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, W. L., Graham, D. Y., Marshall, B. J. és mtsai: Clarithromycin as monotherapy for eradication of Helicobacter pylori: a randomized, double-blind trial. Am. J. Gastroenterol., 1993, 88 , 1860

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. Clarithromycin [6-O-methyl erythromycin] synthesized by substituting a methoxy group for the C-6 hydroxyl group of erythromycin (Figure 1c ) is a second-generation macrolide with broad spectrum of antibiotic activity [ 8 ]. It is active against the organisms

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Clarithromycin is an antibiotic widely used for Helicobacter pylori (H. pylori) eradication and together with amoxicillin and proton pump inhibitors they constitute the first line triple treatment regimen against H. pylori. Diarrhoea is one of the major drawbacks during H. pylori eradication and is majorly attributed to clarithromycin, while Saccharomyces boulardii is a probiotic and is shown to be effective in the treatment of antibiotic associated diarrhoea. We aimed to evaluate the effect of clarithromycin on orocecal transit in rats and to identify whether the supplementation with S. boulardii has a role on orocecal transit index. Adult rats of both sexes were divided into two groups to determine immediate or chronic effects of S. boulardii and clarithromycin on orocecal transit. The first group was given single dose of the test drug, while the second group received the test drugs for one week through orogastric intubation. Both groups were randomly distributed into four subgroups; the placebo group (group A), the S. boulardii group (group B), the clarithromycin group (group C), and the co-administration that is clarithromycin plus S. boulardii group (group D). Rats were given 20 mg kg−1 clarithromycin and 500 mg kg−1 S. boulardii. We did not find any difference among the subgroups in group 1, where only single dose of the test drugs was administered. In chronic administration group, that is group 2, significant differences among the subgroups were observed (P=0.004). Post-hoc comparisons of orocecal transit index between group “2A and 2C” and “2C and 2D” were significantly different (P=0.013 and P=0.005, respectively). Our results show that long term clarithromycin administration leads to rapid orocecal transit index and S. boulardii supplementation to clarithromycin can abolish this adverse effect in rats. Those findings suggest the beneficial use of S. boulardii in H. pylori eradication regimens.

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Acta Microbiologica et Immunologica Hungarica
Authors: B. Kádár, M. Szász, Katalin Kristóf, Natasa Pesti, G. Krizsán, Julianna Szentandrássy, L. Rókusz, K. Nagy, and Dóra Szabó

The aim of the study was to investigate the biofilm-production of 60 Pseudomonas aeruginosa strains isolated from clinical samples and to examine the effect of different antimicrobials and their combinations with clarithromycin on biofilm-formation.The minimal inhibitory concentrations (MICs), minimal biofilm inhibitory concentrations (MBICs), and antibiotic synergy by calculating the fractional inhibitory concentration (FIC) index were determined for the following antibiotics: ceftazidime, cefepime, piperacillin/tazobactam, imipenem, meropenem, levofloxacin, ciprofloxacin, gentamicin, amikacin, tobramycin, netilmicin and clarithromycin.A total of 14 (23.3%) isolates out of 60 isolates of P. aeruginosa were biofilm positive. Cefepime, imipenem and meropenem had the lowest MIC90 values. Piperacillin/tazobactam and clarithromycin had the highest MIC90 values. Imipenem, meropenem, piperacillin/tazobactam and clarithromycin had the lowest MBIC90 values.For biofilm-forming P. aeruginosa strains 2-fold to 128-fold higher MBIC values than MIC values were obtained for ceftazidime, cefepime, imipenem, amikacin and netilmicin. The MBIC was 2-fold to 512-fold lower then the MIC values in the case of piperacillin/tazobactam, ciprofloxacin, levofloxacin and clarithromycin.Synergy was generally demonstrated for clarithromycin in combination with aminoglycosides, fluoroquinolones or ceftazidime. However, surprisingly it was found that combinations of clarithromycin with carbapenems or cefepime led to an antagonistic interaction: combination of clarithromycin with imipenem, meropenem or ertapenem showed antagonism in 37.5%, 50% and 62.5% of the strains tested whereas its combination with cefepime expressed antagonism in 75% of the strains, respectively. To the best of our knowledge no one has previously described this phenomenon so far.

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Clarithromycin used for the treatment of respiratory tract infection. Anew alternative simple, rapid, sensitive, and selective high-performance thin-layer chromatography (HPTLC) method was developed and validated for the estimation of clarithromycin in plasma. HPTLC analysis was performed on pre-coated silica gel 60F254 plates. Separation was carried out using ethyl acetate-methanol-15% ammonium acetate (pH 10.6) as solvent system. Densitometry measurements were performed in absorbance mode at 506 nm after derivatising with xanthydrol solution. The R F of the drug was found to be 0.62. The method was linear over the range of 0.1–3.0 μg mL−1 (r 2 = 0.9974). The mean extraction recoveries were over 85%. The intra-day and inter-day precision (%CV) of the assay was in the range of 0.79–4.55%. The accuracy was found to be above 95%. The method was successfully applied to a pharmacokinetic study of clarithromycin 250 mg tablet in healthy human male volunteers.

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The purpose of this work was to develop a TLC-densitometric method for simultaneous identification and quantitative determination of azithromycin, clarithromycin, roxithromycin, spiramycin, and troleandomycin. The method was developed on TLC aluminium plates precoated with silica gel F254 using solvent system izopropanol:n-hexane:ammonia 25% (8:12:3, v/v/v), which gives compact spots for azithromycin (R F = 0.65), clarithromycin (R F = 0.54), roxithromycin (R F = 0.49), spiramycin (R F = 0.22), and troleandomycin (R F = 0.36). Densitometric analysis was carried out at 478 nm after spraying with (1:4, v/v) sulphuric acid:ethanol and heating at 100°C for 5 min. The linear regression analysis data for the calibration plots showed good linear relationship with correlation coefficient higher than 0.99. The method is distinguished by high sensitivity, with limit of detection (LOD) from 0.34 μg/spot for troleandomycin to 0.67 μg/spot for clarithromycin and limit of quantification (LOQ) from 1.02 μg/spot for troleandomycin to 2.04 μg/spot for clarithromycin and a wide linearity range from 2 to 12 μg/spot for spiramycin and 2–15 μg/spot for other antibiotics. The precision of the determination was good; relative standard deviation (RSD) varied in the range from 1.49% to 4.14%.

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A selective densitometric analysis has been adopted for the determination of pantoprazole sodium sesquihydrate, metronidazole, and clarithromycin as they play an important rule as co-administrated drugs in the treatment of helicobacter infection. The aim of this work was to find greener thin-layer chromatographic (TLC) solvents to follow the environmental safety measurements. The three drugs are vastly different in chemical structure, so it was very challenging to carry out the simultaneous separation and quantitation by TLC technique at R F values 0.49 ± 0.01, 0.72 ± 0.01, and 0.83 ± 0.01, respectively. In the developed method, chromatography was performed on TLC plates with pre-coated silica gel 60 F254 using ethyl acetate and absolute ethanol (3:1)‒heptane‒ammonia 33% (14:5:1, v/v) as the developing system with calculated polarity (3.535). Densitometric measurements were carried out using CAMAG Linomat 5 TLC scanner at 280 nm. Regression line data were evaluated by the least square method within the concentration range of pantoprazole sodium sesquihydrate, metronidazole, and clarithromycin 0.8–8, 4–40, and 5–50 μg band−1, and the detection limits of the drugs were 0.15, 0.76, and 0.88 μg band−1, respectively. The suitability of this TLC method for the quantity determination of three compounds in drug substances and drug products was proved by validation in accordance with the International Conference on Harmonization (ICH) guidelines (Q2R1). Statistical analysis was performed using Student’s t and F test, revealing no significant difference between the TLC method and the official ones concerning accuracy and precision.

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clarithromycin treatment for Helicobacter pylori eradication: the HYPER Study. Gut, 2007, 56 , 475–479. Fiocca R. Comparison of 1 and 2 weeks of omeprazole, amoxicillin and

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857 867 Gisbert, J. P., Gonzalez, L., Calvet, X., Gaercia, N., Lopez, T., Roque, M., Gabriel, R., Pajares, J. M.: Proton pump inhibitor, clarithromycin and either

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European Journal of Microbiology and Immunology
Authors: Isabel Stephany-Brassesco, Stefan Bereswill, Markus M. Heimesaat, and Matthias F. Melzig

-positive bacteria such as Bacillus cereus , Staphylococcus aureus and Enterococcus faecalis [ 16 ]. This prompted us to uncover potential synergistic antimicrobial effects of Cefabronchin ® and antibiotics such as amoxicillin and clarithromycin on clinical

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