Shuai Xia,1 Liyan Ma,2 Guoxing Wang,1 Jie Yang,1 Meiying Zhang,3 Xuechen Wang,1 Jianrong Su,2 Miaorong Xie1
1Department of Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China; 2Department of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China; 3Department of Emergency Center, Beijing University First Hospital, Beijing University, Beijing, 100050, People’s Republic of China
Correspondence: Miaorong Xie, Department of Emergency and Critical Care, Center, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing, 100050, People’s Republic of China, Email [email protected]
Thanks to Dr. Savita V Jadhav and the medical stuff for their interest in our article.1 We would like to clarify the specific comments.
First, concerns about the “CLSI Methodology Guideline Reference Number 19” may be the result of a misunderstanding. In this context, we mentioned that the MIC determination method was recommended by the CLSI guideline rather than why RIF and CLI were selected for testing. Secondly, comments on RIF prescribing should be avoided in diseases other than Mycobacterial diseases are very constructive. At present, our research remains at the laboratory stage; it is necessary to apply in vivo to evaluate the clinical effects as RIF alone is rarely used to treat MRSA. However, no paperwork or guidelines show that RIF can not treat MRSA infection. According to the updated MRSA treatment guidelines from the United Kingdom,2 RIF is recommended in combination with other agents to treat MRSA infections. Our study found that berberine in combination with RIF has an excellent synergistic effect that does not conflict with clinical application. In addition, the synergistic activities are ongoing in vivo and it is our pleasure to improve the clinical practice that expands the RIF indication if the experimental results are satisfactory. Finally, regarding your advice to us to further evaluate other synergistic effects with oxacillin, azithromycin and levofloxacin as well as additive effects with ampicillin and cefazolin, these have already been reported in previous studies.3,4 We believe this is a meaningful proposal and will carry out the in vivo experiments in the near future.
The authors do not report any conflicts of interest in this Communication.
1. Xia S, Ma L, Wang G, et al. In vitro antimicrobial activity and mechanism of berberine against methicillin-resistant staphylococcus aureus isolated from circulatory infection patients. Infect Drug Resist. 2022; 15: 1933–1944. doi: 10.2147 / IDR.S357077
2. Brown NM, Goodman AL, Horner C, Jenkins A, Brown EM. Treatment of methicillin-resistant Staphylococcus aureus (MRSA): updated UK guidelines. JAC Antimicrob Resist. 2021; 3 (1): dlaa114. doi: 10.1093 / jacamr / dlaa114
3. Yu HH, Kim KJ, Cha JD, et al. Antimicrobial activity of berberine alone and in combination with ampicillin or oxacillin against methicillin-resistant Staphylococcus aureus. J Med Food. 2005; 8 (4): 454–461. doi: 10.1089 / jmf.2005.8.454
4. Zuo GY, Li Y, Han J, Wang GC, Zhang YL, Bian ZQ. Antibacterial and synergy of berberines with antibacterial agents against clinical multi-drug resistant isolates of methicillin-resistant Staphylococcus aureus (MRSA). Molecules. 2012; 17 (9): 10322–10330. doi: 10.3390 / molecules170910322
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