice. [Method] A total of 48 healthy adult male mice were randomly divided into group A, group B, group C and control group, 12 mice in each group. The mice in the group A, group B and group C were respectively administrated with clindamycin at doses of 15, 30 and 60 mg/kg.d via intraperitoneai injection, and those in the control group were trea- ted with normal saline. On Day 29 after administration, the mice were killed by dislocation, and the sperm motility rate, sperm deformity rate and the percentage of sperm having swollen tail membrane were determined, respectively. [ Result] The sperm motility rate and the percentage of sperm having swollen tail membrane of the group B and group C were lower than those of the control group; and the sperm deformity rate of the group B and group C was higher than that of the control group. The sperm motility rate, sperm deformity rate and percentage of sperm having swollen tail membrane had no significant difference between the group A and control group. [ Conclusion] The clindamycin at a dose equal to or more than that used for severe infection affects the normal function of sperm in mice.展开更多
Objective:To investigate the infection of hospital-and community-acquired"erythromycininduced clindamycin resistant"strains or D-test positives of clinical isolates of Staphylococcus aureus(S.aureus)(with an...Objective:To investigate the infection of hospital-and community-acquired"erythromycininduced clindamycin resistant"strains or D-test positives of clinical isolates of Staphylococcus aureus(S.aureus)(with and without methicillin resistance)in a hospital.Methods:Strains of S.aureus isolated from clinical specimens were subjected to D-test and antibiotic profiling.Results:Of the total 278 isolates,140(50.35%)were D-test positives and the rest were D-test negatives.Further,of 140(100%)pesitives,87(62.14%)and 53(37.85%)strains were from males and females,respectively.Of 140(100%)pesitives,117(83.57%)were methicillin resistant S.aureus and23(16.42%)were methicillin sensitive S.aureus;of 140 strains,103(73.57%)strains front persons with and 37(26.42%)were without related infections;of 140 strains,91(65%)and 49(35%)were from hospital-and community-acquired samples,respectively.In 140 strains,118(84.28%)with comorbidities and 22(15.71%)without comorbidities cases were recorded;similarly,persons with prior antibiotic uses contributed 108(77.14%)and without 32(22.85%)positive strains.These binary data of surveillance were analyzed by a univariate analysis.It was evident that the prior antibiotic uses and comorbidities due to other ailments were the determinative factors in D-test positivity,corroborated by low P values,P=0.001 1 and 0.0024,respectively.All isolates(278)were resistant to17 antibiotics of nine groups,in varying degrees;the minimum of 28%resistance for vancomycin and the maximum of 97%resistance for gentamicin were recorded.Further,of 278 strains,only42(15.1%)strains were resistant constitutively to both antibiotics,erythromycin resistant and clindamycin resistant,while 45(16.2%)strains were constitutively sensitive to both antibiotics(erythromycin sensitive,and clindamycin sensitive).Further,of the rest 191(68.7%)strains were with erythromycin resistant and clindamycin resistant,of which only 140(50.35%)strains were D-test positives,while the rest 51(18.34%)strains were D-test negatives.Conclusions:In view of high prevalence of D-test positive S.aureus strains,and equally high prevalence of multidrug resistant strains both in community and hospital sectors,undertaking of D-test may be routinely conducted for suppurative infections.展开更多
Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a global superbug widely distributed in hospitals, communities and livestock settings. This study investigated the presence and molecular characterizat...Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a global superbug widely distributed in hospitals, communities and livestock settings. This study investigated the presence and molecular characterization of MRSA co-resistance to clindamycin and vancomycin in the southeastern region of Nigeria. The susceptibility of these organisms to other selected antibiotics was also investigated. Method: Biological samples were obtained from consenting patients from three establishments in Enugu, Nigeria and cultured for isolation and purification. The pure isolates were subjected to antimicrobial susceptibility profiling using conventional antibiotics. The genomic DNAs of the pure isolates were isolated using the Promega genomic DNA purification kit while the antibiotic resistance genes (mecA) genes were identified using a multiplex polymerase chain reaction. Also, the minimum inhibitory concentration of the clindamycin and vancomycin antibiotics was determined as well as their combined activity on the MRSA isolates. Results: A large proportion (71%) of the MRSA isolates was from urine samples and then from the High Vaginal Swab (19%). All the isolates were resistant to cloxacillin while 95% were resistant to ciprofloxacin. MRSA isolates demonstrated resistance to clindamycin (with MIC of 23.44 - 250 μg/ml) and to vancomycin (with MIC of 62.5 - 250 μg/ml). The isolated MRSA also demonstrated multidrug-resistant traits. The combined effects of vancomycin and clindamycin against different species of MRSA exhibited additive, antagonistic and indifferent effects and none had a synergistic effect. Multiplex Polymerase Chain Reaction revealed that the majority of the strains were positive for the 162-bp internal fragment of the mecA gene of MRSA and basically displayed SCCmec type III, indicating that they were multidrug-resistant and hospital-acquired. Conclusion: Clindamycin and vancomycin-resistant MRSA infections are also within the Eastern region of Nigeria as found in other countries of the world. This superbug, therefore, may require drastic and urgent measures to curtail its spread and attendant healthcare challenges like outbreaks of infections. In addition, strict adherence to antibiotic policy and continuous surveillance is highly advocated.展开更多
Introduction: S. aureus is recognized as the common cause of nosocomial and community-acquired infections. Macrolide-Lincosamide-Streptogramin B (MLSB) is thought to be alternative therapies against MRSA infections. C...Introduction: S. aureus is recognized as the common cause of nosocomial and community-acquired infections. Macrolide-Lincosamide-Streptogramin B (MLSB) is thought to be alternative therapies against MRSA infections. Clindamycin is the most favored agent because of exceptional pharmacokinetic characteristics. However, increasing resistance to clindamycin among MRSA strains is a serious challenge. The current study investigated the profile of clindamycin resistance among MRSA isolates from Humans, and their respective livestock (in particular swine) using D-test in greater Kabale region. Materials and Methods: Three hundred phenotypic MRSA isolates previously isolated from Humans and swine were confirmed by mecA PCR. We performed D-test using erythromycin (15 μg) and clindamycin (2 μg) discs in accordance to Clinical and Laboratory Standards Institute (CLSI) protocol. Results: Of all 300 MRSA isolates, 6% (n = 18) were sensitive to Erythromycin and Clindamycin (S). The rate of inducible clindamycin resistance (iMLSB) was 42% (n = 125) and 38% (n = 115) was resistance to both Erythromycin and clindamycin (cMLSB). However, 14% (n = 42) were resistant to erythromycin but sensitive to clindamycin (MS) without “D” zone negative. Conclusion: Clindamycin resistance (both cMLSB and iMLSB) among MRSA was high and “D” test should be adopted routinely during antimicrobial susceptibility testing by disc diffusion testing to rapidly detect iMLSB and cMLSB.展开更多
Extraction of third mandibular tooth is one of the most commonly performed surgical procedures in oral surgery. One of the most common complications following the extraction of third mandibular molar teeth is dry sock...Extraction of third mandibular tooth is one of the most commonly performed surgical procedures in oral surgery. One of the most common complications following the extraction of third mandibular molar teeth is dry socket (alveolar osteitis). Dry socket is the delayed healing of the wound of the alveolar bone after dental extractions. The purpose of this study was to determine if the intra-alveolar application of Clindamycin could reduce the incidence of dry socket following the extraction of third mandibular molar tooth. Patients who qualified for the prospective, randomized, double-masked, placebo-controlled trial were randomly divided into 2 groups, each group 30 patients. The first group (30 patients) included smokers and the second group (30 patients) included non smokers. Both groups had the mandibular third molar extracted in both sides at the same time. In total, 120 third molars were extracted. The left site was a study group in which we applied the clindamycin and the right site was a control group. The patients were also divided by gender. Dry socket occurred in 3.3% of cases for patients whom were given Clindamycin, regardless of their smoking habits, as opposed to 31.7% for those who did not receive the antibiotic. Results clearly showed that Clindamycin had a huge impact on reducing dry socket regardless of smoking habits.展开更多
A simple efficient isocratic reversed-phase HPLC method was developed and validated for the determination of clindamycin palmitate hydrochloride (CPH) and its commercially available oral solution products. Separation ...A simple efficient isocratic reversed-phase HPLC method was developed and validated for the determination of clindamycin palmitate hydrochloride (CPH) and its commercially available oral solution products. Separation was achieved on a Phenomenex Zorbax (Luna) cyano column (150 × 4.6 mm, 5 μm) with a Phenomenex cyano guard cartridge (4 × 3.0 mm) on Agilent 1050 series HPLC system. CPH and its resolution standard lincomycin were eluted isocratically at a flow rate of 1 mL/min with a simplified mobile phase (potassium phosphate buffer (5 mM, pH 3.0)—acetonitrile—tetrahydrofuran (20:75:5, v/v/v)) and detected at 210 nm. The column was maintained at 25?C. The method was validated according to USP category I requirements. Robustness and forced degradation studies were also conducted. CPH marketed drug products were obtained from a drug distributor and assayed for potency using the validated method. Validation acceptance criteria were met in all cases. The analytical range for CPH was 15 - 500 μg/mL and the linearity was r2 > 0.999 over three days. The method was determined to be specific and robust. Both accuracy (92.0% - 103.8%) and precision (0.67% - 1.52%) were established across the analytical range for low, intermediate and high QC concentrations. Method applicability was demonstrated by analyzing two marketed products of CPH, in which results showed potency >98%. The method was determined to be an enhancement over the current USP methodology for assay as a result of increased efficiency, reduced organic solvents and the elimination of matrix modifiers. This method was successfully applied for the quality assessment of: 1) currently marketed drug products and 2) will in future assess the product quality of novel dosage forms of CPH for pediatric use.展开更多
<b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"...<b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">To </span><span style="font-family:Verdana;">evaluat</span><span style="font-family:Verdana;">e</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> the efficacy of He-Ne laser in combination with topical clindamycin in the treatment of AV at 108 Military Central Hospital from Oct 2015 to Aug 2016. </span><b><span style="font-family:Verdana;">Subjects and Methods</span></b><span style="font-family:Verdana;">: 61 patients with AV were divided into 2 groups: Group 1: 31 patients were treated with He-Ne laser in </span><span style="font-family:Verdana;">combination with topical Clindamycin, Group 2: 30 patients were only treated </span><span style="font-family:Verdana;">with topical clindamycin. Laser HE-NE was applied 2 times/week </span></span><span style="font-family:Verdana;">for</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> 6 weeks. </span><b><span style="font-family:Verdana;">Result</span></b><span><span style="font-family:Verdana;">: After 3 months of treatment Group 1: very good</span><span style="font-family:Verdana;">—51</span></span></span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;">6%, good—48</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;">4%. Group 2: very good—30%, good—50% and moderate—20%. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> </span><span style="font-family:Verdana;">The combination of He-Ne laser with topical clindamycin shows more rapid clinical improvement compared to topical clindamycin alone in the treatment of mild and moderate AV.</span>展开更多
Diabetic foot complications are very common and represent a serious health problem in Mexico because of their high frequency, high costs and difficulties in handling. The treatment of choice to inhibit bacteria relate...Diabetic foot complications are very common and represent a serious health problem in Mexico because of their high frequency, high costs and difficulties in handling. The treatment of choice to inhibit bacteria related to diabetic foot ulcer consists mainly of the use of cefotaxime however the problem with this treatment (antibiotics) is not always effective due to the pathophysiological condition of the patient, together with the resistance bacteria develop to the drugs. OMS has suggested the use of probiotics for research directed to the development of microbial interference therapies. This project used the Lyophilized conditioned medium with probiotics, extracellulars of probiotics, because there are reports in which wound healing in mice is observed employing probiotics. The objective of this study was to evaluate the biological activity of cefotaxime, clindamycin and thelyophilized conditioned media Lactobacillus acidophilus (LCMLa) on bacterias isolated from diabetic foot ulcer, this bioassay was performed by the turbidimetric method. The macroscopic analysis of the colonies was carried out and the morphological analysis of the bacteria was carried out using the atomic force microscope;in addition, the type of Gram and oxygen requirements for its growth were determined. From the diabetic foot ulcers, three strains were isolated, of which strain 1 and 3 whose morphology corresponds to a bacillus, was susceptible to cefotaxime and to the lyophilized conditioned medium of L. acidophilus. The potential of microbial interference that exhibits L. acidophilus on bacteria related to diabetic foot ulcer is demonstrated.展开更多
Objective:To investigate the pharmacokinetics of clindamycin phosphate vaginal gel in healthy Chinese female volunteers.Methods:Ten healthy Chinese female volun- teers were intravaginally given with 5.0g of clindamyci...Objective:To investigate the pharmacokinetics of clindamycin phosphate vaginal gel in healthy Chinese female volunteers.Methods:Ten healthy Chinese female volun- teers were intravaginally given with 5.0g of clindamycin phosphate vaginal gel (equivalent to 100mg of clindamycin) once for single dose treatment,and 5.0g,once a day for 3 days,for mul- tiple dose treatment.The serum concentration of clindamycin were determined by HPLC-MS method and its pharmacokinetic parameters of clindamycin were calculated by DAS 1.0 soft- ware.Results:The main pharmacokinetic parameters of clindamycin for single dose and multiple doses were as follows:t_(1/2) were (15.30±2.62) hours and (14.78±2.49) hours,Tmax were (4.88±0.94) hours and (4.70±0.59) hours,Cmax were (38.30±22.77) ng/ml and (44.87±26.71) ng/ml,AUC0_(-∞) were (783.45±351.19) ng·ml^(-1)·h^(-1) and (1015.68±456.95) ng·ml^(-1)·h^(-1),respectively.Conclusion:The Cmax of clindamycin phosphate vaginal gel after a single dose and multiple doses are obviously lower and t_(1,2) are longer than that of clindamycin phosphate oral preparations,which suggests that clindamycin phosphate vaginal gel acts locally and can be slowly absorbed to circulation for systemic actions.展开更多
Objective:To evaluate the synergistic effect ofα-mangostin with tetracycline,erythromycin,and clindamycin against bacteria involved in acne production.Methods:A broth microdilution method was used to determine the mi...Objective:To evaluate the synergistic effect ofα-mangostin with tetracycline,erythromycin,and clindamycin against bacteria involved in acne production.Methods:A broth microdilution method was used to determine the minimum inhibitory concentration(MIC)ofα-mangostin and a range of antibiotics.Synergistic effects on antibacterial activity were determined based on their own MIC,and then using a checkerboard method and a time-kill assay at 37°C for24 h.Results:α-Mangostin exhibited antibacterial activity against Propionibacterium acnes,Staphylococcus aureus,S.epidermidis and S.pyogenes with MIC values of 0.78,3.13,0.78,and 6.25μg/m L,respectively.The results of the checkerboard assay showed thatα-mangostin produced synergistic effects with tetracycline,erythromycin,and clindamycin against all tested bacteria,with a fractional inhibitory concentration index(FICI)between 0.09 and 0.32.Moreover,time-kill curve data indicated thatα-mangostin increased the antibacterial activity of tetracycline,erythromycin,and clindamycin.Conclusion:These findings suggested thatα-mangostin may be used to enhance the antibacterial activity of some antibiotics against bacteria involved in acne production.展开更多
Background: The preferred therapeutic regimen for Toxoplasma encephalitis (TE) is a combination of pyrimethamine and sulfadiazine, and trimethoprim-sulfamethoxazole (TMP-SMX) plus azithromycin is the widespread altern...Background: The preferred therapeutic regimen for Toxoplasma encephalitis (TE) is a combination of pyrimethamine and sulfadiazine, and trimethoprim-sulfamethoxazole (TMP-SMX) plus azithromycin is the widespread alternative therapeutic regimen. The synergistic sulfonamides tablet contains TMP, sulfadiazine, and SMX and hypothetically could be used for TE treatment. This study aimed to compare the efficacy and safety of synergistic sulfonamides plus clindamycin (regimen B) with TMP-SMX plus azithromycin (regimen A) for the treatment of human immunodeficiency virus (HIV) associated TE.Methods: This was an open-labeled, multi-center randomized controlled trial recruited from 11 centers. Each recruited patient was randomly assigned to receive regimen A or regimen B for at least 6 weeks. The overall response was evaluated by assessment of the clinical response of TE-associated clinical features and the radiological response of TE-associated radiological findings. The overall response rate, clinical response rate, radiological response rate, and adverse events were assessed at 2, 6, and 12 weeks. Death events were compared between the two regimens at 6, 12, and 24 weeks.Results: A total of 91 acquired immunodeficiency syndrome (AIDS)/TE patients were included in the final analysis (44 in regimen Avs. 47 in regimen B). The overall response rate, which refers to the combined clinical and radiological response, was 18.2% (8/44) for regimen A and 21.3 % (10/47) for regimen B at week 6. The results of clinical response showed that, in comparison with regimen A, regimen B may perform better with regards to its effect on the relief of clinical manifestations (50.0% [22/44]vs. 70.2% [33/47],P = 0.049). However, no significant differences in radiological response, mortality events, and adverse events were found between the two regimens at week 6.Conclusions: Synergistic sulfonamides plus clindamycin, as a novel treatment regimen, showed no significantly different efficacy and comparable safety in comparison with the TMP-SMX plus azithromycin regimen. In addition, the regimen containing synergistic sulfonamides may exhibit advantages in terms of clinical symptom alleviation.Trial Registration: ChiCTR.org.cn, ChiCTR1900021195.展开更多
Clindamycin phosphate （CP）, an antibacterial agent, has been reported to form several solid-state forms. The crystal structures of two CP solvates, a dimethyl sulfoxide （DMSO） solvate and a methanol/water solvate ...Clindamycin phosphate （CP）, an antibacterial agent, has been reported to form several solid-state forms. The crystal structures of two CP solvates, a dimethyl sulfoxide （DMSO） solvate and a methanol/water solvate （solvate V）, have been determined by single crystal X-ray diffraction. The properties and transformations of these forms were characterized by powder X-ray diffraction, Single-crystal X-ray diffraction, differential scanning calorimetry, thermo gravimetric analysis, hot-stage microscopy, and dynamic vapor sorption. Very different hydrogen bonding networks exist among the host-host and host-solvent molecules in the two crystal structures, resulting in different moisture stabilities. The thermal stabilities of the two solvates upon heating and desolvation were also studied. When the temperature was above the boiling point of methanol, solvate V converted to a polymorphic phase after a one step desolvation process, whereas the desolvation temperature of the DMSO solvate was below the boiling point of DMSO. At the relative humidity above 43%, the DMSO solvate transformed to a hydrate at 25 ℃. In contrast, solvate V did not transform at any of the humidities studied.展开更多
Objective:Combination therapy is currently the preferred acne treatment.We conducted this study to compare the efficacy and tolerability of 0.1%adapalene with 1%clindamycin versus 0.1%adapalene with 2.5%benzoyl peroxi...Objective:Combination therapy is currently the preferred acne treatment.We conducted this study to compare the efficacy and tolerability of 0.1%adapalene with 1%clindamycin versus 0.1%adapalene with 2.5%benzoyl peroxide(BPO)in the treatment of acne vulgaris.Methods:This study was conducted over a period of 1 year from September 2014 to September 2015.One-hundred patients aged 14 to 30 years with mild to moderate acne vulgaris were included.The patients were randomly allocated to 2 equal groups(n=50 in each group),and received a topical combination of 0.1%adapalene with 1%clindamycin andtopical combination of 0.1%adapalene with 2.5%BPO,respectively).The efficacy and tolerability of two treatments were compared.The unpaired studentt test was used to compare the difference in continuous variables between 2 groups,while the chi-square test or Fisher exact test was used for categorical variables.Results:One-hundred patients with mild to moderate acne vulgaris were randomly allocated to 2 equal groups(n=50 in each group).After 12 weeks of treatment,there were no significant differences between the adapalene-clindamycin and adapalene-BPO in the mean reductions in the numbers of non-inflammatory lesions(11.16±8.01 and 11.12±8.62,respectively),inflammatory papules(49.78±37.57 and 50.48±36.57,respectively),and total lesions(67.50±44.59 and 70.12±46.83,respectively).The incidence of a burning sensation was significantly greater in the adapalene-BPO group than the adapalene-clindamycin group(32%vs.6%;P=0.002).Conclusion:Topical adapalene plus clindamycin and adapalene plus BPO had similar efficacies in the treatment of acne.Adapalene with clindamycin was better tolerated than adapalene with BPO.展开更多
文摘We report a case of acute hepatotoxicity in a 42-yearold woman after administration of clindamycin for a dental infection. After 6 d of treatment, she had fatigue, nausea, vomiting, anorexia, pruritus and jaundice. Her laboratory analysis showed alanine aminotransferase （ALT）, 1795 IU/L （normal range 0-40）; aspartate aminotransferase （AST）, 1337 IU/L （normal range 5-34）; alkaline phosphatase （ALP）, 339 IU/L （normal range 40-150）; 7-glutamyl transpeptidase （GGT）, 148 IU/L （normal range 9-64 IU/L）; total bilirubin, 4.1 mg/dL; direct bilirubin, 2.9 mg/dL and prothrombin time （PT）, 13.5 s, with international normalized ratio （INR）, 1.04. She was hospitalized, with immediate drug discontinuation. Her liver biopsy specimen showed mixed-type （both hepatocellular and cholestatic） hepatic injury, compatible with a diagnosis of drug-induced hepatitis. An objective causality assessment using the Naranjo probability scale suggested that clindamycin was the probable cause of the acute hepatitis. In susceptible individuals, clindamycin use may lead to acute mixedtype liver toxicity. Complete recovery may be possible if the drug is discontinued before severe liver injury is established.
基金the Faculty of Pharmaceutical Sci-ences,Burapha University for financial support(grant num-bers 9/2558)
文摘In this study, we developed a polymeric nanofiber patch(PNP) for topical disease treatment using electrohydrodynamic atomization(EHDA). The nanofibers were prepared using various concentrations of polyvinyl alcohol(PVA) and tamarind seed gum and loaded with clindamycin HCl as a model drug. The precursor polymer solutions were sprayed using the EHDA technique; the EHDA processing parameters were optimized to obtain blank and drug-loaded PNPs. The skin adherence, translucence, and ventilation properties of the prepared PNPs indicated that they are appropriate for topical application. The conductivity of the polymer solution increased with increasing PVA and clindamycin concentrations, and increasing the PVA concentration enhanced the solution viscosity. Based on scanning electron microscopy analysis, the PVA concentration had a pronounced effect on the morphology of the sprayed product. Nanofibers were fabricated successfully when the solution PVA concentration was 10%, 13%, or 15%(w/v). The applied voltage significantly affected the diameters of the prepared nanofibers, and the minimum nanofiber diameter was 163.86 nm. Differential scanning calorimetry and X-ray diffraction analyses indicated that the modeldrug was dispersed in PVA in an amorphous form. The PNP prepared with a PVA:gum ratio of 9:1 absorbed water better than the PVA-only PNP and the PNP with a PVA:gum ratio of 9.5:0.5. Moreover, the PNPs loaded with clindamycin at concentrations of 1%–3% prohibited the growth of Staphylococcus aureus more effectively than clindamycin gel, a commercially available product.
基金supported by the grants from the University Scientific Research Project of Inner Mongolia Autonomous Region (NJzc08159)
文摘[ Objective] To study the effects of clindamycin on germ cells of male mice. [Method] A total of 48 healthy adult male mice were randomly divided into group A, group B, group C and control group, 12 mice in each group. The mice in the group A, group B and group C were respectively administrated with clindamycin at doses of 15, 30 and 60 mg/kg.d via intraperitoneai injection, and those in the control group were trea- ted with normal saline. On Day 29 after administration, the mice were killed by dislocation, and the sperm motility rate, sperm deformity rate and the percentage of sperm having swollen tail membrane were determined, respectively. [ Result] The sperm motility rate and the percentage of sperm having swollen tail membrane of the group B and group C were lower than those of the control group; and the sperm deformity rate of the group B and group C was higher than that of the control group. The sperm motility rate, sperm deformity rate and percentage of sperm having swollen tail membrane had no significant difference between the group A and control group. [ Conclusion] The clindamycin at a dose equal to or more than that used for severe infection affects the normal function of sperm in mice.
基金supported by the research scheme from CSIR(New Delhi),No.21(0859)/11/EMR-11
文摘Objective:To investigate the infection of hospital-and community-acquired"erythromycininduced clindamycin resistant"strains or D-test positives of clinical isolates of Staphylococcus aureus(S.aureus)(with and without methicillin resistance)in a hospital.Methods:Strains of S.aureus isolated from clinical specimens were subjected to D-test and antibiotic profiling.Results:Of the total 278 isolates,140(50.35%)were D-test positives and the rest were D-test negatives.Further,of 140(100%)pesitives,87(62.14%)and 53(37.85%)strains were from males and females,respectively.Of 140(100%)pesitives,117(83.57%)were methicillin resistant S.aureus and23(16.42%)were methicillin sensitive S.aureus;of 140 strains,103(73.57%)strains front persons with and 37(26.42%)were without related infections;of 140 strains,91(65%)and 49(35%)were from hospital-and community-acquired samples,respectively.In 140 strains,118(84.28%)with comorbidities and 22(15.71%)without comorbidities cases were recorded;similarly,persons with prior antibiotic uses contributed 108(77.14%)and without 32(22.85%)positive strains.These binary data of surveillance were analyzed by a univariate analysis.It was evident that the prior antibiotic uses and comorbidities due to other ailments were the determinative factors in D-test positivity,corroborated by low P values,P=0.001 1 and 0.0024,respectively.All isolates(278)were resistant to17 antibiotics of nine groups,in varying degrees;the minimum of 28%resistance for vancomycin and the maximum of 97%resistance for gentamicin were recorded.Further,of 278 strains,only42(15.1%)strains were resistant constitutively to both antibiotics,erythromycin resistant and clindamycin resistant,while 45(16.2%)strains were constitutively sensitive to both antibiotics(erythromycin sensitive,and clindamycin sensitive).Further,of the rest 191(68.7%)strains were with erythromycin resistant and clindamycin resistant,of which only 140(50.35%)strains were D-test positives,while the rest 51(18.34%)strains were D-test negatives.Conclusions:In view of high prevalence of D-test positive S.aureus strains,and equally high prevalence of multidrug resistant strains both in community and hospital sectors,undertaking of D-test may be routinely conducted for suppurative infections.
文摘Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) is a global superbug widely distributed in hospitals, communities and livestock settings. This study investigated the presence and molecular characterization of MRSA co-resistance to clindamycin and vancomycin in the southeastern region of Nigeria. The susceptibility of these organisms to other selected antibiotics was also investigated. Method: Biological samples were obtained from consenting patients from three establishments in Enugu, Nigeria and cultured for isolation and purification. The pure isolates were subjected to antimicrobial susceptibility profiling using conventional antibiotics. The genomic DNAs of the pure isolates were isolated using the Promega genomic DNA purification kit while the antibiotic resistance genes (mecA) genes were identified using a multiplex polymerase chain reaction. Also, the minimum inhibitory concentration of the clindamycin and vancomycin antibiotics was determined as well as their combined activity on the MRSA isolates. Results: A large proportion (71%) of the MRSA isolates was from urine samples and then from the High Vaginal Swab (19%). All the isolates were resistant to cloxacillin while 95% were resistant to ciprofloxacin. MRSA isolates demonstrated resistance to clindamycin (with MIC of 23.44 - 250 μg/ml) and to vancomycin (with MIC of 62.5 - 250 μg/ml). The isolated MRSA also demonstrated multidrug-resistant traits. The combined effects of vancomycin and clindamycin against different species of MRSA exhibited additive, antagonistic and indifferent effects and none had a synergistic effect. Multiplex Polymerase Chain Reaction revealed that the majority of the strains were positive for the 162-bp internal fragment of the mecA gene of MRSA and basically displayed SCCmec type III, indicating that they were multidrug-resistant and hospital-acquired. Conclusion: Clindamycin and vancomycin-resistant MRSA infections are also within the Eastern region of Nigeria as found in other countries of the world. This superbug, therefore, may require drastic and urgent measures to curtail its spread and attendant healthcare challenges like outbreaks of infections. In addition, strict adherence to antibiotic policy and continuous surveillance is highly advocated.
文摘Introduction: S. aureus is recognized as the common cause of nosocomial and community-acquired infections. Macrolide-Lincosamide-Streptogramin B (MLSB) is thought to be alternative therapies against MRSA infections. Clindamycin is the most favored agent because of exceptional pharmacokinetic characteristics. However, increasing resistance to clindamycin among MRSA strains is a serious challenge. The current study investigated the profile of clindamycin resistance among MRSA isolates from Humans, and their respective livestock (in particular swine) using D-test in greater Kabale region. Materials and Methods: Three hundred phenotypic MRSA isolates previously isolated from Humans and swine were confirmed by mecA PCR. We performed D-test using erythromycin (15 μg) and clindamycin (2 μg) discs in accordance to Clinical and Laboratory Standards Institute (CLSI) protocol. Results: Of all 300 MRSA isolates, 6% (n = 18) were sensitive to Erythromycin and Clindamycin (S). The rate of inducible clindamycin resistance (iMLSB) was 42% (n = 125) and 38% (n = 115) was resistance to both Erythromycin and clindamycin (cMLSB). However, 14% (n = 42) were resistant to erythromycin but sensitive to clindamycin (MS) without “D” zone negative. Conclusion: Clindamycin resistance (both cMLSB and iMLSB) among MRSA was high and “D” test should be adopted routinely during antimicrobial susceptibility testing by disc diffusion testing to rapidly detect iMLSB and cMLSB.
文摘Extraction of third mandibular tooth is one of the most commonly performed surgical procedures in oral surgery. One of the most common complications following the extraction of third mandibular molar teeth is dry socket (alveolar osteitis). Dry socket is the delayed healing of the wound of the alveolar bone after dental extractions. The purpose of this study was to determine if the intra-alveolar application of Clindamycin could reduce the incidence of dry socket following the extraction of third mandibular molar tooth. Patients who qualified for the prospective, randomized, double-masked, placebo-controlled trial were randomly divided into 2 groups, each group 30 patients. The first group (30 patients) included smokers and the second group (30 patients) included non smokers. Both groups had the mandibular third molar extracted in both sides at the same time. In total, 120 third molars were extracted. The left site was a study group in which we applied the clindamycin and the right site was a control group. The patients were also divided by gender. Dry socket occurred in 3.3% of cases for patients whom were given Clindamycin, regardless of their smoking habits, as opposed to 31.7% for those who did not receive the antibiotic. Results clearly showed that Clindamycin had a huge impact on reducing dry socket regardless of smoking habits.
文摘A simple efficient isocratic reversed-phase HPLC method was developed and validated for the determination of clindamycin palmitate hydrochloride (CPH) and its commercially available oral solution products. Separation was achieved on a Phenomenex Zorbax (Luna) cyano column (150 × 4.6 mm, 5 μm) with a Phenomenex cyano guard cartridge (4 × 3.0 mm) on Agilent 1050 series HPLC system. CPH and its resolution standard lincomycin were eluted isocratically at a flow rate of 1 mL/min with a simplified mobile phase (potassium phosphate buffer (5 mM, pH 3.0)—acetonitrile—tetrahydrofuran (20:75:5, v/v/v)) and detected at 210 nm. The column was maintained at 25?C. The method was validated according to USP category I requirements. Robustness and forced degradation studies were also conducted. CPH marketed drug products were obtained from a drug distributor and assayed for potency using the validated method. Validation acceptance criteria were met in all cases. The analytical range for CPH was 15 - 500 μg/mL and the linearity was r2 > 0.999 over three days. The method was determined to be specific and robust. Both accuracy (92.0% - 103.8%) and precision (0.67% - 1.52%) were established across the analytical range for low, intermediate and high QC concentrations. Method applicability was demonstrated by analyzing two marketed products of CPH, in which results showed potency >98%. The method was determined to be an enhancement over the current USP methodology for assay as a result of increased efficiency, reduced organic solvents and the elimination of matrix modifiers. This method was successfully applied for the quality assessment of: 1) currently marketed drug products and 2) will in future assess the product quality of novel dosage forms of CPH for pediatric use.
文摘<b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">To </span><span style="font-family:Verdana;">evaluat</span><span style="font-family:Verdana;">e</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> the efficacy of He-Ne laser in combination with topical clindamycin in the treatment of AV at 108 Military Central Hospital from Oct 2015 to Aug 2016. </span><b><span style="font-family:Verdana;">Subjects and Methods</span></b><span style="font-family:Verdana;">: 61 patients with AV were divided into 2 groups: Group 1: 31 patients were treated with He-Ne laser in </span><span style="font-family:Verdana;">combination with topical Clindamycin, Group 2: 30 patients were only treated </span><span style="font-family:Verdana;">with topical clindamycin. Laser HE-NE was applied 2 times/week </span></span><span style="font-family:Verdana;">for</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> 6 weeks. </span><b><span style="font-family:Verdana;">Result</span></b><span><span style="font-family:Verdana;">: After 3 months of treatment Group 1: very good</span><span style="font-family:Verdana;">—51</span></span></span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;">6%, good—48</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;">4%. Group 2: very good—30%, good—50% and moderate—20%. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> </span><span style="font-family:Verdana;">The combination of He-Ne laser with topical clindamycin shows more rapid clinical improvement compared to topical clindamycin alone in the treatment of mild and moderate AV.</span>
文摘Diabetic foot complications are very common and represent a serious health problem in Mexico because of their high frequency, high costs and difficulties in handling. The treatment of choice to inhibit bacteria related to diabetic foot ulcer consists mainly of the use of cefotaxime however the problem with this treatment (antibiotics) is not always effective due to the pathophysiological condition of the patient, together with the resistance bacteria develop to the drugs. OMS has suggested the use of probiotics for research directed to the development of microbial interference therapies. This project used the Lyophilized conditioned medium with probiotics, extracellulars of probiotics, because there are reports in which wound healing in mice is observed employing probiotics. The objective of this study was to evaluate the biological activity of cefotaxime, clindamycin and thelyophilized conditioned media Lactobacillus acidophilus (LCMLa) on bacterias isolated from diabetic foot ulcer, this bioassay was performed by the turbidimetric method. The macroscopic analysis of the colonies was carried out and the morphological analysis of the bacteria was carried out using the atomic force microscope;in addition, the type of Gram and oxygen requirements for its growth were determined. From the diabetic foot ulcers, three strains were isolated, of which strain 1 and 3 whose morphology corresponds to a bacillus, was susceptible to cefotaxime and to the lyophilized conditioned medium of L. acidophilus. The potential of microbial interference that exhibits L. acidophilus on bacteria related to diabetic foot ulcer is demonstrated.
文摘Objective:To investigate the pharmacokinetics of clindamycin phosphate vaginal gel in healthy Chinese female volunteers.Methods:Ten healthy Chinese female volun- teers were intravaginally given with 5.0g of clindamycin phosphate vaginal gel (equivalent to 100mg of clindamycin) once for single dose treatment,and 5.0g,once a day for 3 days,for mul- tiple dose treatment.The serum concentration of clindamycin were determined by HPLC-MS method and its pharmacokinetic parameters of clindamycin were calculated by DAS 1.0 soft- ware.Results:The main pharmacokinetic parameters of clindamycin for single dose and multiple doses were as follows:t_(1/2) were (15.30±2.62) hours and (14.78±2.49) hours,Tmax were (4.88±0.94) hours and (4.70±0.59) hours,Cmax were (38.30±22.77) ng/ml and (44.87±26.71) ng/ml,AUC0_(-∞) were (783.45±351.19) ng·ml^(-1)·h^(-1) and (1015.68±456.95) ng·ml^(-1)·h^(-1),respectively.Conclusion:The Cmax of clindamycin phosphate vaginal gel after a single dose and multiple doses are obviously lower and t_(1,2) are longer than that of clindamycin phosphate oral preparations,which suggests that clindamycin phosphate vaginal gel acts locally and can be slowly absorbed to circulation for systemic actions.
基金the National Research Council of Thailand(NRCT)for providing a research grant.
文摘Objective:To evaluate the synergistic effect ofα-mangostin with tetracycline,erythromycin,and clindamycin against bacteria involved in acne production.Methods:A broth microdilution method was used to determine the minimum inhibitory concentration(MIC)ofα-mangostin and a range of antibiotics.Synergistic effects on antibacterial activity were determined based on their own MIC,and then using a checkerboard method and a time-kill assay at 37°C for24 h.Results:α-Mangostin exhibited antibacterial activity against Propionibacterium acnes,Staphylococcus aureus,S.epidermidis and S.pyogenes with MIC values of 0.78,3.13,0.78,and 6.25μg/m L,respectively.The results of the checkerboard assay showed thatα-mangostin produced synergistic effects with tetracycline,erythromycin,and clindamycin against all tested bacteria,with a fractional inhibitory concentration index(FICI)between 0.09 and 0.32.Moreover,time-kill curve data indicated thatα-mangostin increased the antibacterial activity of tetracycline,erythromycin,and clindamycin.Conclusion:These findings suggested thatα-mangostin may be used to enhance the antibacterial activity of some antibiotics against bacteria involved in acne production.
基金National Science and Technology Major Project of China during the 13th Five-year Plan Period(No. 2018ZX10302104)Key Project of Joint Medical Research Project of Science and Health in Chongqing in 2019(No. 2019ZDXM012)+1 种基金Joint Medical Research Project of Chongqing Municipal Health Commission and Chongqing Municipal Science and Technology Bureau(No. 2020GDRC004)Chongqing Talent Cultivation Program(No. cstc2021ycjh-bgzxm0275)。
文摘Background: The preferred therapeutic regimen for Toxoplasma encephalitis (TE) is a combination of pyrimethamine and sulfadiazine, and trimethoprim-sulfamethoxazole (TMP-SMX) plus azithromycin is the widespread alternative therapeutic regimen. The synergistic sulfonamides tablet contains TMP, sulfadiazine, and SMX and hypothetically could be used for TE treatment. This study aimed to compare the efficacy and safety of synergistic sulfonamides plus clindamycin (regimen B) with TMP-SMX plus azithromycin (regimen A) for the treatment of human immunodeficiency virus (HIV) associated TE.Methods: This was an open-labeled, multi-center randomized controlled trial recruited from 11 centers. Each recruited patient was randomly assigned to receive regimen A or regimen B for at least 6 weeks. The overall response was evaluated by assessment of the clinical response of TE-associated clinical features and the radiological response of TE-associated radiological findings. The overall response rate, clinical response rate, radiological response rate, and adverse events were assessed at 2, 6, and 12 weeks. Death events were compared between the two regimens at 6, 12, and 24 weeks.Results: A total of 91 acquired immunodeficiency syndrome (AIDS)/TE patients were included in the final analysis (44 in regimen Avs. 47 in regimen B). The overall response rate, which refers to the combined clinical and radiological response, was 18.2% (8/44) for regimen A and 21.3 % (10/47) for regimen B at week 6. The results of clinical response showed that, in comparison with regimen A, regimen B may perform better with regards to its effect on the relief of clinical manifestations (50.0% [22/44]vs. 70.2% [33/47],P = 0.049). However, no significant differences in radiological response, mortality events, and adverse events were found between the two regimens at week 6.Conclusions: Synergistic sulfonamides plus clindamycin, as a novel treatment regimen, showed no significantly different efficacy and comparable safety in comparison with the TMP-SMX plus azithromycin regimen. In addition, the regimen containing synergistic sulfonamides may exhibit advantages in terms of clinical symptom alleviation.Trial Registration: ChiCTR.org.cn, ChiCTR1900021195.
基金The authors are grateful for the financial support from the National Natural Science Foundation of China （Grant Nos. 81361140344 and 2136164）, the National High Technology Research and Development Program of China （2015AA021002） and the Major National Scientific Instrument Development Project （No.21537812）.
文摘Clindamycin phosphate （CP）, an antibacterial agent, has been reported to form several solid-state forms. The crystal structures of two CP solvates, a dimethyl sulfoxide （DMSO） solvate and a methanol/water solvate （solvate V）, have been determined by single crystal X-ray diffraction. The properties and transformations of these forms were characterized by powder X-ray diffraction, Single-crystal X-ray diffraction, differential scanning calorimetry, thermo gravimetric analysis, hot-stage microscopy, and dynamic vapor sorption. Very different hydrogen bonding networks exist among the host-host and host-solvent molecules in the two crystal structures, resulting in different moisture stabilities. The thermal stabilities of the two solvates upon heating and desolvation were also studied. When the temperature was above the boiling point of methanol, solvate V converted to a polymorphic phase after a one step desolvation process, whereas the desolvation temperature of the DMSO solvate was below the boiling point of DMSO. At the relative humidity above 43%, the DMSO solvate transformed to a hydrate at 25 ℃. In contrast, solvate V did not transform at any of the humidities studied.
文摘Objective:Combination therapy is currently the preferred acne treatment.We conducted this study to compare the efficacy and tolerability of 0.1%adapalene with 1%clindamycin versus 0.1%adapalene with 2.5%benzoyl peroxide(BPO)in the treatment of acne vulgaris.Methods:This study was conducted over a period of 1 year from September 2014 to September 2015.One-hundred patients aged 14 to 30 years with mild to moderate acne vulgaris were included.The patients were randomly allocated to 2 equal groups(n=50 in each group),and received a topical combination of 0.1%adapalene with 1%clindamycin andtopical combination of 0.1%adapalene with 2.5%BPO,respectively).The efficacy and tolerability of two treatments were compared.The unpaired studentt test was used to compare the difference in continuous variables between 2 groups,while the chi-square test or Fisher exact test was used for categorical variables.Results:One-hundred patients with mild to moderate acne vulgaris were randomly allocated to 2 equal groups(n=50 in each group).After 12 weeks of treatment,there were no significant differences between the adapalene-clindamycin and adapalene-BPO in the mean reductions in the numbers of non-inflammatory lesions(11.16±8.01 and 11.12±8.62,respectively),inflammatory papules(49.78±37.57 and 50.48±36.57,respectively),and total lesions(67.50±44.59 and 70.12±46.83,respectively).The incidence of a burning sensation was significantly greater in the adapalene-BPO group than the adapalene-clindamycin group(32%vs.6%;P=0.002).Conclusion:Topical adapalene plus clindamycin and adapalene plus BPO had similar efficacies in the treatment of acne.Adapalene with clindamycin was better tolerated than adapalene with BPO.
