Anti-Infective Agents - Volume 21, Issue 2, 2023

Antibiotics play an essential role in antimicrobial therapy. Among all the medications in children, the most commonly prescribed therapy is antibiotics and is currently the indispensable means to cure transmissible diseases. Several categories of antibiotics have been introduced into clinical practice to treat microbial infections. Reducing the unnecessary use of antibiotics is a global need and priority. This article aims to provide better knowledge and understanding of the impact of the early use of antibiotics. This article highlights the proper use of antibiotics in children, detailing how early and inappropriate use of antibiotics affect the gut microbiome during normal body development and consequently affect the metabolism due to diabetes mellitus, obesity, and recurrence of infections, such as UTI. Several new antibiotics in their development stage, newly marketed antibiotics, and some recalled and withdrawn from the market are also briefly discussed in this article. This study will help future researchers in exploring the latest information about antibiotics used in paediatrics.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a Gram-positive strain whose resistance against existing antibiotics is a significant concern for researchers across the globe. Gram-positive infections, particularly methicillin-resistant Staphylococcus aureus spreading among S. aureus isolates, increased exponentially from 29% in 2009 to 47% in 2014. Literature reviews revealed that about 13-74% of S. aureus strains are Methicillin-resistant worldwide. Objective: In this article, we have summarized the mechanism of bacterium resistance, molecular targets to treat MRSA, and the activity of reported pyridine and pyrimidine derivatives against methicillin-resistant Staphylococcus aureus. Results: The data collected for this study from online peer-reviewed research articles and the Molecular-docking study of reported anti-MRSA agents performed using the Maestro Module of Schrodinger software. In silico studies showed that some pyridine derivatives have better binding interactions than standard anti-MRSA agents. Conclusion: Molecular docking studies of reported pyridine derivatives resulted in excellent hits for developing novel anti- MRSA agents. Overall, this study will be of immense importance for researchers designing and developing target-based anti-MRSA agents.

Background: The first case of COVID-19 emerged in China in 2019 and spread rapidly worldwide. Therefore, all researchers worldwide sought ways to treat and prevent the disease. Since the production of vaccines and new drugs is time-consuming, a good way is to look at existing drugs to find new effects. Objective: Due to the pathogenic mechanism of COVID-19, most of its symptoms, including anosmia, ageusia, and cytokine storm, are dependent on the release of histamine and its activities. Therefore, one category of drugs that may be effective in treating and improving the symptoms of COVID-19 is antihistamines. This paper reviewed studies that have been done so far on the effects of antihistamines, specially famotidine, in COVID-19. Methods: A literature search was performed using scientific databases such as PubMed, Web of Science, Scopus, and Google Scholar from the beginning up to December 2021. The most relevant articles considering the potential impacts of antihistamines against COVID-19 were collected. Results: In addition to the current medications prescribed for the treatment of SARS-CoV-2, H1 and H2 blockers are promising drugs for repurposing in the COVID-19 remedy. Several studies on famotidine were performed using virtual screening to determine whether they are effective. Many studies have shown that famotidine use improved COVID-19 symptoms and reduced the need for intubation and mortality. However, few studies concluded that famotidine is ineffective. Conclusion: Antihistamines, and specifically famotidine, are effective in reducing COVID-19 symptoms. Therefore, they are a good choice for combination therapy with other drugs to treat COVID-19.

Background: Flavonoids are low molecular weight class secondary metabolites found to be present throughout the plant kingdom. Structurally, flavonoid class phytochemicals consist of C6-C3-C6 chemical structures with different substitution patterns and have drug-like nature. Morelloflavone is a biflavonoid class phytochemical found to be present abundantly in the Garcinia genus. Morelloflavone has been investigated in the scientific field for its numerous pharmacological activities. The present work aims to discuss the scientific progress of health beneficial aspects and pharmacological potential of morelloflavone in medicine. Methods: The purpose of this work is to provide scientific information about the biological potential and health beneficial effects of flavonoids in medicine with special reference to the morelloflavone. In this work, we have collected the scientific data of morelloflavone for the biological potential and pharmacological activities against different types of human illnesses with their mechanism of action from Google, Google Scholar, Science Direct and PubMed and analyzed. Further, the preventive role of morelloflavone against various types of human illnesses and the mechanism of action have also been discussed in the present work. This work will provide upto- date information on the health beneficial aspects of morelloflavone in medicine for the prevention and treatment of human complications. Results: Morelloflavone exhibited a wide-range of pharmacologic activity in regulating numerous kinds of human disorders. Present work revealed the health beneficial aspects and pharmacological activities of morelloflavone for the prevention and treatment of human disorders due to its anti-microbial, anti-plasmodial, anti-oxidant, anti-atherosclerosis, anti-inflammatory, anti-tumor anti-restenosis, anti-HIV, aphrodisiac, anti-Alzheimer's and apoptotic potential in the medicine. Further, its biological potential on phospholipase A2, melanin, kallikreins, monoamine oxidase, aromatase, Eg5 Inhibition and proprotein convertases have been also analyzed in the present work. Analytical data signified the importance of modern analytical tools for the separation and isolation of morelloflavone in medicine. Conclusion: Present work revealed the detailed pharmacological activities of morelloflavone that can be utilized in the future for the development of new pharmacologic agents.

Introduction: Since sepsis is a major global health problem, a rapid and correct diagnosis and the initiation of therapy are essential patient consequences. This study aimed to assess the serum levels of calprotectin and a more widely used sepsis biomarker in the patients with bacterial sepsis (BS). Methods: Subjects were classified into BS group with the patients who met the sepsis criteria at the beginning of the study and the control group. We investigated the concentrations of biomarkers in 300 blood samples collected at admission from all patients hospitalized in the Fatemeh Al-Zahra Hospital, Najafabad, Isfahan in April 2019 to April 2020. Results: The microbial etiology in the BS group was confirmed in 35 patients (100%). The most frequently cultivated pathogens were Escherichia coli (n =11). The serum concentrations of calprotectin and CRP were significantly higher in the patients with BS (n= 35) than in the healthy controls (n = 20). Conclusion: Our results suggest that the serum level of calprotectin could have the substantial added value manage BS which is a reliable biomarker of BS.

Background: Hydroxychloroquine (HCQ) may be an effective, safe, and affordable treatment for Covid-19 that can be used in selected patients. However, more evidence on its association when it is used in different stages of the disease with clinical outcomes is required. This observational study investigates the association between treatment with HCQ and mortality in patients with Covid-19. Methods: The data from 6217 patients who died or were discharged from 24 Spanish hospitals were analyzed. Propensity matching scores (PMS) were used. Results: 5094 patients received HCQ. Death was recorded for 17.5% of those who had HCQ and 34.1% of those who did not have it. Mortality was lower for those who had HCQ, OR=0.41 (95% CI=0.34-0.48). The PMS analysis also showed that mortality was lower for those receiving HCQ, OR=0.47 (95%CI=0.36-0.62). PMS analysis for categories revealed an association between HCQ and lowered mortality for patients over 65 years of age, with a past medical history of hypertension, for those who were diagnosed during admission with sepsis related organ failure or pneumonia, and for those with lymphocytopenia, raised troponin, LDH, ferritin and D-dimer. No increase in mortality associated with HCQ was observed in any category of any of the variables investigated. Conclusion: HCQ could be associated with lower mortality for older patients, those with more severe disease and raised inflammatory markers. Further RCTs, observational studies, and summaries of both types of evidence on this topic are necessary to select the precise profile of patients that may benefit from HCQ.

Background: Treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in immuno-compromised patients with complete B cell depletion can be really challenging due to the lack of seroconversion and long-lasting disease. Case Report: We describe a case of long-lasting coronavirus disease (COVID-19) in a female patient with rheumatoid arthritis who was treated with rituximab and continued to show B-cell depletion. An ongoing replication of SARS-CoV-2 was demonstrated for a period of 8 months when nasopharyngeal swabs were tested. She was treated once with remdesivir but without lasting resolution, and she was then treated with convalescent plasma but with a similar effect. Only with a combination of both treatments was clinical resolution achieved. The patient's lack of seroconversion and the prolonged course of the disease illustrate the importance of humoral immunity in resolving SARS-CoV-2 infection. This case report highlights challenges in managing immunocompromised hosts, who may act as persistent shedders and sources of transmission. Conclusion: The combination of remdesivir and convalescent plasma resulted in successfully achieving clinical resolution of SARS-CoV-2 infection in our patient.

Background: Recently, plant-based medications have been considered promising. Scrophularia has been demonstrated to have antibacterial, antifungal, antiparasitic, anticancer, and antiinflammatory effects; however, no evidence of its antiviral potency is available. Objective: This study aimed to evaluate whether the aqueous extract of Scrophularia variegata has antiviral activity against rotavirus as the leading cause of severe diarrhea and acute gastroenteritis in children. Methods: The neutral red assay was utilized to assess the cytotoxicity of the aqueous extract on the cell line. Cytopathic effect (CPE) inhibition, TCID50 (50% cell culture infectious dose), and real-time PCR assays were performed to determine the extract's impact on human rotavirus at non-toxic dilutions. Results: Cell viability was raised following treatment with the aqueous extract at all dilutions. Rotavirus- induced CPEs were considerably reduced when higher dilutions of the aqueous extract were applied to the infected cells. The most substantial inhibitory effect was observed at the highest dilution with no detectable infectious rotavirus titer using the TCID50 assay and no Ct value using the real-time PCR assay. Conclusion: Our findings show that the aqueous extract of Scrophularia variegata may be a promising candidate for the treatment of rotavirus-induced gastroenteritis.

Background: Essential oil of M. vulgare is an important natural source that can be useful in controlling the infection of tomatoes and larvicides. Introduction: This work aimed to determine seasonal variations (winter, spring and summer) of the composition of M. vulgare essential oil and fungicidal and larvicidal potential of this oil. Methods: Essential oils were obtained by a Clevenger-type apparatus and analyzed by using Gas Chromatography (GC) and Gas Chromatography Mass Spectroscopy (GC/MS). The antifungal activities were tested on two strains: Penicillium expansum and Alternaria alternata, and insecticidal activity was tested against Tuta absoluta insect pest of tomatoes. Results: The essential oil of M. vulgare, collected at the same locality throughout the three seasons (winter, spring and summer), was compared in terms of composition and yields. Mostly quantitative, rather than qualitative variation, was observed in the oil composition. Considerable changes were noted for E-β-caryophyllene (4.5-23.5%), E-β-farnesene (3.4-22.9%) and α-humulene (tr- 14.8%). On the other hand, essential oil of M. vulgare collected during the months of April and June (Col EO) was evaluated for its insecticidal and antifungal activity. Col EO showed good invitro antifungal activity against P. expansum and A. alternata with percentages of inhibition of 94% and 100% at 10 mL/L, respectively. Due to the promising results of in-vitro tests, the essential oil of M. vulgare was chosen to determine the protective effects in tomato fruits against infection caused by A. alternata. Observations showed that the treatment of tomato fruits with Col EO resulted in a remarkable reduction of disease severity compared with the controls. Col EO used with the concentration of 0.5 mL/L air showed a very interesting protective activity against black rot of tomatoes caused by A. alternata, up to the 15th day of storage, compared with the control. However, essential oil collected during the month of February (FEO) exhibited no effect of antifungal activity against the phytopathogens tested. On the other hand, the Col EO of M. vulgare exhibited also a good insecticidal activity. At the concentration of 20 mL/L air, the oil caused mortality up to 100% for all larval stages and adults of Tuta absoluta after 24 h of exposure. Conclusion: The Col EO can be used as a potential source to develop control agents to manage some of the main pests and fungal diseases of tomato.