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Tsehay Kassa - One of the best experts on this subject based on the ideXlab platform.
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cost effectiveness analysis of metronidazole versus metronidazole with Diloxanide Furoate in the treatment of amoebiasis in ethiopia
ClinicoEconomics and Outcomes Research, 2021Co-Authors: Nanati Legese, Temesgen Aferu, Tsehay KassaAbstract:Introduction Amoebiasis is one of the world's most prevalent and fatal infectious diseases. Several surveys revealed that amoebiasis is one of the most widely distributed diseases in Ethiopia. The combination of metronidazole with Diloxanide Furoate represents a new approach for the treatment of the infection. Objective This study aimed to analyze the cost-effectiveness of Diloxanide plus metronidazole compared with metronidazole alone in the treatment of amoebiasis in Ethiopia. Methods An analytical decision model was used to analyze costs and effectiveness from a societal perspective by taking adult amoebic patients as the study population with a time horizon of two months. The potential impacts of uncertainty in single parameters were explored in one-way sensitivity analyses. Results Metronidazole with Diloxanide had a higher cost and effect compared to metronidazole alone with an incremental cost-effectiveness ratio (ICER) of 8 US$ per amoebic case cured. The result was sensitive to the decrease in the effectiveness of metronidazole with Diloxanide. Conclusion This study revealed the addition of Diloxanide to standard treatment to be a more effective and more costly treatment strategy. Therefore, a decision for choosing the medication should be based on the ability of patients to pay for the treatment.
Nanati Legese - One of the best experts on this subject based on the ideXlab platform.
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cost effectiveness analysis of metronidazole versus metronidazole with Diloxanide Furoate in the treatment of amoebiasis in ethiopia
ClinicoEconomics and Outcomes Research, 2021Co-Authors: Nanati Legese, Temesgen Aferu, Tsehay KassaAbstract:Introduction Amoebiasis is one of the world's most prevalent and fatal infectious diseases. Several surveys revealed that amoebiasis is one of the most widely distributed diseases in Ethiopia. The combination of metronidazole with Diloxanide Furoate represents a new approach for the treatment of the infection. Objective This study aimed to analyze the cost-effectiveness of Diloxanide plus metronidazole compared with metronidazole alone in the treatment of amoebiasis in Ethiopia. Methods An analytical decision model was used to analyze costs and effectiveness from a societal perspective by taking adult amoebic patients as the study population with a time horizon of two months. The potential impacts of uncertainty in single parameters were explored in one-way sensitivity analyses. Results Metronidazole with Diloxanide had a higher cost and effect compared to metronidazole alone with an incremental cost-effectiveness ratio (ICER) of 8 US$ per amoebic case cured. The result was sensitive to the decrease in the effectiveness of metronidazole with Diloxanide. Conclusion This study revealed the addition of Diloxanide to standard treatment to be a more effective and more costly treatment strategy. Therefore, a decision for choosing the medication should be based on the ability of patients to pay for the treatment.
Nour E Wagieh - One of the best experts on this subject based on the ideXlab platform.
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simultaneous determination of Diloxanide Furoate and metronidazole in presence of Diloxanide Furoate degradation products
Journal of AOAC International, 2011Co-Authors: Samah S Abbas, Nour E Wagieh, Mohamed Abdelkawy, Maha M AbdelrahmanAbstract:Three methods are presented for the simultaneous determination of Diloxanide Furoate (DLX) and metronidazole (MTR), used for their antiprotozoal and antiamoebic effect, in the presence of DLX alkaline degradates and in pharmaceutical formulations, without previous separation. The first method is chemometric-assisted spectrophotometry, in which principal component regression and partial least squares were applied. These two approaches were successfully applied to quantify each drug in the mixture using the information included in, the absorption spectra in the range of 225-320 nm. The second method is TLC-densitometry, in which the binary mixture and degradates were separated on silica gel plates using a chloroform-acetone-glacial acetic acid (9.5 + 0.5 + 0.07, v/v/v) mobile phase and the bands were scanned at 254 nm. The last method is HPLC, in which DLX, MTR, and degradates were separated using the mobile phase acetonitrile-0.05 M dibasic potassium phosphate (25 + 75, v/v), adjusted to pH 4 with orthophosphoric acid, at a flow rate of 1 mL/min, on a C18 analytical column. Detection was at 254 nm. The proposed methods were successfully applied for the analysis of DLX and MTR in pharmaceutical formulations, and the results were statistically compared with a reported spectrophotometric method.
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stability indicating methods for the determination of Diloxanide Furoate
Journal of Pharmaceutical and Biomedical Analysis, 2002Co-Authors: Nagiba Y Hasan, Mohamed A Elkawy, Badr E Elzeany, Nour E WagiehAbstract:Abstract Five new selective, precise and accurate methods are described for the determination of Diloxanide Furoate (DI) in presence of its degradation products. Method A utilizes the first and second derivative spectrophotometry at 270 and 280 nm, respectively. Method B is a RSD1 spectrophotometric method based on the simultaneous use of the first derivative of ratio spectra and measurement at 270 nm. Method C is a pH-induced difference spectrophotometry using UV measurement at 295 nm. Method D is a densitometric one, after separation on silica gel plate using chloroform: methanol as mobile phase and the spots were scanned at 258 nm. Method E is reversed phase high performance liquid chromatography using methanol: water (80:20% v/v) as mobile phase at a flow rate of 1 ml/min and UV detection at 258 nm. Regression analysis showed good correlation in the concentration ranges 5–30, 5–25, 10–40 μg/ml, 100–500 ng/spot, 2–50 μg/ml with percentage recoveries of 99.92±0.56 and 99.79±0.47, 99.23±0.38, 99.96±0.06, 99.03±0.51, 98.81±0.68 for methods A, B, C, D and E, respectively. These methods are suitable as stability indicating methods for the determination of DI in presence of its degradation products either in bulk powder or in pharmaceutical formulations.
Nada S Abdelwahab - One of the best experts on this subject based on the ideXlab platform.
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Different chromatographic methods for simultaneous determination of Diloxanide Furoate, metronidazole and its toxic impurity
Journal of the Iranian Chemical Society, 2016Co-Authors: Martha M. Morcoss, Nada S Abdelwahab, Nourddin W. Ali, Mohammed T. ElsaadyAbstract:TLC densitometric and RP-HPLC methods are innovative chromatographic methods used for determination of Diloxanide Furoate, metronidazole and its impurity, 4-nitroimidazole. In the developed TLC densitometric method, appropriate separation was achieved using silica gel 60 F_254 TLC plates and ethyl acetate/acetone/hexane/ammonia solution (9.5:0.5:0.3:0.3, by volume), as a developing system and the separated bands were UV-scanned at 276 nm. While the developed RP-HPLC method depended on separation of components on C8 column using deionized water containing 0.05 % TEA: methanol (40:60, v/v) as a mobile phase at constant flow rate of 1 mL/min with UV detection at 276 nm. Variables affecting performance of the developed methods were studied and optimized. Regression analysis showed acceptable correlation coefficients in the selected ranges with excellent percentage recoveries. The methods showed no significant interferences from dosage form excipients, and the validity of the proposed methods was further assessed by applying standard addition technique. In addition, results obtained by applying the proposed methods were statistically compared to those obtained by applying the reported method and no significant difference was found between them. The suggested methods were successfully applied for the determination of the cited drugs in bulk powder, laboratory prepared mixtures and commercial tablets.
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simultaneous determination of some antiprotozoal drugs in their binary and ternary mixtures with mebeverine hydrochloride in different dosage forms
Journal of Liquid Chromatography & Related Technologies, 2012Co-Authors: Eglal A Abdelaleem, Nada S AbdelwahabAbstract:A simple, precise, sensitive, and accurate TLC-Densitometric method has been developed and validated for simultaneous determination of the antiprotozoal drugs, metronidazole benzoate (METB), and Diloxanide Furoate (DF) in dimetrol® and furazole® suspensions. Moreover, the method has been optimized to determine metronidazole (MET), DF, and the antispasmodic drug mebeverine hydrochloride (MEH) in dimetrol® tablets using the same solvent system. Developing system consisting of hexane: acetone: triethyl amine (7: 3: 0.6, by volume) was found to be efficient for good chromatographic separation among the studied drugs using pre-activated silica gel 60 F254 TLC plates. Densitometric quantitation was carried out at 254 nm. The method was successfully applied for determination of MET, DF, MEH, and METB in their bulk powders and in their different dosage forms and the results obtained by applying the proposed TLC-Densitometric method showed no significant difference with those obtained by applying the reported methods.
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Simultaneous determination of some antiprotozoal drugs in different combined dosage forms by mean centering of ratio spectra and multivariate calibration with model updating methods
Chemistry Central Journal, 2012Co-Authors: Eglal A Abdelaleem, Nada S AbdelwahabAbstract:Background Metronidazole (MET) and Diloxanide Furoate (DF), act as antiprotozoal drugs, in their ternary mixtures with Mebeverine HCl (MEH), an effective antispasmodic drug. This work concerns with the development and validation of two simple, specific and cost effective methods mainly for simultaneous determination of the proposed ternary mixture. In addition, the developed multivariate calibration model has been updated to determine Metronidazole benzoate (METB) in its binary mixture with DF in Dimetrol^® suspension. Results Method (I) is the mean centering of ratio spectra spectrophotometric method (MCR) that depends on using the mean centered ratio spectra in two successive steps that eliminates the derivative steps and therefore the signal to noise ratio is enhanced. The developed MCR method has been successfully applied for determination of MET, DF and MEH in different laboratory prepared mixtures and in tablets. Method (II) is the partial least square (PLS) multivariate calibration method that has been optimized for determination of MET, DF and MEH in Dimetrol ^® tablets and by updating the developed model, it has been successfully used for prediction of binary mixtures of DF and Metronidazole Benzoate ester (METB) in Dimetrol ^® suspension with good accuracy and precision without reconstruction of the calibration set. Conclusion The developed methods have been validated; accuracy, precision and specificity were found to be within the acceptable limits. Moreover results obtained by the suggested methods showed no significant difference when compared with those obtained by reported methods. Graphical Abstract
Damien Stark - One of the best experts on this subject based on the ideXlab platform.
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In Vitro Susceptibility Testing of Dientamoeba fragilis
Antimicrobial Agents and Chemotherapy, 2011Co-Authors: N Nagata, Deborah Marriott, Jennifer Harkness, John Ellis, Damien StarkAbstract:ABSTRACT Dientamoeba fragilis is a commonly encountered trichomonad which has been implicated as a cause of gastrointestinal disease in humans. Despite the frequency of reports recording infections with this parasite, little research has been undertaken in terms of antimicrobial susceptibility. The aim of this study was to evaluate the susceptibility of D. fragilis to several commonly used antiparasitic agents: Diloxanide Furoate, furazolidone, iodoquinol, metronidazole, nitazoxanide, ornidazole, paromomycin, secnidazole, ronidazole, tetracycline, and tinidazole. Antibiotic susceptibility testing was performed on four clinical strains of D. fragilis, designated A, E, M, and V, respectively. Molecular testing followed, and all strains were determined to be genotype 1. The activities of antiprotozoal compounds at concentrations ranging from 2 μg/ml to 500 μg/ml were determined via cell counts of D. fragilis trophozoites grown in dixenic culture. Minimum lethal concentrations (MLCs) were as follows: ornidazole, 8 to 16 μg/ml; ronidazole, 8 to 16 μg/ml; tinidazole, 31 μg/ml; metronidazole, 31 μg/ml; secnidazole, 31 to 63 μg/ml; nitazoxanide, 63 μg/ml; tetracycline, 250 μg/ml; furazolidone, 250 to 500 μg/ml; iodoquinol, 500 μg/ml; paromomycin, 500 μg/ml; and Diloxanide Furoate, >500 μg/ml. This is the first study to report the profiles of susceptibility to a wide range of commonly used treatments for clinical isolates of D. fragilis. Our study indicated 5-nitroimidazole derivatives to be the most active compounds in vitro against D. fragilis.