Investigating antimicrobial features and drug interactions of sedoanalgesics in intensive care unit: an experimental study

Abstract

Study Objective: Aim of this study was to evaluate antimicrobial effects and interaction between analgesic combinations of fentanyl citrate, dexmedetomidine hydrochloride and tramadol hydrochloride on Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Candida albicans which are some of the most common nosocomial infection related microorganisms. Design: In vitro prospective study. Setting: University Clinical Microbiology Laboratory. Measurements: In order to evaluate in vitro antimicrobial effects and interaction between analgesic combinations, tramadol hydrochloride, fentanyl citrate and dexmedetomidin were used against S. aureus ATCC 29213, K. pneumoniae, E. coli ATCC 25922, P. aeruginosa ATCC 27853 and C. albicans ATCC 10231 standard strains by microdilution method. Main Results: According to microdilution assays tramadol has shown the most efficient antimicrobial activity also it has been observed that 10 mg/ml concentrated dexmedetomidine has antimicrobial effects on S. aureus, K. pneumoniae and P. aeruginosa. Fentanyl has displayed evident inhibitory potency on the pathogens except for Klebsiella pneumoniae, nevertheless our predefined minimum concentration inhibited growth by 9.5 %. Fentanyl and dexmedetomidine together exhibited more antimicrobial effect on P. aeruginosa and E. coli growth. Additionally, when the three drugs examined together, microbial inhibition occurred more than expected on E. coli again and also on C. albicans growth. Conclusions: Our results revealed the antimicrobial properties and synergy with the different combinations of fentanyl, dexmedetomidine and tramadol against the most common nosocomial infection agents in the ICU. This is the first study in the literature looking into the microbial “interactions” of opioids and sedative drugs but more research is needed in order to define clinico-laboratory correlation.
 ©2021 by the authors. This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).

Evaluation of Antimicrobial Activities against Various E. coli Strains of a Novel Hybrid Peptide—LENART01

“…In fact, Rosenberg and Renkonen showed that morphine does not affect microbial growth when administered in the concentration range of 0.2 to 2 mg/mL [ 27 ]; however, some work contradicts this. This includes the work of Unlu et al [ 28 ], in which tramadol and fentanyl showed dose-dependent inhibitory effects on various bacteria, including E. coli . Others compared bupivacaine and pethidine, demonstrating their antimicrobial activity [ 29 ].…”

Influence of tramadol on bacterial burden in the standard neutropenic thigh infection model

“…By contrast, in the neutropenic thigh infection model, tramadol is injected at a different site and not injected together with the bacteria intramuscularly. A recent in vitro study also investigated the antibacterial properties of tramadol against the same strains of E. coli , S. aureus and P. aeruginosa used in this study and against a K. pneumoniae strain 22 . Only at concentrations of 500 µg/ml 100% killing of K. pneumoniae was achieved, whereas that concentration did not result in complete killing of E. coli , S. aureus , and P. aeruginosa 22 suggesting that concentrations in the range of more than 500 µg/ml might be necessary to see complete eradication.…”

“…A recent in vitro study also investigated the antibacterial properties of tramadol against the same strains of E. coli , S. aureus and P. aeruginosa used in this study and against a K. pneumoniae strain 22 . Only at concentrations of 500 µg/ml 100% killing of K. pneumoniae was achieved, whereas that concentration did not result in complete killing of E. coli , S. aureus , and P. aeruginosa 22 suggesting that concentrations in the range of more than 500 µg/ml might be necessary to see complete eradication. Based on pharmacokinetic information about tramadol after subcutaneous administration 31 , these concentrations were not reached in this study.…”

“…This assessment is important as it would enable to use tramadol in the vehicle or untreated group only, supposing that groups treated with antibiotic will not experience discomfort due to the active substance reducing bacterial burden. There are three reports about a potential antibacterial activity of tramadol against different ESKAPE pathogens without elucidating what the mechanism of action is [20][21][22] . Consequently, it is necessary to assess if tramadol exerts an effect at the dose and under the specific infection conditions in this study.…”

Multi drug resistance of bacterial isolated in patient with vaginosis

“…Tracking and treating these infections is essential. a necessity for ensuring responsible use of antimicrobials (Unlu et al, 2021). Anti-infective measures are employed.…”