Toxoplasma gondii is an important opportunistic pathogen that causes toxoplasmosis, which has very few therapeutic treatment options. The most effective therapy is a combination of pyrimethamine and sulfadiazine; however, their utility is limited because of drug toxicity and serious side effects. For these reasons, new drugs with lower toxicity are urgently needed. In this study, the compound, (Z)-1-[(5-nitrofuran-2-yl)methyleneamino]-imidazolidine-2,4-dione (nitrofurantoin), showed anti-T. gondii effects in vitro and in vivo. In HeLa cells, the selectivity of nitrofurantoin was 2.3, which was greater than that of pyrimethamine (0.9). In T. gondii-infected female ICR mice, the inhibition rate of T. gondii growth in the peritoneal cavity was 44.7% compared to the negative control group after 4-day treatment with 100 mg/kg of nitrofurantoin. In addition, hematology indicators showed that T. gondii infection-induced serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, biochemical parameters involved in liver injury, were reduced by nitrofurantoin significantly. Moreover, nitrofurantoin exerted significant effects on the index of antioxidant status, i.e., malondialdehyde (MDA) and glutathione (GSH). The nitrofurantoin-treated group inhibited the T. gondii-induced MDA levels while alleviating the decrease in GSH levels. Thus, nitrofurantoin is a potential anti-T. gondii candidate for clinical application.
Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Drug-Related Side Effects and Adverse Reactions ; Female ; Glutathione ; HeLa Cells ; Hematology ; Humans ; Liver ; Malondialdehyde ; Mice ; Mice, Inbred ICR ; Nitrofurantoin* ; Peritoneal Cavity ; Pyrimethamine ; Sulfadiazine ; Toxoplasma ; Toxoplasmosis*

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Azithromycin ; therapeutic use ; Ceftriaxone ; therapeutic use ; Humans ; Levofloxacin ; therapeutic use ; Male ; Middle Aged ; Nitrofurantoin ; therapeutic use ; Urethra ; microbiology ; pathology ; Urethral Diseases ; drug therapy ; therapy ; Young Adult

With increase of multi-drug resistant Escherichia coli in community-acquired urinary tract infections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibiotic selective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coli isolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well as trimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). The minimal inhibitory concentrations were determined by E-test or agar dilution method according to the Clinical and Laboratory Standards Institute guidelines, using 346 E. coli collected in 12 Korean hospitals from March 2010 to February 2011. FM, NI and TMO showed an excellent susceptibility profile; FM 100% (346/346), TMO 96.8% (335/346), and NI 99.4% (344/346). Conversely, resistance rates of CIP and SMX were 22% (76/346) and 29.2% (101/349), respectively. FEP still retained an activity of 98.5%. In Korea, NI and TMO in addition to FM are a good therapeutic option for uncomplicated CA-UTI, especially for lower UTI.
Anti-Bacterial Agents/*administration & dosage ; Cell Survival/*drug effects ; Cephalosporins/administration & dosage ; Ciprofloxacin/administration & dosage ; Community-Acquired Infections/drug therapy/*microbiology ; Dose-Response Relationship, Drug ; Drug Combinations ; Drug Resistance, Bacterial/drug effects ; Escherichia coli/*drug effects ; Escherichia coli Infections/drug therapy/*microbiology ; Fosfomycin/administration & dosage ; Humans ; Nitrofurantoin/administration & dosage ; Penicillins/administration & dosage ; Republic of Korea ; Sulfadoxine/administration & dosage ; Treatment Outcome ; Trimethoprim/administration & dosage ; Urinary Tract Infections/diagnosis/*microbiology

With increase of multi-drug resistant Escherichia coli in community-acquired urinary tract infections (CA-UTI), other treatment option with a therapeutic efficacy and a low antibiotic selective pressure is necessary. In this study, we evaluated in vitro susceptibility of E. coli isolates from CA-UTI to fosfomycin (FM), nitrofurantoin (NI), temocillin (TMO) as well as trimethoprim-sulfamethoxazole (SMX), ciprofloxacin (CIP) and cefepime (FEP). The minimal inhibitory concentrations were determined by E-test or agar dilution method according to the Clinical and Laboratory Standards Institute guidelines, using 346 E. coli collected in 12 Korean hospitals from March 2010 to February 2011. FM, NI and TMO showed an excellent susceptibility profile; FM 100% (346/346), TMO 96.8% (335/346), and NI 99.4% (344/346). Conversely, resistance rates of CIP and SMX were 22% (76/346) and 29.2% (101/349), respectively. FEP still retained an activity of 98.5%. In Korea, NI and TMO in addition to FM are a good therapeutic option for uncomplicated CA-UTI, especially for lower UTI.
Anti-Bacterial Agents/*administration & dosage ; Cell Survival/*drug effects ; Cephalosporins/administration & dosage ; Ciprofloxacin/administration & dosage ; Community-Acquired Infections/drug therapy/*microbiology ; Dose-Response Relationship, Drug ; Drug Combinations ; Drug Resistance, Bacterial/drug effects ; Escherichia coli/*drug effects ; Escherichia coli Infections/drug therapy/*microbiology ; Fosfomycin/administration & dosage ; Humans ; Nitrofurantoin/administration & dosage ; Penicillins/administration & dosage ; Republic of Korea ; Sulfadoxine/administration & dosage ; Treatment Outcome ; Trimethoprim/administration & dosage ; Urinary Tract Infections/diagnosis/*microbiology

PURPOSE: Enterococcus faecalis is one of the most common pathogens linked to chronic bacterial prostatitis (CBP). Owing to a limited number of previous studies addressing this topic, we aimed to determine the drug resistance patterns of E. faecalis strains isolated from CBP patients. MATERIALS AND METHODS: One thousand twenty-one patients visited a single hospital owing to chronic prostatitis for 5 years. Culture specimens were obtained by use of a modified Meares-Stamey method. The minimal inhibitory concentrations of the antimicrobials were assessed by use of the Vitek II microbial identification system as suggested by the Clinical and Laboratory Standards Institute. RESULTS: Forty-one samples from 41 patients who had significant E. faecalis loads for defining CBP were included in this study. The E. faecalis strains in our study were resistant to penicillin (9.7%), ampicillin (0%), ampicillin/sulbactam (0%), nitrofurantoin (0%), imipenem (0%), vancomycin (0%), teicoplanin (0%), quinupristin/dalfopristin (100%), ciprofloxacin (9.7%), levofloxacin (4.8%), norfloxacin (26.8%), erythromycin (95%), gentamicin (46.3%), tetracycline (97.5%), and trimethoprim/sulfamethoxazole (31.5%), respectively. CONCLUSIONS: Fluoroquinolones have been the preferred antibiotics for treating CBP. Because of their low rate of drug resistance, fluoroquinolones are suitable therapeutic agents for E. faecalis strains causing CBP in Korea. Even though tetracycline, erythromycin, and trimethoprim/sulfamethoxazole have been prescribed as an empirical antimicrobial therapy for chronic prostatitis, we cannot recommend these drugs for treatment of E. faecalis isolates because of the high rates of drug resistance.
Ampicillin ; Anti-Bacterial Agents ; Ciprofloxacin ; Drug Resistance ; Enterococcus ; Enterococcus faecalis ; Erythromycin ; Fluoroquinolones ; Gentamicins ; Humans ; Imipenem ; Korea ; Nitrofurantoin ; Norfloxacin ; Ofloxacin ; Penicillins ; Prostatitis ; Teicoplanin ; Tetracycline ; Vancomycin

The drug resistance of microorganisms isolated from laboratory animals never treated with antibiotics is being reported consistently, while the number of laboratory animals used in medicine, pharmacy, veterinary medicine, agriculture, nutrition, and environmental and health science has increased rapidly in Korea. Therefore, this study examined the development of antimicrobial resistance in bacteria isolated from laboratory animals bred in Korea. A total of 443 isolates (7 species) containing 5 Sphingomonas paucimobilis, 206 Escherichia coli, 60 Staphylococcus aureus, 15 Staphylococcus epidermidis, 77 Enterococcus faecalis, 27 Citrobacter freundii, 35 Acinetobacter baumannii were collected from the nose, intestine, bronchus and reproductive organs of ICR mice and SD rats. Of these species, Acinetobacter baumannii and Enterococcus faecalis showed significant antimicrobial resistance according to the minimum inhibition concentration (MIC) in E-test. In case of Acinetobacter baumannii, several isolates showed MIC values 16-128 microg/mL for cefazolin and cefoxitin, and higher resistance (128-512 microg/mL) to nitrofurantoin than that of standard type. Resistance to cefazolin, cefoxitin and nitrofurantoin was detected in 17.14, 20.00, and 8.57% of the Acinetobacter baumannii isolates, respectively. In addition, 44.1% of the Enterococcus faecalis isolates collected from the laboratory animals were resistant to oxacillin concentration of 16-32 microg/mL range, while MIC value of standard type was below oxacillin concentration of 6 microg/mL. These results suggest that in rodent species of laboratory animals, Acinetobacter baumannii are resistance to cefazolin, cefoxitin and nitrofurantoin, whereas those of Enterococcus faecalis were resistance to oxacillin.
Acinetobacter baumannii ; Agriculture ; Animals ; Animals, Laboratory ; Anti-Bacterial Agents ; Bacteria ; Bronchi ; Cefazolin ; Cefoxitin ; Citrobacter freundii ; Drug Resistance ; Drug Resistance, Microbial ; Enterococcus faecalis ; Escherichia coli ; Intestines ; Korea ; Mice ; Mice, Inbred ICR ; Nitrofurantoin ; Nose ; Oxacillin ; Pharmacy ; Rats ; Rodentia ; Sphingomonas ; Staphylococcus aureus ; Staphylococcus epidermidis ; Veterinary Medicine

Urinary tract infection (UTI) is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it is asymptomatic. However, the risk factors associated with recurrent UTI in elderly women are not widely described. In a multivariate analysis it was found that urinary incontinence, a history of UTI before menopause, and nonsecretor status were strongly associated with recurrent UTI in young postmenopausal women. Another study described the incidence and risk factors of acute cystitis among nondiabetic and diabetic postmenopausal women. Independent predictors of infection included insulin-treated patients and a lifetime history of urinary infection. Borderline associations included a history of vaginal estrogen cream use in the past month, kidney stones, and asymptomatic bacteriuria at baseline. Another important factor in postmenopausal women is the potential role that estrogen deficiency plays in the development of bacteriuria. There are at least two studies showing a beneficial effect of estrogen in the management of recurrent bacteriuria in elderly women. One of these studies showed that vaginal estrogen cream reduced vaginal pH from 5.5+/-0.7 to 3.6+/-1.0, restored lactobacillus, and decreased new episodes of UTI. Another study reported similar results using an estriol vaginal ring. However, contradictory results are found in the literature. For example, additional studies found that the use of estriol-containing vaginal pessaries was less effective than oral nitrofurantoin macrocrystals in preventing UTI in postmenopausal women. Two other studies also did not find any benefit in the reduction of UTI by oral estrogen therapy. Unfortunately, the use of estrogen in preventing UTI in postmenopausal women remains questionable. New strategies have been researched for reducing the use of antibiotics in the prevention and treatment of UTI. Two of them are probiotics and cranberry juice or capsules. Although several studies regarding probiotics and cranberry juice or capsules have reported a reduction of episodes of UTI, there is no conclusive evidence that they are useful in the prevention of UTI in postmenopausal women. As for the optimal drug, dosage, and length of treatment for UTI in the elderly, there are no studies comparing these data with the treatment for young women.
Aged ; Anti-Bacterial Agents ; Bacterial Infections ; Bacteriuria ; Capsules ; Catheters ; Contraceptive Devices, Female ; Cystitis ; Estriol ; Estrogens ; Female ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Kidney Calculi ; Lactobacillus ; Menopause ; Multivariate Analysis ; Nitrofurantoin ; Pessaries ; Probiotics ; Risk Factors ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Vaccinium macrocarpon

PURPOSE: To help the empirical antibiotics selection in diabetic foot infection patients, we investigated prevalence of microorganisms and their antibiotics sensitivity results. MATERIALS AND METHODS: Patients who came to our clinics to treat diabetic foot infections with deep ulceration and were followed up more than 6 months until complete recovery were adopted. From March 2006 to June 2009, there were 140 patients who corresponded with such a inclusion criteria. Wound cultures were done by deep tissue or bone debris at first visit to our clinics. Microorganisms which was documented by wound culture and most susceptible antibiotics by minimum inhibitory concentrations were surveyed retrospectively. RESULTS: Microorganisms were confirmed in 113 cases (80.7%). In the other 27 cases (19.3%), there were no cultured microorganisms. In bacterial growth group, there were 72 cases (63.7%) of gram-positive bacteria and 41 cases (36.3%) of gramnegative bacteria. All of them were aerobic microorganisms and there were no anaerobic microorganisms. Methicillin-sensitive staphylococcus aureus was the most common pathogen and accounted for 35 cases (31.0%). As other common pathogens, there were Enterobacter cloacae (11 cases, 9.7%), pseudomonas aeruginosa (10 cases, 8.8%), Methicillin-resistant staphylococcus aureus (10 cases, 8.8%) and enterococcus faecalis (6 cases, 5.3%), and so on. Common susceptible antibiotics in gram positive microorganism were vancomycin (60 cases, 83.3%), teicoplanin (60 cases, 83.3%), nitrofurantoin (60 cases, 83.3%) and ciprofloxacin (53 cases, 73.6%). In gram negative ones, common susceptible antibiotics were imipenem (35 cases, 85.3%), piperacillin/tazobactam (33 cases, 80.5%) and gentamicin (31 cases, 75.6%). CONCLUSION: Methicillin-sensitive Staphylococcus aureus in gram positive and enterobacter cloacae in gram negative was the most common pathogen in each group. Ciprofloxacin and gentamicin might be adaptable as a first-line empirical antibiotics in infected diabetic foot patients.
Anti-Bacterial Agents ; Bacteria ; Ciprofloxacin ; Diabetic Foot ; Enterobacter cloacae ; Enterococcus faecalis ; Foot ; Gentamicins ; Gram-Positive Bacteria ; Humans ; Imipenem ; Methicillin Resistance ; Microbial Sensitivity Tests ; Nitrofurantoin ; Porphyrins ; Prevalence ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Teicoplanin ; Ulcer ; Vancomycin

PURPOSE: The overuse of ciprofloxacin has recently increased the resistance of the Escherichia coli(E. coli). We studied the prevalence od the ciprofloxacin-resistant(CR) E. coli that were isolated from female patients with community-acquired urinary tract infection(CAUTI), and we demonstrated the resistant rate to other antibiotics to help physicians choose the suitable antibiotics to properly treat CAUTI. MATERIALS AND METHODS: From January 2006 to December 2007, we retrospectively analyzed 910 female patients with CAUTI. Among them, we chose 387 patients infected by E. coli and we evaluated the resistance rate to ciprofloxacin and its relationship with age, the disease causing the UTI and the previous antibiotics. We also compared the resistance to ciprofloxacin with that of other antibiotics, including cephalosporin and the other antibiotics recommended by the guidelines of the Infectious Diseases Society of America(IDSA). RESULTS: The incidence of UTI by E. coli increased with age(p<0.001), and it was highest in the 7th decade (59.0%). One hundred seventeen (30.2%) patients showed ciprofloxacin resistance. It was significantly related to an increased age(p=0.034), complicated UTI(p=0.04) and a previous history of antibiotic use(p=0.023). Trimethoprim/sulfamethoxazole(TMP/SMX) and fosfomycin showed similar resistance rates like ciprofloxacin; 31.8 and 28.2%, respectively. On the other hand, nitrofurantoin showed a low resistant rate of 5.7%. The resistance to cephalosporin was low in general; the lowest was cefepime(5.9%). CONCLUSIONS: Our results imply that the empirical use of ciprofloxacin for female patients with CAUTI is questionable, and especially for patients older than 40 years old, patients with complicated UTI and patients with a previous history of antibiotic use. Nitrofurantoin and cephalosporin can be useful agents for the treatment of female CAUTI.
Anti-Bacterial Agents ; Ciprofloxacin ; Communicable Diseases ; Community-Acquired Infections ; Drug Resistance, Bacterial ; Escherichia ; Escherichia coli ; Female ; Fosfomycin ; Hand ; Humans ; Incidence ; Nitrofurantoin ; Prevalence ; Retrospective Studies ; Urinary Tract ; Urinary Tract Infections

Drug-induced toxic hepatitis is a relatively common hepatic disease in children, and it is usually self-limiting upon cessation of the offending drugs. Antituberculous drugs are well known for inducing hepatitis. Some cases of drug-induced hepatitis with autoimmune features have been reported; in these cases, the offending drugs were usually methyldopa, nitrofurantoin, minocycline, and interferon. The authors report the first case in Korea of drug-induced autoimmune hepatitis associated with thyroiditis and multiple autoantibodies that was induced by the antituberculous drugs isoniazid and rifampin.
Autoantibodies ; Child ; Drug-Induced Liver Injury ; Hepatitis ; Hepatitis, Autoimmune ; Humans ; Interferons ; Isoniazid ; Korea ; Methyldopa ; Minocycline ; Nitrofurantoin ; Rifampin ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Autoimmune