GB2474482A - Daily antibiotic cycling - Google Patents
Daily antibiotic cycling Download PDFInfo
- Publication number
- GB2474482A GB2474482A GB0918077A GB0918077A GB2474482A GB 2474482 A GB2474482 A GB 2474482A GB 0918077 A GB0918077 A GB 0918077A GB 0918077 A GB0918077 A GB 0918077A GB 2474482 A GB2474482 A GB 2474482A
- Authority
- GB
- United Kingdom
- Prior art keywords
- antibiotics
- different
- antibiotic
- treatment
- different antibiotics
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 230000003115 biocidal effect Effects 0.000 title claims description 42
- 230000001351 cycling effect Effects 0.000 title abstract description 4
- 239000003242 anti bacterial agent Substances 0.000 claims abstract description 58
- 229940088710 antibiotic agent Drugs 0.000 claims abstract description 53
- 230000000845 anti-microbial effect Effects 0.000 claims abstract description 16
- 239000003814 drug Substances 0.000 claims abstract description 3
- 238000011282 treatment Methods 0.000 claims description 27
- 238000001228 spectrum Methods 0.000 claims description 15
- 244000005700 microbiome Species 0.000 claims description 13
- 239000002775 capsule Substances 0.000 claims description 10
- 230000015572 biosynthetic process Effects 0.000 claims description 7
- 238000000034 method Methods 0.000 claims description 4
- 241000124008 Mammalia Species 0.000 claims description 2
- 208000015181 infectious disease Diseases 0.000 abstract description 4
- 229940079593 drug Drugs 0.000 abstract 1
- 238000004806 packaging method and process Methods 0.000 abstract 1
- 229940126575 aminoglycoside Drugs 0.000 description 3
- 241000894006 Bacteria Species 0.000 description 2
- 206010067484 Adverse reaction Diseases 0.000 description 1
- 241000233866 Fungi Species 0.000 description 1
- 206010048461 Genital infection Diseases 0.000 description 1
- RJQXTJLFIWVMTO-TYNCELHUSA-N Methicillin Chemical compound COC1=CC=CC(OC)=C1C(=O)N[C@@H]1C(=O)N2[C@@H](C(O)=O)C(C)(C)S[C@@H]21 RJQXTJLFIWVMTO-TYNCELHUSA-N 0.000 description 1
- 206010033078 Otitis media Diseases 0.000 description 1
- 229930182555 Penicillin Natural products 0.000 description 1
- 206010057190 Respiratory tract infections Diseases 0.000 description 1
- 241000700605 Viruses Species 0.000 description 1
- 239000004480 active ingredient Substances 0.000 description 1
- 230000006838 adverse reaction Effects 0.000 description 1
- LSQZJLSUYDQPKJ-NJBDSQKTSA-N amoxicillin Chemical compound C1([C@@H](N)C(=O)N[C@H]2[C@H]3SC([C@@H](N3C2=O)C(O)=O)(C)C)=CC=C(O)C=C1 LSQZJLSUYDQPKJ-NJBDSQKTSA-N 0.000 description 1
- 229960003022 amoxicillin Drugs 0.000 description 1
- -1 ampicyllin Chemical compound 0.000 description 1
- 230000000844 anti-bacterial effect Effects 0.000 description 1
- 206010006451 bronchitis Diseases 0.000 description 1
- 238000002512 chemotherapy Methods 0.000 description 1
- 229940124446 critical care medicine Drugs 0.000 description 1
- 230000007423 decrease Effects 0.000 description 1
- 210000004392 genitalia Anatomy 0.000 description 1
- 239000003120 macrolide antibiotic agent Substances 0.000 description 1
- 229940041033 macrolides Drugs 0.000 description 1
- 229960003085 meticillin Drugs 0.000 description 1
- UWYHMGVUTGAWSP-JKIFEVAISA-N oxacillin Chemical compound N([C@@H]1C(N2[C@H](C(C)(C)S[C@@H]21)C(O)=O)=O)C(=O)C1=C(C)ON=C1C1=CC=CC=C1 UWYHMGVUTGAWSP-JKIFEVAISA-N 0.000 description 1
- 229960001019 oxacillin Drugs 0.000 description 1
- LSQZJLSUYDQPKJ-UHFFFAOYSA-N p-Hydroxyampicillin Natural products O=C1N2C(C(O)=O)C(C)(C)SC2C1NC(=O)C(N)C1=CC=C(O)C=C1 LSQZJLSUYDQPKJ-UHFFFAOYSA-N 0.000 description 1
- 150000002960 penicillins Chemical class 0.000 description 1
- 230000000241 respiratory effect Effects 0.000 description 1
- 210000002345 respiratory system Anatomy 0.000 description 1
- 208000020029 respiratory tract infectious disease Diseases 0.000 description 1
- 201000009890 sinusitis Diseases 0.000 description 1
- 206010040872 skin infection Diseases 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 230000002195 synergetic effect Effects 0.000 description 1
- 210000001635 urinary tract Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/04—Antibacterial agents
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Chemical & Material Sciences (AREA)
- Public Health (AREA)
- Medicinal Chemistry (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Pharmacology & Pharmacy (AREA)
- Epidemiology (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Organic Chemistry (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Chemical & Material Sciences (AREA)
- Oncology (AREA)
- Communicable Diseases (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicines Containing Material From Animals Or Micro-Organisms (AREA)
Abstract
Two or more antibiotics are used to treat a single infection by administering them sequentially on alternate days. Tablet packaging and the use of coloured tablets to aid the cycling of the antimicrobial drugs is also disclosed.
Description
PREVENTING THE DEVELOPMENT OF ANTIBIOTIC RESISTANCE
[0001] The present invention relates to the use of two or more different antibiotics to prevent or minimize the development of antibiotic resistance in microorganisms.
In particular, it relates to the alternate or sequential daily use or administration of two or more different antibiotics having the same or similar spectrum of antimicrobial activity in a single course of antibiotic application or treatment. A single course of treatment may last for one or two weeks.
[0002] It has long been recognised by clinicians and microbiologists that excessive use of antibiotics in medical and veterinary treatments of infections can lead to the appearance of resistant strains of microorganisms, particularly in a health care environment. Thus, the more frequently an antibiotic is prescribed the more likely it is that resistance will develop in the microorganism for which the antibiotic has been prescribed.
[0003] There have been some attempts to prevent the development of antibiotic resistance in microorganisms, in particular bacteria, due to overuse and/or continuous repetition of application of a particular antibiotic. Such attempts have comprised antibiotic cycling or rotation over long periods of time and with lengthy intervals between cycles or rotation. Brown and Nathwani reported in J. Antimicrobial Chemotherapy; 2005; 55; 6-9 the cycling of two aminoglycosides during a 4 month period. Genaramicin was the first aminoglycoside used, which was replaced by amikazin in the following month. No significant decline in the resistance rate to both aminoglycosides was obtained by the rotation during a period of thirty months. H.J. van Loon et al published an article in American Journal of Respiratory and Critical Care Medicine on 29 October 2004 entitled "Antibiotic Rotation & Development of Gram Negative Antibiotic Resistance". The results obtained after a trial period of many months were inconclusive.
[0004] It has now been found that, by daily use of two or more different antibiotics having same or similar spectrum or efficacy of antimicrobial activity on alternate or sequential days in a single course of antibiotic treatment, the formation of resistant microorganisms can be minimized or prevented. In addition, by rotating two or more antibiotics in a single course of treatment, a reduction of from 50% to 80% in the use of any one antibiotic is obtained.
[0005] According to one aspect of the invention there is provided use of two or more different antibiotics having same or similar spectrum of antimicrobial activity to avoid their overuse and minimize or prevent formation of antibiotic resistance in a microorganism, wherein the different antibiotics are used daily on alternate or sequential days in a single course of antibiotic application or treatment.
[0006] According to the Oxford Dictionary an "antibiotic" is a substance produced by microorganisms or made synthetically that can inhibit the growth of or destroy susceptible microorganisms such as bacteria, fungi, viruses and protozoa. The antibiotics for use in this invention may have antibacterial activity.
[0007] The use according to the invention may involve three different antibiotics having the same or similar spectrum of antibiotic activity in a single course of treatment. In this instance the three antibiotics are used daily on sequential days, i.e. one after the other in a cycle of three, which is repeated until the course of antibiotic treatment is completed.
[0008] The different antibiotics that are used may be selected from the same class of antibiotics or they may be selected from different classes of antibiotics provided they are compatible with each other, for example do not cause an adverse reaction.
[0009] One class of antibiotics from which they may be selected is the penicillins, which includes amoxicillin, ampicyllin, meticillin and oxacillin. Such antibiotics are mainly used for treating the most common internal infections, such as sinusitis, bronchitis, urinary tract and gastro infections and also in the treatment of otitis media.
[0010] Another class of antibiotic, which may be selected, is the macrolides.
These antibiotics are mainly used to treat respiratory tract, genital and skin infections.
[0011] It is preferred that the antibiotics to be selected for use in the invention are not only effective for the same or similar antimicrobial spectra but are also compatible with each other. As a result a synergistic effect may occur which could result in a reduction in the total amount of each active ingredient, i.e. a smaller total dosage of each antibiotic, being required to provide an effective treatment.
[0012] According to a second aspect of the invention there is provided a method of preventing or minimizing formation of antibiotic resistance in a microorganism which comprises administering to an infected mammal in need of antibiotic treatment two or more different antibiotics having same or similar spectrum of antimicrobial activity wherein in a single course of application or treatment an effective dose of an antibiotic is administered daily, a different antibiotic being administered on alternate or sequential days.
[0013] Preferably the method comprises administering three different antibiotics having the same or similar spectrum of antimicrobial activity daily on sequential days in a cycle, the cycle being repeated until the course of treatment is completed.
[0014] According to a third aspect of the invention there is provided an antibiotic dispensing pack or device adapted to contain two or more different antibiotics having same or similar spectrum of antimicrobial activity wherein the pack or device has means for retaining, presenting and identifying the different daily antibiotics at separate sequential locations.
[0015] The antibiotic dispensing pack may comprise a blister pack having a base with at least one row of blister cavities in which the different antibiotics, which may be presented in tablet or capsule form, are located. The base is connected to a substantially flat lid for retaining the two or more different antibiotics in the cavities in the desired daily order for the single course of treatment. Each antibiotic may be located in a blister cavity next to each other.
[0016] As an example, an average course of antibiotics lasts for ten days.
Where the effective dosage of each antibiotic to be used according to the invention can be supplied in a single capsule or tablet to be taken once a day, then the single course of treatment will comprise ten capsules or tablets.
[0017] If two antibiotics A' and B' are to be taken according to the invention they may be arranged alternately in the cavities of the blister pack, normally in two rows of five. Thus, the arrangement in the pack will be:-
ABABA
BABAB
[0018] If three antibiotics X', Y' and Z' are to be taken according to the invention they are preferably arranged sequentially in the cavities of the blister pack, usually in two rows of five. Thus, the arrangement in the pack will be:-xYzxY zxYzx [0019] If more than three antibiotics are used, similar arrangements would apply.
In the above arrangements, it can be seen that each antibiotic tablet or capsule is different from the previous tablet or capsule and also different from the next or sequential tablet or capsule.
[0020] Each of the different antibiotics incorporated into a dispensing pack such as a blister pack may be differently colour coded, in order to distinguish between them. Alternately, means may be provided on the dispensing pack itself for identifying the different antibiotics.
[0021] Depending on the number of antibiotics to be used in the single course of antibiotic treatment it can be envisaged that there may be a reduction of any one of the antibiotics used of from 60% to 80% by weight.
[0022] According to a further aspect of the invention there is provided two or more antibiotics having same or similar spectrum of antimicrobial activity for use as a med icament in preventing or minimizing formation of antibiotic resistance in a microorganism, wherein the different antibiotics are used daily on alternate or sequential days in a single course of application or treatment.
Claims (15)
- Claims: 1. Use of two or more different antibiotics having same or similar spectrum of antimicrobial activity to avoid their overuse and prevent or minimize formation of antibiotic resistance in a microorganism, wherein the different antibiotics are used daily on alternate or sequential days in a single course of application or treatment.
- 2. The use according to claim 1, wherein three different antibiotics having the same or similar spectrum of antimicrobial activity are used in the single course of treatment wherein the three antibiotics are used on sequential days in a cycle, the cycle being repeated until the course of antibiotic treatment is completed.
- 3. The use according to claim 1 or claim 2, wherein the different antibiotics are selected from the same class of antibiotics.
- 4. The use according to claim 1 or claim 2, wherein the different antibiotics are selected from different classes of antibiotics.
- 5. The use according to any one of claims 1 to 4 wherein the single course of treatment may last for one or two weeks,
- 6. The use according to any one of claims 1 to 5, wherein the different antibiotics are presented in a dispensing pack or device for a single course of treatment, the pack or device having means for retaining and presenting said different antibiotics at separate locations.
- 7. The use according to claim 6, wherein the different antibiotics are arranged in the dispensing pack or device so that each adjacent antibiotic is different from its immediate neighbours.
- 8. The use according to any one of claims 1 to 7, wherein each different antibiotic has a different colour.
- 9. A method of preventing or minimizing formation of antibiotic resistance in a microorganism comprising administering to an infected mammal in need of antibiotic treatment two or more different antibiotics having same or similar spectrum of antimicrobial activity wherein in a single course of application or treatment an effective dose of an antibiotic is administered daily, a different antibiotic being administered on alternate or sequential days.
- 10. The method according to claim 9, wherein in a single course of treatment three different antibiotics having the same or similar spectrum of antimicrobial activity are administered on sequential days in a cycle, the cycle being repeated until the course of treatment is completed.
- 11. An antibiotic dispensing pack or device adapted to contain two or more different antibiotics having same or similar spectrum of antimicrobial activity, said pack or device having means for retaining, presenting and identifying said different antibiotics at separate daily sequential locations.
- 12. The dispensing pack according to claim 11, wherein the means for presenting the different antibiotics at separate locations comprises a blister pack having a base with at least one row of blister cavities connected to a substantially flat lid.
- 13. The dispensing pack according to claim 11 or claim 12, wherein each antibiotic is presented in the form of a capsule or tablet.
- 14. The dispensing pack according to claim 13, wherein the two or more antibiotics are arranged in the cavities so that each tablet or capsule is different from the previous tablet or capsule and also different from the next or sequentialtablet or capsule.
- 15. Two or more different antibiotics having same or similar spectrum of antimicrobial activity for use as a medicament in preventing or minimizing formation of antibiotic resistance in a microorganism, wherein the different antibiotics are used daily on alternate or sequential days in a single course of application or treatment.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GB0918077A GB2474482A (en) | 2009-10-15 | 2009-10-15 | Daily antibiotic cycling |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GB0918077A GB2474482A (en) | 2009-10-15 | 2009-10-15 | Daily antibiotic cycling |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| GB0918077D0 GB0918077D0 (en) | 2009-12-02 |
| GB2474482A true GB2474482A (en) | 2011-04-20 |
Family
ID=41462395
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| GB0918077A Withdrawn GB2474482A (en) | 2009-10-15 | 2009-10-15 | Daily antibiotic cycling |
Country Status (1)
| Country | Link |
|---|---|
| GB (1) | GB2474482A (en) |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20040018234A1 (en) * | 2000-02-24 | 2004-01-29 | Rudnic Edward M. | Antibiotic composition |
| US20050182303A1 (en) * | 2004-01-06 | 2005-08-18 | Yancey Robert W.Jr. | System for improving antibiotic use in acute care hospitals |
-
2009
- 2009-10-15 GB GB0918077A patent/GB2474482A/en not_active Withdrawn
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20040018234A1 (en) * | 2000-02-24 | 2004-01-29 | Rudnic Edward M. | Antibiotic composition |
| US20050182303A1 (en) * | 2004-01-06 | 2005-08-18 | Yancey Robert W.Jr. | System for improving antibiotic use in acute care hospitals |
Non-Patent Citations (3)
| Title |
|---|
| American Journal of Medicine 85 (1988) Thurn and Goodman 'Post-traumatic ophthalmitis due to bacillus licheniformis' 708 - 710 * |
| Journal of Antimicrobial Chemotherapy 55 (2005) Brown and Nathwani 'Antibiotic cycling or rotation: a systematic review of the evidence of efficacy' 6-9 * |
| Journal of Antimicrobial Chemotherapy 57 (2006) Salomon et al 'Prevention of urinary tract infection in spinal cord-injured patients: safety and efficacy of a weekly oral cyclic antibiotic (WOCA) programme with a 2 year follow-up - an observational prospective study' 784-788 * |
Also Published As
| Publication number | Publication date |
|---|---|
| GB0918077D0 (en) | 2009-12-02 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| Ahmadi et al. | Antibiotic therapy in dentistry | |
| Iqbal et al. | Role of antifungal medicaments added to tissue conditioners: A systematic review | |
| Heitz‐Mayfield | Systemic antibiotics in periodontal therapy | |
| Van Sebille et al. | Management of mucositis during chemotherapy: from pathophysiology to pragmatic therapeutics | |
| Saunders et al. | Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients | |
| Javed et al. | Clinical efficacy of antibiotics in the treatment of peri-implantitis | |
| Walker et al. | Chemotherapeutics: antibiotics and other antimicrobials. | |
| Metcalf et al. | Use of ethanol locks to prevent recurrent central line sepsis | |
| Walters et al. | Should antibiotics be prescribed to treat chronic periodontitis? | |
| Attia et al. | Antimicrobial effect of different intracanal medications on various microorganisms | |
| RU2010140682A (en) | METHOD FOR TREATING PATIENTS FROM INFECTION, PHARMACEUTICAL COMPOSITION (OPTIONS) AND MEDICINE | |
| Mays et al. | New antibiotic therapies for acne and rosacea | |
| WO2009118379A1 (en) | An antimicrobial composition | |
| Ramesh et al. | Local Drug Delivery in periodontal diseases.…… A Review | |
| Zhou et al. | Potential of berberine to enhance antimicrobial activity of commonly used antibiotics for dairy cow mastitis caused by multiple drug-resistant Staphylococcus epidermidis infection | |
| Mirfasihi et al. | Effect of a combination of photodynamic therapy and chitosan on Streptococcus mutans (an in vitro study) | |
| JP2010538066A5 (en) | ||
| HU215443B (en) | Pharmaceutical compositions, first of all vaginal suppositorium, containing more active components with bactericide, fungicide, antiprotozoonic and antiviral combined activity | |
| Lauritano et al. | Zinc plus octenidine: a new formulation for treating periodontal pathogens. A single blind study. | |
| GB2474482A (en) | Daily antibiotic cycling | |
| CN105853449B (en) | A kind of antibacterial compound drug of amikacin sulfate for injection | |
| Bhambri et al. | Use of oral doxycycline for community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections | |
| Pandey et al. | Cysteamine improves the bactericidal efficacy of intra-canal medicaments against Enterococcus faecalis | |
| Akers et al. | Rational prophylactic antibiotic selection for sinus elevation surgery | |
| Hussein et al. | Locally delivered antimicrobials in the management of periodontitis: a critical review of the evidence for their use in practice |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| WAP | Application withdrawn, taken to be withdrawn or refused ** after publication under section 16(1) |