Inhibitory effects of aspirin and indometacin on the growth of Helicobacter pylori in vitro

OBJECTIVE: The interactions between non‐steroidal anti‐inflammatory drugs and Helicobacter pylori have not been sufficiently documented to date. The aim of this study was to investigate the possible effects of aspirin and indometacin on the growth of H. pylori and to determine the effects of aspirin on the susceptibility of H. pylori to some antimicrobials. METHODS: Kinetic studies were performed by inoculating strains of H. pylori in brucella broth with different concentrations of aspirin and indometacin. Growth of bacteria in the broth was assessed spectrophotometrically and by viable colony counts after incubation for 24 and 48 h. Bacterial morphology was determined by Gram stain under light microscopy. The minimal inhibitory concentration (MIC) of aspirin and indometacin was determined by the standard agar dilution method. The MIC of amoxicillin, clarithromycin and metronidazole was measured in the presence and absence of aspirin by the E‐test method. RESULTS: Kinetic studies revealed that aspirin and indometacin inhibited the growth of H. pylori in a dose‐dependent manner. The bactericidal activity of these agents was expressed by cell lysis. Aspirin at 400 µg/mL produced an almost 2‐log decrease in the number of CFU/mL at 48 h. Similar inhibitory effects were obtained when 100 µg/mL indometacin was tested. The MIC at which 90% of H. pylori was inhibited was 512 µg/mL and 128 µg/mL for aspirin and indometacin, respectively. Increased susceptibility of H. pylori to amoxicillin, clarithromycin and metro­nidazole was found in the presence of aspirin. CONCLUSIONS: Aspirin and indometacin could significantly inhibit the growth of H. pylori when incubated in brucella broth in vitro. A subinhibitory concentration of aspirin enhanced the susceptibility of H. pylori to some antimicrobial agents.     

青蒿琥酯分别与诺氟沙星、甲硝唑伍用的体内、外抗恶性疟作用

目的　了解青蒿琥酯分别与诺氟沙星、甲硝唑伍用的体内、外抗疟作用。　方法　采用青蒿琥酯与诺氟沙星 (A组 )或甲硝唑 (B组 )联用 3d疗法治疗无并发症的恶性疟。体外测定采用 Rieckmann体外微量法测定恶性疟原虫对 3种药物单一用药及青蒿琥酯分别与诺氟沙星或甲硝唑联用的敏感性。　结果　体内观察法共收治 70例病人 ,其中 A组 5 5例 ,B组 15例。平均退热时间分别为 (2 6 .5± 16 .5 ) h(8h～ 93h)、(19.2± 11.0 ) h(4h～ 4 1h) ;平均原虫无性体转阴时间分别为 (37.4± 15 .3) h(13h～ 93h)和 (42 .8± 14 .7) h(2 5 h～ 72 h) ;2 8d复燃率分别为 4 7.4 %和 75 .0 %。体外微量法测得青蒿琥酯与诺氟沙星伍用的 ID50 分别为单用组的 5 .9%和 0 .3% ;青蒿琥酯与甲硝唑伍用的 ID50 分别为单用组的38.8%和 5 .6 %。　结论　青蒿琥酯分别与诺氟沙星、甲硝唑伍用在体外对抗青蒿琥酯恶性疟原虫有明显增效作用 ,但在临床治疗中未能提高治愈率     

Treatment of Bacterial Vaginosis with Metronidazole or Pivampicillin

In a double-blind randomized controlled trial from general practice, we assessed the efficacy of treatment with either metronidazole or pivampicillin in patients fulfilling the diagnostic criteria of bacterial vaginosis.

50 women were treated with metronidazole 500 mg twice daily and 54 with pivampicillin 700 mg twice daily, both for seven days.

Evaluated four weeks after the start of treatment, we found a significantly higher cure rate in the metronidazole group (90%) than in the pivampicillin group (69%) (p = 0.01). Cure was defined as lack of fulfilment of the diagnostic criteria of bacterial vaginosis. Test for confounding according to parity and complaint of vaginal discharge showed no influence.

Side-effects were significantly commoner in the pivampicillin group (28%) than in the metronidazole group (8%).

We consider that metronidazole is a potent drug in the treatment of bacterial vaginosis, with pivampicillin as a useful alternative.     

Measuring the severity of Clostridium difficile infection: implications for management and drug development

The appropriate management of Clostridum difficile infection (CDI) has become a growing clinical and economic issue, as a new epidemic strain with enhanced virulence is causing increased morbidity and mortality. Presently, only two antibiotics (metronidazole and vancomycin) are routinely used to treat CDI. Both increasing disease severity and recurrent infections have been an impetus not only to develop new agents, but also to better recognize which patients are at highest risk for treatment failure and/or recurrence so that treatments can be optimized from the outset. The availability of a standardized and validated system for stratifying CDI severity could improve patient management and potentially accelerate the development of new treatment agents.     

Duodenal Ulcer and Eradication of Helicobacter pylori in a Developing Country An 18-Month Follow-up Study

Forty-eight patients with endoscopically proven duodenal ulcer (DU) and Helicobacter pylori infection detected by ¹⁴C-urea breath test (BT) were assigned to 5 days of treatment with furazolidone, metronidazole, and amoxicillin in addition to eventual classical anti-ulcer agents if necessary. Clinical evaluation and BT were repeated at 2, 6, and 18 months after therapy to determine H. pylori eradication or reinfection. Endoscopy was also repeated at 6 and 18 months after treatment to detect DU relapse. In 29 (60%) patients H. pylori had been eradicated at 2 months after therapy, and in 19 (40%) infection persisted. After successful eradication, 6 of 29 (20.7%) were reinfected. All 24 patients who were negative at the 18-month evaluation were asymptomatic, free of anti-ulcer drugs, and with healed ulcers, whereas among the 19 positive patients followed up, 11 (57%) continued to be symptomatic and still using anti-ulcer agents (p < 0.010), and 10 (53%) showed active ulcers at endoscopy (p < 0.010). H. pylori eradication is clearly followed by long-term remission of DU. Reinfection may be an additional problem in treating DU patients in developing countries.     

苯酰甲硝唑生物粘附微球的制备及粘附性能研究

目的：筛选苯酰甲硝唑生物粘附微球的最佳处方并进行粘附性能评价。方法：应用正交试验设计，以收率和包封产率为指标，选择最佳处方配比；并以滞留率为指标考察制备微球的粘附性能。结果：当苯酰甲硝唑投药量为35％，分散相与连续相比为0．9，乳化剂Span-80用量为7．5g时，苯酰甲硝唑生物粘附微球的收率和包封产率最高；离体法与在体法测得微球胃粘膜上的滞留率分别为（93．4&#177;4．5）％与（58．4&#177;9．3）％。结论：该处方设计合理，制备工艺可靠，质量稳定。     

联合用药体外抗幽门螺杆菌相互影响的实验研究

目的观察阿莫西林(A)、甲硝唑(M)和胶体次枸橼酸铋(B)单独和联合使用时体外抗幽门螺杆菌效果及相互影响作用,为临床治疗幽门螺杆菌感染的合理用药和新药研究提供参考。方法采用二倍稀释法和棋盘格法,通过测定最低抑菌浓度(MIC),计算出联合抑菌分数(FIC),作为抗菌效果评价指标,测定三种药物及联合使用时的抗菌效果。结果MICA为0.078μg.mL-1,MICM为31.2μg.mL-1,MICB为62.5μg.mL-1。A与M联用FIC指数为0.75,有协同作用;A与B联用、M与B联用FIC指数均等于1,无协同作用。A、M与B三药联合使用FIC指数为0.75,有一定的协同作用。结论A与M联合使用有一定的协同抗菌作用,A、M与B联合使用亦有一定的协同抗菌作用,但主要的抗菌效果是来自A的作用。     

双唑泰阴道泡腾片微生物限度检查方法学验证

目的建立双唑泰阴道泡腾片微生物限度检查的验证方法。方法根据2005年版《中国药典（二部）》附录ⅪJ微生物限度检查法,对双唑泰阴道泡腾片的微生物限度检查进行方法学验证。结果平皿法可检查该制剂的霉菌、酵母菌数,薄膜过滤法可检查该制剂的细菌、控制菌数。结论薄膜过滤法能有效去除双唑泰阴道泡腾片中的杀菌成分,使污染的微生物得以生长,故能较好地对细菌和控制菌进行检测。     

复方替硝唑栓剂体内外抗阴道毛滴虫研究

目的观察复方替硝唑栓剂的体内外抗阴道毛滴虫作用。方法将临床确诊的滴虫性阴道炎患者100例随机分为两纽，试验纽用复方替硝唑栓治疗，对照组用双唑泰栓治疗，每晚睡前放入阴道1粒。6d为1个疗程，共治疗2个疗程；选用临床分离的阴道毛滴虫9株。观察复方替硝唑栓的体外抗阴道毛滴虫作用。结果临床治愈率复方替硝唑栓为100％，双唑泰栓为78．7％，两者有显著性差异（P〈0．05）；复方替硝唑栓体外抗阴道毛滴虫的抑虫50％浓度（MIC50）、抑虫90％浓度（MIC50）厦最低杀虫浓度（MBC）范围均低于双唑泰栓。结论复方替硝唑检体内外抗阴道毛滴虫作用显著．比双唑泰栓疗效更佳。     

复方甲硝唑乳膏的制备及质量控制

目的:制备复方甲硝唑乳膏并建立其质量控制方法。方法:以甘油、硬脂酸等为基质制备乳膏;采用高效液相色谱法测定其中主药含量。结果:制备的乳膏性状、鉴别、检查等均符合2005年版《中国药典》相关规定;甲硝唑、氯霉素检测浓度线性范围分别为10·16～101·60(r=0·9995,n=6)、10·02～100·20mg·L-1(r=0·9999,n=6);平均回收率分别为96·82%(RSD=0·94%,n=6)、98·11%(RSD=0·85%,n=6)。结论:本制剂组方合理,制备工艺简便可行,质量稳定可控。