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PubMed2004

Comparison of ranitidine bismuth citrate, tetracycline and metronidazole with ranitidine bismuth citrate and azithromycin for the eradication of Helicobacter pylori in patients resistant to PPI based triple therapy.

BACKGROUND/AIMS: Helicobacter pylori is the most common infectious disease all over the world. Ten to twenty percent of the patients remain infected despite treatment with proton pump inhibitors (PPIs), amoxicillin and clarithromycin. We compared PPI, bismuth, tetracycline and metronidazole with ranitidine bismuth citrate, tetracycline and metronidazole in cases resistant to PPIs-based triple therapies. METHODS: The study included 52 patients who underwent a triple therapy with PPI, clarithromycin and amoxicillin for 14 days between September 2001 and December 2002, and were found to be resistant to the therapy. They were randomized to take ranitidine bismuth citrate (Rb) 400 mg twice a day, tetracycline (T) 1 g twice a day and metronidazole (M) 500 mg three times a day for 14 days (RbTM), or ranitidine bismuth citrate (Rb) 400 mg twice a day for 14 days and azithromycin (A) 500 mg once a day for 7 days (RbA). Four weeks after the treatment, endoscopies were repeated, and patients were assessed with respect to changes in symptoms. When H. pylori was negative on histological analysis and urease test, eradication was achieved. RESULTS: A total of 52 patients, 32 females and 20 males with a mean age of 49+/-12 years, were included in the study. Eradication was achieved in 15 (28%) out of 52 patients in total. There was a significant difference between RbA and RbTM groups (p=0.01). In fact, H. pylori was eradicated in 3 (12%) out of 25 patients in the RbA group, whereas it was eradicated in 12 (44.4%) out of 27 patients in the RbTM group. Symptom scores significantly improved in both groups after the treatment, though there was not a significant difference between the groups (p=0.705). CONCLUSIONS: Triple therapy including azithromycin does not seem to be a good choice in cases resistant to the first line therapies; however, a similarly lower rate of eradication was achieved with the quadruple therapy proposed. Therefore, different treatment schemes should be applied in resistant patients, and further studies are needed as well.

Adult↗
PubMed2005

Synthesis of sub-20-nm-sized bismuth 1-D structures using gallium-bismuth systems.

Bismuth (Bi) nanowires are interesting one-dimensional systems due to the significant quantum confinement effects exhibited as a function of the wire diameters, and synthesizing Bi nanowires with sizes below 20 nm is of fundamental importance in understanding quantum effects. Here, we report a bulk synthesis method to synthesize ultrafine Bi nanowires and a new morphology of bismuth nanostructures, tapered whiskers. These tapered whiskers are about 10-20 mum in length and have diameters of 5-10 nm at the tip and 250-500 nm at the base. The synthesis method is based upon the multiple nucleation and basal growth of nanometer scale nuclei from molten gallium (Ga) melts that result from the low solubility of Bi in Ga and the low eutectic temperature of the Ga-Bi binary system. Adopting different methods of supplying bismuth and using variations in simple heating and cooling, we have synthesized a variety of bismuth nanostructures.

Letter↗
PubMed2004

Influence of omeprazole on bioavailability of bismuth following administration of a triple capsule of bismuth biskalcitrate, metronidazole, and tetracycline.

The objective of this study was to determine the impact of omeprazole on bismuth (Bi) bioavailability when given in a three-in-one capsule containing bismuth biskalcitrate, metronidazole, and tetracycline. Thirty-four healthy volunteers were randomly assigned to receive three capsules (each containing bismuth biskalcitrate 140 mg + metronidazole 125 mg + tetracycline 125 mg) qid alone x 6 days or the same treatment + omeprazole (OM) 20 mg bid. Blood was drawn at intervals for 24 hours after the last dose. After the last dose, mean (CV) C(min) for plasma bismuth was 2882 pg/mL (36%) and 1195 pg/mL (23%) (p< 0.001), with and without OM, respectively. Mean (CV) C(max) was 25493 pg/mL (69%) and 8061 pg/mL (28%) (p < 0.001) with and without OM, respectively. AUC(0-24) increased by 2.9 in presence of OM (p < 0.001). Adverse events in both groups were usually mild and of a gastrointestinal nature, and all had resolved by the end of the trial. This study confirms an interaction between Bi biskalcitrate and OM. Risk of Bi toxicity, seen after long-term use of Bi compounds, is minimal here because plasma levels of Bi remained well below the toxic levels of 50 microg/L, and the treatment period with this triple capsule + OM is only 10 days, a substantially lower number of days compared to that which might produce Bi toxicity.

Adult↗
PubMed2003

Definitive identification of cysteine and glutathione complexes of bismuth by mass spectrometry: assessing the biochemical fate of bismuth pharmaceutical agents.

Solutions containing BiCl3, bismuth subsalicylate or Bi(NO3)3 with L-cysteine, DL-homocysteine, D-methionine or glutathione have been examined by electrospray mass spectrometry. Prominent peaks are assigned to bismuth complexes of these biomolecules and provide insight towards understanding the bioactivity of bismuth compounds.

Bismuth↗
PubMed1978

[The intracerebral distribution of bismuth in bismuth encephalopathy. Pathological and toxicological study of 3 cases (author's transl)].

Neuropathological study of 3 patients dying from bismuth encephalopathy showed the absence of specific lesions and the probably secondary nature of the abnormalities found. Multiple samples taken from various areas of the brain were used for the purpose of the analysis of the topographical distribution of bismuth. Levels were invariably very high and to toxic agent diffusely distributed. The concentration was nevertheless higher in the grey matter than in the white matter. They hypothesis of a liposoluble compound which would explain the affinity of bismuth for cerebral tissue is probable.

Aged↗
PubMed1997

Halide Ion Addition to Bismuth-Containing Iron Carbonyl Compounds: Synthesis and Characterization of the Two Bridged-Butterfly Cluster Compounds [Et(4)N][(&mgr;-H)Fe(2)(CO)(6)Bi(2){&mgr;-Fe(CO)(4)}] and [{PhCH(2)NMe(3)}{(&mgr;-H)Fe(2)(CO)(6)Bi(2)(&mgr;-Cl)(2)}](infinity) and Stabilization of Reduced-Hypervalent Bismuth Centers by Coordination to a Metal Center in [PhCH(2)NMe(3)](3)[Bi(3)Cl(4)(&mgr;-Cl)(4){Fe(CO)(3)}].

The reaction of [Q](2)[Bi(4)Fe(4)(CO)(13)] ([Q](2)[1]; [Q] = [Et(4)N](+), [PhCH(2)NMe(3)](+)) with MePCl(2) in MeCN is a complicated reaction which gives different results depending upon the stoichiometry of the reaction. At a ratio of 1:1.33 (cluster:phosphine), the reaction yields a mixture of the new bismuth-iron carbonyl compounds [Q][(&mgr;-H)Fe(2)(CO)(6)Bi(2){Fe(CO)(4)}] ([Q][2]), which has a tetrahedral Fe(2)Bi(2) core edge-bridged across the bismuth centers by an [Fe(CO)(4)](2)(-) fragment, and [Q](3)[Bi(3)Cl(4)(&mgr;-Cl)(4){Fe(CO)(3)}] ([Q](3)[3]), containing a reduced complex ion [Bi(3)Cl(8)](-) stabilized by coordination to an iron tricarbonyl fragment. Extended Hückel molecular orbital calculations on this unusual anion are consistent with each bismuth atom possessing the same reduced oxidation state of +2.33. The compound [Et(4)N][2] crystallizes in the triclinic space group P&onemacr; (No. 2) with a = 10.246(2) Å, b = 11.859(2) Å, c = 12.474(2) Å, alpha = 71.11(3) degrees, beta = 79.60(3) degrees, gamma = 76.37(3) degrees, V = 1384.7(4) Å(3), and Z = 2, while [PhCH(2)NMe(3)](3)[3].0.87Et(2)O was characterized in the orthorhombic space group Pbca (No. 61) with a = 20.801(4) Å, b = 19.937(4) Å, c = 25.480(5) Å, V = 10566.8(36) Å(3), and Z = 8. When the reaction is carried out at a ratio of 1:2, the novel hydride [{Q}{(&mgr;-H)Fe(2)(CO)(6)Bi(2){&mgr;-Cl}(2)}](infinity) ([{Q}{4}](infinity)) is isolated. This cluster also has a "tetrahedral" core, with the Bi-Bi vector bridged by a chloride ligand and the molecules joined into infinite polymeric chains in the solid state by the second intermolecularly-bridging chloride ligand. [{PhCH(2)NMe(3)}{4}](infinity) crystallizes in the monoclinic space group P2(1)/n (No. 14) with a = 7.864(2) Å, b = 22.465(4) Å, c = 13.797(3) Å, beta = 105.96(3) degrees, V = 2343.5(9) Å(3), and Z = 4. The metal framework of [4](-) is similar to that of [2](-) with the notable exception that the Bi-Bi bond present in [2](-) is missing in [4](-) because of the additional electrons provided by the chloride ions. At stoichiometries greater than 2:1, the previously reported [Fe(CO)(4)Bi(2)Cl(6)](2)(-) ion is formed.

Journal Article↗
PubMed2003

Bismuth-based quadruple therapy using a single capsule of bismuth biskalcitrate, metronidazole, and tetracycline given with omeprazole versus omeprazole, amoxicillin, and clarithromycin for eradication of Helicobacter pylori in duodenal ulcer patients: a prospective, randomized, multicenter, North American trial.

OBJECTIVES: This multicenter, randomized, active-controlled trial assessed efficacy of bismuth-based quadruple therapy with omeprazole, bismuth biskalcitrate, metronidazole, and tetracycline (OBMT) using a single-triple capsule of BMT compared with triple therapy with omeprazole, amoxicillin, and clarithromycin (OAC) in treatment of patients with Helicobacter pylori infection and duodenal ulcers. METHODS: Patients with active duodenal ulcer or diagnosed within the past 5 yr and with infection documented by (13)C-urea breath test plus histology or culture were randomly assigned to 10-day course of OBMT using a single-triple capsule containing bismuth biskalcitrate 140 mg, metronidazole 125 mg, and tetracycline 125 mg given as three capsules q.i.d. with omeprazole 20 mg b.i.d., or a 10-day course of OAC, omeprazole 20 mg plus amoxicillin 1 g plus clarithromycin 500 mg, all b.i.d. Eradication was confirmed by two negative urea breath tests at >1 month and >2 months after therapy. RESULTS: One hundred thirty-eight patients received OBMT and 137 OAC. Modified intent-to-treat eradication rates were 87.7% for OBMT and 83.2% for OAC (95% CI = -3.9%-12.8%; p = 0.29). OBMT eradicated 91.7% metronidazole-sensitive and 80.4% metronidazole-resistant strains (p = 0.06). OAC eradicated 92.1% clarithromycin sensitive and 21.4% clarithromycin-resistant strains (p < 0.001). Adverse events occurred in 58.5% of OBMT patients and 59.0% of OAC patients. CONCLUSIONS: OBMT regimen using the single-triple capsule is as efficacious and well-tolerated as the widely used OAC regimen for H. pylori eradication. This OBMT therapy largely overcomes H. pylori metronidazole resistance, present in 40% of patients in this study.

Administration, Oral↗
PubMed2001

Bismuth-based quadruple therapy with bismuth subcitrate, metronidazole, tetracycline and omeprazole in the eradication of Helicobacter pylori.

BACKGROUND: A previous study showed that 14 days of qid bismuth-based triple therapy with tetracycline 500 mg, metronidazole 250 mg and colloidal bismuth subcitrate 120 mg resulted in excellent Helicobacter pylori eradication rates (89.5%). The present study looked at a shorter treatment period by adding omeprazole and by reducing the dose of tetracycline. METHODS: One hundred sixty-one patients with H pylori confirmed by histology and (13)carbon urea breath test were included in the study. They were treated for seven days with bismuth subcitrate 120 mg plus metronidazole 250 mg plus tetracycline 250 mg qid plus omeprazole 20 mg bid (OBMT). Patients were 18 to 75 years of age and had dyspepsia with or without a history of peptic ulcer. Patients with irritable bowel syndrome, active ulcer or previous attempt at eradication, or those who had used antibiotics or antiulcer drugs in the previous 30 days were excluded. Eradication was determined by two (13)carbon urea breath tests done one and three months, respectively, after treatment. Strains with minimal inhibitory concentrations of 8 microg/mL or higher were considered to be resistant to metronidazole. RESULTS: The overall per protocol eradication rate was 84%-89.5% in metronidazole-sensitive and 70.8% in metronidazole-resistant strains. Modified intent-to-treat analysis resulted in a 80% eradication rate--82.5% in metronidazole-sensitive and 66.7% in metronidazole-resistant strains. Only one patient discontinued treatment because of adverse events. CONCLUSIONS: The OBMT regimen used in this study is safe and effective against metronidazole-sensitive H pylori strains.

Adolescent↗
PubMed1997

The subcellular localisation and the time course of bismuth in the gastric mucosa of rats after short-term administration of colloidal bismuth subcitrate.

The aim of this study was to investigate if colloidal bismuth subcitrate (CBS) can penetrate the gastric mucus barrier to reach the different sites of the antral mucosa and to estimate the time course for CBS to reach and remain in the mucosa. A single dose of CBS was administered orally to rats that were sacrificed at different time intervals post treatment. The control group received gum acacia without CBS. Colloidal bismuth subcitrate, visualised as electron dense precipitate (EDP), was seen in the gastric mucus layer, intercellular spaces and intracellularly after 30 minutes and disappeared after 6 hours. Scant amounts of EDP were observed in the gastric crypts, confined only to the upper parts of these structures. We concluded that CBS can penetrate the mucus and has a wide but uneven distribution in the gastric mucosa. Colloidal bismuth subcitrate, in the concentration given only penetrated the upper two-thirds of gastric pits and not the lower one-third. We also concluded that CBS has to be given 6 hourly to ensure its continuous presence in the gastric mucosa.

Animals↗
PubMed2006

Fabrication of bismuth subcarbonate nanotube arrays from bismuth citrate.

Bismuth subcarbonate ((BiO)2CO3) nanotubes with uniform diameters of about 3-5 nm were fabricated from bismuth citrate; these nanotubes exhibit antibacterial properties against Helicobacter pylori (50% inhibition at 10 microg mL(-1)), a bacterium causing peptic ulcers and gastritis.

Anti-Bacterial Agents↗
PubMed1999

Seven-day 'rescue' therapy after Helicobacter pylori treatment failure: omeprazole, bismuth, tetracycline and metronidazole vs. ranitidine bismuth citrate, tetracycline and metronidazole.

BACKGROUND: Eradication therapy with omeprazole (O), amoxycillin (A) and clarithromycin (C) is used extensively, although it often fails. A 'rescue' therapy with a quadruple combination of O, bismuth (B), tetracycline (T) and metronidazole (M) has been recommended. AIM: : To assess ranitidine bismuth citrate (Rbc) instead of O and B for treatment failure. METHODS: Sixty consecutive patients (13 duodenal ulcer, 47 non-ulcer dyspepsia) in whom a previous eradication trial with O, A and C had failed were randomized to receive one of two regimens for 7 days: O (20 mg b.d.), B (120 mg q. d.s.), T (500 mg q.d.s.) and M (250 mg q.d.s.) (group OBTM, n=30); or Rbc (400 mg b.d.), T (500 mg q.d.s.) and M (250 mg q.d.s.) (group RbcTM, n=30). Eradication was defined as a negative 13C-urea breath test 1 month after completing therapy. RESULTS: Mean age +/- s.d. was 45 +/- 12 years, 47% were males. Distribution of studied variables (age, sex, smoking, duodenal ulcer/non-ulcer dyspepsia) was similar in both therapeutic groups. Per protocol eradication was achieved in 17 out of 29 patients (59%) in group OBTM and in 25 out of 29 patients (86%) in group RbcTM (P < 0.05). Intention-to-treat eradication was achieved, respectively, in 17 out of 30 (57%) and in 25 out of 30 (83%) (P < 0.05). In the multivariate analysis the variables which influenced on H. pylori eradication were the type of therapy (odds ratio, OR=3.9; 95%CI: 1.02-15; P < 0.05) and diagnosis (duodenal ulcer/non-ulcer dyspepsia) (OR=0.1; CI: 0.02-0.4). Adverse effects were infrequent and mild with both regimens. CONCLUSION: Therapy with RbcTM is a promising option after H. pylori eradication failure with OCA, achieving a higher efficacy than quadruple therapy with OBTM.

Adult↗
PubMed1994

Extradural application of bismuth iodoform paraffin paste causing relapsing bismuth encephalopathy: a case report with CT and MRI studies.

Bismuth iodoform paraffin paste (BIPP) is used in dressings in ear, nose, and throat, dental, and neurosurgical practice. Neurotoxicity due to absorption of bismuth from the BIPP pack is rare. It is preventable and reversible but likely to be fatal if unrecognised. A case of relapsing but reversible toxic encephalopathy due to a large extradural BIPP pack is reported in a 57 year old Caucasian woman, operated on for a huge basal cell carcinoma of the vertex invading the skull and extradural space. Clinical, neuroradiological (CT and MRI), and biochemical studies are presented and discussed in the light of the available literature.

Bandages↗
PubMed1991

[Effect of meals on resorption of bismuth from an oral bismuth gallate/bismuth nitrate preparation].

In a cross-over study in ten healthy volunteers the effect of food on the absorption of bismuth following a single oral dose of 1200 mg (= 12 Bismofalk tablets) was evaluated by measuring its serum levels (0 to 24 h) and urinary excretion (for seven days). If this high dose was ingested one hour prior to the breakfast maximal serum concentrations (16.5 +/- 13.7 micrograms/l; mean +/- SD) were rapidly achieved (tmax = 0.7 +/- 0.5 h). These levels and the low urinary recovery of 0.32 +/- 0.25 mg (corresponding to 0.027% of the dose) indicated a minimal absorption. If the tablets were taken one hour after the breakfast absorption was slightly delayed (tmax = 1.9 +/- 2.4 h), however, the extent appeared to be unchanged. In spite of the high dosage as well as the large interindividual variability in the urinary recovery and the serum concentrations potential "toxic" serum levels of 100 micrograms/l were never reached. Thus, it can be concluded that the bismuth preparation used is suitable for topical action.

Administration, Oral↗
PubMed1987

Tissue and subcellular distribution of bismuth radiotracer in the rat: considerations of cytotoxicity and microdosimetry for bismuth radiopharmaceuticals.

The whole-body clearance, organ distribution, and subcellular distribution of no-carrier-added and carried-added intraperitoneally administered bismuth radiotracers (205Bi-206Bi) has been determined in Sprague-Dawley rats. Differences in clearance rate kinetics were observed for this study with the administration of neutral solutions of tracers in a carbonate buffer compared to other studies with other chemical forms. The final organ distribution was not strongly dependent on administered chemical form. We provide definitive evidence that bismuth does indeed enter subcellular organelles such as the nucleus and the mitochondria, which had 30-50% and 10-25%, respectively, of activity in kidney tissue. The kidneys were the main sink for radiotracer with uptake ranging from 20 to 50% of total body activity. The calculated energy deposition by recoil nuclei after alpha emission of potentially therapeutically useful 212Bi was found to equal or exceed the alpha energy deposition per organelle if the source is inside the cell nucleus or mitochondria.

Animals↗
PubMed1980

[Bismuth osteoarthropathies. Concern with bone bismuth dosage].

Impulsion polarography with anodic redissolution, a very sensitive means of dosage that is easy to repeat and more selective than atomic absorption, makes it possible to affirm the presence of bismuth in the bones after oral or parenteral treatment in 6 patients, 5 of whom suffered from osteoarthropathies that could be linked, given their nature, to the treatment administered, though this could not be proven. The presence of bismuth in the bone tissue of these patients must be considered in the physiopathological discussion of their osteoarthropathies, especially since none of them showed signs of encephalopathies.

Adult↗
PubMed1996

Stereochemical Consequences of the Bismuth Atom Electron Lone Pair, a Comparison between MX(6)E and MX(6) Systems. Crystal and Molecular Structures of Tris[N-(P,P-diphenylphosphinoyl)-P,P-diphenylphosphinimidato]bismuth(III), [Bi{(OPPh(2))(2)N}(3)], -indium(III), [In{(OPPh(2))(2)N}(3)].C(6)H(6), and -gallium(III), [Ga{(OPPh(2))(2)N}(3)].CH(2)Cl(2).

The tetraphenylimidodiphosphinate [N-(P,P-diphenylphosphinoyl)-P,P-diphenylphosphinimidate] ion forms stable tris-chelates with the Bi(III), In(III), and Ga(III) cations. The crystal and molecular structures of [M{(OPPh(2))(2)N}(3)] (M = Ga, In, Bi) were determined by X-ray diffractometry. The geometry around the bismuth atom in compound 3 displays an approximately C(3)(v)() symmetry. This arrangement suggests the presence of a stereoactive lone pair of electrons, which is located in one of the triangular octahedral faces. Derivative 3 crystallizes in the triclinic space group P&onemacr; with Z = 2, a = 14.006(6) Å, b = 14.185(4) Å, c = 17.609(8) Å, alpha = 88.45(2) degrees, beta = 79.34(2) degrees, and gamma = 78.23(2) degrees. The structures of the gallium(III) and indium(III) tris-chelate oxygen-based complexes (1 and 2, respectively) were compared with the bismuth analogue in order to determine the ligand steric bulk influence on the coordination sphere in the absence of the electron lone pair. Complex 1 crystallizes as the [Ga{(OPPh(2))(2)N}(3)].CH(2)Cl(2) solvate in the triclinic space group P&onemacr;; Z = 2, a = 13.534(4) Å, b = 13.855(4) Å, c = 18.732(7) Å, alpha = 95.48(2) degrees, beta = 98.26(2) degrees, and gamma = 97.84(2) degrees. Crystal data for the benzene solvate of 2, [In{(OPPh(2))(2)N}(3)].C(6)H(6): triclinic space group P&onemacr;, Z = 2, a = 13.542(9) Å, b = 15.622(3) Å, c = 18.063(5) Å, alpha = 98.21(1) degrees, beta = 104.77(0) degrees, and gamma = 92.260(0) degrees.

Journal Article↗
PubMed1997

The Structurally Flexible Bicyclic Bis(2-hydroxyethanethiolato)bismuth(III) Complex: A Model for Asymmetric Monoanionic Chelation of Bismuth(III).

Reaction of Bi(NO(3))(3) with 2-mercaptoethanol gives [Bi(SCH(2)CH(2)OH)(2)][NO(3)], 5(NO(3)), independent of stoichiometry. Other salts or derivatives of 5, 5(Cl) and 5(Br), are readily prepared by anion exchange reactions and can also be obtained by reaction of BiX(3) (X = Cl, Br) with 2-mercaptoethanol. Reaction of Bi(CH(3)COO)(3) with 2-mercaptoethanol gives the conjugate base of 5 which is readily protonated with glacial acetic acid to give the acetate salt 5(CH(3)COO). The compounds have been characterized by IR, Raman, and NMR spectroscopies and APCI mass spectrometry. X-ray crystallographic studies of 5(NO(3)) [crystal data: C(4)H(10)O(5)BiS(2)N.H(2)O, I4(1)/a, a = 20.337(6) Å, b = 20.337(6) Å, c = 11.303(7) Å, Z = 16], 5(Cl) [crystal data: C(4)H(10)O(2)BiS(2)Cl, P2(1)/n, a = 8.653(2) Å, b = 10.618(3) Å, c = 10.564(2) Å, beta = 100.51(2) degrees, Z = 4], and 5(CH(3)COO) [crystal data: C(6)H(13)O(4)BiS(2), P2(1)/c, a = 8.089(2) Å, b = 16.313(3) Å, c = 8.708(2) Å, beta = 98.37(3) degrees, Z = 4] show them to each contain the bicyclic bis(2-hydroxyethanethiolato)bismuth framework 5. The conformational features of 5 are dramatically different in each of the structures, perhaps reflecting the relative donor capabilities of the anions. The observations reveal a substantial thermodynamic preference for the thiolate-alcohol chelate in a 2:1 stoichiometry over other possible structural arrangements, which is interpreted in terms of hard and soft acid-base theory and mediation of the acidity of the bismuth site by the double hydroxyl coordination.

Journal Article↗
PubMed2003

Structure of colloidal bismuth subcitrate (CBS) in dilute HCl: unique assembly of bismuth citrate dinuclear units ([Bi(cit)(2)Bi](2-)).

Colloidal bismuth subcitrate (CBS, De-Nol) has been used for several decades for the treatment of gastric and duodenal ulcers, and Helicobacter pylori infection together with antibiotics. The solubility of CBS in water is found to be dramatically affected by pH, from >70 mg/mL at pH 7 to only about 1 mg/mL at pH 3. CBS was crystallized in dilute HCl at pH 3, and unique assembly of three basic bismuth citrate dimeric units ([Bi(cit)2Bi]2-) leads to the formation of two-dimensional sheets and 3D polymer.

Anti-Infective Agents↗