An evaluation of safety and efficacy of nadifloxacin 1% ointment versus mupirocin 1% ointment in Indian children with skin and soft tissue infection
DOI:
https://doi.org/10.18203/2349-3291.ijcp20200097Keywords:
Background, Although nadifloxacin has been shown to be effective in the treatment of skin & soft tissue infections (SSTI), there is a paucity of data comparing its efficacy and safety with other antibacterials, especially in Indian paediatric population.Abstract
Background: Although nadifloxacin has been shown to be effective in the treatment of skin & soft tissue infections (SSTI), there is a paucity of data comparing its efficacy and safety with other antibacterials, especially in Indian paediatric population. Therefore, objective of this study was to compare the safety and efficacy of nadifloxacin with mupirocin in children with SSTI.
Methods: This was a single-centre, open label, randomized, parallel group, comparative study in 60 children of <12 years of age with SSTI. Test group (n=30) received nadifloxacin 1% ointment and reference group (n=30) received mupirocin 1% ointment, to be applied twice daily. Patients were followed up at day 4, 8 and 15. Efficacy of the study drugs was evaluated by clinical and bacteriological cure rate. Safety was assessed by reporting of adverse events.
Results: Baseline characteristics of enrolled patients were comparable between treatment groups and all 60 patients completed the study. At Day 15, 100.0% cases among nadifloxacin group and 96.7% cases among mupirocin group achieved clinical cure (p=0.313). The most common bacteria found in culture were Gram positive cocci in both the groups (86.7% in nadifloxacin and 58.8% in mupirocin group). None of the cases in any of the groups showed bacteriological presence at day 15. No adverse event was reported in any of the treatment groups during the study duration.
Conclusions: Nadifloxacin was found to be equally efficacious and safe to mupirocin in the treatment of SSTI in Indian pediatric population.
References
Ki V, Rotstein C. Bacterial skin and soft tissue infections in adults: a review of their epidemiology, pathogenesis, diagnosis, treatment and site of care. Canad J Infect Dis Med Microbiol. 2008;19(2):173-84.
Indian Network for Surveillance of Antimicrobial Resistance (INSAR) group Methicillin resistant Staphylococcus aureus (MRSA) in India: prevalence & susceptibility pattern. Ind J Med Res. 2013;137(2):363-9.
Vasani RJ, Medhekar SV. Topical 2% mupirocin versus 2% fusidic acid versus 1% nadifloxacin cream in the treatment of superficial bacterial infections of the skin. Ind J Drugs Dermatol. 2015;1(1):16.
Doudoulakakis A, Spiliopoulou I, Spyridis N, Giormezis N, Kopsidas J, Militsopoulou M, et al. Emergence of a Staphylococcus aureus clone resistant to mupirocin and fusidic acid carrying exotoxin genes and causing mainly skin infections. J Clini Microbiol. 2017;55(8):2529-37.
Rudresh MS, Ravi GS, Motagi A, Alex AM, Sandhya P, Navaneeth BV. Prevalence of mupirocin resistance among staphylococci, its clinical significance and relationship to clinical use. J laboratory Physic. 2015;7(2):103.
CDSCO drug approval (2002). Available at: http://www.cdsco.nic.in/writereaddata/list_of_drugs_approved_during_2002.htm. Accessed 30 September 2019.
Jacobs MR, Appelbaum PC. Nadifloxacin: a quinolone for topical treatment of skin infections and potential for systemic use of its active isomer, WCK 771. Expert opinion on pharmacotherapy. 2006;7(14):1957-66.
Narayanan V, Motlekar S, Kadhe G, Bhagat S. Efficacy and safety of nadifloxacin for bacterial skin infections: results from clinical and post-marketing studies. Dermatol therapy. 2014;4(2):233-48.
Alba V, Urban E, Dominguez MA, Nagy E, Nord CE, Palacín C, et al. In vitro activity of nadifloxacin against several Gram-positive bacteria and analysis of the possible evolution of resistance after 2 years of use in Germany. Intern J antimicrobial agents. 2009;33(3):272-5.
Blondeau JM. The role of fluoroquinolones in skin and skin structure infections. Am J Clin Dermatol. 2002;3(1):37-46.
Gisby J, Bryant J. Efficacy of a new cream formulation of mupirocin: comparison with oral and topical agents in experimental skin infections. Antimicrobial agents and chemotherapy. 2000;44(2):255-60.
Gollnick HP. Topical quinolone OPC-7251: a clinical and microbiological study in acne. Eur J Dermatol. 1994;4:210-5.
Haustein UF, Nenoff P, Hittel N. Topical quinolone nadifloxacin (OPC-7251) in bacterial skin disease: clinical evaluation in a multicenter open trial and in vitro antimicrobiological susceptibility testing. J dermatol treatment. 1997;8(2):87-92.
Choudhury S, Chatterjee S, Sarkar DK, Dutta RN. Efficacy and safety of topical nadifloxacin and benzoyl peroxide versus clindamycin and benzoyl peroxide in acne vulgaris: A randomized controlled trial. Ind J pharmacol. 2011;43(6):628.
Kimata H. Effect of nadifloxacin on atopic dermatitis with methicillinresistant Staphylococcus aureus in young children. Eur J Pediatr. 1999;158(11):949.
Nenoff P, Haustein UF, Hittel N. Activity of nadifloxacin (OPC-7251) and seven other antimicrobial agents against aerobic and anaerobic Gram-positive bacteria isolated from bacterial skin infections. Chemotherapy. 2004;50(4):196-201.
Patel K, Goldman JL. Safety concerns surrounding quinolone use in children. The J Clini Pharmacol. 2016;56(9):1060-75.