Efficacy of Commercially Used Antibacterial Agents against Oral Bacteria Associated with HIV/AIDS Patients in South Western Uganda
Joseph Obiezu Chukwujekwu Ezeonwumelu *
Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology, Uganda, P.O.Box 1410, Mbarara Uganda and Department of Clinical and Biopharmacy, School of Pharmacy, Kampala International University Western Campus, Ishaka, P.O.Box 71, Bushenyi, Uganda and Kampala International University Complementary and Alternative Medicine Research (KIUCAMRES) Group, Ishaka, P.O.Box 71, Bushenyi, Uganda.
Muhammad Ntale
Department of Chemistry, Makerere University, Kampala, Uganda.
Steve Okwudili Ogbonnia
Department of Pharmacognosy, Faculty of Pharmacy, University of Lagos, Nigeria.
Ezera Agwu
Department of Microbiology, Faculty of Biomedical Sciences, Kampala International University Western Campus, Box 71, Ishaka, Bushenyi, Uganda and Department of Medical Microbiology and Immunology, Kabale University in Kabale, Uganda[U1] .
Julius Kihdze Tanayen
Kampala International University Complementary and Alternative Medicine Research (KIUCAMRES) Group, Ishaka, P.O.Box 71, Bushenyi, Uganda and Department of Pharmacology and Therapeutics, Faculty of Medicine, Mbarara University of Science and Technology, Uganda, P.O.Box 1410, Mbarara Uganda.
Keneth Iceland Kasozi
Department of Physiology, Faculty of Biomedical Sciences, Kampala International University Western Campus, Box 71, Ishaka, Uganda.
Ambrose Amamchukwu Akunne
Department of Clinical and Biopharmacy, School of Pharmacy, Kampala International University Western Campus, Ishaka, P.O.Box 71, Bushenyi, Uganda.
Chukwudi Onyeka Okonkwo
Department of Human Physiology, Faculty of Basic Medical Sciences, College of Medicine, Nnewi Campus, Nnamdi Azikiwe University, Nnewi, Anambra State, Nigeria.
Frederick Byarugaba
Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, P.O.Box 1410, Mbarara, Uganda.
*Author to whom correspondence should be addressed.
Abstract
Aims: This was to determine efficacy and resistance profiles against commonly used commercial antibacterial agents in Uganda in the management of oral pathogens in HIV/AIDS patients.
Study Design: This was an experimental study.
Place and Duration of Study: Microbiology Laboratory, Mbarara University of Science and Technology, Mbarara, Uganda between September 2015 and February 2016.
Methodology: Bacterial isolates were tested against commercial antibacterial agents in Uganda. Drug shops, pharmacies and hospitals were purposively and conveniently sampled. Drugs commonly used for the management of opportunistic infections amongst HIV/AIDS patients were purchased and used in the laboratory for susceptibility, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) using standard protocols.
Results: All the bacterial isolates showed mean total resistance above 60%[C1] against erythromycin [85 isolates (69.7%)] and cotrimoxazole [79 isolates, (64.8%)]; with injectable gentamicin [97 isolates (79.5%)] and ceftriaxone [105 isolates (86.0%)] displaying high susceptibility; and ciprofloxacin [65 isolates (53.3%)] showing moderate susceptibility. This shows that national policy on effective regulation of these antibacterial agents needs to be revised to ensure that the situation is reversed. Gentamicin showed increased significant mean activity (P***< .005, ANOVA, multiple comparisons) in MIC and MBC when compared with the other antimicrobial agents.
Conclusion: Gentamicin was highly efficacious in this study and resistance of these oral bacteria to common commercial antibacterial agents is a major public health burden especially among Uganda HIV/AIDS patients. Improving drug regulation activities will reduce antibacterial resistance and treatment failures. We recommend a survey on the reasons for efficacy of gentamicin against all the commercially available antimicrobials used in this study.
Keywords: Antibacterial resistance, drug efficacy, oral bacteria, HIV and AIDS, drug policy, Uganda