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At least 487 records · Page 27Linked to original sources
PubMed2005

Sodium ferric gluconate complex therapy in anemic children on hemodialysis.

Pediatric patients with end-stage renal disease undergoing hemodialysis (HD) frequently develop anemia. Administration of recombinant human erythropoietin (rHuEPO) is effective in managing this anemia, although the additional demand for iron often results in iron deficiency. In adult patients undergoing HD, intravenous (IV) iron administration is known to replenish iron stores more effectively than oral iron administration. Nevertheless, IV iron supplementation is underutilized in pediatric patients, possibly because of unproved safety in this population. This international, multicenter study investigated the safety and efficacy of two dosing regimens (1.5 mg kg(-1) and 3.0 mg kg(-1)) of sodium ferric gluconate complex (SFGC) therapy, during eight consecutive HD sessions, in iron-deficient pediatric HD patients receiving concomitant rHuEPO therapy. Safety was evaluated in 66 patients and efficacy was evaluated in 56 patients. Significant increases from baseline were observed in both treatment groups 2 and 4 weeks after cessation of SFGC dosing for mean hemoglobin, hematocrit, transferrin saturation, serum ferritin, and reticulocyte hemoglobin content. Efficacy and safety profiles were comparable for 1.5 mg kg(-1) and 3.0 mg kg(-1) SFGC with no unexpected adverse events with either dose. Administration of SFGC was safe and efficacious in the pediatric HD population. Given the equivalent efficacy of the two doses, an initial dosing regimen of 1.5 mg kg(-1) is recommended for pediatric HD patients.

Adolescent↗
PubMed2006

Sodium ferric gluconate complex maintenance therapy in children on hemodialysis.

Intravenous iron therapy is recommended for children and adults who receive hemodialysis (HD) and recombinant human erythropoietin (rHuEPO). However, limited information exists on the use of any maintenance IV iron regimen in children. Therefore, we conducted a prospective, multicenter, open-label trial of maintenance therapy with sodium ferric gluconate complex (SFGC) in iron-replete pediatric HD patients receiving rHuEPO. Patients received SFGC weekly at an initial dose of 1.0 mg kg(-1) week(-1), not to exceed 125 mg. Doses could be adjusted based on iron indices. Twenty-three patients (mean age: 13.2+/-2.39 years) were enrolled and received at least one dose of SFGC, while twelve patients completed the study. After 12 weeks of treatment, the mean SFGC dose delivered was 1.0 mg/kg. Mean TSAT and serum ferritin levels remained within NKF-K/DOQI target ranges and the mean Hgb level remained unchanged from baseline. No unexpected or unusual safety risks were associated with SFGC use. In summary, this experience provides evidence for the safety and efficacy of intravenous SFGC and supports the recommendation that the maintenance SFGC starting dose should be 1.0 mg/kg, not to exceed 125 mg, with subsequent adjustments made according to TSAT and/or serum ferritin levels.

Adolescent↗
PubMed1986

Effects of chlorhexidine gluconate in drinking water on dental caries and oral microorganisms in the Syrian hamster.

Hamsters infected with Streptococcus sobrinus (formerly Streptococcus mutans) strain 6715-1119 were given high-sucrose diet 2000. After 5 days, they were presented with 0.05 or 0.1 per cent w/v chlorhexidine gluconate (CHX) continuously in their drinking water, which was well-tolerated. Compared to infected but untreated controls, their caries scores were less by 84 and 97 per cent respectively after 42 days. Coronal dental plaque deposits were reduced in a dose-related fashion. Culture plates of oral swabs showed reductions in Strep. sobrinus and total streptococci after 10 and 35 days of CHX. Hamster oral streptococci were more sensitive to CHX than were lactobacilli but neither was completely eliminated. The incidence of stained tooth deposits after 0.1 per cent CHX was slightly but not significantly greater than in controls.

Animals↗
PubMed1989

Production and characterization of antisera raised to the manninotrionate group [alpha-D-Galp-(1----6)-alpha-D-Galp-(1----6)-D-gluconate].

Manninotrionate [alpha-D-Galp-(1----6)-alpha-D-Galp-(1----6)-D-gluconate] was coupled to bovine serum albumin (BSA), and antisera were raised in rabbits to this carbohydrate-protein conjugate. The antisera were studied by quantitative precipitation and hapten inhibition. Antisera against the manninotrionate-BSA conjugate showed the greatest reactivity with the homologous manninotrionate-BSA antigen, but also cross-reacted extensively with a manninotrionate-ovalbumin conjugate. The antisera gave weak precipitin reactions with beef-lung galactan, guaran, gum arabic, and larch arabinogalactan. Quantitative hapten-inhibition studies with a series of galactosyloligosaccharides indicated that the antisera possess a high degree of specificity toward terminal alpha-D-Galp-(1----6)-alpha-D-Galp units. The antisera did not agglutinate Ehrlich ascites tumor-cells, which have been demonstrated to contain cell-surface glycoproteins having alpha-D-galactosyl end-groups.

Agglutination Tests↗
PubMed1989

Confirmation of the structures of the products obtained on acylation of 2-amino-2-deoxy-D-gluconic acid.

Acetylation of 2-amino-2-deoxy-D-gluconic acid (1) with acetyl chloride-pyridine gave 2,3-unsaturated six- and five-membered lactones (2 and 3). Their benzoylated analogs (4 and 5) were obtained by benzoylation of 1 with benzoyl chloride-pyridine. Reaction of 1 with hot acetic anhydride-sodium acetate gave a approximately 1:2 mixture of (E)- and (Z)-2-acetamido-6-acetoxyhexa-2,4-dien-4-olide (6-E and 6-Z). Treatment of 3 with 1,8-diazabicyclo[5.4.0]undec-7-ene also gave as the main product 6-Z, which was isolated crystalline from the reaction mixture. The same reaction applied to compound 5 gave selectively the Z-isomer of the benzoylated furanone 7. Partial and total hydrogenation (H2-Pd-C) of the mixture 6-E, Z gave, respectively, a racemic monounsaturated lactone (8) and a dideoxy lactone (9), for which the threo-configuration for the chiral centers at C-2 and C-4 was determined. Acidic removal of the acetyl groups from 9 afforded the 2-amino-6-hydroxy-1,4-lactone hydrochloride 10. On the other hand, acetylation at high temperature of the 4,6-O-benzylidene derivative of 1 (11) gave the 2,3-unsaturated, six-membered lactone (12), precursor of 2-acetamido-6-acetoxyhexa-2,4-dien-5-olide (14).

Acetylation↗
PubMed1989

An in-use comparison of chlorhexidine gluconate 4% w/v, glycol-poly-siloxane plus methylcellulose and a liquid soap in a special care baby unit.

The effectiveness and harshness of three hand-wash agents, chlorhexidine gluconate 4%, glycol-poly-siloxane gel and a bland liquid soap were studied in-use in a Special Care Baby Unit (SCBU). Each product was used for consecutive 2-week periods by the same groups of 8 health care workers among the 56 in the SCBU. The first group had normal skin, the second had 'sensitive skin' and the third group were known MRSA nasal carriers. Blood agar and methicillin mannitol salt agar were inoculated before and after hand washing and differences in colony counts calculated. Nursing activities before washing were graded from clean to dirty on an eight-point scale and correlated with before-wash colony counts. Product acceptability was assessed with a self-reporting questionnaire. Chlorhexidine was the most effective product in reducing skin microflora but users preferred to wash with the gel preparation. The sensitive-skin group achieved the best effects from washing, irrespective of the product used. Nasal carriers of MRSA recorded the lowest reduction levels of methicillin-resistant organisms but achieved the same reduction levels as the normal-skin group for other microflora. No relationship could be established between the pre-wash activity and the pre-wash colony count. The weekly MRSA colonization rate in neonates on the SCBU remained unaffected by any of the products tested.

Chlorhexidine↗
PubMed1992

Handwashing in a neonatal intensive care nursery: product acceptability and effectiveness of chlorhexidine gluconate 4% and triclosan 1%.

The effectiveness of triclosan 1% w/v against methicillin-resistant Staphylococcus aureus (MRSA) and its effect on skin were compared with chlorhexidine gluconate 4% w/v ('Hibiclens') in a 7-week trial. Clinical information of MRSA rates obtained during the previous 10 months and results from earlier user acceptability trials were included. The average number of new cases of MRSA per week was reduced from 3.4 to 0.14 (P less than 0.0001) in the experimental ward whilst no significant changes occurred in the control ward. Staff reported less skin damage and a higher rate of acceptance with the experimental product. Based on results of the trial, a proposal to introduce triclosan for a 12-month study period has been accepted.

Aerosols↗
PubMed1988

Comparative antibacterial efficacy of a 2-minute surgical scrub with chlorhexidine gluconate, povidone-iodine, and chloroxylenol sponge-brushes.

Chlorhexidine gluconate (Hibiclens), povidone-iodine (E-Z Scrub 201), and chloroxylenol (ParaSoft) sponge-brushes were compared for antibacterial efficacy in 2-minute surgical scrubs. Thirty-nine volunteers completed a 7-day baseline period and a 5-day treatment period. Thirteen participants were assigned to a chlorhexidine group, 12 to a povidone-iodine group, and 14 to a chloroxylenol group. Subjects followed a standardized protocol, performing 11 scrubs during the treatment period. Bacterial counts were taken by the glove-juice procedure immediately after scrubbing and at 3 and 6 hours later on days 1, 2, and 5. The use of chlorhexidine achieved significantly (p less than 0.01) greater adjusted mean log10 bacterial count reductions than did povidone-iodine and chloroxylenol at all sampling times, with greater reductions as the study progressed.

Adult↗
PubMed1991

The effects of a 0.12% chlorhexidine gluconate mouthrinse on orthodontic patients aged 11 through 17 with established gingivitis.

The purpose of this study was to assess the effectiveness of a 0.12% chlorhexidine gluconate (CH) mouthrinse, Peridex, on orthodontic patients 11 through 17 years of age with established gingivitis. Thirty-four subjects were divided into two groups (CH and placebo) of 17 subjects each on the basis of gender, and they were evaluated at baseline, at 6 weeks, and at 12 weeks in a double-blinded manner. The gingival index (GI) of Löe and Silness, the plaque index (PI) of Silness and Löe, the Eastman Interproximal Bleeding Index, and the CWRU staining index were recorded for each subject. The subjects in the CH group, as compared with the placebo group, had statistically significant reductions, expressed as percent reductions against baseline, at the conclusion of this 3-month period: PI = 64.9%, GI = 60.0%, and gingival bleeding = 77.2%. Staining was in the moderate range, and it was concentrated on the mandibular lingual surfaces. Peridex, in combination with mechanical plaque removal, proved to be an important therapeutic agent in controlling gingival inflammation, bleeding, and plaque accumulation in orthodontic patients 11 through 17 years of age with established gingivitis.

Adolescent↗
PubMed2005

Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant.

The efficacy of a new skin disinfectant, 2% (w/v) chlorhexidine gluconate (CHG) in 70% (v/v) isopropyl alcohol (IPA) (ChloraPrep), was compared with five commonly used skin disinfectants against Staphylococcus epidermidis RP62A in the presence or absence of protein, utilizing quantitative time-kill suspension and carrier tests. All six disinfectants [70% (v/v) IPA, 0.5% (w/v) aqueous CHG, 2% (w/v) aqueous CHG, 0.5% (w/v) CHG in 70% (v/v) IPA and 10% (w/v) aqueous povidone iodine (PI)] achieved a log(10) reduction factor of 5, in colony-forming units/mL, in a suspension test (exposure time 30s) in the presence and absence of 10% human serum. Subsequent challenges of S. epidermidis RP62A in a biofilm (with and without human serum) demonstrated reduced bactericidal activity. Overall, the most effective skin disinfectants tested against S. epidermidis RP62A were 2% (w/v) CHG in 70% IPA and 10% (w/v) PI. These results suggest that enhanced skin antisepsis may be achieved with 2% (w/v) CHG in 70% (v/v) IPA compared with the three commonly used CHG preparations [0.5% (w/v) aqueous CHG, 2% (w/v) aqueous CHG and 0.5% (w/v) CHG in 70% (v/v) IPA].

2-Propanol↗
PubMed1994

A comparison of 2.0% chlorhexidine gluconate and 5.25% sodium hypochlorite as antimicrobial endodontic irrigants.

Sodium hypochlorite, as an endodontic irrigant, poses problems including toxicity, odor, and discoloration of operatory items. An equally effective, but safer irrigant is desirable. Therefore, we compared the antimicrobial activity of 2.0% chlorhexidine gluconate with that of 5.25% sodium hypochlorite in an in vitro root canal system. Freshly extracted human teeth with pulpal pathosis were instrumented using chlorhexidine, sodium hypochlorite, or saline as irrigants. Microbiological samples were taken from the teeth immediately after accessing the canal, after instrumentation and irrigation, and after standing in an anaerobic atmosphere for 24 h. Irrigation with chlorhexidine or sodium hypochlorite significantly reduced the numbers of postirrigant positive cultures and colony-forming units compared with saline-irrigated teeth. The number of postirrigant positive cultures and the number of colony-forming units in positive cultures obtained from chlorhexidine-treated teeth were lower than the numbers obtained from sodium hypochlorite-treated teeth, but the differences were not statistically significant.

Analysis of Variance↗
PubMed1997

Chlorhexidine gluconate (CHG) activity against clinical isolates of vancomycin-resistant Enterococcus faecium (VREF) and the effects of moisturizing agents on CHG residue accumulation on the skin.

The effectiveness of skin decontamination by chlorhexidine gluconate (CHG) in the presence of commonly-used skin moisturizing lotions was evaluated using vancomycin-resistant Enterococcus faecium (VREF) as a representative nosocomial pathogen. Anti-bacterial efficacy was determined in vitro using pigskin preparations inoculated with five VREF clinical isolates to evaluate Calgon Vestal 2 and 4% (by weight) CHG solutions in comparison with Hibiclens Antiseptic Antimicrobial Cleaner (4% CHG solution). Control inocula were determined for each experiment from recovery of VREF harvested directly from the surface of each control piece of skin. These CHG formulations were evaluated in the presence and absence of Calgon Vestal 'Lotion Soft Skin Conditioner' (LSSC) to determine potential interactions of CHG with LSSC, and also with ¿Vaseline Intensive Care' lotion as a CHG-deactivating agent. The 2% Calgon Vestal CHG alone reduced VREF 10(2)-10(3)-fold, as well as 10(3)-10(4)-fold when LSSC was present, and was as efficacious as either 4% CHG solution when these were tested in the presence of LSSC. Four percent Calgon Vestal CHG produced reductions of 10(3)-10(5)-fold with or without LSSC present. Conversely, ¿Hibiclens' showed similar reductions in the presence of LSSC to that for the Calgon Vestal 4% CHG, but only a 10(1)-10(3)-fold reduction without LSSC. ¿Vaseline Intensive Care' lotion completely inactivated the VREF-killing effects for all of the CHG formulations tested, while LSSC and ¿Vaseline Intensive Care' lotion both showed minimal activity alone against these VREF isolates. These results indicate that the Calgon Vestal 2% CHG solution is as effective against VREF, even in the presence of LSSC, as either the 4% Calgon Vestal or Hibiclens 4% CHG formulations; the use of this lower concentration of CHG may be associated with less irritation, particularly with concomitant use of LSSC.

Animals↗
PubMed1999

Comparison of the antibacterial efficacy of 4% chlorhexidine gluconate and 1% triclosan handwash products in an acute clinical ward.

The antibacterial efficacy of 4% chlorhexidine gluconate (CHG) and 1% triclosan as handwash antiseptics is well established. Few published studies have identified hand bacteria found in glove juice samples, and most studies have used nonclinical study subjects. We report a longitudinal comparative study to determine the effect of 4% CHG and 1% triclosan on the composition of the hand bacterial flora of clinical staff in a specialist surgical unit. Prehandwash and posthandwash samples were collected on 3 separate occasions throughout each day by using the glove juice method and a supervised handwashing technique. Total bacterial counts were determined as well as counts for specific pathogens including methicillin-resistant Staphylococcus aureus and coliforms. Both 4% CHG and 1% triclosan were found to effectively reduce the total hand bacterial count preduty (P =.0001). Four percent CHG also was consistently more effective at reducing the total count than was 1% triclosan. However, 1% triclosan eliminated methicillin-resistant S aureus, whereas 4% CHG failed to do so (P =.0001). Gram-negative bacteria were more likely to be eliminated after the use of 4% CHG compared with 1% triclosan. This study is the first to report the effects of 1% triclosan on the bacterial flora present on the hands of clinical staff and demonstrates the ability of 1% triclosan to eliminate methicillin-resistant S aureus.

Anti-Infective Agents, Local↗
PubMed2001

Sodium ferric gluconate complex in the treatment of iron deficiency for patients on dialysis.

Intravenous iron has been found to be an important adjunctive therapy in the treatment of anemia for patients on dialysis. In the United States, iron dextran had been the only form available for parenteral use until 1999. This agent has been associated with a concerning number of severe adverse reactions, in some cases resulting in patients' deaths. Recently, a form of iron used for many years in Europe, sodium ferric gluconate complex in sucrose, was approved for intravenous use in the United STATES: Because this agent does not contain the immunogenic dextran component of iron dextran, it is expected that the safety profile of this drug should be superior to that of iron dextran. The purpose of this review is to critically appraise the relevant literature and to synthesize the information into a strategy for clinical use of this drug.

Anemia, Iron-Deficiency↗
PubMed2000

Chitosan films and hydrogels of chlorhexidine gluconate for oral mucosal delivery.

Topical delivery of antimicrobial agents is the most widely accepted approach aimed at prolonging active drug concentrations in the oral cavity. As most antifungals do not posses inherent ability to bind to the oral mucosa, this is best achieved through improved formulations. Chitosan, a partially deacetylated chitin, which is a biologically safe biopolymer, prolongs the adhesion time of oral gels and drug release from them. Chitosan also inhibits the adhesion of Candida albicans to human buccal cells and has antifungal activity. The antifungal agent, chlorhexidine gluconate (Chx), also reduces C. albicans adhesion to oral mucosal cells. The aim of this study was to design a formulation containing chitosan for local delivery of Chx to the oral cavity. Gels (at 1 or 2% concentration) or film forms of chitosan were prepared containing 0.1 or 0.2% Chx and their in vitro release properties were studied. The antifungal activity of chitosan itself as well as the various formulations containing Chx was also examined. Release of Chx from gels was maintained for 3 h. A prolonged release was observed with film formulations. No lag-time was observed in release of Chx from either gels or films. The highest antifungal activity was obtained with 2% chitosan gel containing 0.1% Chx.

Absorption↗
PubMed1986

The antiseptic efficacy of chlorxylenol-containing vs. chlorhexidine gluconate-containing surgical scrub preparations.

The studies described here evaluate the efficacy of the chlorxylenol-containing surgical scrub formulations against the chlorhexidine gluconate-containing formulations using the Glove Juice Test, as recommended by the FDA's panel to develop guidelines for the study of antiseptic agents. Similar reports from the literature evaluating the relative efficacies of the iodophor-containing and the hexachlorophene-containing formulations are cited. Results fail to detect any significant differences in the efficacy of these two preparations, each significantly reducing the bacterial flora on the hands as indicated by immediate post-wash colony counts, and each demonstrating the continuing ability to significantly reduce bacterial growth with continued regular use.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Purification and identification of an Escherichia coli beta-keto ester reductase as 2,5-diketo-D-gluconate reductase YqhE.

An NADPH-dependent enzyme that reduces ethyl 2-methylacetoacetate stereoselectively to ethyl (2R)-methyl-(3S)-hydroxybutanoate was purified 730-fold from Escherichia coli. The N-terminal amino acid sequence data obtained from the purified reductase were used to search the E. coli genome, and a single match was found at the start of the yqhE open reading frame. The YqhE protein had been identified previously by Yum et al. as a 2,5-diketo-D-gluconate reductase on the basis of sequence similarity to other bacterial homologues [Yum, D.-Y.; Lee, B.-Y.; Pan, J.-G. Appl.Environ. Microbiol. 1999, 65, 3341-3346]; however, it had not been examined for beta-keto ester reductions. Our results thus link a key enzyme in the microbial production of ascorbate with stereoselective beta-keto ester reductions, two important fields in biocatalysis. The purified YqhE reductase accepts ethyl acetoacetate and a variety of 2-substituted derivatives, and its sequence is similar to other aldose reductase superfamily members that also reduce alpha-substituted beta-keto esters to syn-(2R,3S) alcohols.

Escherichia coli↗