Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new zithromax research articles will be listed here shortly after becoming available to us.
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Medical research on zithromax
Int J STD AIDS. 2008 Jul; 19(7): 469-472
McClean H, Carne C, Bunting P, Bhaduri S, Fernandes A, Dhar J, Estreich S, Daniels D,
The case notes of cases of genital chlamydial infection were audited against the UK National Guideline. This was the first web-based and the largest national audit to date, with 193 clinics in all UK Regions contributing data. About half of all cases had no symptoms, with about one-third attending for routine or asymptomatic screens; suggesting significant provision of screening by clinics that might be managed differently to reduce workload. Nucleic acid amplification tests (NAATs) are now well established for chlamydial detection in UK clinics, with 93% of cases having genital NAATs. Azithromycin is now more commonly used than doxycycline (54% vs. 37%). Of 26 pregnant women, 20 were treated with azithromycin, suggesting that most prescribers treating pregnant women consider that erythromycin is not an adequate alternative to azithromycin. Most women had NAATs obtained from sites recommended by the Guideline, with 93% of women who had genital NAATs having these from the cervix or vulvovaginal area.
J Med Microbiol. 2008 Jul; 57(Pt 7): 856-63
Pazhani GP, Niyogi SK, Singh AK, Sen B, Taneja N, Kundu M, Yamasaki S, Ramamurthy T
Shigella species represent one of the growing numbers of antimicrobial-resistant bacteria in developing countries. Fluoroquinolone-resistant strains of Shigella dysenteriae type1 and Shigella flexneri type 2a emerged in India during 2002 and 2003, respectively. Sixty strains of Shigella from different parts of India were analysed for antimicrobial susceptibility, the presence of the qnr plasmid, mutations in the quinolone resistance determining regions (QRDRs), fluoroquinolone accumulation, and the presence of other genes encoding resistance to various antimicrobials. Fluoroquinolone-resistant strains had mutations in gyrA and parC genes and had an active efflux system. They were also resistant to several other antimicrobials but were susceptible to azithromycin and ceftriaxone. The majority of the strains harboured genes encoding resistance to ampicillin (97 %), tetracycline (95 %), streptomycin (95 %) and chloramphenicol (94 %). PFGE analysis revealed clonality among strains of S. dysenteriae types 1 and 5, S. flexneri type 2a and Shigella boydii type 12.
Southeast Asian J Trop Med Public Health. 2008 May; 39(3): 461-6
Srifuengfung S, Tribuddharat C, Champreeda P, Daniels J, Chokephaibulkit K, Wongwan N, Polwichai P
A total of 400 clinical Streptococcus pneumoniae strains from patients with respiratory diseases were collected from January 2002 to December 2005. In this study, an increased prevalence of penicillin-nonsusceptible S. pneumoniae (PNSP) from 63% in 2002-2003 to 69% in 2004-2005 was found. During 2004-2005, 56% were erythromycin-nonsusceptible S. pneumoniae (ENSP) and 54% were both PNSP and ENSP. The PNSP, ENSP and PNSP+ENSP groups showed similar trends, ie, sensitive to amoxicillin/clavulanate (range 97.2-98.5%), levofloxacin (range 90.7-92.4%), ceftriaxone (range 87.1-89.4%), and ofloxacin (range 64.8-66.1%). Lower levels of susceptibility were detected for azithromycin, clarithromycin, cefdinir, cefprozil, clindamycin, co-trimoxazole, chloramphenicol and tetracycline in penicillin and erythromycin-nonsusceptible strains. Of the macrolide-resistant S. pneumoniae, 55% of strains exhibited the M phenotype and 45% the constitutive MLS(B) phenotype. No pneumococci with the inducible MLS(B) phenotype were detected in Thailand.
Recent advances in management of genital ulcer disease and anogenital warts.
Dermatol Ther. 2008 May-Jun; 21(3): 196-204
Kaliaperumal K
Genital ulcer disease (GUD) constitutes a major public health problem. Most of them are the result of sexually transmitted diseases. Genital herpes, syphilis, lymphogranuloma venereum, granuloma venereum, or chancroid are the commonly encountered GUD. The treatment modalities for these disorders have changed with advent and use of drugs such as azithromycin. The treatment modalities differ in patients with HIV disease. Further vaccines for herpes genitalis and human papilloma virus has opened new avenues in management of these diseases. In regions where there are no diagnostic facilities or where the costs of diagnostic tests are prohibitive, syndromic management of GUD is preferred.
Antibiotic drug use of children in the Netherlands from 1999 till 2005.
Eur J Clin Pharmacol. 2008 Jun 18;
de Jong J, van den Berg PB, de Vries TW, de Jong-van den Berg LT
OBJECTIVE: Antibiotics are the most commonly prescribed drugs used by children. Excessive and irrational use of antibiotic drugs is a world-wide concern. We performed a drug utilization study describing the patterns of antibiotic use in children aged 0-19 years between 1999 and 2005 in the Netherlands. METHODS: We used IADB.nl, a database with pharmacy drug dispensing data covering a population of 500,000 people and investigated all prescriptions of oral antibiotic drugs (ATC J01) for children
Emergence and spread of azithromycin-resistant Neisseria gonorrhoeae in Scotland.
J Antimicrob Chemother. 2008 Jun 13;
Palmer HM, Young H, Winter A, Dave J
Objectives The aim of this study was to analyse the trend in azithromycin susceptibility (AzDS) of Neisseria gonorrhoeae in Scotland between April 2004 and December 2007, and to characterize isolates exhibiting decreased AzDS or high-level azithromycin resistance (AzHLR). Methods Antibiotic susceptibility testing and N. gonorrhoeae multiantigen sequence typing (NG-MAST) were performed on all gonococcal isolates received by the Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) during the study period. Results AzHLR isolates were observed for the first time in 2004 and increased from 0.3% to 3.9% in 2007. AzDS declined from 2.1% to 1.3% in the same period. Taken together, AzDS and AzHLR isolates accounted for 5.2% of the gonococcal infections in Scotland in 2007. NG-MAST revealed that only a small number of sequence types (STs) contained AzHLR and AzDS isolates; these STs also included azithromycin-susceptible isolates. Most STs containing AzHLR isolates were genetically related on the basis of their por and tbpB alleles; however, demographic data suggested that they formed discrete sexual networks. Conclusions AzHLR strains of N. gonorrhoeae are increasing in Scotland. A 1 g dose of azithromycin should not be considered as an alternative antibiotic therapy for gonococcal infections. The use of azithromycin to treat chlamydia in patients co-infected with N. gonorrhoeae results in a level of azithromycin in vivo that is sublethal for N. gonorrhoeae, which may lead to resistance.
Can Respir J. 2008 May-Jun; 15(4): 199-202
Porhownik NR, Batobara W, Kepron W, Unruh HW, Bshouty Z
BACKGROUND: Bronchiolitis obliterans syndrome (BOS), the main cause of late mortality following lung transplantation, is defined as an irreversible decline in forced expiratory volume in 1 s (FEV(1)). Previous studies using azithromycin for BOS in lung transplant patients have demonstrated a potential reversibility of the decline in FEV(1). OBJECTIVES: To examine whether initiating azithromycin reverses decline in FEV(1) in lung transplant recipients with established BOS of at least three months. METHODS: Pulmonary function tests were performed every three months in seven lung transplant recipients with established BOS of at least three months. FEV(1) was recorded at six and three months before initiation, at time of initiation, and three, six, nine and 12 months postazithromycin initiation. The primary end point was change in FEV1. During the study, no immunosuppressive medication changes or acute rejection episodes occurred. RESULTS: Mean time from transplant to azithromycin initiation was 64 months (range 17 to 117 months). Mean time from BOS diagnosis to azithromycin initiation was 22 months (range three to 67 months). Rate of FEV(1) decline from six months before azithromycin initiation, and rates of FEV(1) increase from initiation to three and 12 months post-treatment initiation, were not statistically significant (P=0.32, P=0.16 and P=0.18, respectively). Following a trend toward improvement in the first three months after treatment initiation, FEV(1) tended to stabilize. DISCUSSION: Although several studies address the possible benefit of maintenance azithromycin in lung transplant patients with BOS, the role of the drug remains unproven in these patients, and would best be addressed by a large randomized controlled trial.
Amiodarone modulates pharmacokinetics of low-dose methotrexate in rats.
Biopharm Drug Dispos. 2008 Jun 11;
Fuksa L, Brcakova E, Cermanova J, Hroch M, Chladek J, Kolouchova G, Malakova J, Martinkova J, Staud F, Micuda S
Clinical studies of low-dose methotrexate (LDMTX) pharmacokinetics document increased plasma concentrations of MTX after co-administration of the drug with amiodarone or macrolide antibiotics. As drug-drug interactions may increase the toxicity of LDMTX, a rat model was used to follow renal and biliary elimination of MTX during its constant-rate i.v. infusion and concomitant single bolus i.v. injections of amiodarone or azithromycin. The mean steady-state plasma concentration of 1.7+/-0.1 micromol/l was reached and the total clearance achieved 17.7+/-1.0 ml/min/kg. Administration of amiodarone decreased the biliary clearance of MTX to 73% of the control values (p
J Feline Med Surg. 2008 Jun 6;
Ruch-Gallie RA, Veir JK, Spindel ME, Lappin MR
Thirty-one cats showing clinical signs of upper respiratory tract disease with a presumed bacterial component based on clinical signs were administered either amoxycillin or azithromycin to determine which drug protocol was optimal for empirical use. A clinical score was determined and nasal and pharyngeal swabs were collected for bacterial culture, virus isolation and polymerase chain reaction prior to the start of therapy. Cats failing to respond to the initial antibiotic were then administered the other drug. There were no differences in clinical scores between the two groups at the start of therapy. Eleven of 31 cats improved after administration of the first antibiotic, 16 cats were switched to the alternate antibiotic, and four cats were removed from the study for additional supportive treatments. Eight of 27 cats failed to respond to either antibiotic. The chi(2) test for outcomes revealed no differences in response to therapy for either antimicrobial.
Anat Histol Embryol. 2008 Jun 5;
Karabulut AK, Uysal II, Acar H, Fazliogullari Z
Macrolides are considered to be one of the safest anti-infective groups in clinical use, with severe adverse reactions being rare. However, there are limited data about their embryotoxicity and teratogenicity. We aimed to investigate and compare the effects of these agents on embryonic growth and development. Rat embryos were cultured in vitro for 48 h in rat serum. Whole rat serum was used as a culture medium for the control group while different concentrations of spiramycin and azithromycin (1.25-6.25 mug/ml), and clarithromycin (2.5-30 mug/ml) were added to rat serum for the experimental groups. Dose-dependent effects of macrolides on embryonic developmental parameters were compared using morphological methods. Embryos were evaluated for the presence of any malformations. After morphological examination of the embryos, total DNA was extracted from the cells using standard procedures to determine fragmentation of nuclear DNA of embryonic cells. When compared with the control embryos, the macrolides significantly decreased all growth and developmental parameters dose dependently. While clarithromycin was found to cause more developmental toxicity than spiramycin and azithromycin, azitromycin was determined to have more teratogenicity potential. Compared with controls, there was no difference regarding the fragmentation of nuclear DNA of all the agents used. According to these results, when the toxic and teratogenic potential of the used agents compared, because of the lower toxic and teratogenic effects observed with spiramycin, this agent may be preferred for parturients.