RESUMO
The aim of this study was to investigate in vitro the antimicrobial effect and diffusion against E. faecalis of new intracanal medications on the external root surface. The medications tested were a placebo gel (PC); the new formulations with either 3% nitrofurantoin (NIT) or 3% doxycycline hydrochloride (DX) and 2% chlorhexidine (CHX) gel as positive control. The new formulations were tested using the traditional agar diffusion test (ADT) and an adapted agar diffusion method (AADM), where the teeth were filled with the medications and left to diffuse on agar surface seeded with E. faecalis. In the ADT, the larger zones of microbial growth inhibition were seen in DX, followed by CHX and NIT. In the AADM test only DX and CHX showed antimicrobial effect. Statistically significant differences between groups were observed by the Kruskal-Wallis test (ï£2=47.126; p<0.001). The new intracanal formulations with DX and NIT have demonstrated antimicrobial effect against E. faecalis, but only DX was able to diffuse through the dentinal tubules and exert antimicrobial effect outside the roots.
Assuntos
Antibacterianos/farmacologia , Cavidade Pulpar/efeitos dos fármacos , Dentina/efeitos dos fármacos , Doxiciclina/farmacologia , Nitrofurantoína/farmacologia , Irrigantes do Canal Radicular/farmacologia , Ágar , Antibacterianos/farmacocinética , Carga Bacteriana/efeitos dos fármacos , Clorexidina/farmacocinética , Clorexidina/farmacologia , Meios de Cultura , Cavidade Pulpar/metabolismo , Cavidade Pulpar/microbiologia , Dentina/metabolismo , Dentina/microbiologia , Difusão , Doxiciclina/farmacocinética , Enterococcus faecalis/efeitos dos fármacos , Humanos , Teste de Materiais , Nitrofurantoína/farmacocinética , Placebos , Irrigantes do Canal Radicular/farmacocinética , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/metabolismo , Raiz Dentária/microbiologiaRESUMO
BACKGROUND AND PURPOSE: In the light of increasing resistance to antibiotics used for the treatment of acute urinary tract infections, nitrofurantoin currently experiences a renaissance. Nitrofurantoin shows good efficacy against most bacteria expected in urinary tract infection, and the development of resistance is low. A study on the antimicrobial and clinical efficacy of nitrofurantoin in the treatment of acute lower urinary tract infections was conducted in Mexico City, an area where resistance rates of uropathogens to trimethoprim/sulfamethoxazole (cotrimoxazole) are high. PATIENTS AND METHODS: In this open-label, single-arm study 20 adult patients (18 females, 2 males) with positive urine culture were treated orally with nitrofurantoin sustained release 100 mg twice daily for 7 days. Urinary nitrofurantoin concentrations were determined at baseline and day 4 of the study. Primary endpoint was the antimicrobial efficacy of nitrofurantoin at 12 to 16 days after baseline, assessed by changes in urine culture results. RESULTS: In the patient population treated per protocol, primary endpoint analysis revealed a microbial eradication rate of 92.3%. At 35 to 42 days, the eradication rate was 83.3%. At these times, all patients in the per protocol population were free of symptoms. In patients with complicating factors, e.g. diabetic polyneuropathy, both antimicrobial and clinical efficacy appeared to be reduced. Urinary nitrofurantoin concentrations were mostly above minimum inhibitory concentrations of the isolated uropathogens. The study drug was generally well tolerated. Most frequent drug-related adverse event was mild headache, occurring in 10.8% of patients. Two patients discontinued the study due to rash. CONCLUSION: The results of the present study indicate good antimicrobial and clinical efficacy of nitrofurantoin in the treatment of acute uncomplicated urinary tract infections as well as acceptable tolerability in adults.
Assuntos
Anti-Infecciosos Urinários/uso terapêutico , Bacteriúria/tratamento farmacológico , Nitrofurantoína/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Administração Oral , Adulto , Idoso , Anti-Infecciosos Urinários/efeitos adversos , Anti-Infecciosos Urinários/farmacocinética , Bacteriúria/urina , Preparações de Ação Retardada , Esquema de Medicação , Feminino , Humanos , Masculino , Taxa de Depuração Metabólica/fisiologia , México , Pessoa de Meia-Idade , Nitrofurantoína/efeitos adversos , Nitrofurantoína/farmacocinética , Recidiva , Resultado do Tratamento , Infecções Urinárias/urinaAssuntos
Humanos , Masculino , Feminino , Anti-Infecciosos Urinários/classificação , Metenamina/administração & dosagem , Metenamina/farmacocinética , Metenamina/uso terapêutico , Nitrofurantoína/administração & dosagem , Nitrofurantoína/farmacocinética , Nitrofurantoína/uso terapêutico , Quinolonas/administração & dosagem , Quinolonas/farmacocinética , Quinolonas/uso terapêuticoRESUMO
A comparison of the in vitro sensitivity (disc method) of Furadantin and Nalidixic Acid on proven urinary pathogens has been presented. The latter was introduced at the University Hospital of the West Indies in 1967, on a trial basis. It was found to be more effective, than the former, except aganist E. coli which was equally sensitive to both drugs. The former, in use at the above Hospital since 1962, was found to be just as effective in 1967 except against Proteus sp. This organism became markedly more resistant over the 5-year period (AU)