Anti-Parasitic and Anti-Bacterial Agents

Total Page:16

File Type:pdf, Size:1020Kb

Anti-Parasitic and Anti-Bacterial Agents University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School January 2013 Anti-parasitic and anti-bacterial agents: Studies on 1,4-dihydropyridines and 2,4-diaminoquinazolines Kurt Steven Van Horn University of South Florida, [email protected] Follow this and additional works at: http://scholarcommons.usf.edu/etd Part of the Chemistry Commons Scholar Commons Citation Van Horn, Kurt Steven, "Anti-parasitic and anti-bacterial agents: Studies on 1,4-dihydropyridines and 2,4-diaminoquinazolines" (2013). Graduate Theses and Dissertations. http://scholarcommons.usf.edu/etd/4784 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Anti-parasitic and anti-bacterial agents: Studies on 1,4-dihydropyridines and 2,4- diaminoquinazolines by Kurt Steven Van Horn A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Chemistry College of Arts and Sciences University of South Florida Major Professor: Roman Manetsch, Ph.D. Bill J. Baker, Ph.D. Wayne Guida, Ph.D. Dennis E. Kyle, Ph.D. Lindsey Shaw, Ph.D. Date of Approval: 11 June 2013 Keywords: Malaria, Leishmaniasis, methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, antimicrobial, structure-activity relationship, structure-property relationship Copyright © 2013, Kurt Steven Van Horn Acknowledgements First and foremost I would like to acknowledge Roman Manetsch. He has been my mentor and friend these last eight years and without him I would never have accomplished what I have. Thank you, Roman, it has been a real pleasure. Working in a medicinal chemistry lab, it is impossible to get anything done without collaborations. Within the Manetsch lab, Niranjan Namelikonda was a great help and most of the lactone work in Chapter 2 would not have occurred without him. He has also been a great help with chemical discussions and has provided much insight that otherwise would not have been found. Within the chemistry department at the University of South Florida, the help of Edwin Rivera and the NMR TA’s including David Badger, Will Tay, Andrii Monastyrskii and Arthur Maknenko has indeed been beneficial for all of the projects within. Their support and commitment to keeping the instruments serviced and running and providing proper education to the users has enabled the smooth characterization of numerous compounds. Along this same line, the HPLC facility has been well run by Ted Gautier and most recently Mohanraja Kumar. Without their help much of the reactions run herein would not have been followed as well as has been shown within. Lukasz Wojtas also played an important role, facilitating the X-ray crystallography and allowing for the determination of stereochemistry in the 1,4-dihydropyridine project. Collaborations at USF began with the lab of Dennis Kyle, with Brian Vesely and Anuradha Srivastava performing the initial tests for the leishmaniasis project. Without their time and studies the quinazoline class would not have been investigated in as much depth. A great help in the Kyle lab has been Tina Mutka, who has peformed all of the in vitro Plasmodium falciparum assays using the TM90-C2B and W2 strains. Her work has provided numerous points of data that has truly allowed the growth of the 1,4- dihydropyridine project. Another collaboration at USF has been in the lab of Lindsey Shaw. Whittney Burda has performed the bulk of the work concering the MRSA and Acinetobacter baumannii projects and has been able to provide any and all information that I have requested in regards to the project. Another person in the Shaw lab, Renee Fleeman, has been a great help and was involved early on in the chemistry portion of the quinazoline class so she must be thanked two-fold. The Ohio State University has provided a highly beneficial collaboration with Kyle Werbovetz. The Werbovetz lab has led the majority of the testing for the leishmaniasis project and I am extremely grateful to the help of Xiaohua Zhu and Trupti Pandharkar for their enthusiasm for the project and the ability to accomplish their work. None of the pharmacokinetic studies would have been done without the work of Zhuo Michael Wang at the University of Kansas. In the Wang group, Siyung Yang performed the work and was able to reliably show PK data for the leishmaniasis project. The malaria project involving the 1,4-dihydropyridines has been a godsend for me as a highly enjoyable project filled with lofty chemistry goals and great achievements. I would truly like to thank R. Kiplin Guy for involving us on the project, and the rest of his team at the St. Jude Children’s Research Hospital. Martina Sigal has been my go to person and helped me throughout the project. Julie Clark has performed much of the testing and Amy Matheny has been a leader with oversight on the biological side of the project. Again, I am truly grateful for all of the collaborations in which I have been able to take part. Without them, my graduate career could not have been what you see written within. Table of Contents List of Figures .................................................................................................................... ix List of Tables ................................................................................................................... xiv List of Abbreviations ....................................................................................................... xvi Abstract ............................................................................................................................ xix Chapter 1: Introduction to Anti-microbials..........................................................................1 1.1 Overview ......................................................................................................1 1.2 Protozoa .......................................................................................................2 1.2.1 Genus Plasmodium ..........................................................................2 1.2.1.1 Anti-Malarials ..................................................................................5 1.2.2 Genus Leishmania ............................................................................8 1.2.2.1 Anti-leishmanials ...........................................................................11 1.3 ESKAPE Pathogens ...................................................................................12 1.3.1 Staphylococcus aureus ...................................................................14 1.3.1.1 Staphylococcal Toxins ...................................................................15 1.3.1.2 Antibiotics for Staphylococcus aureus ..........................................17 1.3.2 Acinetobacter baumannii ...............................................................25 1.3.2.1 Antibiotics for Acinetobacter baumannii.......................................26 Chapter 2: 1,4-Dihydropyridines as Anti-Malarials ..........................................................29 2.1 Hantzsch Pyridine Synthesis ......................................................................29 2.1.1 Enantioselective Syntheses of 1,4-Dihydropyridines ....................30 2.1.2 Biological Activity of 1,4-Dihydropyridine Derivatives ...............36 2.2 1,4-Dihydropyridine Syntheses..................................................................38 2.2.1 Synthetic Plan ................................................................................39 2.2.1.1 Comparison of Methylene and Oxygen Derivatives ......................40 v 2.2.1.2 Synthetic Scheme with Chiral Auxiliaries .....................................44 2.2.1.3 Synthetic Schemes for Chiral β-Ketolactones ...............................56 2.2.2 Structure-Activity Relationship of 1,4-Dihydropyridines .............62 2.2.2.1 Structure-Activity Relationship at 4- and 7-Positions ...................62 2.2.2.2 Structure-Activity Relationship of the 2- and 3-Positions .............66 2.2.2.3 A Few Polyhydroquinoline Derivatives.........................................68 2.2.2.4 Role of Stereochemistry in Activity ..............................................69 2.2.2.5 Role of Stereochemistry on Solubility and Permeability ...............70 2.3 Summary ....................................................................................................71 Chapter 3: Quinazolines as Anti-Leishmanials..................................................................73 3.1 Chemistry of the Quinazoline Class ..........................................................73 3.2 Medicinal Importance of the Quinazoline Class ........................................74 3.2.1 Quinazolines in the Literature as Anti-Leishmanials.....................76 3.3 Anti-Leishmanial Testing ..........................................................................77 3.3.1 Synthetic Chemistry .......................................................................77 3.3.2 In vitro Anti-Leishmanial Efficacy and Cytotoxicity ....................78 3.3.2.1 Structure-Activity Relationship Studies. .......................................79 3.3.2.2 Cytotoxicity....................................................................................83 3.3.3 Mechanism of Action .....................................................................84
Recommended publications
  • Antibiotic Resistance and Molecular Typing of Pseudomonas Aeruginosa: Focus on Imipenem
    BJID 2002; 6 (February) 1 Antibiotic Resistance and Molecular Typing of Pseudomonas aeruginosa: Focus on Imipenem Ana Lúcia Peixoto de Freitas and Afonso Luis Barth Federal University of Rio Grande do Sul, Pharmacy School, Clinical Hospital of Porto Alegre, Cardiology Institute, Porto Alegre, RS; Catholic University of Pelotas, Pharmacy School, Pelotas, RS, Brazil Susceptibility tests by disk diffusion and by E-test and molecular typing by macrorestriction analysis were performed to determine the relatedness of Pseudomonas aeruginosa isolates from three distinct hospitals. The resistance profile of 124 isolates to 8 antimicrobial agents was determined in three different hospitals, in Porto Alegre, Brazil. Frequencies of susceptibility ranged from 43.9% for carbenicillin to 87.7% for ceftazidime. Cross-resistance data of imipenem-resistant isolates indicated that most (70%) were also resistant to carbenicillin, although 30% remained susceptible to ceftazidime and cefepime. In general, susceptibility profiles were not able to determine relatedness among isolates of P. aeruginosa. On the other hand, molecular typing by macrorestriction analysis demonstrated high discriminatory power and identified 66 strains among 72 isolates of P. aeruginosa. Imipenem-susceptible isolates were all different. However, identical clones of imipenem-resistant isolates were found in two of the hospitals, despite variable response to other antibiotics. No clustering of infection among the different medical centers was observed. In conclusion, clones of P. aeruginosa did not spread among the different hospitals in our city even though related isolates of imipenem- resistant P. aeruginosa were found. Key Words: Pseudomonas aeruginosa, antibiotic resistance, imipenem. Despite improvements in antibiotic therapy, However, nosocomial isolates may easily develop Pseudomonas aeruginosa remains as one of the most resistance to carbapenens due to reduced uptake of prominent Gram-negative bacteria causing hospital- the drug, which leads to outbreaks of multiresistant/ associated infections.
    [Show full text]
  • 28912 Oxoid FDA Cartridge Tables:1
    * Adapted in part from CLSI document M100-S23 (M02-A11) : “Disc diffusion supplemental tablesʼʼ Performance standards for antimicrobial susceptibility testing. The complete standard may be obtained from the Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, PA 19807. Test Cultures (zone diameters in mm) Antimicrobial Agent Disc Code Potency Resistant Intermediate Susceptible Amikacin AK 30 μg EnterobacteriaceaeK, P. aeruginosa, Acinetobacter spp., and Staphylococcus spp. ≤14 15-16 ≥17 Amoxycillin - Clavulanic Acid AMC 20/10 μg EnterobacteriaceaeE ≤13 14-17 ≥18 Staphylococcus spp.A,Q ≤19 — ≥20 Haemophilus spp.A,Y ≤19 — ≥20 AmpicillinC,n AMP 10 μg EnterobacteriaceaeE and Vibrio choleraef ≤13 14-16 ≥17 Staphylococcus spp.A,Q ≤28 — ≥29 Enterococcus spp.A,V,W,k,m ≤16 — ≥17 Haemophilus spp.Y ≤18 19-21 ≥22 Streptococcus spp. ß-Hemolytic GroupA,d — — ≥24 Ampicillin – Sulbactam SAM 10/10 μg EnterobacteriaceaeE, Acinetobacter spp., and Staphylococcus spp. ≤11 12-14 ≥15 Haemophilus spp.A,Y ≤19 — ≥20 Azithromycin AZM 15 μg Staphylococcus spp., Streptococcus spp Viridans Groupn, ß-Hemolytic Group, and S. pneumoniae) ≤13 14-17 ≥18 Neisseria meningitidisA,i — — ≥20 Haemophilus spp.A — — ≥12 Aztreonam ATM 30 μg EnterobacteriaceaeE ≤17 18-20 ≤21 P. aeruginosa ≤15 16-21 ≥22 Haemophilus spp.A — — ≥26 CAR 100 μg Carbenicillin Enterobacteriaceae ≤19 20-22 ≥23 Pseudomonas aeruginosaP ≤13 14-16 ≥17 CEC 30 μg Cefaclor Enterobacteriaceae and Staphylococcus spp. ≤14 15-17 ≥18 Haemophilus spp.Y ≤16 17-19 ≥20 MA 30 μg Cefamandole EnterobacteriaceaeD,E and Staphylococcus spp. ≤14 15-17 ≥18 CefazolinG KZ 30 μg Staphylococcus spp.
    [Show full text]
  • Antibacterial Drug Usage Analysis
    Department of Health and Human Services Public Health Service Food and Drug Administration Center for Drug Evaluation and Research Office of Surveillance and Epidemiology Drug Use Review Date: April 5, 2012 To: Edward Cox, M.D. Director Office of Antimicrobial Products Through: Gerald Dal Pan, M.D., MHS Director Office of Surveillance and Epidemiology Laura Governale, Pharm.D., MBA Deputy Director for Drug Use Division of Epidemiology II Office of Surveillance and Epidemiology Hina Mehta, Pharm.D. Drug Use Data Analysis Team Leader Division of Epidemiology II Office of Surveillance and Epidemiology From: Tracy Pham, Pharm.D. Drug Use Data Analyst Division of Epidemiology II Office of Surveillance and Epidemiology Drug Name(s): Systemic Antibacterial Drug Products Application Type/Number: Multiple Applicant/sponsor: Multiple OSE RCM #: 2012-544 **This document contains proprietary drug use data obtained by FDA under contract. The drug use data/information in this document has been cleared for public release.** 1 EXECUTIVE SUMMARY The Division of Epidemiology II is providing an update of the drug utilization data in terms of number of kilograms or international units of selected systemic antibacterial drug products sold from manufacturers to various retail and non-retail channels of distribution for years 2010-2011 as a surrogate for nationwide antibacterial drug use in humans. Propriety drug use databases licensed by the FDA were used to conduct this analysis. Data findings are as follows: During years 2010 and 2011, the majority of kilograms of selected systemic antibacterial drug products sold were to outpatient retail pharmacy settings. Approximately 3.28 million kilograms of selected systemic antibacterial drug products were sold during year 2010, and around 3.29 million kilograms were sold during year 2011.
    [Show full text]
  • WO 2010/025328 Al
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date 4 March 2010 (04.03.2010) WO 2010/025328 Al (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/00 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, (21) International Application Number: CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, PCT/US2009/055306 DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, 28 August 2009 (28.08.2009) KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, (25) Filing Language: English NO, NZ, OM, PE, PG, PH, PL, PT, RO, RS, RU, SC, SD, (26) Publication Language: English SE, SG, SK, SL, SM, ST, SV, SY, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: 61/092,497 28 August 2008 (28.08.2008) US (84) Designated States (unless otherwise indicated, for every kind of regional protection available): ARIPO (BW, GH, (71) Applicant (for all designated States except US): FOR¬ GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, EST LABORATORIES HOLDINGS LIMITED [IE/ ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, —]; 18 Parliament Street, Milner House, Hamilton, TM), European (AT, BE, BG, CH, CY, CZ, DE, DK, EE, Bermuda HM12 (BM).
    [Show full text]
  • Spectrum Plasmid-Mediated P-Lactamases
    J. Med Microbiol. Vol 38 (1993). 114-1 17 0 1993 The Pathological Society of Great Britain and Ireland Stability of cefdinir ((3-983,FK482) to extended= spectrum plasmid-mediated p-lactamases D. J. PAYNE” and S. G. B. AMYEST Department of Medical Microbiology, The Medical School, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG Summary. Fourteen plasmid-encoded extended-spectrum P-lactamases were purified from Escherichiu coli transconjugants of original clinical isolates. The Vmax, Km and Vmax/Km were each determined for ampicillin, carbenicillin, cephaloridine, cephalexin, cefuroxime, cefixime, cefdinir, ceftazidime and cefotaxime as substrates with eight of these enzymes and with the narrow-spectrum P-lactamase, TEM- 1. The relative rates of hydrolysis of ampicillin, cephaloridine, cephalexin, cefuroxime, cefixime, cefdinir, ceftazidime and cefotaxime were also determined for the remaining six enzymes. Cefdinir had Vmax/Km or relative rates of hydrolysis values either equal to or lower than ampicillin, cephaloridine, cephalexin and cefotaxime for all the enzymes tested. Overall, cefdinir was more stable to the 15 P-lactamases tested than either cefuroxime or cefixime; however, ceftazidime was more stable than cefdinir to hydrolysis by eight of the enzymes tested. Introduction Materials and methods Very few oral cephalosporins have been manu- Bacterial straiiis factured. The early oral cephalosporins, cephradine The p-lactamase preparations used in the stability and cephalexin, have proved effective in certain infec- assays were obtained from the strains of Escherichia tions; however, they are susceptible to hydrolysis by coli listed in table I. many P-lactamases. A similar drug, cefaclor, is also susceptible, but has improved activity against Hucmo- plzilus ir?Jlucnzuc.
    [Show full text]
  • A Thesis Entitled an Oral Dosage Form of Ceftriaxone Sodium Using Enteric
    A Thesis entitled An oral dosage form of ceftriaxone sodium using enteric coated sustained release calcium alginate beads by Darshan Lalwani Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Pharmaceutical Sciences with Industrial Pharmacy Option _________________________________________ Jerry Nesamony, Ph.D., Committee Chair _________________________________________ Sai Hanuman Sagar Boddu, Ph.D, Committee Member _________________________________________ Youssef Sari, Ph.D., Committee Member _________________________________________ Patricia R. Komuniecki, PhD, Dean College of Graduate Studies The University of Toledo May 2015 Copyright 2015, Darshan Narendra Lalwani This document is copyrighted material. Under copyright law, no parts of this document may be reproduced without the expressed permission of the author. An Abstract of An oral dosage form of ceftriaxone sodium using enteric coated sustained release calcium alginate beads by Darshan Lalwani Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Pharmaceutical Sciences with Industrial Pharmacy option The University of Toledo May 2015 Purpose: Ceftriaxone (CTZ) is a broad spectrum semisynthetic, third generation cephalosporin antibiotic. It is an acid labile drug belonging to class III of biopharmaceutical classification system (BCS). It can be solvated quickly but suffers from the drawback of poor oral bioavailability owing to its limited permeability through
    [Show full text]
  • Carbenicillin, Disodium Salt Molecular Structure
    Carbenicillin, Disodium Salt Molecular structure Na Product Description Carbenicillin is recommended as a substitute for ampicillin at the same concentration in molecular biology applications. Both ampicillin and carbenicillin are semi-synthetic penicillins related to penicil- lin. Carbenicillin is penicillin with a carboxyl and benzyl group, whereas ampicillin is an aminopenicil- lin. Carbenicillin inhibits cell wall synthesis in peptidoglycan crosslinking because it is a member of the penicillin family of antibiotics. Carbenicillin demonstrates improved stability over ampicillin when used in growth media. It is more resistant to heat and low pH-induced degradation over time making it particularly useful for large- scale liquid culture growth. It also reduces the presence of satellite colonies seen with ampicillin. Satellite colonies are very small colonies visible on the plate that will grow very close to the larger colonies to survive. These cells are not resistant themselves, so they must grow near the antibiotic- resistant colonies that are destroying the antibiotic in their immediate vicinity. Satellite colonies develop with antibiotics such as ampicillin because ß-lactamases destroy the anti- biotic outside of the cell. Satellites are more likely to develop if the ampicillin plate is old, resulting in partial degradation of the antibiotic. Carbenicillin, being more stable than ampicillin and less labile to ß- lactamase activity, reduces the presence of satellites. Product Specification Molecular weight: 422.4 g/mol Formula: C17H18N2O6SNa2 Synonyms: alpha-Carboxybenzylpenicillin disodium salt Storage and Stability: 2°C to -8°C Page 1 of 2 Life Science Production, a Division of Life Science Group Ltd. Tel: +44 (0) 1234 889180; Email: [email protected] Web: www.lifescienceproduction.co.uk Ordering information Cat.
    [Show full text]
  • Antibiotic and Antimycotic Products
    Antibiotic and Antimycotic Products Corning products include antibiotics and antimycotics for micro- biological/mammalian cell culture selection or prophylactic control of contamination due to bacteria, fungi, mycoplasma, or yeast. Contents Introduction to Antibiotics Type of Antibiotic, Application, and Mode of Action Introduction 2 Penicillin G Penicillin 4 is a narrow-spectrum Gram-positive bacterial antibiotic. Penicillin concentrates are often used with streptomycin prophy- G418 5 lactically in cell culture. Penicillin G inhibits cell wall synthesis and Ampicillin, Sodium Salt 6 is, therefore, bactericidal to actively growing cells. Carbenicillin, Disodium Salt 7 G418 Sulfate is a selection agent for cells transformed using the Hygromycin B 8 aminoglycoside-modifying enzyme aminoglycoside phosphotrans- Puromycin Dihydrochloride 9 ferase (APH). This enzyme covalently modifies the antibiotic’s amino or hydroxyl functions to weaken the drug-ribosome interaction. Tetracycline Hydrochloride 10 Amphotericin B 11 Ampicillin is a narrow-spectrum Gram-positive bacterial antibiotic. Ampicillin is commonly used as a selection agent when transforming Ciprofloxacin Hydrochloride 12 bacteria. It inhibits cell wall synthesis and is, therefore, bactericidal Activity and Mechanism of Action to actively growing cells. of Antibiotics/Antimycotics 13 Carbenicillin is recommended as a substitute for ampicillin at the Antibiotics Quick Reference 14 same concentration in molecular biology applications. Carbenicillin demonstrates improved heat stability over ampicillin when used in growth media and reduces the presence of satellite colonies com- monly seen with ampicillin. Hygromycin B, produced by Streptomyces hygroscopicus, is used as a selection agent and inhibits protein synthesis in cells not carrying hygromycin phosphotransferase (HPH). HPH inactivates hygromycin B and restores protein synthesis. 2 Tetracycline inhibits protein synthesis by binding to the 30S ribo- Gentamycin is a broad-spectrum aminoglycoside antibiotic.
    [Show full text]
  • Appendix C Medication Tables
    Appendix C Medication Tables Note: The medication tables are not meant to be inclusive lists of all available therapeutic agents. Approved medication tables will be updated regularly. Discrepancies must be reported. See Resource Section of this manual for additional contact information. Release Notes: Aspirin Table Version 1.0 Table 1.1 Aspirin and Aspirin-Containing Medications Acetylsalicylic Acid Acuprin 81 Alka-Seltzer Alka-Seltzer Morning Relief Anacin Arthritis Foundation Aspirin Arthritis Pain Ascriptin Arthritis Pain Formula ASA ASA Baby ASA Baby Chewable ASA Baby Coated ASA Bayer ASA Bayer Children's ASA Buffered ASA Children's ASA EC ASA Enteric Coated ASA/Maalox Ascriptin Aspergum Aspir-10 Aspir-Low Aspir-Lox Aspir-Mox Aspir-Trin Aspirbuf Aspircaf Aspirin Aspirin Baby Aspirin Bayer Aspirin Bayer Children's Aspirin Buffered Aspirin Child Aspirin Child Chewable Aspirin Children's Aspirin EC Aspirin Enteric Coated Specifications Manual for National Appendix C-1 Hospital Quality Measures Table 1.1 Aspirin and Aspirin-Containing Medications (continued) Aspirin Litecoat Aspirin Lo-Dose Aspirin Low Strength Aspirin Tri-Buffered Aspirin, Extended Release Aspirin/butalbital/caffeine Aspirin/caffeine Aspirin/pravachol Aspirin/pravastatin Aspirtab Bayer Aspirin Bayer Aspirin PM Extra Strength Bayer Children’s Bayer EC Bayer Enteric Coated Bayer Low Strength Bayer Plus Buffered ASA Buffered Aspirin Buffered Baby ASA Bufferin Bufferin Arthritis Strength Bufferin Extra Strength Buffex Cama Arthritis Reliever Child’s Aspirin Coated Aspirin
    [Show full text]
  • Guidelines on Urological Infections
    Guidelines on Urological Infections M. Grabe (Chairman), T.E. Bjerklund-Johansen, H. Botto, M. Çek, K.G. Naber, P. Tenke, F. Wagenlehner © European Association of Urology 2010 TABLE OF CONTENTS PAGE 1. INTRODUCTION 7 1.1 Pathogenesis of urinary tract infections 7 1.2 Microbiological and other laboratory findings 7 1.3 Classification of urological infections 8 1.4 Aim of guidelines 8 1.5 Methods 9 1.6 Level of evidence and grade of guideline recommendations 9 1.7 References 9 2. UNCOMPLICATED URINARY TRACT INFECTIONS IN ADULTS 11 2.1 Definition 11 2.1.1 Aetiological spectrum 11 2.2 Acute uncomplicated cystitis in premenopausal, non-pregnant women 11 2.2.1 Diagnosis 11 2.2.1.1 Clinical diagnosis 11 2.2.1.2 Laboratory diagnosis 11 2.2.2 Therapy 11 2.2.3 Follow up 12 2.3 Acute uncomplicated pyelonephritis in premenopausal, non-pregnant women 12 2.3.1 Diagnosis 12 2.3.1.1 Clinical diagnosis 12 2.3.1.2 Laboratory diagnosis 12 2.3.1.3 Imaging diagnosis 13 2.3.2 Therapy 13 2.3.2.1 Mild and moderate cases of acute uncomplicated pyelonephritis 13 2.3.2.2 Severe cases of acute uncomplicated pyelonephritis 13 2.3.3 Follow-up 14 2.4 Recurrent (uncomplicated) UTIs in women 16 2.4.1 Diagnosis 16 2.4.2 Prevention 16 2.4.2.1 Antimicrobial prophylaxis 16 2.4.2.2 Immunoactive prophylaxis 16 2.4.2.3 Prophylaxis with probiotics 17 2.4.2.4 Prophylaxis with cranberry 17 2.5 Urinary tract infections in pregnancy 17 2.5.1 Definition of significant bacteriuria 17 2.5.2 Screening 17 2.5.3 Treatment of asymptomatic bacteriuria 17 2.5.4 Duration of therapy 18 2.5.5 Follow-up 18 2.5.6 Prophylaxis 18 2.5.7 Treatment of pyelonephritis 18 2.5.8 Complicated UTI 18 2.6 UTIs in postmenopausal women 18 2.6.1 Risk factors 18 2.6.2 Diagnosis 18 2.6.3 Treatment 18 2.7 Acute uncomplicated UTIs in young men 19 2.7.1 Men with acute uncomplicated UTI 19 2.7.2 Men with UTI and concomitant prostate infection 19 2.8 Asymptomatic bacteriuria 19 2.8.1 Diagnosis 19 2.8.2 Screening 19 2.9 References 26 3.
    [Show full text]
  • DISKS for ANTIBIOTIC SUSCEPTIBILITY TESTING 50 DISKS CARTRIDGE Study of Susceptibility to Antimicrobial Agents
    DISKS FOR ANTIBIOTIC SUSCEPTIBILITY TESTING 50 DISKS CARTRIDGE Study of susceptibility to antimicrobial agents. 2016/11 1- CLINICAL VALUE These disks are used to semi quantitatively evaluate the in vitro susceptibility to antimicrobial agents of rapidly growing bacteria and several difficult species by an agar diffusion method. (1) This method is based on a standardized procedure published by the WHO and adopted as consensual standard by the CLSI(2, 3) CA-SFM(4) and EUCAST(5) (it is periodically revised). Consult the most recent CLSI(2,3), CA-SFM(4) , EUCAST(5) documents for guidelines concerning antibiotic susceptibility testing and interpretation of the results. 2- PRINCIPLE Paper disks impregnated with a defined concentration of antimicrobial agent are deposited on the surface of an appropriate medium(A) previously inoculated with a calibrated inoculum(A) of pure and fresh culture of the bacterial strain to be tested. After incubation(A) , the Petri dishes are examined and the zones of inhibition around the disks are measured and compared to critical values(A) for the various antimicrobial agents tested, in order to determine the clinical category of susceptibility (resistant, intermediate, susceptible…). The diameter of the zone of inhibition is proportional to the susceptibility of the bacterial strain tested (A)According to current guidelines CLSI(2, 3) CA-SFM(4) EUCAST(5). 3- PRESENTATION Bio-Rad disks are 6.5 mm disks made from superior quality absorbent paper and impregnated with precise concentrations of antimicrobial agents. The disks are clearly identified by a code, comprising 1 to 3 letters, printed on each side of the disk (see table 1).
    [Show full text]
  • Escherichia Coli
    ARTICLE https://doi.org/10.1038/s41467-020-19713-w OPEN High-throughput laboratory evolution reveals evolutionary constraints in Escherichia coli ✉ Tomoya Maeda 1,4 , Junichiro Iwasawa 2,4, Hazuki Kotani1, Natsue Sakata1, Masako Kawada1, ✉ Takaaki Horinouchi1, Aki Sakai1, Kumi Tanabe1 & Chikara Furusawa 1,2,3 Understanding the constraints that shape the evolution of antibiotic resistance is critical for predicting and controlling drug resistance. Despite its importance, however, a systematic 1234567890():,; investigation of evolutionary constraints is lacking. Here, we perform a high-throughput laboratory evolution of Escherichia coli under the addition of 95 antibacterial chemicals and quantified the transcriptome, resistance, and genomic profiles for the evolved strains. Uti- lizing machine learning techniques, we analyze the phenotype–genotype data and identified low dimensional phenotypic states among the evolved strains. Further analysis reveals the underlying biological processes responsible for these distinct states, leading to the identifi- cation of trade-off relationships associated with drug resistance. We also report a deceler- ated evolution of β-lactam resistance, a phenomenon experienced by certain strains under various stresses resulting in higher acquired resistance to β-lactams compared to strains directly selected by β-lactams. These findings bridge the genotypic, gene expression, and drug resistance gap, while contributing to a better understanding of evolutionary constraints for antibiotic resistance. 1 RIKEN Center for Biosystems Dynamics Research, 6-2-3 Furuedai, Suita, Osaka 565-0874, Japan. 2 Department of Physics, The University of Tokyo, 7-3-1 Hongo, Tokyo 113-0033, Japan. 3 Universal Biology Institute, The University of Tokyo, 7-3-1 Hongo, Tokyo 113-0033, Japan.
    [Show full text]