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Elimination include biliary and renal excretion. Metabolic inhibition is an unlikely mechanism for drug interactions, because in vitro studies in human liver microsomes indicate that common human CYP isoforms (1A2, 2C8, 2C9, 2C19, 2D6, and 3A4) are not inhibited by tigecycline 40 . Because tigecycline is not extensively metabolized, drugs that inhibit or induce the activity of these CYP isoforms are unlikely to affect the clearance of tigecycline. A limited amount of information regarding...

References

1 Capasso L. 5300 years ago, the Ice Man used natural laxatives and antibiotics. Lancet 1998 352(9143) 1864. 2 Hoel D, Williams DN. Antibiotics past, present, and future. Unearthing nature's magic bullets. Postgrad Med 1997 101(1) 114-8, 121-2. 3 Alexander Fleming medicine's accidental hero. US News World Rep 1998 58-63. 4 Goldsworthy PD, McFarlane AC. Howard Florey, Alexander Fleming and the fairy tale of penicillin. Med J Aust 2002 176(4) 176-8. 5 Raper K. The penicillin saga remembered. ASM...

Antibiotic use in developing countries

Because the world is a global village'' when it comes to antibiotic resistance, any efforts toward prevention in the developed world will be less than successful unless and until the issue is addressed on a global level 61 . It is estimated that 4123 million (78 ) of the world's population of 5267 million lived in the developing countries in 1990. Infectious diseases were estimated to have caused 9.2 million of the 39.5 million deaths. Infections are the most common cause of death in children,...

The rest is history awakening to the possibilities and confronting the challenges

Subsequently, more broad-spectrum penicillins and other aminoglyco-sides were developed, followed by more antibiotic classes. More than 5000 antibiotics are now known. Approximately a thousand of these have been carefully investigated, and about 100 are currently used to treat infections. Most are produced by actinomycetes and bacteria, many of which are then chemically modified (semisynthetic). Others are completely synthetic. Penicillin, the prototype b-lactam, is a 6-aminopenicillanic acid...

Older antibiotics revisited

The recent interest in rediscovering new applications for older antibiotics has developed because of changes in pathogen distribution and resistance. The use of some older antibiotics has increased because of an increase in infections for which the antibiotic was used, which leads to an increase in usage for some established indications 4,5 . Antibiotic resistance is one of the factors responsible for the resurgence of some older antimicrobials. Among gram-positive organisms, there has been an...

Cyp3a4

The relative proportions of clinically used drug metabolized by cytochrome P450 enzymes. Significant interindividual variability exists in the outcomes of drug interactions. This variability is associated with patient-specific factors such as disease state, other concomitant medications, and genetics. Specifically, there is at least 10-fold interindividual variability in CYP450 content, which is most likely due to a combination of clinical factors and genetics. In addition, certain...

Shilpa M Patel MDa Louis D Saravolatz Md Macpb

ADivision of Infectious Diseases, Department of Internal Medicine, St. John Hospital and Medical Center, 19251 Mack Avenue, Suite 340, Grosse Pointe Woods, MI 48236, USA bDepartment of Medicine, St. John Hospital and Medical Center, 19251 Mack Avenue, Suite 335, Grosse Pointe Woods, MI 48236, USA The science of antibiotic therapy for infectious diseases continues to evolve. In many instances where empiric coverage is necessary, treatment with more than one agent is considered prudent. If an...

The future of antibiotic therapy

The strategies for developing new antibacterial agents will continue to involve inhibition of bacterial growth and multiplication, bacterial death, and interference with cellular attachment. In addition, improving drug delivery systems, reducing side effect profiles, improving antimicrobial susceptibility testing and reporting, and improving antibiotic use in the clinical setting will all play important roles in determining the future of antibacterial therapy 43 . Antibiotics with novel modes...

Manjunath P Pai PharmDa Kathryn M Momary PharmDb Keith A Rodvold Pharm Dbc

A University of New Mexico, College of Pharmacy, MSC09 5360, Albuquerque, NM 87131, USA b University of Illinois at Chicago, College of Pharmacy, Room 164, 833 South Wood Street, m c 886, Chicago, IL 60612, USA c University of Illinois at Chicago, College of Medicine, 833 South Wood Street, m c 886c, Chicago, IL 60612, USA The prescribing of safe and effective drug therapy is becoming increasingly complex. More and more patients are receiving multiple drug therapies for acute and chronic...

New uses for older antibiotics

The combination of increasing resistance among selected gram-positive and gram-negative pathogens has prompted a re-evaluation of the antibiotic armamentarium, because few antimicrobials are effective against previously or newly highly resistant micro-organisms. Among the tetracyclines, doxycy-cline and minocycline maintain their effectiveness in their traditional areas of use (eg, rickettsial infections, ehrlichiosis, Lyme and other spirochetal infections) and against bacterial zoonoses 1,3 ....