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PubMed1993

Clinical efficacy of dirithromycin versus miocamycin in the treatment of acute bronchitis or acute exacerbations of chronic bronchitis.

A multicentre trial was carried out to compare the efficacy and safety of dirithromycin with miocamycin in the treatment of patients with acute bronchitis or acute exacerbations of chronic bronchitis. The study was a single-blind, randomized, parallel-group study. Dirithromycin was administered orally at a dosage of 500 mg once daily and miocamycin was administered orally at a dosage of 600 mg twice daily; the duration of therapy was five to seven days for both drugs. The results, in 161 assessable patients (78 taking dirithromycin; 83 taking miocamycin), show that dirithromycin and miocamycin have comparable efficacy and safety in the treatment of bronchitis caused by susceptible bacterial pathogens.

Acute Disease↗
PubMed1988

Efficacy of miocamycin in the therapy of non-specific genital infections (NSGI): non-gonococcal urethritis (NGU) and acute urethral syndrome (AUS).

The therapeutic efficacy of miocamycin against Ureaplasma urealyticum and Chlamydia trachomatis was the object of this study. Two different groups of patients were included in the trial: 40 males and 20 females affected by NGU and AUS respectively. All the patients positive for chlamydiae and/or ureaplasmas received 1200 mg/die of miocamycin for 12 days; a microbiological examination was performed 5 days from the end of the therapy. The therapy with miocamycin caused the resolution of both symptoms and microorganisms present. The use of miocamycin in current therapy could be favourable.

Acute Disease↗
PubMed1988

Erythromycin, miocamycin and clindamycin towards adhesivity and phagocytosis of gram-positive bacteria.

To estimate the antibacterial activity of sub-MIC concentrations of Erythromycin and Miocamycin in the mucosal surfaces, we studied the adhesivity of Gram-positive pathogenic strains (S. pyogenes, S. aureus) towards oral and urinary epithelial cells. Erythromycin strongly inhibits the adhesivity of Staphylococci to oral cells (50% of inhibition) and to a lesser extent the adhesivity of Streptococci (21%), while Miocamycin reduced the adhesivity of Staphylococci by about 16%. In some cases, an increase in the adhesivity on urinary cells was found mainly for Miocamycin. Therefore Erythromycin, at sub-MIC concentrations, is able to induce a marked reduction in the adhesivity of Staphylococci and Streptococci; this may interfere with the invasivity and subsequent pathogenicity of these bacteria. As far as phagocytosis is concerned, one strain of enterotoxic coagulase + S. aureus bearing A-protein on its surface but lacking the capsule was taken into consideration. The presence of A-protein induces resistance to phagocytosis and opsonization by normal serum. The addition of antibiotics which inhibit protein biosynthesis, such as Clindamycin, Miocamycin and Erythromycin, increases either uptake of this strain or intracellular killing. In particular Clindamycin and Erythromycin, at sub-MIC concentrations, are able to affect the interaction of Staphylococcus with phagocytic cells.

Bacterial Adhesion↗
PubMed1987

Effect of miocamycin on theophylline kinetics in children.

The interaction between a new macrolide antibiotic, miocamycin, and theophylline was evaluated in a single cross-over study in 5 asthmatic children. Each patient received a single dose of theophylline (4.3 mg/kg) delivered in 15 min using a constant-rate infusion pump, immediately before and after a 10 day course of miocamycin 17.5 mg/kg b.d. The pharmacokinetics of theophylline were calculated for each phase of the study. The elimination rate constant (3.92 vs 3.74 h-1), the mean total body clearance (1.71 vs 1.8 ml X min X kg-1) and the mean apparent volume of distribution (0.57 vs 0.581 X kg-1) did not differ. The result can be explained by the inability of the antibiotic to form inactive cytochrome P-450 metabolite complexes which can interfere with the metabolism of theophylline. Thus, miocamycin can safely be administered to asthmatic children requiring theophylline treatment, when they have an infection due to susceptible pathogens.

Asthma↗
PubMed1990

In-vitro postantibiotic effects of miocamycin and erythromycin on gram-positive cocci.

The capability of miocamycin to induce a postantibiotic effect (PAE) on a Group A Streptococcus beta-haemolyticus clinical isolate and on Staphylococcus aureus ATCC 29213 has been studied. Erythromycin was chosen as a reference molecule. The exposure time to antibiotics was 90 min. The removal technique of the antibiotic agents consisted of a 1:200 dilution in cultural broth. Miocamycin displayed a PAE of 2 h 30 min in relation to the minimum inhibitory concentration (MIC) of Streptococcus and a PAE of 2 h 30 min in relation to the MIC of Staphylococcus. The PAE value lasting longer than the others was of 5 h 40 min towards Streptococcus and of 4 h 18 min towards Staphylococcus at a concentration eightfold the MIC. Erythromycin showed a PAE of 1 h 36 min in relation to the MIC of Streptococcus and a PAE of 1 h 30 min in relation to the MIC of Staphylococcus. The PAE value lasting longer than the others was of 3 h 15 min against Streptococcus and of 2 h 30 min against Staphylococcus at a concentration eightfold the MIC. In some cases a PAE was observed in relation to subinhibitory concentrations (1/2 MIC). Miocamycin therefore proved to possess a more evident capability to induce a PAE against the clinical isolate of Group A Streptococcus beta-haemolyticus and on Staphylococcus aureus ATCC 29213 than did erythromycin.

Adult↗
PubMedDate not supplied

Comparison of miocamycin versus amoxycillin in lower respiratory tract infections in children. Clinical response and effect on natural killer activity.

The clinical efficacies of 50 mg/kg.day miocamycin and 60 mg/kg.day amoxycillin were studied in 23 patients aged 3-11.5 years with presumed bacterial infection of the lower respiratory tract (bronchopneumonia and acute bronchitis). During the therapy, which continued for 10 days, non-specific immune function, represented by natural killer cell activity, was monitored by measurement of the rate of lysis induced on target K-562 51Cr-labelled tumour cells. The results confirmed the therapeutical efficacy of miocamycin and amoxycillin in the oral therapy of bronchopneumonia and acute bronchitis in paediatric patients. The natural killer cell activity of patients treated with miocamycin was increased on days 7 and 10 of therapy compared with baseline. This finding did not occur in patients treated with amoxycillin.

Acute Disease↗
PubMed1988

Miocamycin doesn't affect theophylline serum levels in COPD patients.

The effects resulting from the administration of therapeutic doses (1,200 mg/day for 8 days) of miocamycin, a novel macrolid derived from midecamycin, on theophylline elimination kinetic were investigated on 25 patients affected with chronic obstructive pathology on the respiratory tract. The curves of theophylline clearance, recorded before and after the treatment with miocamycin have shown to be perfectly overlapping (trend analysis). The assumption that the capacity of slackening the theophylline pharmacokinetic would be tightly bound to the particular structure of some macrolids appears to be fully confirmed by the results of the present investigation. When miocamycin is administered in combination with theophylline, the monitoring precautions of plasma levels of the latter are practically of no use.

Adult↗
PubMed1989

Clinical and microbiological evaluation of miocamycin activity against group A beta-hemolytic streptococci in pediatric patients. Three years' incidence of erythromycin-resistant group A streptococci.

The authors have evaluated the incidence of Group A streptococci, and the prevalence of erythromycin-resistant strains in the years 1985/86/87 at the I.C.P. of Milan. The minimum inhibitory concentrations (MICs) for erythromycin, penicillin and miocamycin of 40 erythromycin-resistant strains were also studied (MIC50-MIC90 = 4.5-8, 0.015-0.015, 0.041-0.186 micrograms/ml respectively). A clinical trial with miocamycin vs. erythromycin in the elimination of Group A streptococci (67 patients) showed good and comparable efficacy for both the antibiotics.

Child↗
PubMed1992

Effects of miocamycin and erythromycin on polymorphonuclear cell function.

Previous studies have shown that erythromycin can enter phagocytic cells, stimulating their functional activity. In this work we compared the effects of erythromycin and another newer macrolide antibiotic, miocamycin, on a series of in vitro tests aimed at evaluating their influence on polymorphonuclear cell (PMN) functions. Results indicate that erythromycin induces an increase in leukotriene B4 production in PMNs, while chemotaxis, killing of Candida albicans and respiratory burst are not influenced, at least at the doses used in this study. On the contrary, all these activities are significantly enhanced following incubation with miocamycin, and the response varies according to the antibiotic concentration.

Candida albicans↗
PubMed2003

Significant increase in the prevalence of erythromycin-resistant, clindamycin- and miocamycin-susceptible (M phenotype) Streptococcus pyogenes in Spain.

In 1998 we conducted a multicentre study in Spain on the susceptibility of Streptococcus pyogenes isolates to different 14-, 15- and 16-membered macrolides and clindamycin, in which the number of strains examined was proportional to the number of inhabitants in each geographical area. The aim of the present work was to re-examine the antimicrobial susceptibility of S. pyogenes in 2001, using the same methodology and centres as in 1998, to determine the different susceptibility phenotypes to macrolides-lincosamides, and to compare the results from the 2 years by statistical tests. A total of 529 unique isolates of S. pyogenes, collected in 21 laboratories, were studied. Throat swabs provided 417 isolates (78.8%), and the remaining 112 were from other sources. Four hundred and thirty-five (82.2%) were isolated from children and 94 (17.8%) from adults. One hundred and fifty-seven (29.7%) of the isolates were resistant to erythromycin and azithromycin, whereas resistance to miocamycin, a 16-membered macrolide, was 1.5%. The prevalence of resistance to clindamycin was 1.3%. The majority (98.7%) of the 157 erythromycin-resistant strains presented the M phenotype. When we compared the results obtained in 1998 and 2001, we observed a statistically significant increase in resistance to erythromycin and azithromycin (P = 0.02, chi(2) test), but not to clindamycin or miocamycin (P = 0.47, chi(2) test with Yates' correction). The significant increase in the prevalence of resistance to some macrolides of S. pyogenes in Spain underscores the need for continuous surveillance of antimicrobial resistance in this species.

Anti-Bacterial Agents↗
PubMed1989

Pharmacokinetics of miocamycin in patients with liver cirrhosis.

The pharmacokinetics of miocamycin, a new macrolide antibiotic, was studied in 6 healthy controls and 6 patients with compensated liver cirrhosis. The results indicate that in chronic liver disease the kinetics of the drug is altered. Therefore, a dosage adjustment of miocamycin is recommended when dealing with these patients.

Administration, Oral↗
PubMed1991

[The interference of miocamycin on the adhesiveness and coaggregation of the bacteria responsible for periodontopathies].

The authors studied the effect miocamycin has on the adherence and coaggregation of pathogenic bacteria in periodontopathy. The data obtained by optic microscopy, after treatment of the strains with doses of miocamycin equal to 1/4 and 1/8 of the MIC after 3 and 6 hours, shows the interference effect on the coaggregation and adhesivity of the antibiotic. These results have been confirmed by the observations obtained by scanning electron microscope (SEM).

Bacteria↗
PubMed1991

Some pharmacokinetic data on miocamycin II. Concentrations in gynaecological tissues.

The gynaecological tissue levels of miocamycin were studied in ten female patients after pre-operative administration. The patients were divided into two groups on the basis of the scheduled sampling time. All the patients received 4200 mg of the drug, divided in 7 tablets of 600 mg each every 8 h, last administration 2 or 3 h before surgery. The tissue levels, obtained by means of the microbiological method (Sarcina lutea 9341), were frequently higher than those obtained in the serum at the same time. Miocamycin reached the highest concentration in the endometrium (2.5 micrograms/g) and the lowest in the vagina (1.1-0.8 micrograms/g).

Biological Assay↗
PubMed1990

Streptococcal pharyngitis in Italian children: epidemiology and treatment with miocamycin.

A prospective multicentre study of Italian children with acute pharyngotonsillitis was carried out to determine the incidence of beta-haemolytic streptococcal infection and its epidemiological characteristics and to evaluate the effectiveness of a recently marketed macrolide, miocamycin. From February 1988 to March 1989, 865 children (aged 5 months to 14 years) were enrolled in 11 paediatric departments. Of these 31.9% had a positive throat culture for beta-haemolytic streptococci (26.6% group A streptococci, 5.3% group B, C, D or F). In 68.1% of the patients the throat culture did not yield any pathogen and the disease was considered to be probably viral. No epidemiological (age, season of occurrence, sex) or clinical characteristics (fever, pharyngeal hyperaemia, exudate etc.) could differentiate children with streptococcal pharyngotonsillitis from those with a probably viral one. Breese's score correctly identified only 19.1% of the cases with group A streptococcal infection. Miocamycin was given 50 mg/kg/day in 2 divided doses for 10 days in 225 children with streptococcal pharyngitis. The drug exhibited good clinical efficacy (resolution or improvement of acute signs and symptoms) in 96.3% of the children and a microbiological efficacy (eradication of the causative bacteria) in 85.3%.

Adolescent↗
PubMed1989

[In vitro activity of miocamycin compared with four other macrolides and with pristinamycin against Branhamella catarrhalis].

The in vitro antibacterial activity of miocamycin was compared with four other macrolides (erythromycin, roxithromycin, josamycin, spiramycin) and pristinamycin against 90 clinical isolates of Branhamella catarrhalis by determination of minimum inhibitory concentrations. Sixty three strains were producing penicillinase. Fourteen carbons macrolides and pristinamycin are more effective than sixteen carbons macrolides. In this group, miocamycin have the best activity. There were no significant differences of susceptibility between penicillinase producing and non producing strains.

Anti-Bacterial Agents↗
PubMed1988

Clinical and microbiological effects of in vivo miocamycin therapy on oral infections and in surgical prophylaxis.

Periodontal disease is a chronic irregularly progressing condition, posing many therapeutic problems. Difficulties arise particularly when antibiotic therapy is to be added to mechanical and surgical therapy because, in these cases, pharmacotherapy must be long-lasting. For such reasons the antibiotic of choice must have high activity but low toxicity, in order to avoid side-effects. Antibiotic therapy is also used in both marginal and apical acute phlogistic cases, so that the ideal compound should have high diffusion in gingival tissues and alveolar bone. Miocamycin shows all of these features and it can thus be considered the antibiotic of choice in the therapy of acute periodontal infections and in stomatological surgery. In this clinical study the efficacy of miocamycin has been evaluated in 120 cases of acute periodontal phlogosis and in the treatment of advanced periodontal diseases. Patients were microbiologically monitored for the identification of aerobic and anaerobic bacteria all through the study. In acute cases very good results were obtained, both concerning the reduction of pathological signs (94.1% of the cases) and the occurrence of side-effects (10% of the cases). Among the patients who underwent surgical therapy, only 11 out of 80 showed small problems (slight fever and swelling).

Bacteria, Aerobic↗
PubMed1988

Some pharmacokinetic data on miocamycin. I: Serum, urinary and prostatic levels.

The pharmacokinetics of miocamycin were studied in ten healthy male volunteers after three different administrations: the first group received 600 mg in a single oral dose; the second received 1200 mg divided into two administrations of 600 mg, each one every 12 h; the third received 1200 mg in a single oral dose. Prostatic levels of miocamycin were recorded after the administration of 1200 mg, divided into two administrations of 600 mg every 12 h. The pharmacokinetic analysis was carried out by applying a single-compartment kinetic model with zero-order absorption. The apparent duration of absorption (T) was about 0.55 h for all subjects. The area under the curve was 7.5767 +/- 0.2511 mg/h/l in the first group; 6.7333 +/- 0.6058 mg/h/l in the second group; and 18.6825 +/- 15.1555 mg/h/l in the third. The prostatic levels were five times higher than those in the serum at the same time.

Adolescent↗
PubMed1986

Miocamycin and theophylline blood levels.

Two groups of patients were studied in order to evaluate the possible interference of miocamycin with theophylline blood levels. One group was treated with i.v. theophylline and another one was treated with slow-release theophylline. Both groups did not show any changes in theophylline blood levels. Therefore we can draw the conclusion that miocamycin, a new macrolide, is active on gram-positive and some gram-negative bacteria besides mycoplasma, legionella and chlamydia and it can be used in association with theophyllinic compounds without interaction on theophylline blood concentrations.

Administration, Oral↗