A review on antibiotics induced nephrotoxicity

One of the common causes of acute kidney injury (AKI) is drug nephrotoxicity. AKIs around 20-60% in hospitalised patients are caused by drug-induced nephrotoxicity, which is also linked to higher morbidity and death both in children and adults. Antibiotics are one of the most frequently prescribed drug classes worldwide and, also one of the leading contributors to nephrotoxicity. Nephrotoxicity has been related to a wide range of antimicrobial medications, although the characteristics of kidney damage vary depending on the agent, the site of toxicity and the mechanism of injury within the renal. Acute tubular necrosis, acute interstitial nephritis, crystal nephropathy, and proximal/distal tubulopathy with electrolyte problems are the most frequent mechanisms. Pre-existing chronic renal disease and concurrent use of medications with nephrotoxic potential are two general risk factors for antimicrobial-induced AKI. The various types of antimicrobial-induced nephrotoxicity especially antibiotics will be discussed in this review and offer guidance on how to prevent AKI and recognize it early in order to reduce it and prevent morbidity

REVIEW ON CLINICALLY DEVELOPING ANTIBIOTICS

The world is running out of antibiotics. Between 1940 and 1962, more than 20 new classes of antibiotics were marketed. Since then, only two new classes of antibiotics were marketed. Now, not enough analogues are reaching the market to stem the tide of antibiotic resistance, particularly among gram-negative bacteria which indicates the need of novel antibiotics for their effective action. This review describes those antibiotics in late-stage clinical development. Most of them belong to existing antibiotic classes and a few with a narrow spectrum of activity are novel compounds directed against novel targets. The reasons for some of the past failures to find new molecules and a path forward to help attract investments to fund the discovery of new antibiotics are described

EXPERIMENTAL DESIGN APPROACH TO FABRICATE AND OPTIMIZE FLOATING TABLETS OF LEVOFLOXACIN FOR HELICOBACTER PYLORI INFECTION

Objective: To improve the treatment of H. pylori infection, by achieving the required bactericidal concentrations of antibiotics in the stomach, by delivering the antibiotics to the mucus layer and release the drug at the site of infection for a prolonged period would be significantly more effective than conventional dosage forms. Methods: The experimental method of the research was designed to prepare Levofloxacin floating by using Hydroxypropyl Methylcellulose (HPMC K4M), Hydroxypropyl Methylcellulose (HPMC K100M) and Xanthan gum by Three-level Box–Behnken design optimization method. The prepared tablets were evaluated for Thickness, Hardness, Friability, Weight variation, Swelling index (SI), Floating lag time (FLT) and Time required to release 90% of the drug from the tablet (T90%). Results: It was found that the Thickness-3.12±0.11 mm to 3.28±0.10 mm, Hardness-4.52±0.36 kg/cm2 to 4.81±0.24 kg/cm2, Friability-0.81±0.02g to 0.86±0.12g, Weight variation-480±1.90 mg to 523±0.89 mg, Swelling index (SI)-61.9±0.624% to 99.95±0.226%, Floating lag time (FLT)-81.12±0.63 s to 119.7±0.567 s and Time required to release 90% of the drug from the tablet (T90%)-7.0±0.55 h to 10.33±0.289 h. HPMC K100M and Xanthan gum showed good swelling as compared to HPMC K4M. The study revealed that HPMC K100M grade had a significant effect on drug release. Conclusion: The developed gastro-floating tablets can extend levofloxacin duration in the stomach and produce a prolonged release effect. The prepared levofloxacin floating tablet oral drug delivery system appears to be a promising choice for the efficient eradication of H. pylor

Antibiotic choice for respiratory infection in pediatric

Respiratory infection (RTI) is one of the leading factors of death in children in India. In most countries, RTI is a common cause of hospitalisation in children under five years old. There are different guidelines for management of various type of RTI. Most of these, emphasis on use of antibiotics in specific sub type of RTI. While literatures recommend avoiding antibiotic in viral infections, they mostly suggest beta lactams as first line drugs. Depends on patients, amoxicillin remains drug of choice for most of out-patients. In case of hypersensitivity to penicillin, cephalosporin commonly will be substituent. If specific and atypical organism found, need to switch to other type such as macrolides. In this research, we aimed to briefly review current guidelines and literatures regarding antibiotic selection in paediatrics suffering from different type of respiratory tract infection