This article needs more reliable medical references for verification or relies too heavily on primary sources .(August 2024) |
Combination of | |
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Thiamphenicol glycinate | Antibiotic |
Acetylcysteine | Mucoactive agent |
Identifiers | |
CAS Number | |
PubChem CID | |
UNII | |
CompTox Dashboard (EPA) | |
ECHA InfoCard | 100.039.597 |
Chemical and physical data | |
Formula | C19H27Cl2N3O9S2 |
Molar mass | 576.46 g·mol−1 |
3D model (JSmol) | |
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Thiamphenicol glycinate acetylcysteine (TGA) is a pharmaceutical drug that is a combination of thiamphenicol glycinate ester (TAFGE), which is a derivative of the antibiotic thiamphenicol, and N-acetylcysteine (NAC), which is a mucus-thinning drug. Upon contact with tissue esterases, TGA releases both TAFGE and NAC. As a standalone medication, NAC is widely used in respiratory tract infections for its mucolytic activity. [1]
Thiamphenicol glycinate acetylcysteine (TGA) effectively treats upper respiratory tract infections, including otitis media, pharyngotonsillitis, and rhinosinusitis. It is also used to treat exacerbations of chronic obstructive pulmonary disease (COPD) and chronic bronchitis with bronchiectasis. [1] [2]
TGA is effective in eradicating biofilms in otolaryngologic infections, [2] as biofilms are often resistant to treatment with antibiotics. [3] Biofilms are complex communities of bacteria that can adhere to surfaces and are known to be highly resistant to antibiotic treatment and immune responses, [4] [5] so the ability of TGA to effectively eradicate biofilms represents an advantage over traditional antibiotics. [2]
TGA works by releasing thiamphenicol glycinate ester (TAFGE) and N-acetylcysteine (NAC) upon contact with tissue esterases. [1] Esterases are enzymes that break down esters into an acid and an alcohol in a chemical reaction with water called hydrolysis. [6] Such reaction is needed to split TGA into its active components. TAFGE is an antibiotic, while NAC has mucolytic properties. [1]
Thiamphenicol and TAFGE are related compounds, but they have different forms and uses: thiamphenicol is an antibiotic that is the methyl-and-sulfonyl analogue of chloramphenicol; it has a similar spectrum of activity to chloramphenicol but is 2.5 to 5 times as potent; [7] it is used in many countries as a veterinary antibiotic, but is also used in some countries such as Brazil, China, Italy, Moldova and Morocco for use in humans. On the other hand, TAFGE is a form of thiamphenicol that is used in parenteral [8] and aerosol dosage forms. After administration, TAFGE is rapidly hydrolysed by tissue esterases, releasing thiamphenicol. Its antibacterial activity is due to thiamphenicol. [9]
TGA can be administered intramuscularly or by aerosol. [1] It can be used by a sprayer or via a nebulizer. [10] [1]
TGA is sold under various brand names, including "Fluimucil Antibiotic IT".
Sinusitis, also known as rhinosinusitis, is an inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include thick nasal mucus, a plugged nose, and facial pain.
A biofilm is a syntrophic community of microorganisms in which cells stick to each other and often also to a surface. These adherent cells become embedded within a slimy extracellular matrix that is composed of extracellular polymeric substances (EPSs). The cells within the biofilm produce the EPS components, which are typically a polymeric combination of extracellular polysaccharides, proteins, lipids and DNA. Because they have a three-dimensional structure and represent a community lifestyle for microorganisms, they have been metaphorically described as "cities for microbes".
N-acetylcysteine, also known as Acetylcysteine and NAC, is a medication that is used to treat paracetamol (acetaminophen) overdose and to loosen thick mucus in individuals with chronic bronchopulmonary disorders such as pneumonia and bronchitis. It has been used to treat lactobezoar in infants. It can be taken intravenously, orally, or inhaled as a mist. It is also sometimes used as a dietary supplement.
Laryngitis is inflammation of the larynx. Symptoms often include a hoarse voice and may include fever, cough, pain in the front of the neck, and trouble swallowing. Typically, these last under two weeks.
Serratia marcescens is a species of rod-shaped, Gram-negative bacteria in the family Yersiniaceae. It is a facultative anaerobe and an opportunistic pathogen in humans. It was discovered in 1819 by Bartolomeo Bizio in Padua, Italy. S. marcescens is commonly involved in hospital-acquired infections (HAIs), also called nosocomial infections, particularly catheter-associated bacteremia, urinary tract infections, and wound infections, and is responsible for 1.4% of HAI cases in the United States. It is commonly found in the respiratory and urinary tracts of hospitalized adults and in the gastrointestinal systems of children.
An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, larynx or trachea. This commonly includes nasal obstruction, sore throat, tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold. Most infections are viral in nature, and in other instances, the cause is bacterial. URTIs can also be fungal or helminthic in origin, but these are less common.
Cefuroxime axetil, sold under the brand name Ceftin among others, is a second generation oral cephalosporin antibiotic.
Carrion's disease is an infectious disease produced by Bartonella bacilliformis infection.
Mastoiditis is the result of an infection that extends to the air cells of the skull behind the ear. Specifically, it is an inflammation of the mucosal lining of the mastoid antrum and mastoid air cell system inside the mastoid process. The mastoid process is the portion of the temporal bone of the skull that is behind the ear. The mastoid process contains open, air-containing spaces. Mastoiditis is usually caused by untreated acute otitis media and used to be a leading cause of child mortality. With the development of antibiotics, however, mastoiditis has become quite rare in developed countries where surgical treatment is now much less frequent and more conservative, unlike former times.
Moraxella catarrhalis is a fastidious, nonmotile, Gram-negative, aerobic, oxidase-positive diplococcus that can cause infections of the respiratory system, middle ear, eye, central nervous system, and joints of humans. It causes the infection of the host cell by sticking to the host cell using trimeric autotransporter adhesins.
Sultamicillin, sold under the brand name Unasyn among others, is an oral form of the penicillin antibiotic combination ampicillin/sulbactam. It is used for the treatment of bacterial infections of the upper and lower respiratory tract, the kidneys and urinary tract, skin and soft tissues, among other organs. It contains esterified ampicillin and sulbactam.
Respiratory tract infections (RTIs) are infectious diseases involving the lower or upper respiratory tract. An infection of this type usually is further classified as an upper respiratory tract infection or a lower respiratory tract infection. Lower respiratory infections, such as pneumonia, tend to be far more severe than upper respiratory infections, such as the common cold.
Feline viral rhinotracheitis (FVR) is an upper respiratory or pulmonary infection of cats caused by Felid alphaherpesvirus 1 (FeHV-1), of the family Herpesviridae. It is also commonly referred to as feline influenza, feline coryza, and feline pneumonia but, as these terms describe other very distinct collections of respiratory symptoms, they are misnomers for the condition. Viral respiratory diseases in cats can be serious, especially in catteries and kennels. Causing one-half of the respiratory diseases in cats, FVR is the most important of these diseases and is found worldwide. The other important cause of feline respiratory disease is feline calicivirus.
Thiamphenicol is an antibiotic. It is the methyl-sulfonyl analogue of chloramphenicol and has a similar spectrum of activity, but is 2.5 to 5 times as potent. Like chloramphenicol, it is insoluble in water, but highly soluble in lipids. It is used in many countries as a veterinary antibiotic, but is available in China, Morocco and Italy for use in humans. Its main advantage over chloramphenicol is that it has never been associated with aplastic anaemia.
Erdosteine is a molecule with mucolytic activity. Structurally it is a thiol derivative characterized by the presence of two thiol groups. These two functional sulfhydryl groups contained in the molecule are released following first-pass metabolism with the conversion of erdosteine into its pharmacologically active metabolite Met-I.
Chronic bacterial prostatitis is a bacterial infection of the prostate gland. It should be distinguished from other forms of prostatitis such as acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS).
ELOM-080 is the active ingredient of the herbal medicine named GeloMyrtol forte. The acronym ELOM stands for the oils from Eucalyptus, Lemon, (Sweet) Orange and Myrtle that it contains.
Enzybiotics are an experimental antibacterial therapy. The term is derived from a combination of the words “enzyme” and “antibiotics.” Enzymes have been extensively utilized for their antibacterial and antimicrobial properties. Proteolytic enzymes called endolysins have demonstrated particular effectiveness in combating a range of bacteria and are the basis for enzybiotic research. Endolysins are derived from bacteriophages and are highly efficient at lysing bacterial cells. Enzybiotics are being researched largely to address the issue of antibiotic resistance, which has allowed for the proliferation of drug-resistant pathogens posing great risk to animal and human health across the globe.
Histophilus somni is a non-motile, gram-negative, rod or coccobacillus shaped, facultative anaerobe bacterial species belonging to the family Pasteurellaceae. Prior to 2003, it was thought Haemophilus somnus, Histophilus ovis, and Histophilus agni were three different species, but now are all classified as Histophilus somni. Histophilus somni is a commensal bacteria of mucous membranes of the upper respiratory tract and reproductive tract with a global prevalence and is found in cattle and other small ruminants. Histophilus somni is also a known causative agent that is a part of the Bovine Respiratory Disease (BRD) complex, which typically involves multiple pathogens residing together in biofilm environments. Histophilus somni may also cause Histophilosus symptoms and clinical presentation will depend on the tissue affected. When disease does occur, it can be difficult to catch in time and is often diagnosed post mortem. This means that treatment often involves metaphylactic mass treatment or no treatment at all. This organism is more fastidious than others and requires knowledge for sample collection, storage and culture. Genomic studies related to this bacteria have enabled scientists to pinpoint antibiotic resistance genes.
Prosthetic joint infection (PJI), also known as peri-prosthetic joint infection (PJI), is an acute, sub-acute or chronic infection of a prosthetic joint. It may occur in the period after the joint replacement or many years later. It usually presents as joint pain, erythema, joint swelling and sometimes formation of a sinus tract. PJI is estimated to occur in approximately 2% of hip and knee replacements, and up to 4% of revision hip or knee replacements. Other estimates indicate that 1.4-2.5% of all joint replacements worldwide are complicated by PJIs. The incidence is expected to rise significantly in the future as hip replacements and knee replacements become more common. It is usually caused by aerobic gram positive bacteria, such as Staph epidermidis or Staphylococcus aureus but enterococcus species, gram negative organisms and Cutibacterium are also known causes with fungal infections being a rare culprit. The definitive diagnosis is isolation of the causative organism from the synovial fluid, but signs of inflammation in the joint fluid and imaging may also aid in the diagnosis. The treatment is a combination of systemic antibiotics, debridement of infectious and necrotic tissue and local antibiotics applied to the joint space. The bacteria that usually cause prosthetic joint infections commonly form a biofilm, or a thick slime that is adherent to the artificial joint surface, thus making treatment challenging.