Correlation between in vivo and in vitro efficacy of antimicrobial agents against foreign body infections

Implant-associated infections are often resistant to antibiotic therapy. Routine sensitivity tests fail to predict therapeutic success. Therefore experimental in vitro tests were sought that would better correlate with drug efficacy in device-related infections. The activity of six different antibiotics against methicillin-resistant Staphylococcus epidermidis was investigated. In vivo studies were performed with the guinea pig tissue-cage animal model; in vitro studies with minimum inhibiting and bactericidal concentrations, time-kill studies of growing and stationary-phase microorganisms, the killing of glass-adherent S. epidermidis. Drug efficacy on stationary and adherent microorganisms, but not minimum inhibiting concentrations, predicted the outcome of device-related infections. Rifampin cured 12 of 12 infections and was also the most efficient drug in any experimental in vitro test. Similarly, the failure of ciprofloxacin to eradicate foreign body infections correlated with its low efficacy on stationary-phase and adherent S. epidermidis.     

Platelet function after in vivo and in vitro treatment with thrombolytic agents.

Whereas in vitro studies showed that plasmin may induce both inhibition and activation of platelets, in vivo and ex vivo investigations suggested that thrombolytic agents are responsible for platelet stimulation. To gain further information on this topic, ex vivo platelet function was studied in 24 subjects with acute myocardial infarction treated with streptokinase or recombinant tissue-type plasminogen activator (rt-PA). Ten patients with acute myocardial infarction who did not receive thrombolytic treatment were also investigated. The data shows that at the end of thrombolytic infusion, the maximal extent of platelet aggregation and adenosine triphosphate release was reduced in treated patients compared with that in untreated ones. In subjects treated with streptokinase, the defect in platelet aggregation derived from both cellular and plasmatic defects. Plasmatic beta-thromboglobulin concentration was significantly reduced after streptokinase, but unchanged after rt-PA. Three days after thrombolytic treatment, platelet aggregation of patients receiving streptokinase or rt-PA was not significantly different from that of untreated subjects. A similar defect in platelet function was obtained in vitro, incubating normal platelet-rich plasma with pharmacologic concentrations of streptokinase. Again, platelet function defect derived from both cellular and plasmatic damages. It cannot be excluded that platelet activation occurs in patients with acute myocardial infarction during the very early phases of thrombolytic treatment. However, it is suggested that a transient defect in platelet function follows both streptokinase and rt-PA infusion.     

Antibacterial activity of Co-trimazine in vitro and in vivo

Summary Co-trimazine is a new drug combination especially designed for the treatment of urinary tract infections. It consists of trimethoprim (90 mg) and sulphadiazine (410 mg). When combined in vitro, the components show high activity and a high frequency of synergy against urinary tract pathogens. After oral absorption sulphadiazine has a serum half-life similar to that of trimethoprim and is excreted in active form into the urine to a much higher degree than sulphamethoxazole. The ratio of the concentrations of trimethoprim and sulphadiazine in the urine following co-trimazine is favourable for a strong synergistic action between the compounds. In cross-over studies in volunteers receiving repeated daily doses of co-trimazine, either 500 mg twice daily or 1000 mg once daily, it was found that the antibacterial activity in the urine was at least as high as that provided by co-trimoxazole (2 × 960 mg) and considerably higher and more uniform than that given by nitrofurantion (3 × 50 mg).

---

Die antibakterielle Aktivität in vitro und in vivo von Co-trimazine

Zusammenfassung Co-trimazine ist eine neue Kombination aus Trimethoprim (90 mg) und Sulfadiazin (410 mg), die besonders für die Behandlung von Harnwegsinfektionen entwickelt worden ist. Kombinationen von Trimethoprim und Sulfadiazin zeigen in vitro eine hohe Aktivität und in hohem Ausmaße synergistische Wirkung gegen Erreger der Harnwegsinfektionen. Nach oraler Gabe zeigt Sulfadiazin praktisch dieselbe Halbwertszeit in Serum wie Trimethoprim und wird in viel höherem Ausmaß als Sulfametoxazol in aktiver Form in den Harn ausgeschieden. Das Konzentrationsverhältnis Trimethoprim zu Sulfadiazin, das in Harn von Co-trimazine gegeben wird, begünstigt eine synergistische Wirkung zwischen den beiden Komponenten. In Cross-over-Versuchen bei Freiwilligen mit wiederholter Gabe zeigte Co-trimazine (2 × 500 mg und 1 × 1000 mg) eine antibakterielle Aktivität im Harn, die mindestens so hoch war wie die von Co-trimoxazole (2 × 960 mg) und deutlich höher und gleichmäßiger als die von Nitrofurantoin (3 × 50 mg).

     

Quantitative determination of adenovirus-mediated gene delivery to rat cardiac myocytes in vitro and in vivo.

To optimize the use of modified adenoviruses as vectors for gene delivery to the myocardium, we have characterized infection of cultured fetal and adult rat cardiac myocytes in vitro and of adult cardiac myocytes in vivo by using a replication-defective adenovirus carrying the chloramphenicol acetyltransferase (CAT) reporter gene driven by the cytomegalovirus promoter (AdCMVCATgD). In vitro, virtually all fetal or adult cardiocytes express the CAT gene when infected with 1 plaque-forming unit of virus per cell. CAT enzymatic activity can be detected in these cells as early as 4 hr after infection, reaching near-maximal levels at 48 hr. In fetal cells, CAT expression was maintained without a loss in activity for at least 1 week. Using in vitro studies as a guide, we introduced the AdCMVCATgD virus directly into adult rat myocardium and compared the expression results obtained from virus injection with those obtained by direct injection of pAdCMVCATgD plasmid DNA. The amount of CAT activity resulting from adenovirus infection of the myocardium was orders of magnitude higher than that seen from DNA injection and was proportional to the amount of input virus. Immunostaining for CAT protein in cardiac tissue sections following adenovirus injection demonstrated large numbers of positive cells, reaching nearly 100% of the myocytes in many regions of the heart. Expression of genes introduced by adenovirus peaked at 5 days but was still detectable 55 days following infection. Adenoviruses are therefore a very useful tool for high-efficiency gene transfer into the cardiovascular system.     

In vitro susceptibility vs. in vivo efficacy of various antimicrobial agents against the Bacteroides fragilis group.

In vitro susceptibility testing is only one step in the evaluation of the potential efficacy of antimicrobial agents against the Bacteroides fragilis group. An assessment of in vivo efficacy, with a consideration of the factors that can best be studied in an infected host, is also an integral part of this process. Abscess models in rodents have been used to correlate in vitro activity with in vivo efficacy against this group of microorganisms. For metronidazole, clindamycin, moxalactam, and cefoxitin, the correlation was strong; for chloramphenicol and carbenicillin, it was not. In vivo studies of mixed infection with the B. fragilis group and Escherichia coli showed that cefoxitin and imipenem were effective; in contrast, cefotetan was not effective against resistant strains. Only strains susceptible to ceftizoxime in the agar dilution test were also affected by this drug in vivo. The so-called inoculum effect noted with ceftizoxime may explain this finding. In vivo elimination of encapsulated organisms of the B. fragilis group was found to be more difficult than elimination of unencapsulated isolates. The beta-lactamase produced by Bacteroides species can protect the enzyme-producing organism as well as its partners in mixed infections from the effects of beta-lactam antibiotics. These data illustrate the complexity and difficulties encountered when in vitro activity is correlated with in vivo efficacy.     

Quantitative effects of salycylhydroxamic acid and glycerol on Trypanosoma brucei glycolysis in vitro and in vivo.

During anaerobic glycolysis in vitro in the presence of salicylhydroxamic acid, Trypanosoma brucei brucei converts glucose to equimolar amounts of glycerol and pyruvate as end products. Glycerol, whether generated endogenously and pyruvate as end products. Glycerol, whether generated endogenously or added exogenously, can inhibit anaerobic glycolysis sufficiently in vitro to result in cell death. The concomitant administration of salicylhydroxamic acid and glycerol to rats infected with T. brucei brucei results in a rapid clearance of parasitemia. Our results clearly demonstrate a new and approachable chemotherapeutic target for African trypanosomes.     

Antitumor activity of interferon against murine osteogenic sarcoma in vitro and in vivo.

Murine interferon inhibited the growth of a continuous line of osteogenic sarcoma cells in tissue culture. Inhibition of tumor cell growth was documented by decreased clone formation in liquid medium, decreased tumor cell counts in monolayer cultures, suppression of colony formation in semi-solid agar, and decreased uptake of 3H-thymidine by the osteogenic sarcoma cells in culture. The capacity of anti-interferon antibody to block the tumor cell growth inhibitory activity of the interferon preparation suggested that interferon itself is the biologically active component of the interferon preparations. In vivo, a 7-day course of 30,000-60,000 units/day of type I interferon prepared in cell cultures either completely inhibited or delayed the appearance of tumors in experimental animals inoculated with osteogenic sarcoma cells by the sc route. The therapeutic efficacy of a preparation of murine sera containing type II interferon as well as other lymphokine activity was compared with the type I interferon preparation. Animals treated with 600 units of type II interferon were protected against tumor development as effectively as with 60,000 units/day of type I.     

In vitro and in vivo anticancer activity of Indigofera cassioides Rottl. Ex. DC

ObjectiveTo evaluate the antitumor, cytotoxic and antioxidant activities of methanolic leaf extract of Indigofera cassioides (MEIC) against transplantable tumors and human cancer cell lines.MethodsMEIC was investigated for its short term cytotoxicity on EAC and DLA cells by trypan blue dye exclusion method and in vitro cytotoxicity on HeLa, HEp-2, HEpG-2, MCF-7, HT-29, Vero and NIH 3T3 cells by MTT assay. In vivo antitumor activity was studied on EAC and DLA tumor bearing mice. Activity was assessed by monitoring the mean survival time, effect on hematological parameters, antioxidant enzyme levels and solid tumor volume.ResultsMEIC exhibit potent in vitro cytotoxicity against all the tested cancer cell lines, but it was found to be safe on normal cells. The extract significantly (P < 0.001) increase the mean survival time and also have a protective effect on the hemopoietic system at the tested dose levels (200 and 400 mg/kg). The extract prevented lipid peroxidation and restored the antioxidant enzymes catalase, superoxide dismutase, glutathione peroxidase and glutathione-s-transferase in the liver of tumor control animals. It also significantly (P < 0.01) reduce the solid tumor volume.ConclusionsThe results strongly support that MEIC shows potent antitumor and cytotoxic effects against EAC, DLA and human cancer cell lines. The extract prevents lipid peroxidation and promotes the enzymatic antioxidant defense system in tumor bearing animals which might be due to activities like scavenging of free radicals by the phytochemicals in MEIC.     

The microfilaricidal activity of ivermectin in vitro and in vivo

Ivermectin has been tested against the microfilariae of Onchocerca lienalis, Brugia pahangi and Dirofilaria immitis in vitro and in vivo. All in vitro tests were performed on larvae incubated for 48 hours at 37 degrees C in Hepes buffered medium 199 containing 20% serum, benzylpenicillin and streptomycin. In vivo tests were performed on larvae in female BALB/C mice dosed with ivermectin, 5 mg/kg, orally. The microfilariae of B. pahangi in vitro were insensitive to ivermectin at concentrations to 30 ng/ml. In vivo, an 87% reduction in the level of microfilaraemia was obtained by 24 hours after drugging but no reduction was observed in the numbers of peritoneal microfilariae. O. lienalis microfilariae in vitro were killed by ivermectin at 3 ng/ml and the larvae of this species within the subcutaneous and cutaneous tissues of the mouse were also eliminated by ivermectin at 5 mg/kg. D. immitis larvae within the bloodstream of the mouse were also sensitive to ivermectin at the dosage employed but were unaffected by ivermectin in vitro at concentrations up to 30 ng/ml.     

Lack of correlation between in vitro and in vivo effects of low density lipoprotein on the inflammatory activity of monosodium urate crystals.

The effect of coating monosodium urate crystals (MSU) with low density lipoprotein (LDL), postulated previously as a major regulator of gouty inflammation, was studied in a neutrophil chemiluminescence (CL) assay and an air pouch model of inflammation induced by MSU. LDL crystalline coating abrogated the neutrophil CL response but, in contrast, had no inhibitory effect on leucocyte accumulation, levels of the prostaglandin (PG) metabolite 6-keto-PGF1 alpha, and exudation of plasma proteins in the in vivo model. This latter observation raises doubts about the postulated physiological role of LDL in terminating the acute gouty attack.     

Principles of selection and use of antibacterial agents. In vitro activity and pharmacology

The selection of an antimicrobial treatment regimen is based on many factors, including the nature of the infection, the identity and susceptibility pattern of the infecting organisms, and the pharmacokinetics and pharmacodynamics of the antibacterial drugs. This article discusses principles of susceptibility testing, pharmacology, and monitoring of therapy.     

Comparative in vitro and in vivo activity of fleroxacin and ofloxacin against various mycobacteria.

In vitro antimicrobial activity of fleroxacin (6,8- difluoro-1-(2-fluoroethyl)-1, 4-dihydro-7-(4-methyl-1-piperazinyl)-4-oxo-3-quinolinecarboxylic acid) and ofloxacin against representative pathogenic mycobacteria was evaluated by the agar dilution method, using 7H11 agar medium. Fleroxacin showed appreciable antimicrobial activity against Mycobacterium tuberculosis (MIC90 = 6.25 mg/l), M. kansasii (MIC90 = 3.13 mg/l), and M. fortuitum (MIC90 = 6.25 mg/l), whereas M. marinum, M. scrofulaceum, M. avium, M. intracellulare, and M. chelonae were highly resistant to the agent. The activity of fleroxacin was comparable to that of ofloxacin. Fleroxacin showed antimicrobial activity against M. intracellulare phagocytosed in murine peritoneal macrophages at a concentration of 10 mg/l in the culture medium, but its activity was considerably lower than that of ofloxacin. On the other hand, the therapeutic activity of fleroxacin against M. fortuitum infection induced in mice was higher than that of ofloxacin. Neither fleroxacin nor ofloxacin was efficacious against M. intracellulare infection. Fleroxacin significantly depressed the growth of M. leprae in the mouse footpad.     

In vitro and in vivo anticandidal activity of human immunodeficiency virus protease inhibitors.

Highly active antiretroviral therapy that includes human immunodeficiency virus (HIV) aspartyl protease inhibitors (PIs) causes a decline in the incidence of some opportunistic infections in AIDS, and this decline is currently attributed to the restoration of specific immunity. The effect of two PIs (indinavir and ritonavir) on the enzymatic activity of a secretory aspartyl protease (Sap) of Candida albicans (a major agent of mucosal disease in HIV-infected subjects) and on growth and experimental pathogenicity of this fungus was evaluated. Both PIs strongly (>/=90%) and dose dependently (0.1-10 microM) inhibited Sap activity and production. They also significantly reduced Candida growth in a nitrogen-limited, Sap expression-dependent growth medium and exerted a therapeutic effect in an experimental model of vaginal candidiasis, with an efficacy comparable to that of fluconazole. Thus, besides the expected immunorestoration, patients receiving PI therapy may benefit from a direct anticandidal activity of these drugs.     

The relationship between in vitro cellular aging and in vivo human age.

Differences between early and late passage cell cultures on the organelle and macromolecular levels have been attributed to cellular "aging". However, concern has been expressed over whether changes in diploid cell populations after serial passage in vitro accurately reflect human cellular aging in vivo. Studies were therefore undertaken to determine if significant differences would be observed in the in vitro lifespans of skin fibroblast cultures from old and young normal, non-hospitalized volunteers and to examine if parameters that change with in vitro "aging" are altered as a function of age in vivo. Statistically signigificant (P less than 0.05) decreases were found in the rate of fibroblast migration, onset of cell culture senescence, in vitro lifespan, cell population replication rate, and cell number at confluency of fibroblast cultures derived from the old donor group when compared to parallel cultures from young donors. No significant differences were observed in modal cell volumes and cellular macromolecular contents. The differences observed in cell cultures from old and young donors were quantitatively and qualitatively distinct from those cellular alterations observed in early and late passage WI-38 cells (in vitro "aging"). Therefore, although early and late passage cultures of human diploid cells may provide an important cell system for examining loss of replicative potential, fibroblast cultures derived from old and young human donors may be a more appropriate model system for studying human cellular aging.     

Daphnetin: a novel antimalarial agent with in vitro and in vivo activity.

Daphnetin is a dihydroxycoumarin that is being used in China for the treatment of coagulation disorders. It is also a chelator and an antioxidant. In vitro, daphnetin causes a 50% inhibition (IC50) of 3H-hypoxanthine incorporation by Plasmodium falciparum at concentrations between 25 and 40 microM. Several related compounds, such as scopoletin, 2, 3-dihydroxybenzoic acid and 3, 4-dihydroxybenzoic acid show no inhibitory activity. The antimalarial activity of daphnetin is inhibited by the addition of iron. Daphnetin does not appear to be an oxidant drug, since it does not spontaneously generate superoxide in vitro. However, it does alkylate bovine serum albumin when incubated in the presence of iron. In vivo, daphnetin significantly prolongs survival of P. yoelli-infected mice.