RESUMEN

OBJECTIVE: To review the significance of a United States Food and Drug Administration (FDA) approved Phase I clinical trial of a new use for an old drug, quinacrine. To discover whether ultrasound may have utility in quinacrine sterilization (QS). METHOD: This clinical trial began on 16 September 2000 at the Women's and Children's Hospital of Buffalo (WCHOB) in Buffalo, New York. Ten patients volunteered to have QS. These subjects were carefully followed with regularly scheduled examinations, including extensive laboratory blood tests. In addition, each patient had a trans-abdominal ultrasound examination six weeks or later past the date of the second insertion of quinacrine. The trial was completed on 30 April 2003. RESULTS: Laboratory results fell within normal limits, thus providing additional evidence to affirm the lack of toxic effects of QS. With ultrasound, we were able to see scars in both oviducts on all of our patients. One patient with a small scar as seen on ultrasound became pregnant. CONCLUSION: QS was found to be safe and effective. Ultrasound holds the promise of reducing the failure rate.

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RESUMEN

OBJECTIVE: To review the significance of a United States Food and Drug Administration (FDA) approved Phase I clinical trial of a new use for an old drug, quinacrine. To discover whether ultrasound may have utility in quinacrine sterilization (QS). METHOD: This clinical trial began on 16 September 2000 at the Women's and Children's Hospital of Buffalo (WCHOB) in Buffalo, New York. Ten patients volunteered to have QS. These subjects were carefully followed with regularly scheduled examinations, including extensive laboratory blood tests. In addition, each patient had a trans-abdominal ultrasound examination six weeks or later past the date of the second insertion of quinacrine. The trial was completed on 30 April 2003. RESULTS: Laboratory results fell within normal limits, thus providing additional evidence to affirm the lack of toxic effects of QS. With ultrasound, we were able to see scars in both oviducts on all of our patients. One patient with a small scar as seen on ultrasound became pregnant. CONCLUSION: QS was found to be safe and effective. Ultrasound holds the promise of reducing the failure rate.

RESUMEN

The laminin binding properties of eight species of the genus Bacteroides were examined using latex particle agglutination assay. B. fragilis was found to bind strongly to laminin, whereas all other species tested showed no or only weak laminin adherence. The pronounced differences in laminin binding activity between B. fragilis on the one side and B. thetaiotaomicron and B. ovatus on the other were determined to be statistically significant (p < 0.001 and p < 0.01, respectively). With regard to the relevance of laminin adherence for bacterial pathogenicity and invasiveness, our results give a possible explanation for the well-known finding that B. fragilis is the most frequently isolated pathogen in anaerobic bacteremia.

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The aim of the present study was to compare the in vitro activity of meropenem (ICI 194660, CAS 96036-03-2) with imipenem, metronidazole, clindamycin, ampicillin and ampicillin/sulbactam against a variety of anaerobic bacteria using an agar dilution method. 423 clinical isolates were tested belonging to 70 species of 15 anaerobic genera. They included Bacteroides fragilis (n = 62), Bacteroides thetaiotaomicron (n = 45), Prevotella bivia (n = 11), Fusobacterium nucleatum (n = 12), Clostridium perfringens (n = 15) and several rarely isolated species and genera, e.g. Selenomonas sputigena and Clostridium symbiosum. Bacteroides species were inhibited by meropenem at < or = 2.0 micrograms/ml, Clostridium species, including C. difficile, at < or = 4.0 micrograms/ml and all the other anaerobes at < or = 0.5 microgram/ml. Meropenem and imipenem were the most active substances, but often equal to, or only slightly better than, metronidazole, clindamycin or ampicillin/sulbactam, dependent on species. Meropenem was especially active against Bacteroides gracilis (MIC90 0.015 microgram/ml), Prevotella disiens (MIC90 0.03 microgram/ml), Fusobacterium nucleatum (MIC90 0.015 microgram/ml), Clostridium perfringens (MIC90 0.015 microgram/ml) and Veillonella parvula (MIC90 0.03 microgram/ml). The results obtained indicate that meropenem might be a useful adjunct to chemotherapy of anaerobic and mixed aerobic and anaerobic infections.

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