Cefazolin Research Articles

Phenotypic and Genotypic Correlates of the NaHCO3-Responsive Phenotype Among Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Skin and Soft Tissue Infections (SSTIs)

ObjectivesTo assess the frequency of the novel NaHCO3-responsive phenotype, wherein clinical methicillin-resistant Staphylococcus aureus (MRSA) isolates are rendered susceptible to standard-of-care β-lactams in the presence of NaHCO3, in a collection of 103 clinical US MRSA skin and soft tissue infection (SSTI) isolates and 22 clinical European SSTI isolates. Determined the correlation between specific phenotypic and genotypic metrics and the NaHCO3-responsive phenotype among US SSTI isolates. MethodsAntimicrobial susceptibility testing (AST) was performed to determine susceptibility phenotypes. Targeted and whole genome sequencing (WGS) with a genome-wide sequence analysis (GWAS) were conducted to identify specific and novel genotypes of interest that may be associated with the NaHCO3-responsive phenotype. Gene expression analysis and targeted gene deletion were performed to assess the role of a specific novel genetic locus in the NaHCO3-responsive phenotype. ResultsThe NaHCO3-responsive phenotype was identified in 78/103 US isolates and 4/22 UK isolates to cefazolin (CFZ), and in 17/103 US isolates and 1/22 UK isolates to oxacillin (OXA). In US isolates, a significant association was identified between NaHCO3-responsiveness to CFZ and: i) susceptibility to amoxicillin-clavulanate; ii) a specific mecA genotype; iii) clonal complex (CC) type 8; and iv) spa type t008. GWAS identified SNPs in an AraC family regulator (SAUSA300_RS00540) to be exclusively found in NaHCO3-non-responsive SSTI strains. In vitro HCO3 exposures of NaHCO3-responsive strains, but not -non-responsive strains, caused >2-fold up-regulated expression of this gene. Deletion of this gene rendered NaHCO3-responsive strain MRSA 11/11 no longer NaHCO3-responisve to CFZ; we have termed this gene the staphylococcal AraC bicarbonate-response regulator, sabR. ConclusionsNaHCO3-responsiveness is highly associated with CC8/spa t008, a commonly circulating genetic background in North America. The AraC bicarbonate-response regulator, sabR, appears to be associated with the mechanism of NaHCO3-responisveness, more work is needed to verify. Word count 288.

Photoelectrochemical sensor based on copper tetraamino phthalocyanine graphene oxide covalent compound for sensitive detection of cefazolin sodium

In the present research, a novel photoelectrochemical (PEC) sensor was built to detect cefazolin sodium. A copper tetraamino phthalocyanine (CuTAPc) covalently linked graphene oxide compound (CuTAPc-GO) was fabricated successfully by covalent bonding of CuTAPc with graphene oxide (GO). The novel PEC sensing platform was prepared using CuTAPc-GO as a photoelectric material. The prepared PEC sensor showed a higher PEC efficiency under red light. In the perfect conditions, the PEC sensor exhibited a linear correlation in detecting cefazolin sodium concentrations between 0.25 and 12.5 μM, featuring a detection limit at 0.15 μM. Furthermore, the manufacturing sensor was employed to detect cefazolin sodium in a real-world sample, demonstrating commendable sensitivity and stability. Thus, our study provides a new method for cefazolin sodium detection.

Fibrinolytic treatment using recombinant tissue-type plasminogen activator (rt-PA) for staphylococcal infective endocarditis

Infective endocarditis (IE) is a severe illness characterized by vegetation of bacterial thrombosis. We hypothesized that adding recombinant tissue-type plasminogen activator (rt-PA) to antibiotics would contribute to good results in the treatment of IE. As an in vitro study, we injected labeled Staphylococcus aureus (S. aureus) and either rt-PA or PBS + plasminogen into a polydimethylsiloxane flow chamber with fibrin on a coverslip, and then performed immunofluorescent area assessment. As an in vivo experiment, IE model rats that had suffered mechanical damage in the aortic valve by catheter and revealed bacterial vegetation caused by S. aureus injection were treated with either a control, cefazolin (CEZ), rt-PA, or rt-PA + CEZ, for 7 days. Survival was assessed for 14 days after the appearance of vegetation, with daily monitoring of the vegetation by transthoracic echocardiography (TTE). The in vitro investigation showed that perfusion of rt-PA could detach S. aureus significantly more efficiently than PBS could. In the in vivo research, the rt-PA + CEZ group survived significantly longer than the other groups, and rt-PA + CEZ was more effective than CEZ in the dissolution of vegetation, as observed by TTE. In conclusion, adding rt-PA to antibiotic treatment could dissolve the vegetation component synergistically and improve the survival rate.

Unveiling antibiotic resistance dynamics in single and two-stage anaerobic digestion of dairy cow manure: Implications for environmental health

This study investigated antibiotic-resistant bacteria (ARB) survival during mesophilic anaerobic digestion (AD) of dairy cow manure with cefazolin (CEZ) antibiotic. Comparing single- and two-stage AD systems, we assessed ARB removal rates, biogas yield, volatile fatty acid concentration, and microbial populations. The results revealed that in the two-stage AD system, the methanogenic phase (MP) exhibited the highest removal rates of CEZ-resistant (CEZ-r) and oxytetracycline-resistant (OTC-r) bacteria at 9–16 % and 69–72 %, respectively. However, the MP had a higher proportion of ARB among the total culturable bacteria (24–30 %) compared to the acidogenic phase (AP) and single-stage AD. CEZ negatively impacted ARB removal rates and biogas production in both systems, with a more pronounced effect in single-stage AD. Biogas yield in the two-stage AD ranged from 337.7–385.6 mL/gVS, which was 10–20 % higher than that of the single-stage AD, regardless of CEZ addition. The reduction in biogas production due to CEZ was primarily attributed to the suppression of VFA production. As for microbial populations, the changes in the percentages of Firmicutes, Bacteroidetes, and Proteobacteria were likely related to the variations in ARB numbers, and the abundance of Methanosaetaceae significantly influenced biogas production.

Peracetic Acid Activation by Modified Hematite for Water Purification: Performance, Degradation Pathways, and Mechanism.

Natural mineral-based advanced oxidation processes (AOPs) are now receiving increasing attention for the efficient degradation of pollutants. In this work, we used a common reducing agent (NaBH4) to treat natural Hematite to obtain modified Hematite (Hematite-(R)) and applied it to activate peracetic acid (PAA) for efficient degradation of cefazolin (CFZ). Compared with Hematite, the Hematite-(R)/PAA system increased the degradation rate of CFZ by 21.7% within 80 min under neutral conditions. Scavenging experiments and electron paramagnetic resonance (EPR) technology were introduced to identify the principal roles of 1O2, CH3C(O)OO•, and •OH for CFZ removal over the Hematite-(R)/PAA process. The outstanding capability of Hematite-(R) could be mainly due to the higher percentage of Fe(II) (52%) on the surface of catalysts. Furthermore, the possible degradation pathways of CFZ were explored. Moreover, the Hematite-(R)/PAA process showed a superior CFZ removal efficiency with a wide initial pH scope of 1.0-9.0. The degradation efficiency of CFZ showed a negligible effect in the presence of Cl-, SO42-, and NO3-, while significant inhibition was recorded after the addition of H2PO4- and CO32-. The inhibition of humic acid (HA) on CFZ degradation via the Hematite-(R)/PAA process showed an obvious concentration dependence. This work could provide strong support for the use of natural Hematite in water purification.

Synergistic and antagonistic adsorption mechanisms of copper(II) and cefazolin onto bio-based chitosan/humic composite: A combined experimental and theoretical study

In this study, a bio-based chitosan adsorbent modified by humic was synthesized. The adsorbent exhibited amphoteric adsorption properties and had a higher adsorption capacity for Cu(II) and cefazolin (CEF) than its precursors. The impacts of pH on the speciation and adsorption of Cu(II) and CEF were analyzed. The synergistic and antagonistic adsorption in Cu(II)/CEF co-existing system were systematically investigated. The adsorption amount of CEF significantly increased by 84 %, owing to the bridge effect of Cu(II). While the uptake of Cu(II) decreased by 29 % at CEF concentration of 0.3 mmol/L, due to the formation of organic ligand complex between Cu(II) and CEF with low affinity to the adsorbent. The adsorption mechanisms of Cu(II) and CEF were analyzed by XPS and Density functional theory (DFT). Through DFT calculations, the interaction configurations of Cu(II) and CEF on adsorbent as well as Cu(II)-CEF complexes were configurated. The possible Cu(II)-CEF complexes configuration were optimized, and the complex configuration (Cu-N2/O1/O2) was the most stable combination structure with the lowest binding energy (−2066.61 kJ/mol). Interaction region indicator (IRI) model further elucidated the chemical and weak interactions between CEF and Cu(II) in coexisting system. In addition, the influence of common inorganic electrolytes on the adsorption of Cu(II) and CEF was assessed. The adsorbent could be stably recycled for five cycles with little loss, indicating the potential application in the treatment of combined pollution. This study proposed more insights into the interactions of heavy metal ions and antibiotics in the coexistence system onto the adsorbents containing amine and carboxyl groups.

Using the Natural Language Processing System Medical Named Entity Recognition-Japanese to Analyze Pharmaceutical Care Records: Natural Language Processing Analysis.

Large language models have propelled recent advances in artificial intelligence technology, facilitating the extraction of medical information from unstructured data such as medical records. Although named entity recognition (NER) is used to extract data from physicians' records, it has yet to be widely applied to pharmaceutical care records. In this study, we aimed to investigate the feasibility of automatic extraction of the information regarding patients' diseases and symptoms from pharmaceutical care records. The verification was performed using Medical Named Entity Recognition-Japanese (MedNER-J), a Japanese disease-extraction system designed for physicians' records. MedNER-J was applied to subjective, objective, assessment, and plan data from the care records of 49 patients who received cefazolin sodium injection at Keio University Hospital between April 2018 and March 2019. The performance of MedNER-J was evaluated in terms of precision, recall, and F1-score. The F1-scores of NER for subjective, objective, assessment, and plan data were 0.46, 0.70, 0.76, and 0.35, respectively. In NER and positive-negative classification, the F1-scores were 0.28, 0.39, 0.64, and 0.077, respectively. The F1-scores of NER for objective (0.70) and assessment data (0.76) were higher than those for subjective and plan data, which supported the superiority of NER performance for objective and assessment data. This might be because objective and assessment data contained many technical terms, similar to the training data for MedNER-J. Meanwhile, the F1-score of NER and positive-negative classification was high for assessment data alone (F1-score=0.64), which was attributed to the similarity of its description format and contents to those of the training data. MedNER-J successfully read pharmaceutical care records and showed the best performance for assessment data. However, challenges remain in analyzing records other than assessment data. Therefore, it will be necessary to reinforce the training data for subjective data in order to apply the system to pharmaceutical care records.

A validated LC-MS/MS method for simultaneous quantitation of piperacillin, cefazolin, and cefoxitin in rat plasma and twelve tissues

BackgroundThe investigation of drug disposition in tissues is critical to improving dosing strategy and maximizing treatment effectiveness, yet developing a multi-tissue bioanalytical method could be challenging due to the differences among various matrices. Herein, we developed an LC-MS/MS method tailored for the quantitation of piperacillin (PIP), cefazolin (CFZ), and cefoxitin (CFX) in rat plasma and 12 tissues, accompanied by validation data for each matrix according to the FDA and EMA guidelines. ResultsThe method required only a small sample volume (5 μL plasma or 50–100 μL tissue homogenates) and a relatively simple protocol for simultaneous quantitation of PIP, CFZ, and CFX within different biological matrices. Mobile phase A was composed of 5 mM ammonium formate and 0.1 % formic acid in water, while mobile phase B contained 0.1 % formic acid in acetonitrile. The mobile phase was pumped through a Synergi Fusion-RP column equipped with a guard column with a gradient elution program at a 0.3 mL/min flow rate. The mass spectrometer was operated in positive ionization mode (ESI+) using multiple reaction monitoring. SignificanceThe validated method has been successfully applied to quantify PIP, CFZ, and CFX from the plasma and tissue samples collected in a pilot rat study and will further be used in a large pharmacokinetic study. To our knowledge, this is also the first report presenting long-term, freeze-thaw, and autosampler stability data for PIP, CFZ, and CFX in rat plasma and multiple tissues.

Population pharmacokinetics and pharmacodynamic target attainment analysis of cefazolin using total and unbound serum concentration in patients with prostatectomy or nephrectomy.

The aim of this study was to analyze the population pharmacokinetics of total and unbound concentrations of prophylactic cefazolin (CFZ) in patients with prostatectomy or nephrectomy. We also aimed to calculate a pharmacodynamics target unbound concentration that exceeded the minimum inhibitory concentration (MIC), to design an effective dosing regimen. Briefly, 614 total concentration and 610 unbound concentration samples from 152 individuals were evaluated, using a nonlinear mixed-effects model. The obtained pharmacodynamics index target value reflected the probability of maintaining CFZ unbound trough concentrations exceeding MIC90, 0.5 mg/L, and MIC50, and 1.0 mg/L, to account for methicillin-susceptible Staphylococcus aureus (MSSA) or Escherichia coli. Population pharmacokinetics were estimated using a two-compartment model with nonlinear protein binding. Unbound systemic clearance (CL) was significantly associated with creatinine clearance, while the maximum protein-binding constant was significantly associated with albumin levels. The probability of achieving an unbound concentration exceeding the MIC50 for E. coli or MIC90 for MSSA in a patient with normal renal function following a 1 g CFZ infusion over 15 min was above 90% at 3 h after the initial dose. Our findings indicated that population pharmacokinetic parameters are useful for determining unbound CFZ pharmacokinetics and evaluating intraoperative CFZ redosing intervals.

FeS2 nanosheets-luminol-O2 chemiluminescence method for determination of venlafaxine hydrochloride, imipramine hydrochloride, and cefazolin sodium.

This study introduces a novel chemiluminescence (CL) approach utilizing FeS2 nanosheets (NSs) catalyzed luminol-O2 CL reaction for the measurement of three pharmaceuticals, namely venlafaxine hydrochloride (VFX), imipramine hydrochloride (IPM), and cefazolin sodium (CEF). The CL method involved the phenomenon of quenching induced by the pharmaceuticals in the CL reaction. To achieve the most quenching efficacy of the pharmaceuticals in the CL reaction, the concentrations of reactants comprising luminol, NaOH, and FeS2 NSs were optimized accordingly. The calibration curves demonstrated exceptional linearity within the concentration range spanning from 4.00 × 10-7 to 1.00 × 10-3mol L-1, 1.00 × 10-7 to 1.00 × 10-4mol L-1, and 4.00 × 10-6 to 2.00 × 10-4mol L-1 with detection limits (3σ) of 3.54 × 10-7, 1.08 × 10-8, and 2.63 × 10-6mol L-1 for VFX, IPM, and CEF, respectively. This study synthesized FeS2 NSs using a facile hydrothermal approach, and then the synthesized FeS2 NSs were subjected to a comprehensive characterization using a range of spectroscopic methods. The proposed CL method was effective in measuring the aforementioned pharmaceuticals in pharmaceutical formulations as well as different water samples. The mechanism of the CL system has been elucidated.

Mechanism of the Synergistic Toxicity of Ampicillin and Cefazoline on Selenastrum capricornutum.

Ampicillin (AMP) and cefazolin (CZO) are commonly used β-lactam antibiotics which are extensively globally produced. Additionally, AMP and CZO are known to have relatively high ecotoxicity. Notably, the mix of AMP and CZO creates a synergistic effect that is more harmful to the environment, and how exposure to AMP-CZO can induce synergism in algae remains virtually unknown. To yield comprehensive mechanistic insights into chemical toxicity, including dose-response relationships and variations in species sensitivity, the integration of multiple endpoints with de novo transcriptomics analyses were used in this study. We employed Selenastrum capricornutum to investigate its toxicological responses to AMP and CZO at various biological levels, with the aim of elucidating the underlying mechanisms. Our assessment of multiple endpoints revealed a significant growth inhibition in response to AMP at the relevant concentrations. This inhibition was associated with increased levels of reactive oxygen species (ROS) and perturbations in nitrogen metabolism, carbohydrate metabolism, and energy metabolism. Growth inhibition in the presence of CZO and the AMP-CZO combination was linked to reduced viability levels, elevated ROS production, decreased total soluble protein content, inhibited photosynthesis, and disruptions in the key signaling pathways related to starch and sucrose metabolism, ribosome function, amino acid biosynthesis, and the production of secondary metabolites. It was concluded from the physiological level that the synergistic effect of Chlorophyll a (Chla) and Superoxide dismutase (SOD) activity strengthened the growth inhibition of S. capricornutum in the AMP-CZO synergistic group. According to the results of transcriptomic analysis, the simultaneous down-regulation of LHCA4, LHCA1, LHCA5, and sodA destroyed the functions of the photosynthetic system and the antioxidant system, respectively. Such information is invaluable for environmental risk assessments. The results provided critical knowledge for a better understanding of the potential ecological impacts of these antibiotics on non-target organisms.

Effect of cefazolin sodium and amoxicillin sodium/clavulanate potassium on postoperative infection, pain and expression of inflammatory factors in patients undergoing orthopedic surgery

Purpose: To investigate the comparative effect of two antibacterial treatments in orthopedic surgery.
 Methods: A total of 96 patients who had undergone orthopedic surgery in Department of Nosocomial Infection Management, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou, China from January 2021 to December 2022 were retrospectively analyzed and equally divided into two groups based on the postoperative medications administered to prevent infection. The control group was treated with amoxicillin sodium/clavulanate potassium while the study group was treated with cefazolin sodium. The incidence of postoperative infection, pain score, inflammatory factors and quality of life were determined and compared between both groups.
 Results: The incidence of postoperative infection in the study group was lower than in the control group (p < 0.05). Prior to intervention, the visual analogue scale (VAS) scores of the two groups were similar (p > 0.05), but decreased significantly after intervention (p < 0.05), with the score of the former after intervention lower than that of the latter (p < 0.05). Prior to intervention, the inflammatory factor levels in both groups were identical (p > 0.05); however, the levels fell significantly in both groups after intervention (p < 0.05), but the levels in the study group were lower than in the control group (p < 0.05). The quality of life scores were also higher for both groups after intervention (p < 0.05), but higher for the study group than for the control group (p < 0.05).
 Conclusion: Cefazolin sodium is more effective than amoxicillin sodium/clavulanate potassium in preventing infection in orthopedic patients after orthopedic surgery. However, there is a need to extend this treatment strategy to other clinical sites in order to validate these findings.

Transcriptional responses of cytokines, immunoglobulin A, and nitric oxide genes in 1-day-old chicks post Salmonella typhimurium infection: An experimental study.

Salmonella has become one of the hazards prevalent foodborne pathogens causing different diseases in chickens. However, Salmonella typhimurium (ST), a nonhost-specific serovar, is a major avian agent that causes severe disturbance in young chicken wellness. The occurrence of Salmonella in chickens and their antimicrobial resistance were explored in this study. In addition, the immune response of 1-day-old broiler chicks, against multidrug resistant (MDR) ST infection, was also assessed at 4 and 24 hours post infection (pi) in the cecum and spleen, representing their mucosal and systemic immune responses, respectively. A total of 375 samples from 130 diseased and apparently healthy broiler and layer chickens were randomly collected for Salmonella isolation, identification, and resistance profile evaluation, from farms and different clinical laboratories. The immune response of 1-day-old broiler chicks, Ross 308, against in-vivo ST infection was ascertained through the evaluation of heterophile phagocytosis and s expression of cytokines, immunoglobulin A and other immune-regulating genes in the cecum and spleen. Twenty-four, 1-day-old nonvaccinated broiler chicks were used and divided into two groups. The chicks in the infected group were orally inoculated with 0.5 ml of 2 × 108 colony forming units (CFU)/ml of MDR ST suspension, while those in the control group were taken nutrient broth. Seven out of 130 (5.38%) examined chickens were positive for Salmonella. All isolates (100%) were resistant to amoxicillin-clavulanic acid (AMC), cefazolin (CZ), cefoxitin (FOX), ciprofloxacin (CIP), nalidixic acid (NA), tetracycline (TE), fosfomycin (FOS), and colistin (CT) with multiple antimicrobial resistances (MARs) index range of 0.72-0.83, where none of them was resistant to meropenem (MEM). The results of immune response revealed that chicks infected with ST showed significantly different phagocytosis percentages and index values compared to controls. According to the real-time quantitative polymerase chain reaction (RT-qPCR) results, the transcription of IL-8, iNOS, IL-18, IgA, and IFN-γ for chicks infected by ST showed a significantly increased trend (p < 0.01) with increasing chicken age and was higher in the cecum than spleen compared to controls (p < 0.05) during 24 hours after infection. The findings indicated a strong mucosal immune response in the chicks after the ST challenge, which reflects humoral and cellular responses. Our insight recommended the occurrence of a natural immune response stimulator at 1 day age to face the infection, and this can prevent the resistance transfer, with efficient control measures.

Colon-Targeted Oral Delivery of Hydroxyethyl Starch-Curcumin Microcapsules Loaded with Multiple Drugs Alleviates DSS-Induced Ulcerative Colitis in Mice.

Combination therapy through colon-targeted oral delivery of multiple drugs presents a promising approach for effectively treating ulcerative colitis (UC). However, the codelivery of drugs with diverse physicochemical properties in a single formulation remains a formidable challenge. Here, microcapsules are designed based on hydroxyethyl starch-curcumin (HES─CUR) conjugates to enable the simultaneous delivery of hydrophobic dexamethasone acetate (DA) and hydrophilic cefazolin sodium (CS), yielding multiple drug-loaded microcapsules (CS/DA-loaded HES─CUR microcapsules, CDHC-MCs) tailored for colon-targeted therapy of UC. Thorough characterization confirms the successful synthesis and exceptional biocompatibility of CDHC-MCs. Biodistribution studies demonstrate that the microcapsules exhibit an impressive inflammatory targeting effect, accumulating preferentially in inflamed colons. In vivo experiments employing a dextran-sulfate-sodium-induced UC mouse model reveal that CDHC-MCs not only arrest UC progression but also facilitate the restoration of colon length and alleviate inflammation-related splenomegaly. These findings highlight the potential of colon-targeted delivery of multiple drugs within a single formulation as a promising strategy to enhance UC treatment, and the CDHC-MCs developed in this study hold great potential in developing novel oral formulations for advanced UC therapy.

Sterility of antibiotic-admixed peritoneal dialysis solution over time.

Intraperitoneal antibiotics may be required daily for up to three weeks to treat peritoneal dialysis (PD)-related peritonitis. In some jurisdictions, antibiotic-admixed PD solutions are required to be used within 24 h due to concerns regarding microbial contamination and growth. This requires patients to attend the PD unit daily or alternatively for staff to perform home delivery with associated transport, staffing and cost implications. The aim of this study was to determine if significant microbial growth occurs in PD solutions following their injection with antibiotic or sterile water. Twelve PD solution bags were admixed with cefazolin sodium 1 g, diluted in 10 mL sterile water, while a further 12 PD solution bags were admixed with 10 mL sterile water using aseptic technique (AT) under supervision. All bags were stored at room temperature. Three bags from each experimental group were sampled for microbiologic culture at 0-, 24-, 48- and 72-h intervals. One sterile water admixed bag sampled at 24 h yielded a Corynebacterium spp. after microbiologic culture. A repeat specimen from the same bag at day nine returned a negative culture result. All other sterile water and cefazolin admixed bags returned negative culture results at all time points. Antibiotic-admixed PD solutions prepared using AT and stored at room temperature remained sterile for up to 72 h. This suggests that patients can be safely issued with a supply of antibiotic-admixed PD bags for up to three days at a time.

Antimicrobial Prophylaxis With Ampicillin-sulbactam Compared With Cefazolin for Esophagectomy: Nationwide Inpatient Database Study in Japan.

To assess the effect of antimicrobial prophylaxis with ampicillin-sulbactam (ABPC/SBT) compared with cefazolin (CEZ) on the short-term outcomes after esophagectomy. CEZ is widely used for antimicrobial prophylaxis in esophagectomy without procedure-specific evidence, whereas ABPC/SBT is preferred in some hospitals to target both aerobic and anaerobic oral bacteria. Data of patients who underwent esophagectomy for cancer between July 2010 and March 2019 were extracted from a nationwide Japanese inpatient database. Overlap propensity score weighting was conducted to compare the short-term outcomes [including surgical site infection (SSI), anastomotic leakage, and respiratory failure] between antimicrobial prophylaxis with CEZ and ABPC/SBT after adjusting for potential confounders. Sensitivity analyses were also performed using propensity score matching and instrumental variable analyses. Among 17,772 eligible patients, 16,077 (90.5%) and 1695 (9.5%) patients were administered CEZ and ABPC/SBT, respectively. SSI, anastomotic leakage, and respiratory failure occurred in 2971 (16.7%), 2604 (14.7%), and 2754 patients (15.5%), respectively. After overlap weighting, ABPC/SBT was significantly associated with a reduction in SSI [odds ratio 0.51 (95% CI: 0.43-0.60)], anastomotic leakage [0.51 (0.43-0.61)], and respiratory failure [0.66 (0.57-0.77)]. ABPC/SBT was also associated with reduced respiratory complications, postoperative length of stay, and total hospitalization costs. The proportion of Clostridioides difficile colitis and noninfectious complications did not differ between the groups. Propensity score matching and instrumental variable analyses demonstrated equivalent results. The administration of ABPC/SBT as antimicrobial prophylaxis for esophagectomy was associated with better short-term postoperative outcomes compared with CEZ.

Purification and characterization of thioredoxin reductase enzyme from commercial Spirulina platensis tablets by affinity chromatography and investigation of the effects of some chemicals and drugs on enzyme activity.

Thioredoxin reductase (TrxR, enzyme code [E.C.] 1.6.4.5) is a widely distributed flavoenzyme that catalyzes nicotinamide adenine dinucleotide phosphate (NADPH)-dependent reduction of thioredoxin and many other physiologically important substrates. Spirulina platensis is a blue-green algae that is often used as a dietary supplement. S. platensis is rich in protein, lipid, polysaccharide, pigment, carotenoid, enzyme, vitamins and many other chemicals and exhibits a variety of pharmacological functions. In the present study, a simple and efficient method to purify TrxR from S. platensis tablets is reported. The extractions were carried out using two different methods: heat denaturation and 2',5'-adenosine diphosphate Sepharose 4B affinity chromatography. The enzyme was purified by 415.04-fold over the crude extract, with a 19% yield, and specific activity of 0.7640U/mg protein. Optimum pH, temperature and ionic strength of the enzyme activity, as well as the Michaelis constant (Km ) and maximum velocity of enzyme (Vmax ) values for NADPH and 5,5'-dithiobis(2-nitrobenzoic acid) were determined. Tested metal ions, vitamins, and drugs showed inhibition effects, except Se4+ ion, cefazolin sodium, teicoplanin, and tobramycin that increased the enzyme activity in vitro. Ag+ , Cu2+ , Mg2+ , Ni2+ , Pb2+ , Zn2+ , Al3+ , Cr3+ , Fe3+ , and V4+ ions; vitamin B3 , vitamin B6 , vitamin C, and vitamin U and aciclovir, azithromycin, benzyladenine, ceftriaxone sodium, clarithromycin, diclofenac, gibberellic acid, glurenorm, indole-3-butyric acid, ketorolac, metformin, mupirocin, mupirocin calcium, paracetamol, and tenofovir had inhibitory effects on TrxR. Ag+ exhibited stronger inhibition than 1-chloro-2,4-dinitrobenzene (a positive control).

Tissue Levels of Cefazolin During Coronary Artery Bypass Graft Surgery

Surgical site infections (SSIs) remain a devastating complication following cardiac surgery. Prophylactic antimicrobials administered at the time of surgery are one of the most important strategies for preventing SSIs. This research aimed to improve understanding of how to best prevent SSIs and ensure responsible, evidence-based use of antimicrobials. Cardiac surgery infection occurs in bone, subcutaneous and deep tissue; blood is not the most important compartment when considering antibiotic levels required to provide optimal surgical site prophylaxis. It was hypothesised that current Australian Therapeutic Guidelines: Antibiotic recommendations have led to suboptimal tissue cefazolin (CFZ) levels. This study was funded by the Robin Smallwood Bequest awarded by ANZCA.

Determination of scums in medicine materials

The current study is describing the main degrading scums in bromazepam, diazepam, Cefixime trihydrate, cefazolin sodium, simvastatin, and lovastatin, among other materials and manufactured items. HPLC was used to characterize pharmaceutical substance scums by comparing their retention lengths to reference standards. Before deciding, they sorted all the material from its main scums. Scums fell between 1.23 to 20.57 min, and parent compounds had try values between 2.71 and 9.22. Thus, isolating and identifying these compounds takes 20 minutes. This study identified parent compounds and degradation products using HPLC after confirming the European Pharmacopeial methodology. HPLC method validation for parent pharmaceuticals and degradation scums examined specificity, linearity, precision, and accuracy. The process can be applied to commodities and waste products using each compound's values for these qualities. 98%–102% of parent and scum materials are recovered. The experimental technique repeats within 3%. In compliance with pharmacopeial and regulatory norms, scums above 0.1% must be determined for pharmaceutical safety, efficacy, and quality. It's vital due to the effects of packaging, transit, storage, and manufacturer synthetic pathways. Adjuvants may cause degradation scums. The selected drugs' raw material and finished product levels of their main degrading scums were examined, and a concentration range was provided.

Facile one-step synthesis of a versatile nitrogen-doped hydrochar from olive oil production waste, “alperujo”, for removing pharmaceuticals from wastewater

In line with the principles of zero waste and recycling, alperujo (AL) was used in this study to produce a value-added product: hydrochar (HC) with high adsorption capacity. An optimization of the hydrothermal carbonization (HTC) conditions, such as temperature, residence time, and water/solid ratio, was carried out to maximize the adsorption capacity. Eight HCs were obtained, and an in-depth comparative characterization, as well as adsorption tests of two pharmaceuticals with very different physicochemical properties (fluoxetine (FLX) and cefazolin (CFZ)), were performed. This first step allowed for elucidation of the best candidates to carry out nitrogen grafting on their surface, resulting in the HC obtained at a higher water/solid ratio and temperature, and longer residence time: 3-220°C-2.5 h with a maximum uptake of 4.6 and 0.4 mg/g for FLX and CFZ, respectively. After that, a facile one-step, one-pot synthesis of nitrogen-doped hydrochars (N-HC) was developed to prepare a versatile bio-adsorbent with enhanced adsorption capacity. Two N–HCs were prepared using urea (U-HC) and polyethyleneimine (PEI-HC) and were intensively characterized to shed light on the adsorption mechanism. In both cases, amide groups were formed, which favored the adsorption process. PEI-HC acquired an outstanding maximum adsorption capacity of 983.84 mg/g for CFZ, and 29.31 mg/g for FLX, and the process was well described by the Freundlich isotherm and pseudo-second-order kinetic model. A co-adsorption test was performed using PEI-HC for both pharmaceuticals, finding that the adsorption process occurs in different active sites because there was no interference between the pollutants. This fact corroborates the versatility of the new bio-adsorbent synthesized.