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102 protocols using clindamycin

1

Amoxicillin and Clindamycin Quantification

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Amoxicillin (Amoxicillin trihydrate; CAS number 61336-70-7; MW 419.45) and clindamycin (clindamycin hydrochloride, CAS number 58207-19-5; MW 479.46) were purchased from Merck (Soeborg, Denmark).
Stock solutions of Amoxicillin and clindamycin were prepared by dissolving 25 mg in 25 mL of 0.9% NaCl. Standards were prepared for Amoxicillin (blank, 1, 5, 12.5, 25, 50 and 100 mg/L) and clindamycin (blank, 1, 5, 10 and 15 mg/L) by adding stock solutions to EDTA plasma. The QCs were prepared in plasma at concentrations levels of 2.5 and 50 mg/L for Amoxicillin and 5 and 12 mg/L for clindamycin. The standard and QC samples were stored at −80°C until use.
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2

Antimicrobial Susceptibility of Group B Streptococcus

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The GBS isolates were tested for antimicrobial susceptibility to ampicillin, penicillin, cefotaxime, ceftriaxone, cefepime, meropenem, levofloxacin, clindamycin, erythromycin, tetracycline, chloramphenicol, and vancomycin using the MICroSTREP plus antimicrobial panel (Beckman Coulter, Brea, CA, USA). For 23 clindamycin non-susceptible or erythromycin non-susceptible GBS isolates, the minimum inhibitory concentrations (MICs) of clindamycin (Sigma Chemical Company, St. Louis, MO, USA) and erythromycin (Sigma Chemical Company) were determined using the CLSI-recommended broth microdilution method employing lysed horse blood-supplemented cation-adjusted Mueller-Hinton broth [14 ]. The MICs of clindamycin and erythromycin forStreptococcus pneumoniae ATCC 49619 (Microbiologics, Inc., St. Cloud, USA) were within acceptable quality control ranges.
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Antimicrobial Susceptibility of Gardnerella vaginalis

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Clinical G. vaginalis isolates were evaluated for antimicrobial susceptibilities in vitro to metronidazole and clindamycin (Sigma-Aldrich, St. Louis, MO, US) targeting planktonic cells; to achieve this, we used the anaerobic agar dilution method described by the Clinical and Laboratory Standards Institute (CLSI).
One-hundred microliters of the prepared bacterial suspension (106 CFU/mL) was added to different concentrations of metronidazole and clindamycin at 37°C. After 48 h, the bacterial growth was evaluated by taking an endpoint reading at OD595 with a microplate reader (Bio-Rad Laboratories, Hercules, CA, USA). The minimum inhibitory concentration (MIC) for metronidazole and clindamycin was defined as the lowest antibiotic concentration yielding marked reduction in the growth or no growth at all. Under the same conditions, G. vaginalis ATCC®14018 was tested using the broth microdilution assay. The microbiological susceptibility and resistant breakpoints for metronidazole (<8 μg/mL and ≥32 μg/mL) and clindamycin (<2 μg/mL and ≥8 μg/mL), as defined by CLSI, were used for interpreting MIC results [21 ].
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4

PEG and Clindamycin Intestinal Modulation

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For PEG treatment groups, 15% PEG 3350 (Miralax) was administered in the drinking water for either 5- or 1-day periods depending on the experiment. The PEG solution was prepared fresh every 2 days in distilled water and administered to the mice in water bottles. clindamycin treatment groups received distilled water in water bottles during the PEG treatment periods, with the water being changed at the same frequency. For clindamycin treatment, groups of mice received 10 mg/kg clindamycin (Sigma-Aldrich) via intraperitoneal injection. All PEG treatment groups received a sham intraperitoneal injection containing filter-sterilized saline.
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5

Antibiotic Combination Treatments in Mice

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We initially treated four different groups of mice (4–5 per group) separately with either metronidazole (5 mg/mL) or a combination of metronidazole (5 mg/mL) + clindamycin (10 mg/mL), metronidazole (5 mg/mL) + imipenem (5 mg/mL), or metronidazole (5 mg/mL) + imipenem (5 mg/mL) + clindamycin (10 mg/mL) (Sigma Aldrich, USA) (Figure 1A). All mice received a daily dose of 200 µL of antibiotic preparations via the oral gavage for four weeks. The metronidazole (5 mg/mL) + clindamycin (10 mg/mL) treatment was repeated in two additional independent experiments using different sets of mice (Figure 1B,C). Fresh antibiotics were prepared at every 3-day interval.
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6

Antimicrobial Compounds Acquisition and Purification

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Non-radiolabeled erythromycin, azithromycin, chloramphenicol, clindamycin, and linezolid were purchased from MilliporeSigma (USA). Unless stated otherwise, all other reagents and chemicals were obtained from MilliporeSigma (USA). Hygromycin A was isolated and purified from S. hygroscopicus strain NRRL-2388 as described previously49 (link),53 (link). A201A was kindly provided by Dr. Daniel Wilson. Ketolides (telithromycin and solithromycin) were provided by Cempra Inc (USA). Radioactively labeled [14C]-ERY was obtained from American Radiolabeled Chemicals (USA).
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7

Gut Microbiome Manipulation via Antibiotics

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To manipulate the composition of the gut microbiome we used a high-dose antibiotic mixture administered to the mice. A mixture of Ampicillin (Millipore Sigma, A5354), Clindamycin (Millipore Sigma, PHR1159), and Streptomycin (Millipore Sigma, S9137) were provided via sterile drinking water at a concentration of 0.33mg/mL for each antibiotic. Such antibiotics were chosen based off previous literature to provide broad spectrum capacity and effect on the gut microbiome29 (link). Animals drank ad libitum from the water and was replaced every 3 days. Control mice received normal food and water diets. All animals were singly housed in a reversed 12-hour light cycle.
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8

Antibiotic Resistance Profiling of Isolates

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The antibiotic resistance profile of the isolates was determined by the Kirby-Bauer disk-diffusion method on Muller-Hinton agar (MHA) (Merck & Co., Kenilworth, NJ, USA) with 5% sheep's blood, and the results were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.
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The antimicrobial agents (Mast Group Ltd, Bootle, UK) tested in the present study included ampicillin (10 μg), vancomycin (30 μg), erythromycin (15 μg), clindamycin (2 μg), levofloxacin (5 μg), chloramphenicol (30 μg), cefepime (30 μg), and linezolid (30 μg).
Streptococcus pneumoniaeATCC 49619 was used for quality control of antibiotic susceptibility testing.
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9

Antibiotic Resistance Profiling of Probiotic LAB

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Antibiotic resistance of the selected potential probiotic LAB was assessed, according to the ISO 10932/IDF 223 standard (2010) [64 ] and a previous report [63 (link)]. Minimal inhibitory concentrations (MICs) of ampicillin, chloramphenicol, clindamycin, erythromycin, gentamycin, kanamycin, streptomycin, and tetracycline (all antibiotics were purchased from Merck) were determined using the microdilution method using bacterial cells cultivated for 18 h as described above. Antibiotic resistance was evaluated by comparing to the MIC breakpoint values for L. rhamnosus recommended by the European Food Safety Authority Panel on Additives and Products or Substances used in Animal Feed [65 ].
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10

Anaerobic Bacterial Antibiotic Resistance

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Additional 0.1 mL aliquots of subgingival biofilm specimen dilutions were inoculated onto EBBA plates supplemented with either metronidazole at 16 mg/L, doxycycline at 4 mg/L, amoxicillin at 8 mg/L, or clindamycin at 4 mg/L (all antibiotics obtained as pure powder from Sigma-Aldrich, St Louis, MO, USA), and incubated anaerobically for 7 days. These antimicrobial concentrations represent non-susceptible/resistant breakpoint concentrations against anaerobic bacteria for amoxicillin, clindamycin, and metronidazole as recommended by the Clinical and Laboratory Standards Institute, 24 and for doxycycline as recommended by the French Society for Microbiology. 25 In vitro resistance to an antibiotic breakpoint concentration was recorded when test species growth was detected on an antibiotic-supplemented EBBA plate. 26 (link) Bacteroides thetaiotaomicron ATCC 29741, Clostridium perfringens ATCC 13124, and a multi-antibiotic-resistant clinical periodontal isolate of Fusobacterium nucleatum were used as positive and negative controls for antibiotic resistance testing on antibioticsupplemented EBBA plates. 26 (link)
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