Interplay of the Quality of Ciprofloxacin and Antibiotic Resistance in Developing Countries

Sharma, D.; Patel, Rahul P.; Zaidi, Syed Tabish Razi; Sarker, Md. Moklesur Rahman; Lean, Qi Ying; Ming, Long Chiau

doi:10.3389/fphar.2017.00546

Cited by 84 publications

(55 citation statements)

References 57 publications

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“…Recent studies have reported that 20–40 percent of anti-malarials and antibiotics sold in official outlets in Ghana fail quality standards (<= 80% of active ingredient: Kaur et al, 2016; Fadeyi et al, 2015; Tivura et al, 2016). Globally, poor-quality anti-malarial and antibiotic medicines are thought to be responsible for more than 100,000 under-five deaths annually, concentrated in Sub-Saharan Africa (Renschler et al, 2015; WHO, 2017b), in addition to risks of accelerated antimicrobial resistance that arise through persistent under-dosing (Dondorp et al, 2009; Newton et al, 2016; Brock et al, 2018; Sharma et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Managing uncertainty in medicine quality in Ghana: The cognitive and affective basis of trust in a high-risk, low-regulation context

Hamill

Hampshire

Mariwah

et al. 2019

Social Science & Medicine

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Where regulation is weak, medicine transactions can be characterised by uncertainty over the drug quality and efficacy, with buyers shouldering the greater burden of risk in exchanges that are typically asymmetric. Drawing on in-depth interviews (N = 220) and observations of medicine transactions, plus interviews with regulators (N = 20), we explore how people in Ghana negotiate this uncertainty and come to trust a medicine enough to purchase or ingest it. We identify two mechanisms – attempts to mitigate uncertainty through seeking observable signs of quality and attempts to reduce informational asymmetry – that underpin cognitive assessments of a medicine's trustworthiness. However, these ‘cognitive’ forms of trust assessment have limited traction where uncertainty is high and trustworthiness remains unknowable, so a third mechanism comes into play: one based on affective relationships within which transactions are socially embedded. Even these, however, cannot eliminate uncertainty, because of the dispersed and under-regulated nature of wider supply chains. In conclusion, we reflect on the need for careful research on actors' practices and decision-making across supply chains to inform more effective policy and regulation.

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Section: Introductionmentioning

confidence: 99%

Managing uncertainty in medicine quality in Ghana: The cognitive and affective basis of trust in a high-risk, low-regulation context

Hamill

Hampshire

Mariwah

et al. 2019

Social Science & Medicine

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“…All N,O-acetal derivatives showed good predictions for absorption values in the human intestine, similar to atovaquone, ciprofloxacin, and furazolidone. Indeed, the compounds 7b and 7c showed absorption values greater than 90%, close to that of ciprofloxacin, which is a good estimative for oral bioavailability 29 .…”

Section: Discussionmentioning

confidence: 65%

Antibiofilm effects of N,O-acetals derived from 2-amino-1,4-naphthoquinone are associated with downregulation of important global virulence regulators in methicillin-resistant Staphylococcus aureus

Novais

Carvalho

Ramundo

et al. 2020

Sci Rep

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Despite the existing antibiotics, antimicrobial resistance is a major challenge. Consequently, the development of new drugs remains in great demand. Quinones is part of a broad group of molecules that present antibacterial activity besides other biological properties. The main purpose of this study was to evaluate the antibiofilm activities of synthetic N,O-acetals derived from 2-amino-1,4-naphthoquinone [7a: 2-(methoxymethyl)-amino-1,4-naphthoquinone; 7b: 2-(ethoxymethyl)-amino-1,4-naphthoquinone; and 7c: 2-(propynyloxymethyl)-amino-1,4-naphthoquinone] against methicillin-resistant Staphylococcus aureus (MRSA). The derivatives 7b and 7c, specially 7b, caused strong impact on biofilm accumulation. This inhibition was linked to decreased expression of the genes fnbA, spa, hla and psmα3. More importantly, this downregulation was paralleled by the modulation of global virulence regulators. The substitution of 2-ethoxymethyl (7b) in comparison with 2-propynyloxymethyl (7c) enhanced sarA-agr inhibition, decreased fnbA transcripts (positively regulated by sarA) and strongly impaired biofilm accumulation. Indeed, 7b triggered intensive autolysis and was able to eliminate vancomycin-persistent cells. Consequently, 7b is a promising molecule displaying not only antimicrobial effects, but also antibiofilm and antipersistence activities. Therefore, 7b is a good candidate for further studies involving the development of novel and more rational antimicrobials able to act in chronic and recalcitrant infections, associated with biofilm formation.

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“…9 This widespread distribution of poor quality cipro, and the linkage to resistant bacteria, is in part due to a lack of regulatory policies governing appropriate manufacturing and quality assurance. 2 Many methods are used to assess the quality of cipro formulations, including the 'gold-standard' high performance liquid chromatography (HPLC) and the 'field-standard' thin-layer chromatography (TLC). 7 -9 Currently, HPLC is the main analysis method for pharmaceutical formulations but is prohibitively expensive for applications in low-resource settings, costing upwards of US$ 100,000 with reoccurring annual costs of approximately US$ 20,000.…”

Section: Conclusion Onclusionsmentioning

confidence: 99%

Quantitative assay for ciprofloxacin and enrofloxacin formulations

Moed

Hall

Lee

et al. 2019

Journal of Global Health Reports

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Back Background ground Ciprofloxacin (cipro) is a broad-spectrum fluoroquinolone antibiotic active against both Gram-positive and Gram-negative bacteria. It is used extensively in both animals and humans due to its high bioavailability and the wide range of susceptible infections. However, the use of substandard (poor quality) and counterfeit formulations of cipro in low-and middle-income countries has contributed to an increased risk of treatment failure due to antimicrobial resistance (AMR). Poor quality medicines especially have been linked to AMR. Therefore, there is a pressing need to screen for quality of cipro in low-resource settings. Methods Methods We have addressed this need by developing a low-cost fluorescence assay capable of quantifying the amount of cipro in tablets. In this assay, cipro is dissolved in deionized water and mixed with palladium(II) and methyl cellulose. Upon addition of these reagents, quenching of cipro is observed and quantified.

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Interplay of the Quality of Ciprofloxacin and Antibiotic Resistance in Developing Countries

Cited by 84 publications

References 57 publications

Managing uncertainty in medicine quality in Ghana: The cognitive and affective basis of trust in a high-risk, low-regulation context

Managing uncertainty in medicine quality in Ghana: The cognitive and affective basis of trust in a high-risk, low-regulation context

Antibiofilm effects of N,O-acetals derived from 2-amino-1,4-naphthoquinone are associated with downregulation of important global virulence regulators in methicillin-resistant Staphylococcus aureus

Quantitative assay for ciprofloxacin and enrofloxacin formulations

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