Browsing by Subject "Clindamycin"

Now showing 1 - 4 of 4
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    Clindamycin-modified Triple Antibiotic Nanofibers: A Stain-free Antimicrobial Intracanal Drug Delivery System
    (Elsevier, 2018-01) Karczewski, Ashley; Feitosa, Sabrina A.; Hamer, Ethan I.; Pankajakshan, Divya; Gregory, Richard L.; Spolnik, Kenneth J.; Bottino, Marco C.; Biomedical Sciences and Comprehensive Care, School of Dentistry
    INTRODUCTION: A biocompatible strategy to promote bacterial eradication within the root canal system after pulpal necrosis of immature permanent teeth is critical to the success of regenerative endodontic procedures. This study sought to synthesize clindamycin-modified triple antibiotic (metronidazole, ciprofloxacin, and clindamycin [CLIN]) polymer (polydioxanone [PDS]) nanofibers and determine in vitro their antimicrobial properties, cell compatibility, and dentin discoloration. METHODS: CLIN-only and triple antibiotic CLIN-modified (CLIN-m, minocycline-free) nanofibers were processed via electrospinning. Scanning electron microscopy, Fourier-transform infrared spectroscopy (FTIR), and tensile testing were performed to investigate fiber morphology, antibiotic incorporation, and mechanical strength, respectively. Antimicrobial properties of CLIN-only and CLIN-m nanofibers were assessed against several bacterial species by direct nanofiber/bacteria contact and over time based on aliquot collection up to 21 days. Cytocompatibility was measured against human dental pulp stem cells. Dentin discoloration upon nanofiber exposure was qualitatively recorded over time. The data were statistically analyzed (P < .05). RESULTS: The mean fiber diameter of CLIN-containing nanofibers ranged between 352 ± 128 nm and 349 ± 128 nm and was significantly smaller than PDS fibers. FTIR analysis confirmed the presence of antibiotics in the nanofibers. Hydrated CLIN-m nanofibers showed similar tensile strength to antibiotic-free (PDS) nanofibers. All CLIN-containing nanofibers and aliquots demonstrated pronounced antimicrobial activity against all bacteria. Antibiotic-containing aliquots led to a slight reduction in dental pulp stem cell viability but were not considered toxic. No visible dentin discoloration upon CLIN-containing nanofiber exposure was observed. CONCLUSIONS: Collectively, based on the remarkable antimicrobial effects, cell-friendly, and stain-free properties, our data suggest that CLIN-m triple antibiotic nanofibers might be a viable alternative to minocycline-based antibiotic pastes.
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    Criticality of Benzoyl Peroxide and Antibiotic Fixed Combinations in Combating Rising Resistance in Cutibacterium acnes
    (Dove Press, 2025-03-31) Ghannoum, Mahmoud; Gamal, Ahmed; Kadry, Ahmed; Del Rosso, James Q.; Stein Gold, Linda; Kircik, Leon H.; Harper, Julie C.; Dermatology, School of Medicine
    Background: Antibiotic resistance is growing globally, with multiple countries reporting resistance in >50% of Cutibacterium acnes (C. acnes) strains. Combination formulations of an antibiotic and the antimicrobial benzoyl peroxide (BPO) may reduce this resistance risk, especially with prolonged use. This 4-part study tested susceptibility of 31 C. acnes clinical strains and development of resistance to antibiotics alone or combined with BPO. Methods: C. acnes susceptibility to single-drug antibiotics was assessed via minimum inhibitory concentration (MIC) values obtained from epsilometer tests, with lower MIC indicating higher susceptibility. Susceptibility to fixed-dose antibiotic/BPO combination products was determined by measuring the zone of inhibition using the agar diffusion method, with larger diameter indicating increased bacterial inhibition. The effect (synergistic, additive, antagonistic, or indifferent [no interaction]) of combining clindamycin with BPO on C. acnes inhibition was evaluated using a checkerboard assay, wherein 2 test compounds are combined in varying concentrations. Resistance development was assessed using serial passage of bacterial cultures in increasing concentrations of clindamycin alone or in combination with BPO. Results: All tested antibiotics (clindamycin, doxycycline, erythromycin, and minocycline) exhibited similar activity. C. acnes susceptibility was variable, with some strains having elevated MIC values-an indication of resistance-against different antibiotics. For 6 strains resistant to clindamycin alone (inhibitory zone=0 cm), formulations with BPO enhanced activity against the same isolates (range: 0.8-2.2 cm). Of 7 acne-associated strains, combining clindamycin and BPO had an additive effect against 4, and no interaction against 3. Bacterial cultures repeatedly exposed to the combination of clindamycin and BPO did not develop antibiotic resistance, which occurred with exposure to clindamycin alone. Conclusion: Overall, antibiotic susceptibility was highly dependent on the C. acnes strain, and antibiotic formulations with BPO exhibited enhanced activity against less susceptible strains. Fixed combinations of BPO with an antibiotic may improve antimicrobial activity and protect against resistance development.
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    Efficacy and Safety of a Fixed-Dose Clindamycin Phosphate 1.2%, Benzoyl Peroxide 3.1%, and Adapalene 0.15% Gel for Moderate-to-Severe Acne: A Randomized Phase II Study of the First Triple-Combination Drug
    (Springer, 2022) Stein Gold, Linda; Baldwin, Hilary; Kircik, Leon H.; Weiss, Jonathan S.; Pariser, David M.; Callender, Valerie; Lain, Edward; Gold, Michael; Beer, Kenneth; Draelos, Zoe; Sadick, Neil; Pillai, Radhakrishnan; Bhatt, Varsha; Tanghetti, Emil A.; Dermatology, School of Medicine
    Background: A three-pronged approach to acne treatment-combining an antibiotic, antibacterial, and retinoid-could provide greater efficacy and tolerability than single or dyad treatments, while potentially improving patient compliance and reducing antibiotic resistance. Objectives: We aimed to evaluate the efficacy and safety of triple-combination, fixed-dose topical clindamycin phosphate 1.2%/benzoyl peroxide (BPO) 3.1%/adapalene 0.15% (IDP-126) gel for the treatment of acne. Methods: In a phase II, double-blind, multicenter, randomized, 12-week study, eligible participants aged ≥ 9 years with moderate-to-severe acne were equally randomized to once-daily IDP-126, vehicle, or one of three component dyad gels: BPO/adapalene; clindamycin phosphate/BPO; or clindamycin phosphate/adapalene. Coprimary endpoints were treatment success at week 12 (participants achieving a ≥ 2-grade reduction from baseline in Evaluator's Global Severity Score and clear/almost clear skin) and least-squares mean absolute changes from baseline in inflammatory and noninflammatory lesion counts to week 12. Treatment-emergent adverse events and cutaneous safety/tolerability were also assessed. Results: A total of 741 participants were enrolled. At week 12, 52.5% of participants achieved treatment success with IDP-126 vs vehicle (8.1%) and dyads (range 27.8-30.5%; P ≤ 0.001, all). IDP-126 also provided significantly greater absolute reductions in inflammatory (29.9) and noninflammatory (35.5) lesions compared with vehicle or dyads (range inflammatory, 19.6-26.8; noninflammatory, 21.8-30.0; P < 0.05, all), corresponding to > 70% reductions with IDP-126. IDP-126 was well tolerated, with most treatment-emergent adverse events of mild-to-moderate severity. Conclusions: Once-daily treatment with the novel fixed-dose triple-combination clindamycin phosphate 1.2%/BPO 3.1%/adapalene 0.15% gel demonstrated superior efficacy to vehicle and all three dyad component gels, and was well tolerated over 12 weeks in pediatric, adolescent, and adult participants with moderate-to-severe acne.
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    P-1502. Clindamycin and Group A Streptococcus: Is It Time To Say Goodbye?
    (Oxford University Press, 2025-01-29) Mann, Keeret; Zijoo, Ritika; Lugar, Richard G.; Graduate Medical Education, School of Medicine
    Background: Group A streptococci (GAS) can cause invasive disease leading to Toxic Shock Syndrome (TSS), a condition linked with high mortality. Initial antibiotic therapy for GAS-TSS includes beta-lactams and clindamycin. When clindamycin resistance is noted, linezolid may be used instead until clinical stability is achieved. We reviewed GAS susceptibility at IUH Ball Memorial Hospital to assess appropriateness of initial clindamycin use as adjunctive therapy for GAS-TSS. Methods: GAS positive cultures recovered from 1/1/23 – 12/31/23 at IU Health Ball Memorial Hospital, Muncie, IN were reviewed. Results: Out of 162 cultures positive for GAS, 29 (17.9%) had susceptibility results. All 29 GAS specimens were sensitive to penicillin and linezolid, but only 16/29 (55.2%) specimens were sensitive to clindamycin. Table 1. and Chart 1. show susceptibility results for penicillin, clindamycin, erythromycin, and linezolid. Table 2. shows number of specimens with inducible clindamycin resistance. Chart 2. shows various sources of culture specimens. Conclusion: GAS susceptibility testing was performed with invasive infections or when requested. Significant resistance was noted to clindamycin. Although our data is limited by a small sample size, it is in line with trends noted by US CDC’s Active Bacterial Core surveillance reports. This raises concern over initial use of clindamycin for TSS before susceptibilities are available. There are both advantages and disadvantages associated with use of clindamycin or linezolid. There is more data to support clindamycin use, however it is linked with increased risk of C. difficile infections. There is limited data for the use of linezolid for this indication, but it does maintain better susceptibility and negates the use of vancomycin at time of empiric therapy. Even though more data may be needed to definitively recommend linezolid over clindamycin or vice versa, clinical decisions will need to be made prior to susceptibility results. We recommend clinicians utilize their local antibiograms to guide decision making, while also accounting for patient factors. This also provides an opportunity for the development of clinical practice guidelines to better assist clinicians in the community.