Mesna 1g/10ml solution for injection ampoules

Otitis media (OM) is a frequent disease with incidence rate of 5300 cases per 100,000 people. Recent studies showed that polymicrobial biofilm formation represents a significant pathogenic mechanism in recurrent and chronic forms of OM. Biofilm enables bacteria to resist antibiotics that would typically be recommended in guidelines, contributing to the ineffectiveness of current antimicrobial strategies. Given the challenges of successfully treating bacterial biofilms, there is an growing interest in identifying novel and effective compounds to overcome antibacterial resistance. The objective of this review was to provide an overview of the novel compounds with antibiofilm effects on bacterial biofilm formed by clinical isolates of OM. The systematic review included studies that evaluated antibiofilm effect of novel natural or synthetic compounds on bacterial biofilm formed from clinical isolates obtained from patients with OM. The eligibility criteria were defined using the PICOS system: (P) Population: all human patients with bacterial OM; (I) Intervention: novel natural or synthetic compound with biofilm effect; (C) Control standard therapeutic antimicrobial agents or untreated biofilms, (O) Outcome: antibiofilm effect (biofilm inhibition, biofilm eradication), (S) Study design. The PRISMA protocol for systematic reviews and meta-analysis was followed. From 3564 potentially eligible studies, 1817 duplicates were removed, and 1705 were excluded according to defined exclusion criteria. A total of 41 studies with available full texts were retrieved by two independent authors. Fifteen articles were selected for inclusion in the systematic review which included 125 patients with OM. A total of 17 different novel compounds were examined, including N-acetyl-L-cysteine (NAC), tea tree oil, xylitol, eugenol, Aloe barbadensis, Zingiber officinale, Curcuma longa, Acacia arabica, antisense peptide nucleic acids, probiotics Streptococcus salivarius and Streptococcus oralis, Sodium 2-mercaptoethanesulfonate (MESNA), bioactive glass, green synthesized copper oxide nanoparticles, radish, silver nanoparticles and acetic acid. Staphylococcus aureus was the most commonly studied pathogen, followed by Pseudomonas aeruginosa and Haemophilus influenzae. Biofilm inhibition only by an examined compound was assessed in six studies; biofilm eradication in four studies, and both biofilm inhibition and biofilm eradication were examined in five studies. This systematic review indicates that some compounds like NAC, prebiotics, nanoparticles and MESNA that have significant effects on biofilm are safe and could be researched more extensively for further clinical use. However, a lack of data about reliable and efficient compounds used in therapy of different types of otitis media still remains in the literature.

Abstract licence: CC BY

BackgroundThe use of antioxidants has been shown to mitigate the symptoms of acute pancreatitis (AP) and improve associated biomarkers.ObjectivesIn light of the antioxidant properties of mesna, this pilot study was undertaken to determine whether the addition of mesna to standard treatment for AP offers superior outcomes compared with standard treatment alone.MethodsIn a randomized open-label pilot trial, patients diagnosed with AP were enrolled in the study. Intravenous mesna at a dose of 400 mg/day was administered for 7 days. Clinical indicators, including the Harmless Acute Pancreatitis Score (HAPS), amylase, lipase, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and malondialdehyde (MDA), were measured at baseline and after the 7-day treatment period.ResultsAlthough MDA levels significantly decreased in the group receiving mesna combined with standard therapy compared with the group receiving standard therapy alone after 7 days (P = 0.01), no significant differences were observed between the 2 groups in terms of HAPS, amylase, lipase, CRP, or ESR.ConclusionsThese findings suggest that the addition of mesna at a daily dose of 400 mg did not influence the overall outcome of AP after 7 days. Further large-scale studies with varying doses and durations of mesna administration are recommended.

Abstract licence: CC BY