Ceftizoxime-induced immune hemolytic anemia associated with multi-organ failure / 영남의대학술지

Drug-induced immune hemolytic anemia (DIIHA) is a rare side effect of drugs. DIIHA may cause a systemic inflammatory response that results in acute multi-organ failure and death. Ceftizoxime belongs to the class of third generation cephalosporins, which are the most common drugs associated with DIIHA. Herein, we present a case of a 66-year-old man who developed fatal DIIHA after receiving a second dose of ceftizoxime. He was admitted to receive photodynamic therapy. He had a history of a single parenteral dose of ceftizoxime 3 months prior to admission. On the day of the procedure — shortly after the infusion of ceftizoxime — the patient's mental status was altered. The blood test results revealed hemolysis. Oliguric acute kidney injury developed, and continuous renal replacement therapy had to be applied. On the suspicion of DIIHA, the patient underwent plasmapheresis. Diagnosis was confirmed by a detection of drug-dependent antibody with immune complex formation. Although his hemolysis improved, his liver failure did not improve. He was eventually discharged to palliative care, and subsequently died.

Ceftizoxime-induced immune hemolytic anemia associated with multi-organ failure / 영남의대학술지

Drug-induced immune hemolytic anemia (DIIHA) is a rare side effect of drugs. DIIHA may cause a systemic inflammatory response that results in acute multi-organ failure and death. Ceftizoxime belongs to the class of third generation cephalosporins, which are the most common drugs associated with DIIHA. Herein, we present a case of a 66-year-old man who developed fatal DIIHA after receiving a second dose of ceftizoxime. He was admitted to receive photodynamic therapy. He had a history of a single parenteral dose of ceftizoxime 3 months prior to admission. On the day of the procedure — shortly after the infusion of ceftizoxime — the patient's mental status was altered. The blood test results revealed hemolysis. Oliguric acute kidney injury developed, and continuous renal replacement therapy had to be applied. On the suspicion of DIIHA, the patient underwent plasmapheresis. Diagnosis was confirmed by a detection of drug-dependent antibody with immune complex formation. Although his hemolysis improved, his liver failure did not improve. He was eventually discharged to palliative care, and subsequently died.

Literature Analysis of Ceftizoxime-induced Hemolytic Anemia / 中国药房

OBJECTIVE:To provide reference for clinical prevention and treatment of ceftizoxime-induced hemolytic anemia by investigating the situation of ceftizoxime-induced hemolytic anemia. METHODS:Using Chinese and English“ceftizoxime”“he-molysis”and other words as key words,related literatures during 1986-2015 were retrieved from CNKI,Wanfang database and PubMed database. Those literatures were analyzed statistically in respects of general information,clinical drug use and manifesta-tion,occurrence time and outcome,etc. The mechanisms of hemolytic anemia were analyzed to put forward prevention and treat-ment measures. RESULTS & CONCLUSIONS:A total of 11 literatures were retrieved,including 4 foreign literatures and 7 domes-tic ones. There were 15 cases in total,including 5 foreign cases and 10 domestic cases. According to the patient’s age,there were 7 cases of infants,4 cases of the elderly,3 cases of middle-aged people and 1 case of youth. The hemolytic anemia often occurred on the 2-7 day(8 cases). Most of the patients were improved after treatment,but there were 3 patients who died. The mechanism of hemolytic anemia mainly included the production of immune complex and non-immunologic protein adsorption. It is suggested to investigate allergic reaction history,pay attention to sensitization test on skin,select suitable drug dosage and avoid drug combina-tion. The patient’s medications should be monitored closely. Once hemolytic anemia occurs,it should be immediately stop using the drug and take appropriate measures as hormone treatment,comprehensive treatment,blood transfusion treatment,to avoid en-dangering the life safety of patients.

Levofloxacin lactate and ceftizoxime for anti-infective therapy of acute edematous biliary pancreatitis: A comparison of efficacy / 第二军医大学学报

Objective To compare the anti-infective effects of levofloxacin lactate and ceftizoxime in treatment of acute edema biliary pancreatitis, so as to provide reference for clinical anti-infective therapy of acute pancreatitis. Methods A total of 180 consecutive patients with acute edema biliary pancreatitis, who were treated in the emergency department of Changhai Hospital from January 2014 to November 2014, were selected in the present study, and they were randomly divided into levofloxacin lactate treatment group and ceftizoxime treatment group. In addition to conventional treatment including water fasting, gastrointestinal decompression, acid suppression, enzyme suppression and nutrition support, etc., levofloxacin lactate therapy and ceftizoxime were given separately to control the infection in the two groups. Then the following parameters were observed: remission of vomiting, abdominal pain and bloating, open eating time, hospital stays, blood routine and biochemistry test, C reaction protein (CRP), serum amylase, and the absorption of inflammation of the pancreas in imaging. Results The levofloxacin lactate treatment group had a significantly higher effective rate than the ceftizoxime treatment group (P <0.05). Compared with the ceftizoxime treatment group, the remission of vomiting and abdominal pain and bloating was significantly faster in the levofloxacin lactate treatment group (P <0.01); the open eating time, hospital stays hemogram and blood amylase recovery were also significantly improved in the levofloxacin lactate treatment group (P <0.05); and the absorption of inflammation of the pancreas in CT imaging was significantly faster (P <0.05). Conclusion The study shows that levofloxacin lactate is more effective than ceftizoxime in the anti-infective therapy of acute edema biliary pancreatitis.

Impurity profile study of ceftizoxime sodium for injection / 中国药学杂志

OBJECTIVE: To investigate the impurity profile of ceftizoxime sodium for injection and develop the impurity control strategy.

A Case of Immune Hemolytic Anemia Induced by Ceftizoxime and Cefobactam (Sulbactam/Cefoperazone) / 대한진단검사의학회지

Simultaneous drug-induced immune hemolytic anemia (DIIHA) caused by multiple drugs is rare. We report a case of a patient who developed DIIHA caused by 2 drugs. The patient's serum exhibited agglutination of ceftizoxime- or sulbactam-coated red blood cells (RBCs; via a drug-adsorption mechanism) and of uncoated RBCs in the presence of sulbactam (via an immune-complex mechanism). Although ceftizoxime is known to exhibit a positive reaction by an immune-complex method with or without reactivity with drug-coated RBCs, this patient's antibodies were reactive only against drug-coated RBCs. On the other hand, sulbactam, which is known to cause hemolytic anemia by nonimmunologic protein adsorption, exhibited positive reactions in tests with both drug-coated RBCs and in the presence of sulbactam. This is the first report of DIIHA due to a sulbactam-cefoperazone combination and the fourth report of DIIHA due to ceftizoxime. Owing to the patient's complicated laboratory results, DIIHA was suspected only at a late stage. We propose that for the prompt diagnosis of DIIHA, tests for all possible causative drugs should be conducted by 2 methods.

Production Technology of Ceftizoxime Sodium / 中国药房

OBJECTIVE:To study the production process of ceftizoxime sodium.METHODS:Ceftizoxime acid was prepared with 7-Amino-3-norcephem-4-carboxylic acid(7-ANCA)and AE-ester ceftizoxime acid as raw material;then ceftizoxime sodium was obtained through the reaction between ceftizoxime acid and sodium carbonate.The effects of parameters including reaction time,and amount and dripping velocity of ethanol,the amount of sodium carbonate,and pH of solution on quality of product were studied.RESULTS:The reaction process could be realized successfully.The optimal parameters for the synthesis of ceftizoxime sodium were as follows:reaction time=1.5h,the velocity of dripping ethanol=400mL? h-1,reaction temperature

Clinical study on the treatment of acute bacterial infection by domestic ceftizoxime sodium / 重庆医科大学学报

Objective:To evaluate the efficacy and safety of domestic ceftizoxime sodium on the treatment of acute bacterial infection compared with the imported one.Methods:A randomized,comparative,double blinded trial was conducted.The usage of the two medicines was the same: The dose was 2.0g,bid and the duration of treatment was 7~14 days.The clinical efficacy,bacterial eradication and adverse reaction were observed.Results:The total number of final evaluated subjects was 50 with 25 subjects in domestic ceftizoxime sodium group and 25 subjects in imported ceftizoxime sodium group(control group).Clinical efficacy rate and bacterial eradication rate for domestic ceftizoxime sodium were 96.00% and 89.47%,respectively.Clinical efficacy rate and bacterial eradication rate for imported ceftizoxime sodium were 100% and 100%.No adverse reaction was observed in two groups.Conclusion:Domestic ceftizoxime sodium has the same efficacy and safety as the imported one on the treatment of acute bacterial infection.

Determination of Content of Ceftizoxime by RP-HPLC / 中国药房

OBJECTIVE:To determine the content of ceftizoxime for injection METHODS:A RP-HPLC method was established,the polarls C18 was used as analysis column The mobile phase consisted of 0 23% sodium hydrogen phosphate and 0 14% trisodium buffer-acetonitrile(85∶15),the flow rate was 1 0ml/min,the detection wavelength was 254nm RESULTS:The linear range of ceftizoxime was 4 1 462～37 3 156?g/ml,r=0 9 999 The relative standard deviation was 0 6% CONCL_USION:The method is rapid,accurate and suitable for determination of content of ceftizoxime for injection

A Clinical Study on Ceftizoxime in the Therapeutic Effect of Urinary Tract Infection / 대한비뇨기과학회지

Ceftizoxime was administered to 30 cases with urinary tract infection for 7 days in the most cases at a daily dose of 1-2 gm intravenously or intramuscularly. The clinical efficacy of Ceftizoxime was as follows: Excellent results were obtained in 13 cases, good result in 14 cases and poor result in 3 cases, the overall effectiveness rate was 90% and no adverse reaction was noted in all cases. bacteriologically, 13 strains were isolated in 26 cases and 4 cases were bacteriologically unknown, and 2 strains in 3 cases, which were a case of proteus morganii and two cases of Pseudomonas fluoresces, were failed in treatment. Judging from the response to Ceftizoxime as shown in al Tables, Ceftizoxime is considered to be a very useful antibiotic in the treatment of urinary tract infection.

THE DOSAGE AND ROUTE OF ADMINISTRATION OF CEFTIZOXIME IN SEVERE PULMONARY INFECTION / 解放军医学杂志

12 cases of severe pulmonary infection were treated with ceftizoxime, one of cepha-losporins of the third generation. Clinical observation and pharmacokinetics were carried out. The result showed that intravenous infusion was the best route of drug administration. It had the advantages of high serum concentration and prolonged maintenance of serum level. 1 gram of ceftizoxi-me, two times a day, was enough for most pathogens except Pseudomonas aeruginosa.