Amoxicillin goodrx

The bacterial load was then evaluated in the same way as on the third day and the seventh day.

Rectal temperature was taken on days 0, 3, 7, and 14 using a digital thermometer. The individual weighing was carried out on days 0, 3, 7, and 14 using a digital scale. The results were expressed as mean values ± SEM (standard error of the mean).

A statistical analysis of the data was performed with a one-way analysis of variance followed by Tukey?s Multiple Comparison Test (ANOVA followed by Tukey?s test) (Graph Pad Prism, version 5.03).

The AMC, gentamicin, and 1,8-cineole MIC values were shown in Table 2.

Effect of the Combination of Antibiotics and 1,8-Cineole.

The effect of the two antibiotics tested against three strains of S.

aureus by combining the two antibiotics, on the one hand, amoxicillin for gastroenteritis and combining each one of them with 1,8-cineole, on the other hand, was shown in Tables 3, 4, and 5.

The combination of AMC and gentamicin gave no synergistic effect; however, an additive effect was noted for the MRSA and MSSA 2 strains.

For the combination of antibiotics with 1,8-cineole, a total synergistic effect is noted for the three strains combining AMC with 1,8-cineole, while the combination of gentamicin with 1,8-cineole showed a total synergistic effect for the MRSA strain and a partial synergistic effect for the other two MSSA strains.

Figure 1 shows the evolution of the rabbit’s body temperature of different groups on days 0, 3, 7, and 14.

It illustrates that, after inoculation, an increase in the body temperature of all groups of rabbits was observed except for the uninfected one. The temperature was around 38.6°C for all the rabbits at the beginning of the experiment, while it exceeded 40°C on day 2 for the groups of infected animals. During four days of treatment, the body temperature of treated rabbits decreased gradually reaching almost the normal temperature. In contrast, the body temperature of infected untreated rabbits remained above 40°C.

Table 6 shows the evolution of the rabbit’s weight during the experiment.

For the groups of infected animals, a weight loss during the three days (day 0–day 3) was noted.

However, during the four days of treatment (day 3–day 7), an increase in weight of treated rabbits

was

Evolution of the Bacterial Load in the Bone Marrow.

The evolution of the bacterial load in the bone marrow of all groups of animals is shown in Figure 2 and Table 7.

Three days after inoculation, the bacterial load was around 10 7 CFU/g for all groups except the uninfected group.

During the four days of treatment (day3–day7), a decrease in the bacterial load was noted and was very significant for the groups of animals treated with AMC + 1,8-cineole, followed by the group treated with AMC + gentamicin, while a moderate decrease was observed for groups

treated

During the second week of the experiment, and despite discontinuation of treatment, the bacterial load continued to decrease slightly in all five treated groups.

? : the efficacy measurement was made by comparing the bacterial load before (day 3 after infection) 236 and after antibacterial therapy (day 7 after infection) (Table 7).

Antibiotic treatment of osteomyelitis remains a clinical challenge [34]. This treatment is confronted with the increasing prevalence of multiresistant bacteria, particularly methicillin-resistant S.

Hence, there is an interest in finding alternatives to overcome the growing resistance of S.

The MIC values of AMC and gentamicin obtained are lower than those reported by Entenza et al.

This difference is probably due to the use of different techniques; Entenza et al.

used the macrodilution method with a higher inoculum of 10 7 CFU/mL. Indeed, the bactericidal activity of antibiotics decreases when the inoculum increases, especially for S.

The bacterial growth phase is also an important parameter that influences the antibacterial activity of antimicrobial agents [37]. The MIC of gentamicin obtained for the MRSA strain (2 ? g/mL) confirms the results of the susceptibility test by the disc diffusion method in which gentamicin resistance was found according to EUCAST [38]. For the AMC, the MICs determined by the microdilution were 1 ? g/mL, 0.5 ? g/mL, and 0.25 ? g/mL for MRSA, MSSA 1 , and MSSA 2 , respectively.

Low MIC (?1 ? g/mL) was obtained by Barry on 4.5% among 397 of cefoxitin-resistant staphylococci strains [39]. Methicillin resistance is mediated by an additional PBP (PBP2a) with low affinity for beta-lactam agents and it confers resistance to methicillin as well as to other beta-lactam antibiotics [40].

However, no amoxicillin trihydrate 250 mg clinical breakpoints were available for the AMC [41]. With regard to 1,8-cineole, the MIC values obtained are 16 mg/mL for MSSA 1 and 32 mg/mL for MRSA and MSSA 2 . These values are lower than those obtained by Silva et al.

[26] obtained a higher MIC value of 64 mg/mL, using the microdilution method with an inoculum of 5 ? 10 5 CFU/mL.

This could be explained by the fact that the dispersion of EOs using either dimethyl sulfoxide (DMSO) or Tween 80 is known to reduce their antimicrobial activity.

Indeed, our laboratory has already demonstrated that detergents such as Triton-X100 and Tween 80 or solvents such as ethanol decrease the antimicrobial effect of EOs or MICs [21]. The use of agar at 0.2% as a dispersing agent in this study explains the lower MICs obtained.

In order to measure the inhibitory activity of the interaction between AMC, gentamicin, and 1,8-cineole, the checkerboard assay by determining the fractional inhibitory concentration (FIC) was used.

[19] reported that the checkerboard assay is the most frequently reported assay method for testing for synergy between antimicrobial substances. The combination of AMC and gentamicin showed no synergistic effect against the three strains tested, whereas amoxicillin/clavulanic acid and gentamicin are used in combination in the case of osteomyelitis caused by Staphylococcus aureus [43, 44].

[45] tested the effect of the combination of amoxicillin and demethyltexasin (DT) on 4 strains of S.

A synergistic effect was obtained against three strains of MRSA, while no interaction was noted for the susceptible strain. Another study reported that the combination of gentamicin and

daptomycin

For gentamicin, its combination with 1,8-cineole induced a total synergistic effect for the MRSA strain with a 4-fold reduction of MIC, while a partial synergy was obtained for the other two strains. Many studies reported that the combination of EOs with antibiotics has a synergistic effect against microorganisms [20, 47–51].

Plant extracts in association with conventional antibiotics also reported a decrease of antibiotic MIC [49, 51]. This synergistic interaction appeared to be due to various mechanisms including sequential inhibition of common biochemical pathways and inhibition of protective enzymes [47]. Furthermore, the association of natural and synthetic drug induced a double attack on different target sites of bacteria which lead to an additive or synergistic effect [47].

The results obtained in the in vitro study encouraged us to perform the in vivo test.

And so, we decided to test the effect of 1,8-cineole associated with AMC, compared with AMC associated with gentamicin and AMC alone, because the 1,8-cineole showed a total synergistic effect against S.

To our knowledge, this is the first time that 1,8-cineole has been used for this purpose. The experimental model MRSA osteomyelitis in rabbits was used by Soranglou et al. [52] to evaluate the efficacy of intramuscular moxifloxacin, as well as by Taghipour et al. [7] in a comparative study of the effect of vancomycin, enrofloxacin, and trimethoprim/sulfamethoxazole. Bacterial inoculation is more often performed directly by intra-articular injection [33, 53].