An epidemiological survey to assess the clinical use of cephalosporins in community-acquired respiratory tract infections

Background: In outpatient management of respiratory tract infections, the clinicians’ preferences always have  a broad spectrum of antibiotics as an empirical therapy. Clinical use of cephalosporins and fluoroquinolones has been recommended by various international guidelines as a monotherapy or as combination therapy to manage these. This survey was conducted to assess the in-clinic use and preference of cephalosporins or fluoroquinolones as monotherapy or as combination therapy in managing respiratory tract infections by Indian doctors.Methods: A survey questionnaire was drafted to capture the feedback from cross-specialty regarding the preference of using antibiotics in respiratory tract infection in real time clinical settings.Results: Data from 163 physicians were collected and evaluated across India. 79 (48%) clinicians reported pharyngitis/tonsillitis to be the most commonly encountered respiratory tract infection followed by community-acquired pneumonia (CAP) 62 (38%). 100 (61%) clinicians preferred use of cefpodoxime monotherapy as a primary line of treatment for the management of respiratory pharyngitis/tonsillitis. Use of short course therapy (≤1 week) of cefpodoxime and levofloxacin as combination therapy is preferred by 94 (58%) clinicians, in cases of acute exacerbation of chronic bronchitis (AECB) 85 (52%), and CAP 83 (51%). The clinical preference of levofloxacin was observed with only 16 (10%) clinicians, in lower respiratory tract infections, i.e. AECB and CAP.Conclusion: In-clinic use of cefpodoxime as monotherapy is preferred in upper respiratory tract infections. However, clinicians recommend a combination therapy of cefpodoxime and levofloxacin in lower respiratory tract infections

Open-label, randomized, crossover comparative bioavailability study of cefixime from two tablet formulations after single oral administration

Background: Cefixime is an oral extended spectrum third generation cephalosporin, which has marked in vitro bactericidal activity against a wide variety of Gram-positive and Gram-negative organisms, effective in the treatment of community-acquired infections such as respiratory tract infection and urinary tract infection. The objective of this randomized, crossover study was to compare the bioequivalence (BE) of two tablets of test (Milixim® 200 mg, containing 200 mg of cefixime) with Reference formulation (Cefixime, 400 mg).Methods: A total of 12 healthy volunteers were randomly assigned to crossover, single-dose treatment regimens. Serial blood samples were collected, and plasma concentrations of cefixime were analyzed using the high-performance liquid chromatographic technique. Pharmacokinetic parameters and BE limits were calculated using non-compartmental methods.Results: The mean Cmax for the test and reference formulations were 4435.0298±149 and 4408.2150±1021 ng/mL, respectively. The mean area under the serum concentration curve (AUC)0-t were 38108.2614±8583.6535 and 38457.5791±8105.2529 ng/hr/mL The mean ratios (test: reference) for Cmax, AUC0-t, were 99.7% and 98.5%, respectively. There were no significant differences in pharmacokinetic parameters between groups. Overall, the 90% confidence interval for the intra-individual ratios of the log-transformed Cmax and AUC values of the two formulations were within the BE interval of 80-125%.Conclusion: The study has demonstrated the BE of milixim and reference formulation of cefixime

Garenoxacin in skin & skin structure infections complicated by bear bite

Animal bites have always been a common problem to humans. The incidence of resistant organisms is also increasing in the community. Garenoxacin a novel oral des-fluoroquinolone with potent antimicrobial activity against common pathogens causing skin and soft tissue infections, including resistant strains offers the benefit of broad spectrum of coverage including gram positive, gram negative and anaerobic organisms. The result of the case study indicates that garenoxacin is very effective in treating skin and soft tissue infections caused by animal bites

Garenoxacin in the treatment of community-acquired pneumonia

Community-acquired pneumonia (CAP) is a major cause of adult mortality in Asia. Empirical use of antibiotics depends on the pathogens that are commonly responsible. Evolution of resistant pathogens in CAP has added to the burden of treating physicians. Microbiological culture and antibiotic sensitivity testing are helpful for the treatment of such respiratory tract infections. Klebsiella pneumoniae though uncommon pathogen of CAP has been reported in many cases. Garenoxacin a newer fluoroquinolone has found its utility in the treatment of respiratory tract infections. Providing symptomatic relief to the patient with the use of analgesics, antipyretics and cough preparations are also an essential part of the management

Evaluation of Contact Stresses in Bearings Made of Al – Beryl Metal Matrix Composites by Finite Element Method

AbstractIn the present investigation, interference fitted assemblies were analyzed using finite element method to evaluate contact stresses. The main objective of this research work is to develop metal matrix composite of commercially available pure aluminum reinforced with different weight percentage of Beryl to attain a most desirable property combination for bearings. A detailed analysis on the effect of bearing material on contact stresses was undertaken. The work covers the analysis based on Hertzian contact stresses. An appropriate finite element model was developed to analyze the pattern of contact stresses in the interference assemblies. Ansys workbench was used as a tool to construct the model and to perform analysis. The model was simulated by applying a pressure of 100MPa and at different speeds of the shaft. A comparative study on the effect of bearing materials such as bronze, Al-SiC and Al-Beryl MMCs on contact stresses were clearly demonstrated. It has been found that the contact stresses in the bearings made of Al-Beryl metal matrix composite was in the range of 4678.7 to 4680Pa at different speeds which was very much less when compared to the bronze and Al- SiC MMC. The results clearly demonstrated Al-Beryl can be used as one of the most suitable materials for fabricating bushes

Garenoxacin as a prophylactic anti-infective in hydropneumothorax: a case study report

Pneumothorax appears to be a common clinical state. Iatrogenic pneumothorax occurs commonly after procedures such as transthoracic needle biopsy, pleural biopsy, positive pressure ventilation, etc. Diagnosis of iatrogenic pneumothorax is often delayed. Broad spectrum anti-infectives appear to be beneficial in reducing the infections, especially when chest drains are inserted. Garenoxacin, a potent quinolone with its unique structural modification appears to have an edge over other respiratory quinolones

Improved guidelines of indoor airborne transmission taking into account departure from the well-mixed assumption

The well-mixed assumption has been widely used in predicting the spread of infectious diseases in indoor spaces. It is to be expected that a perfect well-mixed state will not be achieved in an indoor space at any reasonable level of ventilation. This work evaluates the well-mixed assumption by comparing the theory with results from large eddy simulations. The robustness of the well-mixed theory is established by comparing at four different levels. The comparison also points out systematic departures in pathogen concentration which can be accurately accounted for with an easily implementable correction factor to quantities such as cumulative exposure time. With the well-mixed model as the baseline, the correction factor can be used to account for additional important problem-specific details. We demonstrate that more accurately accounting for variability in pathogen concentration can help obtain improved estimates for enhanced guidelines of indoor airborne transmission. We further demonstrate that at source-sink separation distances smaller than 5 m, the well-mixed theory on average underestimates the risk of contagion, while for distances larger than about 5 m, the well-mixed theory\u27s prediction, on average, is overly restrictive

Use of garenoxacin: a new generation antibiotic for surgical infections

Background: The management of skin and skin structure infections (SSSI) still continues to be global challenge. USFDA has given strong recommendation for adequate empirical antibiotic coverage to avoid further complication of the wounds. Wound complications, especially in the diabetic population, patients with low immunity remains a big challenge though other factors like site of the wound, age of the patients also play an important role.Methods: A retrospective observational study was conducted to analyze clinical utility of garenoxacin for surgical prophylaxis. A total of 100 patients, 30 patients with diabetic foot and 70 patients with post-surgical intraabdominal wounds who were prescribed garenoxacin 2×200 mg as stat dose prophylactically. Swab culture from the wound slough and drain tube samples were sent for culture/sensitivity on day 0, day 5, and day 7. Wound healing was evaluated by estimating slough discharge, size of the wound, vascularity, and overall healing. They were categorized as treatment failure group, when sough/drain-discharge reduction was ≤50%, improved if sough/drain-discharge reduction was 50-75% and cure when sough/drain-discharge reduction was 75-100%.Results: The healthy granulation tissue was observed post 7 days therapy of garenoxacin 2×200 mg in diabetic foot ulcer (DFU) patients when administered empirically before surgical debridement. In patients with post-operative infectious intraabdominal wounds, the most common isolated organisms were Enterococcus, Acinetobacter and Klebsiella. Post garenoxacin therapy used as switch therapy empirically for 5 days resulted in 100% sterile culture. While evaluating slough/drain-discharge in DFU patients, 84% patients showed cure and 16% showed improvement at the end of day 7 and in patients with post-operative infectious intra-abdominal wounds cure was observed in 86% patients showed cure and 14% patient showed improvement. No side effects were reported during the study.Conclusions: Administration of garenoxacin used as empirical therapy for surgical prophylaxis and as switch therapy in patients with DFU s and post-surgical infectious wounds for the period of 5-7 days has been found effective indicating its wide spectrum of action