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8 protocols using ampicillin sulbactam

1

Generation of Gnotobiotic IL-10-/- Mice

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IL-10−/− mice (in C57BL/6j background, B6) were bred and maintained in the facilities of the “Forschungseinrichtungen für Experimentelle Medizin” (FEM, Charité-Universitätsmedizin, Berlin, Germany) under specific pathogen-free (SPF) conditions.
Gnotobiotic IL-10−/− mice (with a virtually depleted gastrointestinal microbiota) were generated following broad-spectrum antibiotic treatment as described earlier [31 (link), 36 (link)]. In brief, mice were transferred to sterile cages and treated by adding ampicillin/sulbactam (1 g/L; Pfizer, Berlin, Germany), vancomycin (500 mg/L; Hexal, Holzkirchen, Germany), ciprofloxacin (200 mg/L; Hexal), imipenem (250 mg/L; Fresenius Kabi, Graz, Austria), and metronidazole (1 g/L; Braun, Melsungen, Germany) to the drinking water ad libitum starting at 3 weeks of age immediately after weaning and continued for 3 months before the infection experiment [33 (link)]. Three days prior infection, the antibiotic cocktail was replaced by sterile tap water (ad libitum). Mice were continuously kept in a sterile environment (autoclaved food and tap water) and handled under strict antiseptic conditions.
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2

Spinal Cord Injury Protocol: Contusion Model

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The spinal contusion was performed using the New York University impactor under isoflurane anesthesia (by a mixture of 4% enflurane and 95% O2). A laminectomy was performed at the T11 segment of the vertebra and the spinal column was stabilized by clamping the spinous processes of T10 and T12 with the alligator clips. A 10 g weight was dropped onto the spinal cord from a 12.5 mm height (n = 47). After the spinal cord contusion, the musculature was sutured, the skin was autoclipped, and the animals were allowed to recover from the anesthesia. A sham operation (n = 7) was performed using only a laminectomy of the T11 vertebra without a spinal contusion. The bladders were manually expressed twice a day until spontaneous urination returned. In order to prevent a urinary tract infection, Unasyn (ampicillin/sulbactam, 100 mg/kg, Pfizer, Seoul, Korea) was injected intraperitoneally once a day for the first 3 to 5 days. Highly absorbent bedding was used to prevent sores and infections in the paralyzed animals.
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3

Generating Gnotobiotic IL-10-/- Mice

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IL-10-/- mice (in C57BL/10 background, B10) were bred and kept in the facilities of the “Forschungseinrichtungen für Experimentelle Medizin” (FEM, Charité - Universitätsmedizin, Berlin, Germany) under specific pathogen-free (SPF) housing conditions. Gnotobiotic IL-10-/- mice were generated by broad-spectrum antibiotic treatment as described earlier [19 (link)]. In brief, mice were kept in sterile cages and and had ad libitum access to an antibiotic cocktail consisting of ampicillin/sulbactam (1 g/L; Pfizer, Berlin, Germany), vancomycin (500 mg/L; Hexal, Holzkirchen, Germany), ciprofloxacin (200 mg/L; Hexal, Holzkirchen, Germany), imipenem (250 mg/L; Fresenius Kabi, Graz, Austria), and metronidazole (1 g/L; Braun, Melsungen, Germany) in drinking water starting at 3 weeks of age immediately after weaning and continued for 3–4 months before the infection experiment [20 (link)]. Three days prior infection, the antibiotic cocktail was replaced by sterile tap water (ad libitum). These so generated gnotobiotic (i.e. secondary abiotic) mice were continuously kept in a sterile environment (with autoclaved food and drinking water), handeled under strict aseptic conditions and displayed a virtually depleted gastrointestinal microbiota.
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4

Generation and Maintenance of Gnotobiotic IL-10-/- Mice

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C57BL/6j wildtype and IL-10-/- mice (in C57BL/6j background, B6) were bred and maintained in the facilities of the “Forschungseinrichtungen für Experimentelle Medizin” (FEM, Charité—Universitätsmedizin, Berlin, Germany) under specific pathogen-free (SPF) conditions. Gnotobiotic IL-10-/- mice (with a virtually depleted gastrointestinal microbiota) were generated by broad-spectrum antibiotic treatment as described earlier [22 (link)]. In brief, mice were transferred to sterile cages and treated by adding ampicillin/sulbactam (1 g/L; Pfizer, Berlin, Germany), vancomycin (500 mg/L; Hexal, Holzkirchen, Germany), ciprofloxacin (200 mg/L; Hexal), imipenem (250 mg/L; Fresenius Kabi, Graz, Austria), and metronidazole (1 g/L; Braun, Melsungen, Germany) to the drinking water ad libitum starting at three weeks of age immediately after weaning and continued for 3–4 months before the infection experiment [19 (link)]. Three days before infection, the antibiotic cocktail was replaced by sterile tap water (ad libitum). Mice were continuously kept in a sterile environment (autoclaved food and tap water) and handeled under strict antiseptic conditions.
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5

Antimicrobial Evaluation of Enterococcus Species

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For in vitro and in vivo studies, the strains E. faecalis ATCC 29212, E. faecium ATCC 19434 and E. faecalis ATCC 51299 (vancomycin-resistant, with VanB phenotype), were used and kept at −70°C. In vivo experiments with E. faecalis ATCC 29212 were done with Ampicillin (Ampicilina, Genfar, Colombia) and Ceftriaxone (Rocephin, Roche, Switzerland). Due to previous reports of inequivalent Ampicillin generics [21 ], the in vivo activity of the Genfar product (AMP innovator is not available in Colombia) was compared to innovator Ampicillin-Sulbactam (Unasyn, Pfizer, Switzerland) against β-lactamase negative enterococci and found to be equivalent in efficacy and potency. Due to later Genfar generic shortage, the experiments with E. faecium ATCC 19434 and E. faecalis ATCC 51299 were done with Ampicillin-Sulbactam. The minimal inhibitory concentrations of AMP and CRO were determined by broth microdilution in duplicate and repeated independently three times following CLSI methods [22 ].
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6

Postoperative Inpatient Management Protocol

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Patients were treated as inpatients at University Hospital Würzburg. They received a single shot of cefazolin 2 g (Hikma, London, UK) and metronidazole 500 mg (B. Braun Supply Solutions, Melsungen, Germany), or ampicillin/sulbactam 3 g (Unacid®, Pfizer Pharma GmbH, Berlin, Germany), or clindamycin 600 mg (Sobelin® Solubile, Pfizer Pharma GmbH, Berlin, Germany) intraoperatively, as well as up to 48 h following surgery (cefazolin, ampicillin/sulbactam, and clindamycin administered three times daily, and metronidazole once daily in case of administration in the postoperative course).
The CBCT scan was performed according to a standardized protocol a few days after the operation during the hospital stay depending on the degree of swelling, with the final splint and intermaxillary fixation with elastic bands inserted.
Patients maintained a soft diet for six weeks. The elastic bands remained in place for two to three weeks. We recommended each patient to have the metal plates removed after six to nine months.
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7

Antimicrobial Evaluation of LEGO-LPPOs against S. aureus

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The antimicrobial
activity of selected LEGO-LPPOs was determined in 24 strains of S. aureus obtained from the culture collection of
Department of Microbiology (Faculty of Medicine and Dentistry, Palacký
University Olomouc) (for the list of S. aureus strains, see Table 5). All tested microorganisms were stored in cryotubes (ITEST plus,
Czech Republic) at −80 °C. First, the MICs of selected
antibiotics were tested as described above. These antibiotics were
penicillin (Biotika, Slovakia), oxacillin (Bristol-Myers Squibb, United
States), ampicillin/sulbactam (Pfizer, United States), chloramphenicol
(Sigma-Aldrich, United States), tetracycline (Sigma-Aldrich, United
States), erythromycin (Serva, Deutschland), clindamycin (Pfizer, United
States), ciprofloxacin (Sigma-Aldrich, United States), gentamicin
(Lek Pharmaceuticals d.d., Slovenia), teicoplanin (Sanofi, France),
and vancomycin (Mylan, United States). Consequently, the antimicrobial
activity of four LEGO-LPPOs (29, 60, 25, and 38) was tested in 24 S.
aureus
wild-type strains by the means of MIC determination
(as described above).
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8

Generating Gnotobiotic IL-10-Deficient Mice

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IL-10–/– mice (in C57BL/10 background, B10) were bred and maintained in the facilities of the “Forschungseinrichtungen für Experimentelle Medizin” (FEM, Charité – Universitätsmedizin, Berlin, Germany) under specific pathogen-free (SPF) conditions. To overcome physiological colonization resistance and assure stable colonization, gnotobiotic (i.e., secondary abiotic) IL-10–/– mice with a deprived gastrointestinal microbiota were generated following broad-spectrum antibiotic treatment as described earlier [10 (link), 11 (link)]. In brief, mice were transferred to sterile cages and treated by adding ampicillin–sulbactam (1 g/l; Pfizer, Berlin, Germany), vancomycin (500 mg/l; Hexal, Holzkirchen, Germany), ciprofloxacin (200 mg/l; Hexal), imipenem (250 mg/l; Fresenius Kabi, Graz, Austria), and metronidazole (1 g/l; Braun, Melsungen, Germany) to the drinking water ad libitum starting at 3 weeks of age immediately after weaning and continued for approximately 3 months before the infection experiment [12 (link)]. Three days prior infection, the antibiotic cocktail was replaced by sterile tap water (ad libitum). Abiotic status of gnotobiotic mice was confirmed as described earlier [5 (link), 10 (link)].
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