Abstract
The antibacterial activities of nitazoxanide and its main metabolite, tizoxanide, were tested against a broad range of bacteria, including anaerobes. Metronidazole, amoxicillin, amoxicillin-clavulanic acid, piperacillin, cefoxitin, imipenem, and clindamycin were used as positive controls. MICs were determined by reference agar dilution methods. The 241 anaerobes were all inhibited by nitazoxanide, with the MICs at which 90% of isolates are inhibited (MIC90S) being between 0.06 and 4 mg/liter with the exception of those for Propionibacterium species, for which the MIC90 was 16 mg/liter. The MIC90s of nitazoxanide were 0.5 mg/liter for the Bacteroides fragilis group (80 strains), 0.06 mg/liter for Clostridium difficile (21 strains), and 0.5 mg/liter for Clostridium perfringens (16 strains). Metronidazole showed a level of activity comparable to that of nitazoxanide except against Bifidobacterium species, against which it was poorly active, and Propionibacterium species, which were resistant to metronidazole. The other antibiotics showed various levels of activity against anaerobes, with imipenem along with nitazoxanide being the most active agents tested. Tizoxanide was less effective than nitazoxanide except against the B. fragilis group, against which its activity was similar to that of nitazoxanide. Under aerobic conditions, nitazoxanide demonstrated poor activity against members of the family Enterobacteriacae and Pseudomonas, Staphylococcus, and Enterococcus species. The same results were obtained when culture was performed under anaerobic conditions with the notable exception of the results against Staphylococcus aureus. The MICs of nitazoxanide were in the range of 2 to 4 mg/liter for 34 clinical isolates of S. aureus, 12 of which were methicillin resistant, while tizoxanide was not effective.
Full Text
The Full Text of this article is available as a PDF (205.1 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bland S., Sedallian A., Grollier G., Mory F., Houcke I., Dubreuil L. Activité in vitro des carbapénèmes (biapénème, imipénème et méropénème) et de quelques antibiotiques sur les anaérobies stricts. Pathol Biol (Paris) 1995 Apr;43(4):289–293. [PubMed] [Google Scholar]
- Brazier J. S., Citron D. M., Goldstein E. J. A selective medium for Fusobacterium spp. J Appl Bacteriol. 1991 Oct;71(4):343–346. doi: 10.1111/j.1365-2672.1991.tb03798.x. [DOI] [PubMed] [Google Scholar]
- Dublanchet A., Caillon J., Emond J. P., Chardon H., Drugeon H. B. Isolation of Bacteroides strains with reduced sensitivity to 5-nitroimidazoles. Eur J Clin Microbiol. 1986 Jun;5(3):346–347. doi: 10.1007/BF02017795. [DOI] [PubMed] [Google Scholar]
- Dubreuil L., Breuil J., Dublanchet A., Sedallian A. Survey of the susceptibility patterns of Bacteroides fragilis group strains in France from 1977 to 1992. Eur J Clin Microbiol Infect Dis. 1992 Nov;11(11):1094–1099. doi: 10.1007/BF01967804. [DOI] [PubMed] [Google Scholar]
- Grollier G., Mory F., Quentin C., Girard-Pipau F., Tigaud S., Sedallian A., Dubreuil L. Sensibilité aux antibiotiques des anaérobies stricts en France: étude multicentrique. Pathol Biol (Paris) 1994 May;42(5):498–504. [PubMed] [Google Scholar]
- Patey O., Varon E., Prazuck T., Podglajen I., Dublanchet A., Dubreuil L., Breuil J. Multicentre survey in France of the antimicrobial susceptibilities of 416 blood culture isolates of the Bacteroides fragilis group. J Antimicrob Chemother. 1994 May;33(5):1029–1034. doi: 10.1093/jac/33.5.1029. [DOI] [PubMed] [Google Scholar]
- Reysset G., Haggoud A., Sebald M. Genetics of resistance of Bacteroides species to 5-nitroimidazole. Clin Infect Dis. 1993 Jun;16 (Suppl 4):S401–S403. doi: 10.1093/clinids/16.supplement_4.s401. [DOI] [PubMed] [Google Scholar]
- Rossignol J. F., Maisonneuve H. Nitazoxanide in the treatment of Taenia saginata and Hymenolepis nana infections. Am J Trop Med Hyg. 1984 May;33(3):511–512. doi: 10.4269/ajtmh.1984.33.511. [DOI] [PubMed] [Google Scholar]
- Stockis A., Deroubaix X., Lins R., Jeanbaptiste B., Calderon P., Rossignol J. F. Pharmacokinetics of nitazoxanide after single oral dose administration in 6 healthy volunteers. Int J Clin Pharmacol Ther. 1996 Aug;34(8):349–351. [PubMed] [Google Scholar]
- Wilkins T. D., Chalgren S. Medium for use in antibiotic susceptibility testing of anaerobic bacteria. Antimicrob Agents Chemother. 1976 Dec;10(6):926–928. doi: 10.1128/aac.10.6.926. [DOI] [PMC free article] [PubMed] [Google Scholar]