A new nano-antibiotic was synthesized from the conjugation of multi-walled carbon nanotubes with levofloxacin (MWCNT-LVX) through covalent grafting of drug with surface-modified carbon nanotubes in order to achieve an effective, safe, fast-acting nano-drug with the minimal side effects. This study is the first report on the evaluation of in vitro cell viability and antibacterial activity of nano-antibiotic along in addition to the in vivo antibacterial activity in a burn wound model. The drug-loading and release profile at different pH levels was determined using an ultraviolet–visible spectrometer. MWCNT-LVX was synthesized by a simple, reproducible and cost-effective method for the first time and characterized using various techniques, such as scanning electron microscope, transmission electron microscopy, and Brunauer–Emmett–Teller analysis, and so forth. The noncytotoxic nano-antibiotic showed more satisfactory in vitro antibacterial activity against Staphylococcus aureus compared to Pseudomona aeruginosa. The novel synthetic nano-drug possessed high loading capacity and pH-sensitive release profile; resultantly, it exhibited very potent bactericidal activity in a mouse S. aureus wound infection model compared to LVX. Based on the results, the antibacterial properties of the drug enhanced after conjugating with surface-modified MWCNTs. The nano-antibiotic has great industrialization potential for the simple route of synthesis, no toxicity, proper drug loading and release, low effective dose, and strong activity against wound infections. In virtue of unique properties, MWCNTs can serve as a controlled release and delivery system for drugs. The easy penetration to biological membranes and barriers can also increase the drug delivery at lower doses compared to the main drug alone, which can lead to the reduction of its side effects. Hence, MWCNTs can be considered a promising nano-carrier of LVX in the treatment of skin infections.
Backgrounds and Objectives: Aspergillus infection has several manifestations from non-invasive aspergillosis to invasive pulmonary and cerebral aspergillosis. Prophylaxis and treatment regimens for aspergillosis are limited to triazoles, echinocandins, and polyenes, each with different efficacy, complications, and resistance patterns. Drug selection presents challenges, including differences in resistance rates, drug interactions, and concerns about side effects with long-term use. Aspergillus resistance to antifungal agents is an international concern and shows an increasing trend. Each region worldwide has a resistance pattern affecting prevention and treatment regimens. Therefore, we examined the susceptibility rates of Aspergillus species to different antifungal drugs and their gene mutation rates in Iran. Methods: This meta-analysis started with a systematic search that was reported based on the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA), yielding 1631 articles, of which 29 articles were included. Resistance rates were extracted, and a meta-analysis was done on 18 species-drug pairs. Results: Pooled resistance rate of Aspergillus fumigatus was 1.39% to amphotericin B, 17.77% to itraconazole, 2.63% to posaconazole, and 9.17% to voriconazole. For Aspergillus flavus it was 2.43% to amphotericin B, 7.64% to caspofungin, 3.60% to itraconazole, 1.48% to posaconazole, and 1.443% to voriconazole. Conclusion: Our meta-analysis showed that amphotericin B has superior effects on aspergillosis caused by A. fumigatus isolated from patients with unknown minimum inhibitory concentrations (MICs). The next most effective drugs are posaconazole and voriconazole, respectively. For the same problem in A.flavus, our analysis suggests voriconazole, posaconazole, and amphotericin B, respectively. This study also points to increased azole resistance, which should be of concern in clinical practice.
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