Erythromycin

Manufactured by HiMedia

Sourced in India, United Kingdom

Erythromycin is a widely used antibiotic medication. It is a macrolide antibiotic that is effective against a variety of bacterial infections.

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Lab products found in correlation

Ciprofloxacin, by HiMedia (30 mentions) Tetracycline, by HiMedia (26 mentions) Ampicillin, by HiMedia (24 mentions) Gentamicin, by HiMedia (23 mentions) Chloramphenicol, by HiMedia (20 mentions) Clindamycin, by HiMedia (20 mentions) Vancomycin, by HiMedia (16 mentions) Streptomycin, by HiMedia (13 mentions) Amikacin, by HiMedia (10 mentions) Cefoxitin, by HiMedia (10 mentions) Cotrimoxazole, by HiMedia (10 mentions) Azithromycin, by HiMedia (9 mentions) Penicillin, by HiMedia (8 mentions) Ceftriaxone, by HiMedia (8 mentions) Levofloxacin, by HiMedia (8 mentions) Gentamycin, by HiMedia (8 mentions) Linezolid, by HiMedia (7 mentions) Penicillin g, by HiMedia (7 mentions) Norfloxacin, by HiMedia (7 mentions) Imipenem, by HiMedia (7 mentions)

48 protocols using erythromycin

Detecting Inducible Clindamycin Resistance

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The test for inducible clindamycin resistance was performed by the D-test [20 (link)]. The isolates showing erythromycin resistance were lawn cultured over the MHA plate (HiMedia Pvt. Ltd., India). erythromycin (15 µg) and clindamycin (2 µg) disks (HiMedia Pvt. Ltd., India) were placed at a 15-mm edge-to-edge distance. After overnight incubation at 37 °C, different phenotypes were interpreted as follows: (Additional file 1: Photograph S1D).

Moderate-sensitive (MS) phenotype: resistant to erythromycin (zone size ≤ 13 mm), but sensitive to clindamycin (zone size ≥ 21 mm) and giving a circular zone of inhibition around clindamycin (D-test negative).

ii.

Constitutive MLS_B (cMLS_B) phenotype: resistant to both erythromycin (zone size ≤ 13 mm) and clindamycin (zone size ≤ 14 mm) with the circular shape of the zone of inhibition around clindamycin.

iii.

Inducible MLS_B (iMLS_B) phenotype: resistant to erythromycin (zone size ≤ 13 mm), but sensitive to clindamycin (zone size ≥ 21 mm) and giving a D-shaped zone of inhibition around clindamycin with flattening toward erythromycin (D-test positive).

Maharjan S., Ansari M., Maharjan P., Rai K.R., Sabina K.C., Kattel H.P., Rai G, & Rai S.K. (2022). Phenotypic detection of methicillin resistance, biofilm production, and inducible clindamycin resistance in Staphylococcus aureus clinical isolates in Kathmandu, Nepal. Tropical Medicine and Health, 50, 71.

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Enterococcus Antibiotic Susceptibility Patterns

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The present study was conducted at Vinayaka Mission's Medical College and Hospitals, Salem Institutional Ethical Committee (IEC) Clearance (MICROBIOLOGY/Ph.D/01/2015) was obtained prior to this study A total of 1200 clinical samples received at the Department of Microbiology for routine culture and sensitivity were included. A total of 774 isolates of Enterococci obtained from 1200 clinical samples were processed for species identification and antimicrobial sensitivity testing. Identification of isolates to the species level was performed by the sugar utilization test using brain heart infusion broth incorporated with 1% sugar and bromothymol blue indicator.[9 (link)] Isolates of Enterococci were subjected to antimicrobial susceptibility testing by the Kirby–Bauer disc diffusion method as per Clinical and Laboratory Standards Institute guidelines[10 ] using the following drugs: penicillin (10 U), erythromycin (15 μg), high-level gentamicin (120 μg), linezolid (30 μg), teicoplanin (30 μg), ciprofloxacin (5 μg), and nitrofurantoin (300 μg).(Himedia Laboratories Ltd.) The minimum inhibitory concentrations (MICs) for these antibiotics were also determined bythe Vitek automated system.

, & Rajan R. (2023). A Study on Glycopeptide-Resistant Genotypes among Clinical Isolates of Enterococcus with Van B Phenotype. Advanced Biomedical Research, 12, 196.

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Antibiotic Sensitivity Patterns of Isolates

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In vitro antibiotic sensitivity patterns of the isolates were conducted as per the method of Bauer et al., (1966) . Antibiotics disc (Hi Media Ltd., Mumbai, India) used in the present study were Amikacin (30 mcg), Amoxyclav (30 mcg), Ampicillin (10 mcg), Ciprofloxacin (5 mcg), Colistin (10 mcg), Ceftriaxone (30 mcg), Erythromycin (15 mcg), Enrofloxacin (10 mcg), Gentamicin (10mcg), Neomycin (30 mcg), Penicillin-G (10IU), Streptomycin (10 mcg), Sulphadiazine (300 mcg) and Tetracycline (30 mcg). Diameters of the clear zone of inhibition were measured and the interpretation of the results was made in accordance with the instructions supplied by the manufacturer (Hi Media Ltd., Mumbai, India). Multiple Antibiotic resistance index (MARI) were also determined for each isolates by dividing the number of antibiotics to which the isolate is resistant to by the total numbers of antibiotics tested (Adenaike, 2016) .

Vatalia D., Bhanderi B.B., Nimavat V., & Jhala M.K. (2020). Isolation, Molecular Identification and Multidrug Resistance Profiling of Bacteria Causing Clinical Mastitis in Cows. Agricultural Science Digest - A Research Journal.

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Antibiotic Susceptibility Screening of Isolates

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Antibiotic drug susceptibility was determined by spreading overnight grown culture of the isolates on MRS agar plates as a lawn. Standard antibiotic discs (tetracycline, erythromycin, ampicillin, gentamycin, penicillin, chloramphenicol, cefuroxime, cefoperazone, levofloxacin, norfloxacin, Hi-Media, Mumbai) were placed on the surface of the MRS agar medium aseptically. Plates were incubated for 24 h at 37 °C and observed for zones of inhibition.

Panda S.H., Goli J.K., Das S, & Mohanty N. (2017). Production, optimization and probiotic characterization of potential lactic acid bacteria producing siderophores. AIMS Microbiology, 3(1), 88-107.

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Antimicrobial Susceptibility Testing Protocol

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The antimicrobial agents tested included penicillin (P) (10 units), gentamicin (GEN) (10 µg), tetracycline (TE) (30 µg), levofloxacin (LE) (5 µg), cotrimoxazole (COT) (25 µg), erythromycin (E) (15 µg), clindamycin (CD) (2 µg) and linezolid (LZ) (30 µg) (Himedia, India). A D test was used to detect inducible clindamycin resistance. The sensitivities were analyzed based on CLSI breakpoints [11 ].

Abd El rahman A., El kholy Y, & Shash R.Y. (2021). Correlation between mazEF Toxin-Antitoxin System Expression and Methicillin Susceptibility in Staphylococcus aureus and Its Relation to Biofilm-Formation. Microorganisms, 9(11), 2274.

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Antibiotic Source Verification for Bacterial Testing

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The antibiotics for preparation of test plates were procured from the suppliers shown in parentheses: Amikacin, Ampicillin, Cefotaxime, Ceftriaxone, Cipr Ofloxacin, Gentamicin, Nitrofurantoin, Norfloxacin, Piperacillin/Tazobactam, Ofloxacin, (Sigma-Aldrich, USA), Amoxycillin/clavulanate (GlaxoSmithKline; Thane, India), Ceftazidime (VHB; Mumbai, India), Cefepime (Biocon; Bengaluru, India), Cefixime (GlaxoSmithKline; Thane, India), Colistin (Cipla; Pune, India), Erythromycin (Himedia; Mumbai, India), Imipenem (MSD; Mumbai, India), LevOfloxacin (Alkem; Chennai, India), Meropenem (Cipla; Pune, India), Tetracycline (GlaxoSmithKline; Thane, India), Tigecycline (Natco; Chennai, India), Vancomycin (Himedia; Mumbai, India).

Radhakrishnan R., J. R., N. S. D., C. P. T, & K. S. (2020). High-throughput method for Antibiotic Susceptibility Testing based on Fluorescein Quenching by Bacteria: Application to Urinary Tract Infection. Scientific Reports, 10, 4058.

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Antibiotic Susceptibility of E. coli and Salmonella

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Antibiotic sensitivity testing of isolated E. coli and Salmonella spp. was carried out using the disk diffusion assay as previously described [63 (link)]. Antibiotic classes included fluoroquinolones (levofloxacin, LEV—5 μg; ciprofloxacin, CIP—5 μg), aminoglycosides (gentamicin, GEN—10 μg; streptomycin, S—10 μg), carbapenems (Meropenem, MEM—10 μg; imipenem, IMP—10 μg), amphenicols (chloramphenicol, C—10 μg), macrolides (erythromycin, E—15 μg), and tetracyclines (tetracycline, TE—30 μg) purchased from Hi Media (India). Sensitivity tests were performed on freshly grown isolates having a concentration equivalent to 0.5 McFarland standard using Mueller-Hinton agar media (Hi Media, India). All results were interpreted according to the guidelines provided by Clinical and Laboratory Standards Institute [64 ]. Furthermore, isolates showing resistance against three or more different classes of antibiotics were defined as MDR [65 (link)].

Tawyabur M., Islam M.S., Sobur M.A., Hossain M.J., Mahmud M.M., Paul S., Hossain M.T., Ashour H.M, & Rahman M.T. (2020). Isolation and Characterization of Multidrug-Resistant Escherichia coli and Salmonella spp. from Healthy and Diseased Turkeys. Antibiotics, 9(11), 770.

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Antibiotic Susceptibility Testing Protocol

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The antibiotics selected in this study were as follows: penicillin-G 10 units/disc, ampicillin 10 μg/disc, cefotaxime 30 μg/disc, cephalothin 30 μg/disc, erythromycin 15 μg/disc, cefazolin 30 μg/disc, chloramphenicol 30 μg/disc, and methicillin 5 μg/disc (HiMedia). A single colony was picked from 24-h culture BHI agar plate and inoculated into BHI broth. [ 17 ] The test tubes were incubated at 37°C for 24 h. The inoculum was then adjusted to match the turbidity of 0.5 McFarland standards (HiMedia). The test organism was aseptically swabbed on BHI agar using a sterile cotton swab. [ 18 ] The plates were kept for 10 min to dry, and then antibiotic discs were aseptically placed on the inoculated BHI agar. The plates were anaerobically incubated at 37°C for 24 h. The inhibition zones were measured in millimeter (mm). The experiment was performed in triplicate and repeated to confirm the reliability and reproducibility.

Salman H.A., Senthilkumar R., Mahmood B.S, & Imran K. (2019). Detection and characterization of Streptococcus downei, a rare bacterial species of mutans streptococci from caries-active patients. Indian journal of dental research : official publication of Indian Society for Dental Research, 30(4).

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Bacteriological Analysis and Antibiotic Susceptibility

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The swabs collected were directly inoculated in duplicate on blood agar, (Oxoid) Mac Conkey agar and Muller Hinton agar (Oxoid). The pairs of inoculated media were incubated aerobically at 37 °C for 24 h and then examined for bacteria growth according to standard protocol [14 ]. The positive culture growths were examined for colony characteristics, Gram-reaction and biochemical characteristics as described by Cheesbrough (2000) [14 ]. The biochemical characteristics tested were: (i) catalase, (ii) coagulase, (iii) oxidase, (iv) hemolysis, (v) sugar fermentation, (vi) indole production, (vii) citrate utilization, (viii) urease activity, (ix) triple sugar iron and (x) hydrogen sulphide production.
Purified bacterial isolates were subjected to drug susceptibility tests using the Kirby Bauer disc diffusion method [14 ]. Commercially available antibiotic discs that were used include: ciprofloxacin, norfloxacin, gentamycin, erythromycin, clindamycin, cephalexin, co-trimoxazole, tetracycline, cefoxitin, ampicillin, vancomycin and chloramphenicol (Hi Media Laboratories Pvt. Ltd, India). These antibiotics were chosen based on the type of microorganisms frequently isolated and their availability at University Teaching Hospital.

Mwamungule S., Chimana H.M., Malama S., Mainda G., Kwenda G, & Muma J.B. (2015). Contamination of health care workers’ coats at the University Teaching Hospital in Lusaka, Zambia: the nosocomial risk. Journal of Occupational Medicine and Toxicology (London, England), 10, 34.

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Antimicrobial Susceptibility of S. aureus

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All the identified S. aureus isolates were subjected to an in vitro antimicrobial susceptibility test by employing the modified Kirby–Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute (CLSI) guidelines [19 ]. The antimicrobial disks used were ampicillin (30 μg), cefoxitin (30 μg), chloramphenicol (30 μg), ciprofloxacin (25 μg), clindamycin (31 μg), cotrimoxazole (25 μg), erythromycin (26 μg), gentamycin (28 μg), linezolid (30 μg), oxacillin (10 μg), tetracycline (20 μg), and penicillin (10 μg) from HiMedia, India.

Maharjan M., Sah A.K., Pyakurel S., Thapa S., Maharjan S., Adhikari N., Rijal K.R., Ghimire P, & Thapa Shrestha U. (2021). Molecular Confirmation of Vancomycin-Resistant Staphylococcus aureus with vanA Gene from a Hospital in Kathmandu. International Journal of Microbiology, 2021, 3847347.

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