The Potency of a Combined Diclofenac-Ampiclox against Streptococcus Pyogen Isolated from Patients with Pharyngitis: A pilot study

Abstract

Background: Pharyngitis, scarlet fever, and rheumatic fever are of the major infectious problems caused by Streptococcus pyogen. Emergence of antibiotic-resistant strains makes such infection, its rheumatic valvular disease, and glomerulonephritis complications a serious clinical challenge especially in children. Aims and objectives:In a maneuver of overcoming S. pyogen resistance and improve its response to antibiotic, a no steroidal anti-inflammatory drug NSAID is repurposed as antimicrobial against S. pyogen. In intention to be combined with the classical antibiotic recommended by WHO guideline of care. The combination was assessed for its MIC and combination index against S. pyogen. Materials and Methods:A multidrug-resistant strain of S. pyogen was isolated from patients, suffering pharyngitis. The most serious isolate was cultivated for MIC determination of ampicloxdiclofenac combination in comparison with each alone to determine the combination index. Results and conclusions:There was a significant synergism between ampiclox-diclofenac (index ˂ 1) at P= 0.012 and Z score= 2.3 further confirmation of MIC folds of dilutions are to be assessed to obtain reasonable evidence. Recommendations:We recommended to further confirm the antistreptococcal effect of the combined ampiclox-diclofenac on more dilutions of MIC assay and to analyze data of this combination in patients with S. pyogen pharyngitis.