جستجوی مقالات مرتبط با کلیدواژه « azithromycin » در نشریات گروه « پزشکی »

Adipose-derived Mesenchymal stem cells (ASCs) have garnered attention for their regenerative potential; therefore, their cellular senescence-related gene expression remains crucial in therapeutic contexts. Nowadays, combination therapies have shown promising results in reducing senescent cells. This study investigated the effects of vitamin C, doxycycline, and azithromycin co-treatment on the key cellular senescence-associated genes in ASCs.

Human ASCs were cultured and treated for 24 hr with vitamin C, doxycycline, azithromycin, and a combination of three drugs. Total RNAs were extracted, and the expression of p21, p16, Nanog, Oct4, and Sox2 genes was assessed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Additionally, cell cycle alterations were analyzed via flow cytometry after treatment with these compounds. 

Notably, vitamin C treatment resulted in a significant down-regulation of p21 gene expression (P<0.01), implicating the potential role of vitamin C in promoting cell cycle progression. Doxycycline treatment led to a significant up-regulation of p21 and p16 gene expression (P<0.05), as it has previously been shown to induce cell cycle arrest. Similarly, azithromycin treatment predominantly increased p21 expression (P<0.05). Besides, cell cycle analysis revealed that each compound had changed the distribution of cells across different phases of the cell cycle. 

The combined use of all three drugs yielded intricate interactions, suggesting a complex yet promising approach to future research. According to our findings, the major difference in the combination drug-treated group (VDA) can be explained by the neutralizing effect of these three components in the environment.

Doxycycline is commonly prescribed as the primary prophylactic treatment for women undergoing hysterosalpingography (HSG). This study aimed to compare the prophylactic effectiveness and safety of azithromycin and doxycycline in terms of treating infections caused by HSG.

This double-blind randomized clinical trial enrolled 107 women referred to Amiralmomenin Hospital in Arak, Iran, for HSG. After evaluation based on inclusion and exclusion criteria, the participants were randomly allocated to either the doxycycline or
azithromycin group. The primary outcome was the incidence of adverse effects. The patients were also followed up to determine PCR test results for the clearance of chlamydia infection.

The cumulative incidence of side effects was 1.85% in the doxycycline group, with adverse effects observed in only one patient. Conversely, no adverse effects were reported in the azithromycin group (P = 0.505). In the doxycycline group, one patient (1.85%) tested positive in the PCR test, while no positive PCR tests were recorded in the azithromycin group. Neither group exhibited cases of fever or required additional treatments. The results of statistical analyses did not reveal any statistically significant differences between the compared groups (P > 0.05).

A single dose of azithromycin could be considered interchangeable with a 1-week course of doxycycline as antibiotic prophylaxis in women undergoing HSG, as it provides similar effectiveness and safety.

Tubal factor infertility (TFI) is common female infertility responsible for a large portion of female factor infertility. This study reveals the effect of the quercetin of Huoxuehuayu Tongluo Decoction with azithromycin on the pregnancy rate and inflammation of TFI female rats.

Female Sprague Dawley rats were constructed into the TFI model and treated with quercetin, Huoxuehuayu Tongluo Decoction, and combination therapy (quercetin and azithromycin). Pregnancy rate and litter size were measured. Network pharmacology was applied to analyze the interaction between Huoxuehuayu Tongluo Decoction and TFI. The combination of quercetin and IL-6 was analyzed by molecular docking. HE staining and electron microscopy were used to observe the histopathology and ultrastructure of fallopian tube tissues. The TNF-α, IL-1β, IL-6, IL-8, and MPO levels were detected by ELISA. The activation of JAK/STAT, MAPK, and NF-κB p65 pathways was detected by western blot or immunohistochemistry.

Quercetin was the main active component of Huoxuehuayu Tongluo Decoction, and could bind to IL-6 in TFI. Target genes were enriched in the IL-17 signaling pathway, JAK-STAT signaling pathway, inflammatory disease, etc. Under the quercetin and azithromycin combination therapy, both rat pregnancy rates and litter sizes increased significantly. quercetin and azithromycin alleviated the symptoms of hydrosalpinx and inflammatory damage in fallopian tube tissues. The phosphorylation of JAK/STAT and MAPK pathways and NF-κB p65 translocation to the nucleus were significantly inhibited by the quercetin and azithromycin therapy.

Quercetin and azithromycin combination therapy inhibited inflammation and phosphorylation of JAK/STAT and MAPK pathways to improve TFI inflammation and pregnancy function.

Azithromycin-induced severe cutaneous reactions occur rare. We report a case of azithromycin‑induced generalized nonbullous form of fixed‑drug eruption (FDE). A 19-year-old male consulted the dermatology department for multiple painful oval‑shaped, sharply defined, and hyperpigmented patches on his chest, abdomen, and upper limbs after consuming oral azithromycin tablets for his sore throat. The generalized nonbullous form of FDE was diagnosed, and the offending drug was stopped immediately. He was treated with antihistamines and steroids, and recovered on follow-up. This FDE is reported due to the spareseness of documentation from South India and to improve the awareness among the prescribing physicians about this severe cutaneous reaction (FDE) for a commonly used drug. This case report gives insight to the clinicians and health‑care workers on rare side effects caused by the commonly used antimicrobial agent, azithromycin.

The coronavirus disease (COVID)-19 pandemic led to a new challenge in the field of effective treatment methods for this disease. Antiviral and immunomodulatory agents were suggested as potential therapeutic methods in this field. Since the most severe clinical symptoms associated with COVID-19 disease appear to be acute respiratory syndrome, azithromycin has been proposed as a potentially effective drug in this context. We have updated the evidence and selected all relevant items to understand the mechanism of role of azithromycin, clinical efficacy, and their side effects in coronavirus disease-19 treatment on July 20th and updated on March 20th, 2020. A literature search of electronic databases including the Web of Science, PubMed, and Google Scholar was conducted by searching keywords such as "Azithromycin", "COVID-19", and "Combination therapy". The ultimate goal of this review was identifying eligible studies about the pharmacological activities, safety, and effectiveness of azithromycin in treating COVID-19 patients. Immunomodulatory properties of azithromycin include the ability to reduce cytokine production, maintain epithelial cell integrity, or prevent lung fibrosis. The use of azithromycin in some studies was associated with a decrease in mortality and need for ventilation in patients. These properties can be useful during the period of COVID-19 infection, especially in patients with underlying diseases. However, the evidence for the use of azithromycin is still scarce and the quality of the studies is low. In some retrospective studies, azithromycin was mainly evaluated in combination with hydroxychloroquine, which showed no particular advantage. The results of this review showed that azithromycin has appropriate and well-known safety characteristics in the treatment of patients with COVID-19. However, the most appropriate dosage in different stages of the disease and the effect of its combination with other drugs are important questions that should be considered in future clinical trials.

Blepharitis, chronic inflammation of the eyelid, is one of the most common eye diseases that involve eyelashes, parotid glands, and apocrine. The most important symptoms of blepharitis are burning and irritation of the eyes, which are more severe in the morning. Azithromycin 1% solution is a new therapeutic method for treating blepharitis, which has recently entered Iran. The purpose of this study was to compare the treatment of 1% azithromycin eye drops and erythromycin topical ointment on the symptoms and signs of blepharitis.

In this clinical trial study, 98 patients with posterior blepharitis referred to the ophthalmology clinic of Razi Hospital in Birjand in 2020 and 2021 were studied based on inclusion and exclusion criteria. Patients were randomly divided into two groups receiving erythromycin and 1% azithromycin by the blocking method. A two-part questionnaire was completed for the patients before and after the intervention. In the first part of the questionnaire, the demographic information of the patients and the signs and symptoms of the disease, including the degree of dry eyes, redness and swelling of the eyes, itchy eyes, and in the second part, the standard Ocular Surface Disease Index questionnaire was completed by self-declaration. The SMTube test was also performed by the project manager for the patients. The intensity of color sensitivity was checked and recorded by an eye specialist. After collecting the data, they were entered into SPSS software )Version 18) and analyzed by independent T, Mann-Whitney, paired t, Chi-Square and Fisher's exact test at the significance level less than 5%.

Out of a total of 98 patients, 52 patients (53.1%) were female. At the beginning of the study, there was no significant difference between the average OSDI index, staining intensity and SMTube, and at the end of the study, there was no significant difference between the two groups (P>0.05).

Based on the results of the present study, the efficacy of azithromycin eye drops in the patients was the same as the efficacy of topical erythromycin ointment in patients with posterior blepharitis.

The COVID-19 pandemic has caused many economic problems worldwide,in Iran as well, causing Hospitals to face many financial problems.

Based on documented data on pharmacotherapy, costs, and its effectiveness, this study aimed to analyze the costs and outcomes of hospitalized patients with COVID-19 under pharmacotherapy in Iran.

This research was a retrospective analytical descriptive study. Relevant data of the COVID-19 hospitalized patients’ were extracted from the Hospital’s Medical Records Department. All items of direct medical costs, such as visits, nursing services, consuming materials, laboratories, imaging, medical operations, medications, and beds, were extracted by reviewing COVID-19 hospitalized patients’ files in different wards of the Shohada Ashayer Hospital in Khorramabad city in 2021.

A total of 399 patients were examined in this study. The total direct medical costs per patient was 338.63 US$. Of note, the highest cost was related to medicine (32.56%), more than the cost of bed (22.77%). The most commonly used drugs were Lopinavir (95%) and Azithromycin (90%), and the highest medicine cost per patient was related to Immunoglobulin (64.32 US$) and Remdesivir (46.91 US$).

Medicine and hospitalization costs accounted for the largest share of the total treatment costs of patients. Therefore, reducing bed costs requires home treatments and outpatient injections. Furthermore, due to rising drug costs,prescriptions should be based on standard treatment protocols.

Azithromycin (AZ) is a macrolide antibiotic that is soluble in saliva pH; its bitter taste can be well sensed, decreasing the ability of the patient to get the drug. Thus, handling such a bitter taste is challenging in developing the oral formulation. A wide range of methods has been applied to tackle this problem. Cubosomes are considered nanoparticles forming cubic three-dimensional structures with a tastemasking effect. This research aimed to apply cubosomes to mask AZ's bitter taste.

Experimental approach: 

Cubosomes which contained AZ were obtained by applying the film hydration method. Design expert software (version 11) was then employed for optimizing cubosomes that contained the drug. The encapsulation efficiency, particle size as well as polydispersity index of drug-loaded cubosomes were then subjected to evaluation. Assessment of particle morphology was done through SEM. The antimicrobial qualities of AZ-loaded cubosomes were then assessed by utilizing the disc diffusion method. Then, the taste masking study was carried out by referring to human volunteers. Finding/

AZ-loaded cubosomes were spherical in terms of shape and in the 166-272 nm range, with a polydispersity index of 0.17-0.33 and encapsulation efficiency of 80-92%. The results related to the microbial culture revealed that the antimicrobial qualities related to AZ-loaded cubosomes were like those of AZ. The results obtained by taste evaluation also revealed that the cubosomes could well mask the drug's bitter taste.

Conclusion and implications: 

These findings, thus, revealed that while the antimicrobial impact of AZ is not under the influence of loading in cubosomes, its taste could be well improved.

Premature rupture of membrane (PROM) is an important problem among pregnant women, which leads to maternal and neonatal morbidity. This study was done to compare the efficacy of azithromycin with erythromycin on the pregnancy length and the neonatal adverse effects in mothers with PROM.
In this open-label randomized clinical trial, 194 pregnant women with PROM who referred to Akbarabadi Hospital were enrolled and randomly assigned to two groups. Group I received oral Azithromycin (1 gr/orally, Abidi Company,  Iran ) + Ampicillin 2 gram  IV (Abidi Company, Iran)  every six hours for 48 hours; then, only Amoxicillin 500 mg every eight hours for five days. and group II received intravenous Erythromycin (Abidi Company, Iran) 400 mg every six hours for seven days + Ampicillin 2 grams IV every six  hours for 48 hours, then Amoxicillin 500 mg every six hours for five days. Finally, the pregnancy length and neonatal adverse effects or neonatal outcomes were compared between the two groups.
There was no significant difference between the groups in mean of pregnancy length (32.5 versus 32.6 weeks, respectively, p=0.757)  Also the frequency ofIntraventricular hemorrhage, Necrotizing enterocolitis, Respiratory Distress Syndrome sepsis, icter, oxygen demand, ICU admission, duration of hospitalization in the NICU, and mortality in neonate were the same between the groups. The mean of patient satisfaction (by self-report) was 9.8 and 9.5 in group I and II, respectively (P=0.001).
It can be concluded that oral azithromycin and intravenous erythromycin have the same effect on increasing the duration of pregnancy and reducing neonatal complications in women with PROM. But azithromycin was associated with greater satisfaction and its use is recommended.

Macrolides have shown beneficial effects in the treatment of chronic rhinosinusitis (CRS). This study aimed to compare the effect of azithromycin and clarithromycin in combination with conventional therapies for the treatment of CRS.

This single-blind randomized controlled trial was conducted during 2018-2019 at the Otorhinolaryngology Clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran. Out of 102 selected patients, 90 were included in the analysis. Patients were selected through convenience sampling and randomly assigned to two equal groups. In addition to conventional therapies (nasal irrigation, betamethasone injection, oxymetazoline and fluticasone spray, guaifenesin syrup, and steam inhalation), the patients in the clarithromycin group received clarithromycin 500 mg tablets twice daily for four weeks. The other group received azithromycin 500 mg tablets daily for four weeks. Patients’ symptoms were evaluated pre- and post-intervention, and the Lund-Mackay (LM) scoring system was used for the staging of CRS based on computed tomography scan findings. Data were analyzed using SPSS software, and P<0.05 was considered statistically significant.

Patients in both groups were comparable in terms of age and sex. Complete resolution of symptoms was significantly higher in the azithromycin group than the clarithromycin group (71.1% vs. 24.4%, P<0.001). Baseline LM scores did not differ significantly between the groups (P=0.120). However, post-intervention, LM scores reduced considerably in both groups, but the change was significantly higher in the azithromycin group (P<0.001). 

In combination with conventional therapies for CRS in adults, a four-week course of treatment with azithromycin is more effective than clarithromycin.

Stevens Johnson syndrome (SJS) is a severe hypersensitive reaction and a life-threatening, immunologically mediated and usually drug-induced disease. Sulfonamides, allopurinol, and cold medicines are some of these allergen drugs. pregnant women comprise a subset of individuals at risk for SJS development. The aim of the article was to report a success pregnancy and delivery in a woman after 5 years of SJS diagnosis.

Case Report:

 This case report study was conducted at Imam Khomeini Hospital in Khalkhal, Iran. In this study, we discussed on the history of pregnancy and delivery in a woman 5 years following SJS diagnosis with vaginal stenosis resulting from Azithromycin and Naproxen treatment for cold. This study showed that there is a possibility of successful pregnancy and delivery in the people with SJS and long-term complications caused by it.

Health care providers must be careful concerning drug reactions, especially the occurrence of SJS, which is a potentially harmful and fatal condition.

 Undetected coinfections in COVID-19 patients may have serious clinical consequences, including increased hospitalization and mortality. The current study was conducted on 455 patients diagnosed with the new epidemic coronavirus disease who were admitted to quarantine halls in Diwaniyah in Iraq for one month, from February 2021 to March 2021. The aim of the study was to investigate secondary bacterial infections associated with the virus and the effect of using some commonly used antibiotics such as azithromycin, Beta-lactam, ciprofloxacin, and ceftriaxone.

 Sputum samples were collected from all patients who tested positive for COVID-19 (Real-Time PCR) seven days after confirming the infection with the virus. The samples were streaked on a group of culture media, then transferred to pure cultures and diagnosed, and their sensitivity to antibiotics was determined using the Vitek -2 compact system technique.

 According to the findings, the two strains of methicillin-resistant and Staphylococcus aureus sensitive were the most common isolated species with a percentage of 85%, followed by Pseudomonas aeruginosa 78%, in addition to Streptococcus pneumonia 60%, Acinetobacter baumannii 64%, and Legionella pneumophila 60%. Also, many fungi were observed. Most isolated strains were resistant to antibiotics used in the study.

 The study concluded that these antibiotics have no role in treating the infection. Still, it may contribute to the emergence of new, multi-drug resistant MDR species, resulting in increased mortality rates. Also, excessive use of antibiotics may lead to increased mortality.

Conventional topical dosage forms face with some challenges like low intraocularbioavailability, which could be overcome by application of novel drug delivery systems.Therefore, this study was conducted to prepare azithromycin (AZM)-loaded chitosan/polyvinylalcohol/polyvinyl pyrrolidone (CS/PVA-PVP) nanofibers with the prolonged antibacterialactivity by electrospinning method.

After preparation of nanofibers, they were characterized in terms of physicochemicaland morphological properties. In vitro and in vivo release of the drug from nanofibers wereevaluated using microbial assay against the Micrococcus luteus. Antibacterial efficacy of thenanofibers was assessed. The ophthalmic irritation test was also performed. MTT test wascarried out to evaluate cytotoxicity of the formulations.

All the formulations were found to be stable with uniform thickness, weight, and drugcontent. Nanofibers had a diameter range from 119 ± 29 to 171 ± 39 nm. The inserts were nonirritantand non-toxic to the rabbits’ eye. Based on the obtained results, the crosslinked AZMnanofibers showed slower and more controlled drug release in tear fluid compared to the noncrosslinkedones, within 184 hours.

Our results revealed that the prepared nanofibers could be considered as suitableand non-invasive inserts for the prolonged ophthalmic delivery of AZM.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible and pathogenic coronavirus that emerged in late 2019 and has caused a pandemic of acute respiratory disease, named ‘coronavirus disease 2019’ (COVID-19), which has threatened human health and public safety.

Hydroxychloroquine (HCQ) is an anti-malaria drug with controversial antiviral properties. Some in vitro studies have approved its antiviral effects. Many efforts have been made to prevent and treat COVID-19, but effective drugs for complete eradication of COVID-19 have not been found yet and all available drugs are supportive. 

We tried to review some new aspects of HCQ efficacy in the prevention and treatment of COVID-19 infection. Also, some data from recent clinical trials were studied. It has been shown that HCQ may improve some symptoms of patients, but in severe or critical stages, it did not have significant therapeutic effects and did not reduce the rate of mortality.

In this review article, we explained some results of recent studies, including clinical trials on the effects of HCQ on the prevention and treatment of COVID-19 infection. Some studies have revealed HCQ’s beneficial effects in outpatients, and some data showed its hazardous impacts on the heart. The available evidence suggests that CQ or HCQ does not improve clinical outcomes in COVID-19. Well-designed randomized trials are required for assessing the efficacy and safety of HCQ and CQ for COVID. 

It was suggested that the dose of HCQ administration must be adjusted and monitored correctly; furthermore, the levels of some myocardial biomarkers, such as troponin must be measured in mild to moderate, severe, and critical infection. Also, combination therapy with other drugs, such as azithromycin may have better anti-inflammatory and antiviral effects.

Prophylactic antibiotics effectively reduce the incidence of infection associated with cesarean section after labor. The use of a first-generation cephalosporin for antibiotic prophylaxis has been suggested in these patients, but in some studies, increasing the spectrum of antibiotic prophylaxis by adding another antibiotic to standard cephalosporin may provide greater protection against post-cesarean wound infections.

The present study aimed to compare the effects of conventional prophylaxis with cefazolin with a combination of cefazolin and azithromycin in reducing wound infection.

In this quasi-experimental study, 200 cesarean section candidates admitted to Ali Ibn Abi Taleb Hospital in Zahedan, Iran, in 2019 - 2020 were divided into two groups of 100 patients. The control group received cefazolin alone, and the intervention group received cefazolin and azithromycin. Finally, in addition to demographic factors, various underlying diseases, causes of cesarean section, non-infectious wound complications, and post-surgery wound infection were investigated.

The two groups were homogenized in terms of age and BMI of patients. Surgical wound infection occurred after cesarean section in 3% of patients in the control group. Only 1% of infections were observed in patients in the intervention group, and the two groups had a statistically significant difference (P = 0.01).

Compared with cefazolin alone, the combination of cefazolin and azithromycin was more effective in preventing cesarean section wound infection. Therefore, the combined use of these two antibiotics instead of cefazolin alone is recommended for this desirable clinical outcome.

Context: 

The safety and efficacy of several repurposed drugs, including hydroxychloroquine and chloroquine, with or without azithromycin, were presumed to be miraculous in treating patients with COVID-19. However, as it later transpired, these therapeutic agents seem to be associated with critical adverse cardiac events.

 Given the skepticism around the advantages and disadvantages of the aforementioned treatment strategies, the present study aimed to investigate the clinical efficacy and cardiac toxicity of hydroxychloroquine or chloroquine with or without azithromycin in the setting of COVID-19 infection.

 This was an umbrella review conducted on patients with COVID-19 who received hydroxychloroquine or chloroquine with or without azithromycin from January 2020 to November 2020. We systematically searched PubMed, Scopus, Cochrane, ProQuest, Web of Science, and Embase databases.

 Three studies (systematic review and meta-analysis) were analyzed to evaluate the arrhythmogenic potential of hydroxychloroquine or chloroquine with or without azithromycin in patients with COVID-19 and identify the clinical efficacy of such a combination.

 We found no benefit for patients with COVID-19 who received hydroxychloroquine or chloroquine alone or in combination with azithromycin. Moreover, it is noteworthy that these medications, particularly when considering co-administration, could result in both statistically and clinically elevated risks of notorious arrhythmias, such as TdP.

The treatment of Cutaneous Leishmaniasis (CL) is complex, and the search for safer, more efficient, and cost-effective treatments is ongoing. This study aimed to evaluate the efficacy of the combination of liposomal and oral azithromycin as the first clinical study against CL. This assessor-blind, randomized clinical trial was conducted in out-patients Leishmaniasis clinic of Skin Diseases and Leishmaniasis. The cutaneous lesions of eligible participants were randomized to receive either oral azithromycin or the combined oral and topical liposomal azithromycin. All participants received 250 mg of azithromycin twice daily or 8 mg/per kg for 4 weeks. In the combination group, a topical liposomal formulation of 0.04 mmol/mL of azithromycin was administered as 0.2-0.5 cc twice daily according to the lesion size in order to make a thin layer of the drug on the surface of the lesion. The size and induration changes from baseline to the end of the study were analyzed. Twenty-one lesions of 13 patients in the combination group and 20 lesions of 14 patients in the oral group were recruited. The mean ± SD of improvement was significantly different between two groups after 12 weeks (3.89 ± 0.46 vs. 3.15 ± 1.23 P = 0.02 combination group vs. oral group respectively). The patients did not experience any systemic adverse effects related to azithromycin and the only adverse effects related to topical treatment were mild pruritus in 2 cases. In conclusion, the combination of oral and topical liposomal formulation of azithromycin is safe and effective to treat CL.