Antimicrobial agents/drugs

Mandell GL, Sande MA. Antimicrobial agents drugs used in the chemotherapy of tuberculosis and leprosy. In Goodman Gilman A, Rail TW, Nies AS, Taylor P, editors. 

ANTTBIOTTCS - Cm ORANTHENICOL AND ANALOGUES] (Vol 2) -antimicrobial agent for EETERINARY DRUGS] (Vol 24)... 

Antibiotic and Antimicrobial Drugs. The antimicrobial agents (119) flumequiae (160) and (161), and methylflumequiae (S-25930) (162) and (163) effectively eliminate a number of microbial pathogens via inhibition of the topoisomerase II enzyme of c-DNA containing bacteria (120) (see... 

A fluorine atom in position 6 of the basic structure of quinolones enhances the antimicrobial activity considerably. All widely used quinolones are fluorinated in position 6 and the term fluoroquinolones is often used to describe these drugs. However, some new quinolones with similar antimicrobial activity are not fluorinated in position 6 (e.g. garenoxacin, PGE9262932) and therefore the term quinolones is more appropriate to describe this group of antimicrobial agents. 

Host factors can help to ensure selection of the most appropriate antimicrobial agent. Age is an important factor in antimicrobial selection. With regard to dose and interval, renal and hepatic function varies with age. Populations with diminished renal function include neonates and the elderly. Hepatic function in the neonate is not fully developed, and drugs that are metabolized or eliminated by this route may produce adverse effects. For example, sulfonamides and ceftriaxone may compete with bilirubin for binding sites and may result in hyperbilirubinemia and kernicterus. Gastric acidity also depends on... 

Absorption of antimicrobial agents such as fluoroquinolones and tetracyclines that can be bound by divalent and trivalent cations potentially could be compromised by administration with EN formulas containing these cations. The fluoroquinolones (e.g., levofloxacin and ciprofloxacin) have been best studied in this regard, and results of studies are not consistent. Mechanisms for an interaction between fluoroquinolones and EN formulas other than chelation by cations have been postulated.40 Some institutions hold tube feedings for 30 to 60 minutes or more before and after enteral dosages of fluoroquinolones. Because ciprofloxacin absorption has been shown to be decreased with jejunal administration, this drug probably should not be given by jejunal tube.41... 

Nebulizer formulation conforms to sterile product preparation, which means that drug stability in solution in the presence of additives must be evaluated. Historically, it was sufficient to use antimicrobial agents in the formulation, notably benzalkonium chloride. Adding antimicrobials is not now considered an acceptable approach to the formulation of nebulizer solutions. The solubility of the drug is important since it may impact upon the performance of the solution in a selected nebulizer. Additives may form complexes with the drug. 

Controlled and sustained drug delivery has recently begun to make an impression in the area of treatment of dental diseases. Many researchers have demonstrated that controlled delivery of antimicrobial agents, such as chlorhexidine [128-130], ofloxacin [131-133], and metronidazole [134], can effectively treat and prevent periodontitis. The incidence of dental caries and formation of plaque can also be reduced by controlled delivery of fluoride [135,136]. Delivery systems used are film-forming solutions [129,130], polymeric inserts [132], implants, and patches. Since dental disease is usually chronic, sustained release of therapeutic agents in the oral cavity would obviously be desirable. 

Scarpignato C, Pelosini I Antisecretory drugs for eradication of Helicobacter pylori Antibacterial activity and synergism with antimicrobial agents. Progr Basic Clin Pharmacol 1999 11 136-180. 

Gillum JG, Israel DS, Polk RE Pharmacokinetic drug interactions with antimicrobial agents. Clin Pharmacokinet 1993,25 450-482. 

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