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  https://clinicaltrials.gov/show/NCT00002331?order=7
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  https://clinicaltrials.gov/show/NCT00002140?order=4
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Known hypersensitivity to the study drugs.. *Other concurrent mycobacterial disease requiring therapy, i.e., disseminated ... To compare the safety and efficacy of two doses of clarithromycin in combination with ethambutol and either rifabutin or ... with disseminated MAC to be treated with at least two antimycobacterial agents and for every regimen to include a macrolide ( ... Patients are randomized to receive clarithromycin at one of two doses plus ethambutol and either rifabutin or clofazimine. ...
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The highest risk categories are antithyroid medications, macrolides, and procainamides. As stated above, many drugs act by an ... ethambutol, dapsone, ciprofloxacin, trimethoprim, imipenem/cilastatin, zidovudine, fludarabine, acyclovir, and terbinafine.[28 ...
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are isoniazid, pyrazinamide, ethambutol and other similar compounds.. In yet another embodiment of the present invention the ... hypersensitivity reactions, abnormal blood pressure, sweating, bleeding, shortness of. breath and many related problems.. In ... of p-Iactams, macrolides, quinolones, fluoro-quinolones, aminoglycosides,. glycopeptides, rifamycins, folate inhibitors, ... ulcers, cardiotoxicity, hypersensitivity reactions, abnormal blood pressure, sweating,,. bleeding, shortness of breath and many ...
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Macrolides are effective in the treatment of infection due to Legionella, Mycoplasma, Ureaplasma, Corynebacterium (including ... First-line medications, increasingly used together in all tuberculosis, are isoniazid, ethambutol, rifampin, and pyrazinamide. ... Acute and chronic pulmonary hypersensitivity reactions may occur, and pulmonary fibrosis has occurred with prolonged use. ... The role of macrolide antibiotics in increasing cardiovascular risk. J Am Coll Cardiol. 2015 Nov 17;66(20):2173-84. [PubMed: ...
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OBJECTIVES: To test four 16-membered macrolides (josamycin, spiramycin, midecamycin and rokitamycin) along with other compounds in the same class (erythromycin, clarithromycin, roxithromycin and azithromycin) plus clindamycin and telithromycin, against Streptococcus pyogenes and Streptococcus pneumoniae isolates with well-characterized resistance genotypes. METHODS: Four hundred and eighty-six isolates of S. pyogenes and 375 isolates of S. pneumoniae were assayed for their macrolide susceptibilities and investigated by PCR to detect their different erythromycin resistance genes. All strains had been isolated over the period 2002-2003 from specimens of different human origin obtained in 14 different Italian centres. RESULTS: All 16-membered macrolides showed very low MICs (MIC(50)s and MIC(90)s, , or =0.06-0.5 mg/L) for the erythromycin-susceptible isolates and for those with the M phenotype, but the telithromycin MICs for the M-type isolates were at least four times higher ...
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*  Resistance to Macrolides and Lincosamides | cmpt
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*  Overview: Macrolides possess diverse natural activities and an capability to modulate - How NF-B is activated: the role of the...
90% after the widespread use of chronic erythromycin therapy (157). The characteristics of the clinical response to macrolide therapy are summarized as follows (71 157 202 258 (i) it takes up to 3 months of therapy for macrolides to show a significant effect; (ii) doses that are much lower than the MIC (i.e. low-dose macrolide therapy) are effective; (iii) the effect is seen even when patients are infected with macrolide-resistant bacteria such as (214) Mouse monoclonal to CD152(FITC). and (241 290 Clarithromycin has been shown to improve the transportability of secretions in human subjects (241 290 This mucoregulatory effect is seen even Aliskiren hemifumarate when hypersecretion is not induced by bacteria. Improved mucus transport may be associated with changes in the biophysical properties of secretions as well as with reduced inflammation. Ion transport. Tamaoki and coworkers (289) studied the effects of macrolides on the airway bioelectric current measured in an Ussing ...
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In Belgium, decreasing macrolide, lincosamide, streptogramins B, and tetracycline use during 19972007 correlated significantly with decreasing macrolide-resistant Streptococcus pyogenes during 19992009. Maintaining drug use below a critical threshold corresponded with low-level macrolide-resistant S. pyogenes and an increased number of erm(A)-harboring emm77 S. pyogenes with low fitness costs. ...
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*  Efficacy and Safety Study of Oral Solithromycin (CEM-101) Compared to Oral Moxifloxacin in Treatment of Patients With Community...
Community-acquired bacterial pneumonia (CABP) is an acute infection of the pulmonary parenchyma with symptoms such as fever or hypothermia, chills, rigors, chest pain, and/or dyspnea. The widespread emergence of antibiotic resistant pathogens, including the macrolide-resistant Streptococcus pneumoniae, has resulted in a need for new and effective antibiotics that have activity against CABP pathogens. Solithromycin is a fourth generation macrolide antibiotic with excellent activity against resistant S. pneumoniae and other key typical and atypical bacterial respiratory pathogens. A completed Phase 2 study showed comparable efficacy to levofloxacin in adults with CABP ...
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DESCRIPTION (provided by applicant): Glycosyltransferases involved in linking polyketide macrolactones with deoxysugars are key enzymes for combinatorial biosynthesis of novel macrolide anti-infective agents. In this proposal, a new gene shuffling technology, RACHITT, is applied to the desosarninyl transferase (Des VII) from the pikromycin biosynthetic pathway of Streptomyces venezuelae. Des VII is an enzyme with remarkable inherent substrate flexibility, and we expect to expand further its substrate spectrum to include 16-membered ring macrolactones. This technology is expected to provide glycosyltransferase enzymes that can catalyze the biosynthesis of 12-, 14-, and 16-membered ring macrolides. Moreover, we expect to generate a recombinant DesVII that has a higher enzymatic activity toward the 14-membered ring macrolactone narbonolide. This will be a key step in combinatorial biosynthesis of ketolide antibiotics that have a potential to combat multi-drug resistant bacterial pathogens. ...
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Lincomycin, And Clindamycin Azithromycin Clarithromycin Clindamycin Erythromycin Lincomycin The macrolides are similar in structure and activity. All the macrolides, lincomycin, and clindamycin are absorbed when taken orally, and erythromycin, lincomycin, azithromycin, and clindamycin can also be given parenterally. All are primarily bacteriostatic and bind to the 50S subunit of the ribosome, thus inhibiting bacterial protein synthesis. These drugs are active against aerobic and anaerobic gram-positive cocci, with the exception of enterococci, and against gram-negative anaerobes.. Pharmacology After oral or parenteral administration, these drugs diffuse well into body fluids, except CSF. Excretion is mainly in the bile, and dose adjustments are not required when renal failure is present.. Indications. Erythromycin is active against gram-positive cocci (including anaerobes), with the exception of enterococci; but many Staphylococcus aureus strains are now resistant and it ...
  http://antibioticinformation.blogspot.com/2005/12/macrolides.html
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Objectives: Understanding changing resistance patterns is important in determining appropriate antibiotic treatments. This meta-analysis systematically evaluated resistance of Streptococcus pneumoniae and Streptococcus pyogenes to macrolide antibiotics among patients with community-acquired respiratory tract infections.. Methods: MEDLINE and EMBASE databases were searched and experts were consulted to identify published and unpublished literature reporting macrolide resistance rates. Identified studies were evaluated by two independent reviewers; those meeting a priori specified criteria (resistance by patient condition and strain, resistance thresholds, 1997-2003 isolates) were included. Data from included studies were abstracted by two independent reviewers using a standard review form. Discrepancies in abstracted data were resolved by the study investigator.. Results: Random-effects meta-analysis was performed for outcomes present in at least four studies overall and for specified subgroups. ...
  http://oxfordindex.oup.com/view/10.1093/jac/dki060
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Conclusions:In observational studies of almost 10,000 critically ill patients with community-acquired pneumonia, macrolide use was associated with a significant 18% relative (3% absolute) reduction in mortality compared with nonmacrolide therapies. After pooling data from studies that provided adjusted risk estimates, an even larger mortality reduction was observed. These results suggest that macrolides be considered first-line combination treatment in critically ill patients with community-acquired pneumonia and support current guidelines ...
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The emergence of resistance to penicillin and other beta-lactam antibiotics in pneumococci in the 1980s and 1990s led to the increased use of macrolides, fluoroquinolones, and other nonbetalactam antibiotics for pneumococcal infections. This chapter focuses on the molecular mechanisms of non-beta-lactam resistance in Streptococcus pneumoniae. Resistance to macrolides can occur by enzymatic inactivation, modification of the target by methylation or mutation, and active efflux. Proteins of the ABC transporter superfamily are organized such that two ATP-binding domains located cytoplasmically interact with two hydrophobic domains consisting of six to eight transmembrane domains. The esterase activity identified in Staphylococcus hydrolyzed 14- and 16-membered macrolides. The primary targets of other quinolones have been determined; trovafloxacin, levofloxacin, and norfloxacin target topoisomerase IV (ParC), whereas the primary target of gatifloxacin is DNA ...
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