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1.
Article in English | MEDLINE | ID: mdl-38815354

ABSTRACT

After a revision surgery, approximately 1-2 % of patients will develop a periprosthetic joint infection (PJI). During the revision surgery, the infected prosthesis is removed, a debridement is performed and a new or temporary spacer is placed. Additionally, patients are treated with antibiotics during and after the surgery. Adequate exposure of the administered antibiotic to the pathogen is of crucial importance during the treatment of any infection. Inadequately low concentrations are associated with an increase in antibiotic resistance, antibiotic related side effects, treatment failures and prolonged infections. While high concentrations may lead to serious adverse events and potential lasting damage. Despite the importance of optimal dosing, there is a lack of knowledge with respect to the correlation between the plasma concentrations and target site concentrations of the antibiotics. Two of the commonly administered antimicrobial agents during the arthroplasty exchange are cefuroxime and flucloxacillin. Therefore, an accurate, specific, and sensitive quantification method is required in order to assess pharmacokinetics of cefuroxime and flucloxacillin in synovial tissue and bone. The aim of this study is to develop and validate a quantification method for the measurement of cefuroxime and flucloxacillin in human synovial tissue and bone using the UPC2-MS/MS conform Food and Drug Administration guidelines. The method was found linear for both compounds in both matrices (r2 > 0.990) from 1 µg/g to 20 µg/g, except for cefuroxime in bone, which was validated from 1 µg/g to 15 µg/g. We developed and validated a quantification method for cefuroxime and flucloxacillin in synovial tissue and bone using a simple sample preparation and a short analysis run time of 5.0 min, which has been already successfully applied in a clinical study. To our knowledge, no methods have been described earlier for the simultaneous quantification of cefuroxime and flucloxacillin in synovial tissue and bone.


Subject(s)
Cefuroxime , Floxacillin , Tandem Mass Spectrometry , Humans , Tandem Mass Spectrometry/methods , Cefuroxime/analysis , Cefuroxime/pharmacokinetics , Cefuroxime/blood , Chromatography, High Pressure Liquid/methods , Linear Models , Reproducibility of Results , Floxacillin/analysis , Floxacillin/pharmacokinetics , Floxacillin/chemistry , Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/blood , Anti-Bacterial Agents/pharmacokinetics , Bone and Bones/chemistry , Bone and Bones/metabolism , Synovial Membrane/chemistry , Synovial Membrane/metabolism , Limit of Detection
2.
ScientificWorldJournal ; 2021: 6659995, 2021.
Article in English | MEDLINE | ID: mdl-33927582

ABSTRACT

The ever-growing commercialization of poor-quality and substandard medicines, especially anti-infectives characterized by inadequate postmarket surveillance by stakeholders remains a major global health challenge, particularly in developing countries, where antibiotic drug resistance and its repercussions on human health remain dominant. This research sought to evaluate the pharmaceutical quality of six randomly selected brands of cefuroxime axetil tablets (250 mg) marketed in the Greater Accra region of Ghana. The selected brands were coded and subjected to both compendial and noncompendial tests. Statistical analysis and model-independent parameter (similarity factor, f2) were employed in analyzing the dissolution profiles of all the brands. All brands including the reference brand conformed to the pharmacopeial specifications for both compendial and noncompendial tests, indicating that they were of good quality. However, there were significant variations (p < 0.05) in the disintegration time amongst the various brands. All the brands had ƒ2 values > 50 indicating similarity of their drug release profiles with the innovator. Hence, all the sampled cefuroxime axetil brands can be considered as pharmaceutical equivalents to the innovator drug. These brands can, therefore, be used as a substitute for the innovator drug by physicians to patients in cases of unaffordability or unavailability of the innovator brand.


Subject(s)
Anti-Bacterial Agents/standards , Cefuroxime/analogs & derivatives , Cefuroxime/analysis , Cefuroxime/standards , Counterfeit Drugs , Drug Storage , Ghana , Quality Control , Tablets/standards
3.
Article in English | MEDLINE | ID: mdl-33545501

ABSTRACT

BACKGROUND: This study aimed to develop a sensitive, accurate method for simultaneously quantifying cefuroxime and clindamycin in human serum, lumbar anulus fibrosus and nucleus pulposus. METHODS: Cefuroxime and clindamycin were quantified using ultra high-performance liquid chromatography-electrospray ionization tandem mass spectrometry in multiple-reaction-monitoring mode on a triple-quadrupole AB Qtrap 5500 system in positive ion mode. Internal standards were D3-cefuroxime and D3,13C-clindamycin. Samples were pretreated by precipitating total protein. RESULTS: The method showed high sensitivity and good linearity over broad calibration ranges from 100 to 100 000 ng/mL for cefuroxime and 10 to 10 000 ng/mL for clindamycin in serum, and from 10 to 10 000 ng/mL for cefuroxime and 1 to 1 000 ng/mL for clindamycin in lumbar nucleus pulposus. In all sample types, correlation coefficients were greater than 0.99, intra- and inter-day precision (relative standard deviation) was less than 15%, and accuracy (relative error) was within 14% for both analytes. This method was effective at quantifying penetration of cefuroxime and clindamycin in patients undergoing oblique lumbar interbody fusion surgery. CONCLUSIONS: A very sensitive, specific method for simultaneous detection of cefuroxime and clindamycin has been developed for human lumbar anulus fibrosus, nucleus pulposus and serum samples.


Subject(s)
Annulus Fibrosus/chemistry , Cefuroxime/analysis , Chromatography, High Pressure Liquid/methods , Clindamycin/analysis , Nucleus Pulposus/chemistry , Annulus Fibrosus/metabolism , Cefuroxime/blood , Cefuroxime/pharmacokinetics , Clindamycin/blood , Clindamycin/pharmacokinetics , Humans , Linear Models , Lumbosacral Region , Nucleus Pulposus/metabolism , Reproducibility of Results , Sensitivity and Specificity , Tandem Mass Spectrometry/methods
4.
Crit Care ; 24(1): 646, 2020 11 14.
Article in English | MEDLINE | ID: mdl-33189146

ABSTRACT

BACKGROUND: Sepsis is often treated with penicillin-binding protein 3 (PBP-3) acting ß-lactam antibiotics, such as piperacillin-tazobactam, cefotaxime, and meropenem. They cause considerable bacterial structural changes and have in vitro been associated with an increased inflammatory response. In a clinically relevant large animal sepsis model, our primary aim was to investigate whether bacteria killed by a PBP-3-active antibiotic has a greater effect on the early inflammatory response and organ dysfunction compared with corresponding amounts of live or heat-killed bacteria. A secondary aim was to determine whether the addition of an aminoglycoside could mitigate the cefuroxime-induced response. METHOD: Killed or live Escherichia coli were administrated as a 3-h infusion to 16 healthy pigs in a prospective, randomized controlled interventional experimental study. Cefuroxime was chosen as the PBP-3-active antibiotic and tobramycin represented the aminoglycosides. The animals were randomized to receive (I) bacteria killed by cefuroxime, (II) live bacteria, (III) bacteria killed by heat, or (IV) bacteria killed by the combination of cefuroxime and tobramycin. Plasma endotoxin, tumor necrosis factor alpha, interleukin-6, interleukin-10, leukocytes, and organ function were recorded at the start of the experiment and then hourly for 6 h. RESULTS: Differences in dynamics of concentration over time between the four treatment groups were found for the three cytokines (p < 0.001). Animals receiving cefuroxime-killed bacteria demonstrated higher responses than those receiving live (p < 0.05) or heat-killed bacteria (p < 0.01). The addition of tobramycin reduced the cefuroxime-induced responses (p < 0.001). The cytokine responses were associated with leucocyte activation that was further associated with pulmonary dysfunction and increases in lactate (p < 0.01). CONCLUSIONS: In comparison with live or heat-killed bacteria, bacteria killed by a PBP-3-active antibiotic induced an increased inflammatory response that appears to be associated with deteriorated organ and cellular function. The addition of an aminoglycoside to the PBP-3-active antibiotic reduced that response.


Subject(s)
Inflammation/etiology , Multiple Organ Failure/etiology , Penicillin-Binding Proteins/adverse effects , Sepsis/drug therapy , Animals , Cefuroxime/analysis , Cefuroxime/pharmacology , Cefuroxime/therapeutic use , Disease Models, Animal , Endotoxins/analysis , Endotoxins/blood , Escherichia coli/drug effects , Escherichia coli/pathogenicity , Escherichia coli Infections/drug therapy , Escherichia coli Infections/physiopathology , Inflammation/complications , Inflammation/physiopathology , Interleukin-10/analysis , Interleukin-10/blood , Interleukin-6/analysis , Interleukin-6/blood , Multiple Organ Failure/complications , Multiple Organ Failure/physiopathology , Organ Dysfunction Scores , Penicillin-Binding Proteins/therapeutic use , Prospective Studies , Sepsis/physiopathology , Swine , Tobramycin/adverse effects , Tobramycin/pharmacology , Tobramycin/therapeutic use , Tumor Necrosis Factor-alpha/analysis , Tumor Necrosis Factor-alpha/blood
5.
Biomed Chromatogr ; 34(2): e4737, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31950509

ABSTRACT

In this paper, we present the incurred sample reanalysis (ISR) data for cefuroxime in various ocular tissues of rabbits. Based on the cefuroxime concentration vs. time profile in various ocular tissues, three chosen time points enabled ISR assessment. Cefuroxime was quantitated in the ocular tissues using a published liquid chromatography-electrospray ionization/tandem mass spectrometry method operated under the multiple reaction-monitoring mode in positive ion mode. Regardless of the ocular tissue, the linearity range was 12.7-2760 ng/ml with a correlation coefficient (r2 ) of ≥0.996. All of the ISR samples representing various ocular tissues met the acceptance criteria. To the best of our knowledge, this is the first report showing the ISR of ocular tissues in any species.


Subject(s)
Cefuroxime/analysis , Chromatography, Liquid/methods , Eye/chemistry , Tandem Mass Spectrometry/methods , Animals , Linear Models , Rabbits , Specimen Handling
6.
Int Urol Nephrol ; 52(4): 645-654, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31832876

ABSTRACT

OBJECTIVE: This study sought to evaluate the antibacterial effect of fosfomycin tromethamine (FT) on the bacteria inside urinary infection stones. METHODS: The internal structures of urinary stones were observed via scanning electron microscopy to verify the presence of internal bacteria. We randomly assigned equal numbers of patients with kidney stones who met the inclusion criteria into two groups in a prospective study and treated them with different perioperative antibiotics. One group (experimental group) was treated with FT, and the other (control group) was treated with cefuroxime sodium. All stone specimens were collected via percutaneous nephrolithotomy (PCNL). The primary infection stones were screened via a stone component analysis, 30 cases in the experimental group and 31 cases in the control group. High-performance liquid chromatography (HPLC)-mass spectrometry was used to measure the drug concentration inside the stones, the bacterial count was calculated via stone culture, and the clinical infection index were monitored for between-group comparisons. RESULTS: Compared with the control group, the experimental group had a higher internal drug concentration, a higher drug sensitivity against various pathogenic bacteria, a lower bacterial colony count in the stone culture, and a lower incidence of postoperative clinical infection. CONCLUSIONS: FT is more effective than cefuroxime, which is commonly used during the perioperative period of urinary stones, and exerts a high antibacterial effect on these internal bacteria, and effectively reduces the probability of infection and sepsis after urinary stone surgery. FT can be used as an antibiotic during the perioperative period of urinary stones.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Antibiotic Prophylaxis , Bacteria/drug effects , Fosfomycin/therapeutic use , Kidney Calculi/chemistry , Kidney Calculi/microbiology , Adult , Aged , Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/pharmacology , Bacteria/growth & development , Bacteria/isolation & purification , Cefuroxime/analysis , Cefuroxime/pharmacology , Cefuroxime/therapeutic use , Colony Count, Microbial , Female , Fever/etiology , Fever/prevention & control , Fosfomycin/analysis , Fosfomycin/pharmacology , Humans , Kidney Calculi/surgery , Kidney Calculi/ultrastructure , Male , Middle Aged , Nephrolithotomy, Percutaneous/adverse effects , Postoperative Complications/prevention & control , Prospective Studies , Sepsis/etiology , Sepsis/prevention & control
7.
J Pharm Pharmacol ; 72(3): 364-370, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31858616

ABSTRACT

OBJECTIVES: To reduce the incidence of peri- or postoperative infections in orthopaedic surgery, patients are prophylactically treated with antibiotics. Here, we wanted to know whether effective bone and intervertebral disc concentrations of cefuroxime are reached. METHODS: Patients undergoing surgery of hip (N = 40; 62.5% male) or spine (N = 40; 55% male) were pretreated with 1.5 g of the second-generation cephalosporin cefuroxime before surgery. We studied plasma population kinetics and bone and intervertebral disc (C5/6 till L5/S1) concentrations of cefuroxime using high-performance liquid chromatography. KEY FINDINGS: The plasma kinetics of cefuroxime in 80 patients was analysed using a population approach. The clearance amounted to 7.86 l/h. The peripheral and central volumes of distribution were estimated as 8.45 and 10.4 l, respectively. The concentrations in hip samples amounted to 9.8 ± 0.6 µg/g in cancellous bone and 8.9 ± 0.8 µg/g in cortical bone. Cefuroxime concentrations in vertebral bone and intervertebral discs were calculated as 9.6 ± 1.3 and 8.9 ± 1.1 µg/g, respectively. CONCLUSION: Even if a majority of patients undergoing hip or spine surgery probably achieved adequate concentrations of cefuroxime, not all patients reached bone concentrations of cefuroxime above a recommended breakpoint for susceptible germs at the time of surgery.


Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Bone and Bones/metabolism , Cefuroxime/pharmacokinetics , Hip , Orthopedic Procedures , Adult , Aged , Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/blood , Arthroplasty, Replacement, Knee , Cefuroxime/analysis , Cefuroxime/blood , Female , Humans , Male , Middle Aged , Spine
8.
Br J Clin Pharmacol ; 85(4): 818-826, 2019 04.
Article in English | MEDLINE | ID: mdl-30636060

ABSTRACT

AIMS: Surgical site infections contribute to morbidity and mortality after surgery. The authors hypothesized that higher antibiotic tissue concentrations can be reached for a prolonged time span by continuous administration of prophylactic cefuroxime compared to bolus administration. METHODS: Twelve patients undergoing elective cardiac surgery were investigated. Group A received 1.5 g cefuroxime as bolus infusions before surgery, and 12 and 24 hours thereafter. In group B, a continuous infusion of 3.0 g cefuroxime was started after a bolus of 1.5 g. Cefuroxim levels were determined in blood and tissue (microdialysis). T-test, Wilcoxon signed rank test and χ2 test were used for statistical analysis. RESULTS: The area under the curve (AUC) of plasma cefuroxime concentrations was greater in group B (399 [333-518]) as compared to group A (257 [177-297] h mg L-1 , [median and interquartile range], P = .026). Furthermore, a significantly longer percentage of time > minimal inhibitory concentrations of 2 mg L-1 (100% vs 50%), 4 mg L-1 (100% vs 42%), 8 mg L-1 (100% vs 17%) and 16 mg L-1 (83% vs 8%) was found for free plasma cefuroxime in group B. In group B, area under the curve in subcutaneous tissue (78 [61-113] h mg L-1 ) and median peak concentration (33 [26-38] mg L-1 ) were markedly higher compared to group A (P = 0.041 and P = .026, respectively). CONCLUSIONS: Higher cefuroxime concentrations were measured in plasma and subcutaneously over a prolonged period of time when cefuroxime was administered continuously. The clinical implication of this finding still has to be elucidated.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Antibiotic Prophylaxis/methods , Cefuroxime/administration & dosage , Surgical Wound Infection/prevention & control , Aged , Aged, 80 and over , Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/pharmacokinetics , Area Under Curve , Cardiac Surgical Procedures/adverse effects , Cefuroxime/analysis , Cefuroxime/pharmacokinetics , Drug Administration Schedule , Elective Surgical Procedures/adverse effects , Female , Humans , Male , Middle Aged , Pilot Projects , Plasma/chemistry , Subcutaneous Fat/chemistry , Surgical Wound Infection/etiology , Tissue Distribution
9.
J Pharm Sci ; 107(8): 2259-2265, 2018 08.
Article in English | MEDLINE | ID: mdl-29715477

ABSTRACT

Concentrations in the interstitial tissue space are of clinical interest for many antibiotics and can be directly measured by microdialysis. Quantitative microdialysis strongly depends on reliable recovery estimates obtained from a suitable calibrator. Cefazolin (CFZ) is frequently used as a prophylactic antibiotic to prevent surgical site infections. This study aimed to develop a reliable and rapid calibration technique for CFZ microdialysis using cefuroxime (CFR) as a calibrator, which is applied simultaneously in the opposite direction via retrodialysis. Liquid chromatography-tandem mass spectrometry method was used for the measurement of both CFZ and CFR in microdialysate. Results from in vitro microdialysis experiments confirmed that CFR does not interfere with physicochemical properties of CFZ, and the loss of CFR is proportional to the gain of CFZ in microdialysis studies. Therefore, the validated bioanalytical assay is suitable to be applied in clinical microdialysis study of CFZ where microdialysis probes are simultaneously calibrated by retrodialysis of CFR. This approach shortens the overall sampling time of in vivo microdialysis studies significantly since calibration and sampling can be performed simultaneously and not in sequence as usually done. It also eliminates the necessary washout period if probe calibration is carried out before the actual sampling time.


Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Cefazolin/pharmacokinetics , Microdialysis/methods , Anti-Bacterial Agents/analysis , Calibration , Cefazolin/analysis , Cefuroxime/analysis , Cefuroxime/pharmacokinetics , Chromatography, Liquid/methods , Humans , Limit of Detection , Tandem Mass Spectrometry/methods
10.
Br J Clin Pharmacol ; 84(9): 2020-2028, 2018 09.
Article in English | MEDLINE | ID: mdl-29761538

ABSTRACT

AIMS: Very little data exist regarding the effect of cardiopulmonary bypass (CPB) on cefuroxime (CXM) pharmacokinetics in children less than one year of age. METHODS: 50 mg kg-1 CXM i.v. after induction were followed by 75 mg kg-1 into the CPB circuit. In 42 patients undergoing cardiac surgery, 15-20 samples were obtained between 5 and 360 min after the first dose. Total CXM concentrations were measured by high-performance liquid chromatography and a pharmacokinetic/pharmacodynamic (PK/PD) modelling was performed. RESULTS: Using a fixed protein binding of 15.6% for CXM, peak plasma concentrations of unbound CXM were 229 ± 52 µg ml-1 after the first bolus and 341 ± 86 µg ml-1 on CPB. Nadir concentrations before CPB were 69 ± 20 µg ml-1 and six hours later decreased to 41 ± 19 µg ml-1 with and 24 ± 14 µg ml-1 without CPB. A two-compartment model was fitted with the main covariates body weight, CPB and postmenstrual age (PMA). PK parameters were as follows: systemic clearance, 5.15 [95% CI 4.5-5.8] l h-1 ; central volume of distribution, 11.25 [9.41-13.09] l; intercompartmental clearance, 18.19 [14.79-21.58] l h-1 ; and peripheral volume, 17.07 [15.7-18.5] L. ƒT > MIC of 32 µg ml-1 for an 8-h time period was between 70 and 100% (2.5-10 kg BW). According to our simulation, 25 mg ml-1 CXM as a primary bolus and into the prime plus a 5 mg kg-1  h-1 infusion maintain CXM concentrations continuously above 32 µg ml-1 . CONCLUSIONS: The routine dosing regimen provided was sufficient for prophylaxis, but continuous dosing can provide a higher percentage of ƒT > MIC.


Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Antibiotic Prophylaxis/methods , Cardiopulmonary Bypass/adverse effects , Cefuroxime/pharmacokinetics , Surgical Wound Infection/prevention & control , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/analysis , Cefuroxime/administration & dosage , Cefuroxime/analysis , Chromatography, High Pressure Liquid , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Heart Defects, Congenital/surgery , Humans , Infant , Infant, Newborn , Infusions, Intravenous , Male , Metabolic Clearance Rate , Microbial Sensitivity Tests , Models, Biological , Perioperative Care/methods , Surgical Wound Infection/etiology
11.
Ecotoxicol Environ Saf ; 147: 49-54, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28826030

ABSTRACT

In this study a new calix[4]arene triazole 5 was successfully synthesized using click reaction and characterized through UV-visible, FT-IR, 1H NMR spectroscopes and Mass Spectrometry. The supramolecular interaction of compound 5 towards commonly used drugs has been carried out using UV-Visible spectroscopy. The supramolecule 5 showed characteristic enhancement in the absorbance intensity after mixing with Cefuroxime at pH (2-12). Compound 5 displayed considerably good interactions with cefuroxime in the presence of other drugs. Compound 5 exhibits linear relationship with cefuroxime concentration in the range of (10-80µM) with regression value of 0.9954. The standard deviation for 50µM Cefuroxime was found to be 0.01 and the limit of detection for cefuroxime was calculated to be 2µM. Job's plot experiments showed 1:1 (5: cefuroxime) binding stoichiometry between compound 5 and cefuroxime. Supramolecule 5 displayed fairly good spectrophotometric recognition of Cefuroxime in human blood plasma and tap water thus showing that the ingredients of tap water and plasma sample was inert in the recognition of cefuroxime.


Subject(s)
Calixarenes/chemistry , Cefuroxime/blood , Drinking Water/chemistry , Phenols/chemistry , Triazoles/chemical synthesis , Water Pollutants, Chemical/blood , Cefuroxime/analysis , Humans , In Vitro Techniques , Limit of Detection , Magnetic Resonance Spectroscopy , Plasma/chemistry , Spectroscopy, Fourier Transform Infrared , Triazoles/chemistry , Water Pollutants, Chemical/analysis
12.
Am J Trop Med Hyg ; 98(1): 344-348, 2018 01.
Article in English | MEDLINE | ID: mdl-29141717

ABSTRACT

Global Pharma Health Fund (GPHF) Minilab™, a semi-quantitative thin-layer chromatography (TLC)-based commercially available test kit, is widely used in drug quality surveillance globally, but its diagnostic accuracy is unclear. We investigated the diagnostic accuracy of Minilab system for antimicrobials, using high-performance liquid chromatography (HPLC) as reference standard. Following the Minilab protocols and the Pharmacopoeia of the People's Republic of China protocols, Minilab-TLC and HPLC were used to test five common antimicrobials (506 batches) for relative concentration of active pharmaceutical ingredients. The prevalence of poor-quality antimicrobials determined, respectively, by Minilab TLC and HPLC was amoxicillin (0% versus 14.9%), azithromycin (0% versus 17.4%), cefuroxime axetil (14.3% versus 0%), levofloxacin (0% versus 3.0%), and metronidazole (0% versus 38.0%). The Minilab TLC had false-positive and false-negative detection rates of 2.6% (13/506) and 15.2% (77/506) accordingly, resulting in the following test characteristics: sensitivity 0%, specificity 97.0%, positive predictive value 0, negative predictive value 0.8, positive likelihood ratio 0, negative likelihood ratio 1.0, diagnostic odds ratio 0, and adjusted diagnostic odds ratio 0.2. This study demonstrates unsatisfying diagnostic accuracy of Minilab system in screening poor-quality antimicrobials of common use. Using Minilab as a stand-alone system for monitoring drug quality should be reconsidered.


Subject(s)
Anti-Infective Agents/standards , Chromatography, Thin Layer , Amoxicillin/analysis , Amoxicillin/standards , Anti-Infective Agents/analysis , Azithromycin/analysis , Azithromycin/standards , Cefuroxime/analysis , Cefuroxime/standards , Chromatography, High Pressure Liquid , Chromatography, Thin Layer/methods , False Negative Reactions , False Positive Reactions , Levofloxacin/analysis , Levofloxacin/standards , Metronidazole/analysis , Metronidazole/standards , Quality Control , Reproducibility of Results
13.
Drug Test Anal ; 9(7): 1062-1072, 2017 Jul.
Article in English | MEDLINE | ID: mdl-27714984

ABSTRACT

The use of cephalosporins during breast feeding raises several issues, including the risk of drug exposure through breast milk for the infant. In this paper, a hydrophilic interaction liquid chromatography/positive ion electrospray mass spectrometric assay (HILIC/ESI-MS) was developed for the quantitation of cefuroxime, cefoxitin, and cefazolin in breast milk and human plasma. The assay was based on the use of small sample size, 25 µL of biological samples, following acetonitrile precipitation of proteins and filtration that enabled injection into the HILIC/ESI-MS system. All analytes and the internal standard, alfuzosin, were separated by using a ZIC®-HILIC analytical column (150.0 × 2.1 mm i.d., particle size 3.5 µm, 200 Å) with isocratic elution. The mobile phase was composed of a 6% 12.5 mM ammonium acetate water solution in acetonitrile and pumped at a flow rate of 0.25 mL min-1 . The assay was linear over a concentration range of 0.2 to 5 µg mL-1 and 0.4 to 20 µg mL-1 for all the analytes in breast milk and in human plasma, respectively. Intermediate precision was found to be less than 4.2% over the tested concentration ranges. A run time of less than 12 min for each sample made it possible to analyze a large number of biological samples per day. The method is the first reported application of HILIC in the analysis of antibiotics in breast milk and human plasma and it can be used to support a wide range of clinical studies. Copyright © 2016 John Wiley & Sons, Ltd.


Subject(s)
Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/blood , Milk, Human/chemistry , Spectrometry, Mass, Electrospray Ionization/methods , beta-Lactams/analysis , beta-Lactams/blood , Cefazolin/analysis , Cefazolin/blood , Cefoxitin/analysis , Cefoxitin/blood , Cefuroxime/analysis , Cefuroxime/blood , Chromatography, Liquid/methods , Female , Humans , Hydrophobic and Hydrophilic Interactions , Limit of Detection
14.
Environ Sci Pollut Res Int ; 21(22): 12941-50, 2014 Nov.
Article in English | MEDLINE | ID: mdl-24981036

ABSTRACT

The main objective of the current study was to estimate the potential environmental risks associated with human consumption of antimicrobials in Greece. Consumption data was collected for the 24 most often used antimicrobials for the years 2008-2010, and their predicted environmental concentrations (PECs) in raw and treated wastewater were calculated using mass balances and literature data on human excretion and elimination efficiency during wastewater treatment. The ecotoxicological risk was estimated by calculating the ratio of PEC to predicted no-effect concentration (PNEC) for three categories of aquatic organisms (algae, daphnids, and fish). PNEC values were calculated based on experimental ecotoxicity data and data originated from the Ecological Structure Activity Relationship (ECOSAR). PEC values in raw sewage ranged between 0.02 µg L(-1) (erythromycin) and 27 µg L(-1) (amoxicillin), while in treated wastewater, the highest concentration was predicted for cefuroxime axetil (6.6 µg L(-1)). Based on acute toxicity data for algae, risk quotient (RQ) values higher than 1 were obtained for 7 out of the 24 target antimicrobials in raw and treated wastewater, while no significant risk was estimated for daphnids and fish. Regarding the possible risk due to the chronic toxicity of antimicrobials, RQ values higher than 80 were obtained for amoxicillin and clarithromycin in algae. The use of baseline toxicity data from ECOSAR showed that the environmental risk from exposure to mixtures of antimicrobials was low for all three aquatic species. However, further studies on toxicity of mixtures should be performed as calculation of toxicity ratio (TR) values showed that 90 % of the target antimicrobials seem to exhibit a specific mode of toxic action when present in mixtures rather than baseline toxicity. As a result, an underestimation of toxicity based on the ECOSAR model is possible for the mixture of target antimicrobials. For Greek rivers where low (dilution factor, D<10) and medium (D=10-100) dilution of wastewater occurs, moderate to high risk is expected due to the existence of individual antimicrobials such as amoxicillin, clarithromycin, ciprofloxacin, azithromycin, erythromycin, and levofloxacin in discharged treated wastewater.


Subject(s)
Anti-Bacterial Agents/analysis , Wastewater/analysis , Amoxicillin/analysis , Amoxicillin/toxicity , Animals , Anti-Bacterial Agents/toxicity , Cefuroxime/analysis , Cefuroxime/toxicity , Chlorophyta , Daphnia , Drug Utilization/statistics & numerical data , Erythromycin/analysis , Erythromycin/toxicity , Fishes , Greece , Humans , Risk Assessment , Rivers/chemistry , Sewage/analysis , Water Quality
15.
Environ Toxicol Pharmacol ; 38(1): 79-83, 2014 Jul.
Article in English | MEDLINE | ID: mdl-24929476

ABSTRACT

In this study, environmental risks of selected pharmaceuticals were investigated to assess potential hazards. Ciprofloxacin, Clarithromycin, Cefuroxime axetil, antibiotics, Benzalkoniuman antiseptic, Paracetamol, an analgesic, and Naproxen, an anti-inflammatory, were selected due to their high rate of usage in Turkey. Ciprofloxacin was found to have the highest risk due to its high PEC/PNEC ratio (28.636). Benzalkonium, Paracetamol and Clarithromycin have a potential to cause environmental hazards. The biodegradation and biological concentration factors (BCF) of the drugs were also determined using EPA/STWIN and EPA/BCFWIN programs. The results illustrated that these pharmaceuticals are nonbiodegradable in wastewater treatment plants. The BCFs of Benzalkonium and Clarithromycin were found to be very high, 70.790 L/kg and 56.490 L/kg, respectively. It was suggested that alternative treatment methods other than biological ones should be investigated for these pharmaceuticals because of their low biodegradability. Also, unnecessary use of antibiotics is supposed to be discouraged to reduce environmental hazards.


Subject(s)
Pharmaceutical Preparations/analysis , Sewage/analysis , Water Pollutants, Chemical/analysis , 1-Octanol/chemistry , Acetaminophen/analysis , Acetaminophen/chemistry , Adsorption , Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/chemistry , Anti-Infective Agents, Local/analysis , Anti-Infective Agents, Local/chemistry , Anti-Inflammatory Agents, Non-Steroidal/analysis , Anti-Inflammatory Agents, Non-Steroidal/chemistry , Benzalkonium Compounds/analysis , Benzalkonium Compounds/chemistry , Cefuroxime/analogs & derivatives , Cefuroxime/analysis , Cefuroxime/chemistry , Ciprofloxacin/analysis , Ciprofloxacin/chemistry , Clarithromycin/analysis , Clarithromycin/chemistry , Environmental Monitoring , Naproxen/analysis , Naproxen/chemistry , Pharmaceutical Preparations/chemistry , Risk Assessment , Sewage/chemistry , Turkey , Water/chemistry , Water Pollutants, Chemical/chemistry
16.
Biomed Chromatogr ; 28(9): 1199-204, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24519907

ABSTRACT

Cefuroxime lysine is a new second-generation cephalosporins, which can penetrate the blood-brain barrier to cure the meningitis. In order to investigate its acute toxicokinetic study after intraperitoneal injection of 675 mg/kg cefuroxime lysine, a sensitive and clean ultra-fast liquid chromatography-tandem mass spectrometry (UFLC-MS/MS) method for the determination of cefuroxime lysine in microdialysate samples was developed and validated, which was compared with UFLC-UV as a reference method. Chromatographic separation was performed on a Shim-pack XR-ODS C18 column (75 × 3.0 mm, 2.2 µm), with an isocratic elution of 0.1% formic acid in acetonitrile-0.1% formic acid in water (45:55, v/v) for LC-MS and acetonitrile-20 mm potassium dihydrogen phosphate (pH 3.0,20:80, v/v) for LC-UV. The lower limit of detection was 0.01 µg/mL for LC-MS and 0.1 µg/mL for LC-UV method, with the same corresponding linearity range of 0.1-50 µg/mL. The intra- and inter-day precisions (relative standard deviation) for both methods were from 1.1 to 8.9%, while the accuracy was all within ±10.9%. The results of both methods were finally compared using paired t-test; the results indicated that the concentrations measured by the two methods correlated significantly (p < 0.05), which suggested that the two methods based on LC-MS and LC-UV were suitable for the acute toxicokinetic study.


Subject(s)
Brain Chemistry , Cefuroxime/analogs & derivatives , Chromatography, High Pressure Liquid/methods , Tandem Mass Spectrometry/methods , Animals , Cefuroxime/analysis , Cefuroxime/pharmacokinetics , Injections, Intraperitoneal , Limit of Detection , Linear Models , Male , Microdialysis , Rats , Rats, Sprague-Dawley , Reproducibility of Results , Spectrophotometry, Ultraviolet , Toxicokinetics
17.
Braz. j. pharm. sci ; 50(4): 943-953, Oct-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-741353

ABSTRACT

Cefuroxime axetil immediate release tablets were formulated by direct compression method with different percentages of sodium lauryl sulphate (SLS) such as 0.5, 1.0, 1.5 and also without SLS. Resulting batches of tablets were evaluated by both pharmacopeial and non-pharmacopeial methods to ascertain the physico-mechanical properties. Dissolution test were carried out in different medium like 0.07 M HCl, distilled water, 0.1M HCl of pH 1.2 and phosphate buffers at pH 4.5 and 6.8 to observe the drug release against the respective concentration of SLS used. Later, test formulations were compared by f1 (dissimilarity) and f2 (similarity) factors using a reference brand of cefuroxime axetil. Significant differences (p<0.05) in dissolution rate were recorded with the change in concentration of SLS in different media. Test formulation T3 containing 1% SLS was found to be best optimized formulation based on assay, disintegration, dissolution and similarity and dissimilarity factors.


Formularam-se comprimidos de liberação imediata à base de cefuroxima axetil, pelo método de compressão direta, com diferentes percentagens de lauril sulfato de sódio (LSS), tais como 0,5, 1,0, 1,5, e também sem SLS. Os lotes resultantes dos comprimidos foram avaliados por ambos os métodos da farmacopeia e não farmacopeicos para determinar as propriedades físico-mecânicas. O teste de dissolução foi realizado em meios diferentes, como HCl 0,07 M, água destilada, HCl 0,1 M com pH 1,2 e os tampões fosfato (pH 4,5 e 6,8) para observar a liberação do fármaco contra a correspondente concentração de LSS utilizado. Em seguida, as formulações de teste foram comparadas por fatores f1 (dissimilaridade) e f2 (similaridade), utilizando uma marca de referência de cefuroxima axetil. Diferenças significativas (p<0,05) na taxa de dissolução foram registradas com a mudança na concentração de LSS em diferentes meios de dissolução. A formulação T3 contendo LSS a 1% foi considerada a melhor formulação otimizada com base nos ensaios de desintegração, dissolução e fatores de semelhança e dissimilaridade.


Subject(s)
Sodium Dodecyl Sulfate/analysis , Tablets/classification , Cefuroxime/analysis , Chemistry, Pharmaceutical
18.
J Oral Maxillofac Surg ; 70(6): 1398-403, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22459228

ABSTRACT

PURPOSE: To investigate the penetration of cefuroxime into the parotid saliva after short-term intravenous administration in patients undergoing various maxillofacial surgical procedures. PATIENTS AND METHODS: A total of 12 patients, 10 males and 2 females, with a mean age of 41 ± 21.2 years, participated in the present study. Each patient received 1.5 g of intravenous cefuroxime every 8 hours. Blood and parotid saliva samples were collected concomitantly, on the third day of therapy, just before the infusion of the first morning dose, and 0.5 hour after its end. All samples were analyzed using high-performance liquid chromatography. RESULTS: The cefuroxime concentration in plasma and saliva before infusion was 2.08 ± 1.05 mg/L and 0.46 ± 0.33 mg/L, respectively. At 30 minutes after the end of infusion, the corresponding concentrations were 55.54 ± 20.24 mg/L and 14.50 ± 7.85 mg/L. The saliva/plasma ratio was 0.25 ± 0.18 before and 0.26 ± 0.12 after the infusion. CONCLUSIONS: Cefuroxime is excreted in saliva in high levels shortly after infusion but is detected in far lower levels 8 hours after infusion. Taking into consideration the minimum inhibitory concentration values of common pathogens, we have concluded that the saliva concentrations of the drug are sufficient against some, but not all, pathogens involved in the oral-maxillofacial area.


Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Cefuroxime/pharmacokinetics , Oral Surgical Procedures , Parotid Gland/metabolism , Saliva/chemistry , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/blood , Cefuroxime/administration & dosage , Cefuroxime/analysis , Cefuroxime/blood , Chromatography, High Pressure Liquid , Elective Surgical Procedures , Female , Humans , Infusions, Intravenous , Male , Microbial Sensitivity Tests , Middle Aged , Mouth/microbiology , Prospective Studies , Young Adult
19.
Article in English | MEDLINE | ID: mdl-22286057

ABSTRACT

The complexation reaction of cephalosporins namely cefotaxime (CTX), cefuroxime (CRX), and cefazolin (CEFAZ) with palladium (II) ions have been studied in water and DMF in 25 °C by the spectrophotometric methods. The method is based on the formation of yellow to yellowish brown complex between palladium (II) chloride and the investigated cephalosporins in the presence of sodium lauryl sulfate (SLS) as surfactant. The complexation process was optimized in terms of pH, temperature and contact time. The stoichiometry of all the complexes was found to be 2:1 (metal ion/ligand) for CTX, CRX, and 1:2 for CEFAZ. The stoichiometry of palladium (II)-cephalosporins was estimated by mole ratio and continuous variation methods and emphasized by the KINFIT program. These drugs could be determined by measuring the absorbance of each complex at its specific λmax. The results obtained are in good agreement with those obtained using the official methods. The proposed method was successfully applied for the determination of these compounds in their dosage forms.


Subject(s)
Anti-Bacterial Agents/analysis , Cefazolin/analysis , Cefotaxime/analysis , Cefuroxime/analysis , Palladium/chemistry , Spectrophotometry/methods , Calibration , Pharmaceutical Preparations/chemistry , Sensitivity and Specificity , Solvents , Tablets
20.
J Chromatogr Sci ; 49(7): 508-11, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21801481

ABSTRACT

This paper describes the development and evaluation of a HPLC and UV spectrophotometric methods to quantify cefuroxime sodium in injectables. HPLC analysis were carried out using a C18 Wat 054275 column and a mobile phase composed of methanol and water (70:30), with a flow rate of 0.8 mL/min and UV detection at 280 nm. For the spectrophotometric analysis, water was used as solvent and the wavelength of 280 nm was selected for the detection. Both methods were found to quantify cefuroxime sodium in injectables accurately. Therefore HPLC and UV methods presented the most reliable results for the analyses of injectables.


Subject(s)
Cefuroxime/analysis , Chromatography, High Pressure Liquid/methods , Pharmaceutical Preparations/analysis , Spectrophotometry, Ultraviolet/methods
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