Efficacy of Commercially Used Antibacterial Agents against Oral Bacteria Associated with HIV/AIDS Patients in South Western Uganda

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% 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.