Cost effectiveness of intracameral cefuroxime prophylaxis and its efficacy in preventing endophthalmitis after cataract surgery in a referral hospital / Custo-efetividade da profilaxia com cefuroxima intracameral e sua eficácia na prevenção da endoftalmite após cirurgia de catarata em um hospital de referência

ABSTRACT Purpose: To present the results of a retrospective study regarding the clinical and economic impact of intracameral cefuroxime administration to prevent endophthalmitis during cataract surgery in a referral hospital. Methods: This study included 16,902 eyes from patients who had undergone cataract surgery between 2013 and 2017. From May 2014 onwards, all patients received routine intracameral injections of 1 mg cefuroxime (10 mg/1 mL) after phacoemulsification. The prophylactic efficacy was evaluated using the relative risk ratio, whereas the economic impact was evaluated using number needed to treat to avoid endophthalmitis. Results: Before introducing cefuroxime, 3,407 cataract surgeries were performed using the phacoemulsification technique, and 7 post-operatory cases of endophthalmitis occurred (0.2% incidence). After introducing the cefuroxime protocol, 13,495 surgeries were performed, and 4 endophthalmitis cases were registered (0.03% incidence). Cefuroxime was identified as a protective factor against the development of endophthalmitis [risk ratio = 14%, p=0.002, 95% confidence interval (CI) 95%, 4%-49%], with an economic impact of number needed to treat = 568. The potential savings with cefuroxime was approximately US $2,334.36 for every 568 patients treated. Conclusion: The incidence of endophthalmitis decreased by 86% (risk ratio = 14%, p=0.002, 95% CI, 4%-49%) after introducing intracameral cefuroxime prophylaxis at the study hospital. The results presented herein provide strong evidence for the use of cefuroxime in endophthalmitis prophylaxis after phacoemulsification surgeries, outperforming the alter­native by providing both economic and clinical benefits.

RESUMO Objetivo: Apresentar os resultados de um estudo retrospectivo sobre o impacto clínico e econômico da administração de cefuroxima intracameral para prevenir endoftalmite nas cirurgias de catarata em um hospital de referência. Métodos: Este estudo incluiu 16.902 olhos de pacientes submetidos à cirurgia de catarata entre 2013 e 2017. A partir de maio de 2014, todos os pacientes receberam rotineiramente uma injeção intracameral de 1mg de cefuroxima (10mg/1mL) ao final da cirurgia de facoemulsificação. A eficácia da profilaxia foi avaliada usando o risco relativo e o impacto econômico foi avaliado com o número necessário para tratar para se evitar um caso de endoftalmite. Resultados: Antes da introdução do protocolo da cefuroxima, foram realizadas 3.407 cirurgias de catarata por facoemulsificação e ocorreram 7 casos de endoftalmite pós-operatória (incidência de 0,2%). Após a introdução do protocolo da cefuroxima, foram realizadas 13.495 cirurgias e registrados 4 casos de endoftalmite (incidência de 0,03%). A cefuroxima foi um fator de proteção no desenvolvimento de endoftalmite (risco relativo = 14%, p=0,002, Intervalo de Confiança de 95% [IC 95%], 4% - 49%) e o impacto econômico do número necessário para tratar = 568. A economia potencial com a cefuroxima foi de aproximadamente US$ 2.334,36 para cada 568 pacientes tratados. Conclusão: A incidência de endoftalmite diminuiu 86% (risco relativo = 14%, p=0,002, IC 95% 4% - 49%) desde a introdução da profilaxia com cefuroxima intracameral no hospital do estudo. Os resultados apresentados mostram forte evidência para o uso da cefuroxima na profilaxia da endoftalmite após cirurgias de facoemulsificação, por proporcionar economia de custos e benefício clínico.

Research progress of intracameral moxifloxacin in the prevention of bacterial endophthalmitis after cataract surgery / 中华实验眼科杂志

Postoperative endophthalmitis (POE) is a serious vision-threatening complication of cataract surgery, with an incidence rate of 0.033%-0.11% in China.In recent years, numerous retrospective studies and data analyses have reported that intracameral injection of antibiotics can effectively reduce the incidence of bacterial endophthalmitis, which commonly include cefuroxime, vancomycin and moxifloxacin.Globally, due to factors such as the availability, cost-effectiveness, and types of pathogens of POE, the drug choice varies to a large extent.Adverse events caused by antibiotics in the intracameral injection often occur, including macular edema, retinal vascular leakage, and uveitis caused by overdose of cefuroxime, and complications such as hemorrhagic retinal vasculitis obliterans due to vancomycin.Moxifloxacin, as a fourth-generation fluoroquinolone, has a significant effect on the prevention of bacterial endophthalmitis.Studies in the past five years related to moxifloxacin, and the significant advantages of moxifloxacin in the prevention of bacterial endophthalmitis, drug safety, duration of intracameral drug, and cost-effectiveness were summarized in this article.

The Outpatient Prescribing Pattern of Cefuroxime in Al-Kharj

Introduction:Several previous studies reported a high prescribing rate of cephalosporin antibiotics such as cefuroxime. The inappropriate outpatients prescribing of cefuroximeleadsto the development of bacterial resistance.Aim: This study was conducted to demonstrate the prescribing pattern of cefuroxime in the outpatient setting in Alkharj.Methodology:This retrospective study was conducted to know the prescribing pattern of cefuroxime. The data were collected from electronic prescriptions in a public hospital in Alkharj in 2018. The data were collected and analyzed using Excel software and represented as frequencies and percentages.Results:In 2018, there were 316 prescriptions containing cefuroxime. The majority of the patient wasmales (56.01%). The majority of cefuroxime prescriptions include tablet dosage form (81.96%). About 62.03% of the outpatient prescriptions were prescribed by the emergency department.Conclusion:Cephalosporin group (including cefuroxime) was one of the most commonly prescribed antibiotic groups to treat several infections. A high percentage of antibiotic prescriptions were prescribed inappropriately. It is important to increase the awareness about the wise use of antibiotics and to start the implementation of antimicrobial stewardship programs.

Synergistic antibacterial effect and mechanisms of dihydroartemisinin and cefuroxime incombination / 中国中药杂志

In this study, we explored the antibacterial effect and mechanism of dihydroartemisinin(DHA) combined with cefuroxime(CFX) or ampicillin against Escherichia coli. The minimum inhibitory concentration(MIC) of DHA, cefuroxime, and ampicillin against E. coli was 300,25,25 μmol·L~(-1), respectively, determined by broth microdilution method and 2,3,5-triphenyltetrazolium chloride(TTC) method. The minimum bactericidal concentration(MBC) was 25 μmol·L~(-1) for cefuroxime, above 600 μmol·L~(-1) for DHA. The fractional inhibitory concentration index(FICI) of DHA combined with cefuroxime or ampicillin was 0.375 and 0.75, respectively, determined by checkerboard microdilution assay, suggesting the synergistic effect or additive effect of the drug combination. Moreover, the time-effect curve showed that the antibacterial activity of DHA and CFX combination was much stronger than that of either of the drugs, suggesting that combination with DHA can decrease the CFX dosage. Then we studied the synergistic mechanism of DHA combined with cefuroxime and found that the combination of the two drugs had a significant inhibitory effect on the total protein bands, as shown by the results of polypropylene gel electrophoresis. The results of conductivity method and alkaline phosphatase test respectively showed that its conductivity value and alkaline phosphatase(AKP) leak were significantly higher than either of the drugs, suggesting that the integrity of bacteria may be damaged. The scanning electron microscope(SEM) results showed that the morphology of E. coli was destroyed most in the combination group. The quantitative fluorescence PCR technology showed that the combination of two drugs can inhibit the expression of superoxide stress gene soxS. In summary, the combination of dihydroartemisinin and cefuroxime has a synergistic antibacterial effect on E. coli.

Profilaxis de la endoftalmitis posquirúrgica con cefuroxima intracamerular / Prophylaxis of postoperative endophthalmitis with intracamerular cefuroxime

RESUMEN Fundamento: La cirugía de catarata es la intervención oftalmológica más realizada en el mundo con exitosos resultados visuales posoperatorio, por lo cual una endoftalmitis posquirúrgica es una de las complicaciones más temidas y devastadoras. Objetivo: Caracterizar los pacientes operados de catarata a los cuales se les administró cefuroxima intracameral como método profiláctico para la endoftalmitis posquirúrgica durante los primeros 6 meses de su aplicación. Metodología: Se realizó un estudio retrospectivo en el Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus del 15 de octubre de 2015 al 15 de abril de 2016. El universo estuvo constituido por 575 pacientes operados de cirugía de cataratas y la muestra por 538 pacientes a los cuales se les aplicó cefuroxima intracamerular como método profiláctico. Resultados: Se incluyeron 538 pacientes de ellos 279 mujeres y 259 hombres con edad promedio de 46 a 60 años. Se presentaron complicaciones en 21 ojos. En ningún paciente se diagnosticó síndrome inflamatorio tóxico asociado al uso de medicamentos intraoculares. Se reportó un solo caso de endoftalmitis al cual se le realizó extracción extracapsular. Conclusiones: La inyección de cefuroxima intracameral es una maniobra sencilla, eficaz y segura para la profilaxis de la endoftalmitis posquirúrgica.

ABSTRACT Background: Cataract surgery is the most performed ophthalmologic intervention in the world with successful postoperative visual results, so a postoperative endophthalmitis is one of the most feared and devastating complications. Objective: To characterize cataract surgery patients who were given intracameral cefuroxime as a prophylactic method of postoperative endophthalmitis during the first 6 months of its application. Methodology: A retrospective study was carried out at Camilo Cienfuegos General Provincial Hospital in Sancti Spíritus from October 15, 2015 to April 15, 2016. The universe consisted of 575 patients operated on from cataract surgery with a sample of 538 patients which were applied intracamerular cefuroxime as a prophylactic method. Results: 538 patients were included, 279 women and 259 men with an average age of 46 to 60 years. There were complications in 21 eyes. In no patient was toxic inflammatory syndrome associated with the use of intraocular medications. A single case of endophthalmitis was reported and extracapsular extraction was performed. Conclusions: The injection of intracameral cefuroxime is a simple, effective and safe maneuver for the prophylaxis of postoperative endophthalmitis.

Investigating the effect of intracameral cefuroxime on oxidative stress and apoptosis in the rat cornea / Investigando o efeito de cefuroxima intracameral sobre o estresse oxidativo e a apoptose na córnea de ratos

ABSTRACT PURPOSE: We examined the effect of intracameral administration of cefuroxime on oxidative stress and endothelial apoptosis in rat corneal tissue. METHODS: In total, 30 rats were divided into 3 groups of 10 rats each (intracameral administration of cefuroxime 0.1 mg/0.01 mL (cefuroxime group); intracameral administration of balanced salt solution 0.01 mL (control group); or absence of intracameral injection (sham group). Corneal endothelial apoptosis was assessed by immunohistochemical analysis using caspase-3 and caspase-8. Total oxidant status, total antioxidant status, oxidative stress index, and paraoxonase and arylesterase levels were examined in corneal endothelial tissue and serum. RESULTS: Paraoxonase levels in the serum were significantly different between the sham and cefuroxime groups (p=0.027). A significant difference was also observed in total oxidant status levels between the cefuroxime and balanced salt solution groups (p=0.023). In addition, there were significant differences in total antioxidant status levels in corneal tissue between the cefuroxime and sham groups (p<0.001) and between the cefuroxime and balanced salt solution groups (p<0.001). Furthermore, significant differences were also observed in oxidative stress index levels between the cefuroxime and balanced salt solution groups (p=0.001) and between the cefuroxime and sham groups (p=0.026). According to the immunohistochemical staining results, a significant association with caspase-3 activity existed between the cefuroxime and balanced salt solution groups (p=0.007), while no significant difference was found with caspase-8 activity (p=0.541). Caspase-3 activity exhibited a significant relationship between the sham and balanced salt solution groups (p=0.018), but no relationship was found with caspase-8 activity (p=0.623). CONCLUSION: Immunohistochemical examination revealed that intracameral cefuroxime increased apoptosis when compared to the sham and balanced salt solution groups. Moreover, intracameral cefuroxime increased oxidative stress in the cornea and simultaneously induced apoptosis.

RESUMO OBJETIVO: Examinamos o efeito da administração intracameral da cefuroxima sobre o estresse oxidativo e a apoptose endotelial no tecido corneano de ratos. MÉTODOS: No total, 30 ratos foram divididos em 3 grupos de 10 ratos cada (administração intracameral de cefuroxima 0,1 mg/0,01 mL (grupo cefuroxima), administração intracameral de solução salina balanceada 0,01 mL (grupo controle) ou ausência de injeção intracameral (grupo sham)). A apoptose endotelial da córnea foi avaliada por análise imuno-histoquimica usando caspase-3 e -8. O status oxidante total, o status antioxidante total, o índice de estresse oxidativo e os níveis de a paraoxonase e arilesterase foram investigados no tecido endotelial da córnea e no soro. RESULTADOS: Os níveis de paraoxonase no soro foram significativamente diferentes entre os grupos sham e cefuroxima (p=0,027). Foi também observada uma diferença significativa nos níveis de estado oxidante total entre os grupos cefuroxima e solução salina balanceada (p=0,023). Além disso, houve diferenças significativas nos níveis de status antioxidante total no tecido da córnea entre os grupos cefuroxima e sham (p<0,001) e entre os grupos cefuroxima e solução salina balanceada (p<0,001). Diferenças significativas também foram observadas nos níveis do índice de estresse oxidativo entre os grupos cefuroxima e solução salina balanceada (p=0,001) e entre os grupos cefuroxima e sham (p=0,026). De acordo com os resultados de coloração imuno-histoquimica, houve associação significativa com a atividade da caspase-3 entre os grupos cefuroxima e solução salina balanceada (p=0,007), enquanto não houve diferença significativa com a atividade da caspase-8 (p=0,541). A atividade da caspase-3 exibiu uma relação significativa entre os grupos sham e solução salina balanceada (p=0,018), mas nenhuma relação foi encontrada com a atividade da caspase-8 (p=0,623). CONCLUSÃO: O exame imuno-histoquímico revelou que a cefuroxima intracameral aumentou a apoptose quando comparada com os grupos sham e solução salina balanceada. Além disso, a cefuroxima intracameral aumentou o estresse oxidativo na córnea e induziu simultaneamente a apoptose.

Effect of sequential therapy of antibacterial drugs on acute mesenteric lymphadenitis caused by bacterial infection in children / 中国基层医药

Objective@#To investigate the effect of cephalosporin sequential therapy on acute mesenteric lymphadenitis caused by bacterial infection.@*Methods@#From December 2015 to December 2018, 66 patients with acute mesenteric lymphadenitis caused by bacterial infection in Shaoxing Central Hospital were randomly selected.The control group(33 cases) received intravenous infusion of cefuroxime.The observation group(33 cases) was treated with intravenous infusion of cefuroxime, after the abdominal pain disappeared and the peripheral blood cell count returned to normal, the cefuroxime axetil tablet was given orally.The clinical efficacy of the two groups was evaluated, and the treatment costs and adverse reactions of the two groups were counted.@*Results@#The total effective rate of the observation group was 96.97%(32/33), compared with 90.91%(30/33) of the control group, the difference was not statistically significant(χ2=1.26, P=0.53). The total cost of treatment in the observation group was (326.85±51.88)CNY, which was lower than that of the control group[(576.82±72.17)CNY], the difference was statistically significant(t=16.15, P=0.00). There were no significant adverse reactions in the two groups during treatment periods.@*Conclusion@#Sequential therapy with cefuroxime and venous infusion of cefuroxime for the treatment of acute mesenteric lymphadenitis in children with bacterial infection is safe, but sequential therapy is less expensive and therefore recommended.

Distribution of cefuroxime in ocular tissues of rabbit after intravenous administration / 中华实验眼科杂志

Objective@#To study the distribution and pharmacokinetics of cefuroxime in rabbit eyes after intravenous administration.@*Methods@#Thirty-five rabbits were randomly divided into 7 groups by random number table method, with 5 rabbits in each group.The rabbits in blank control group were feed without any treatment, the rest rabbits were injected with 40.63 mg/kg cefuroxime intravenously.The rabbits were sacrificed at 0.5 hour, 1.0 hour, 1.5, 2.0, 2.5 and 3.0 hours after injection, and the eyeballs were immediately dissected.The concentration of drug in different ocular tissues was detected by high performance liquid chromatography, and the pharmacokinetic parameters in eyes were computed by the DAS software.This study was approved by the Experimental Animal Ethics Committee of Shanxi Provincial Eye Hospital (201802b).@*Results@#The peak concentrations (Cmax) of cefuroxime were (11.63±0.20), (1.59±0.05), (1.51±0.08), (0.99±0.07), (1.55±0.08) and (8.57±0.17)μg/ml in aqueous humor, iris-ciliary body, vitreous body, retinal-choroid, cornea and sclera, respectively.The times to peak (Tmax) were 1.5 hours, 1.0, 1.0, 0.5, 1.0 and 0.5 hour in aqueous humor, iris-ciliary body, vitreous body, retinal-choroid, cornea and sclera, respectively.The areas under drug time curve (AUC0-t) were (26.60±0.62), (6.22±0.84), (5.86±0.16), (3.75±0.45), (5.50±0.15) and (26.48±0.73)(μg·h)/ml in aqueous humor, iris-ciliary body, vitreous body, retinal-choroid, cornea and sclera, respectively.Cefuroxime was not detected in the lens at different time points after injection.The parameters of pharmacokinetics were fitted to two compartment model.@*Conclusions@#Cefuroxime shows good penetration in aqueous humor, iris-ciliary body, vitreous body, retinal-choroid, cornea and sclera when administrated by intravenous injection in rabbits and cefuroxime has no distribution in lens.Cefuroxime can reach an effective concentration in ocular tissues 0.5 to 1.5 hours after intravenous injection.

Effect of sequential therapy of antibacterial drugs on acute mesenteric lymphadenitis caused by bacterial infection in children / 中国基层医药

To investigate the effect of cephalosporin sequential therapy on acute mesenteric lymphadenitis caused by bacterial infection.Methods From December 2015 to December 2018,66 patients with acute mesenteric lymphadenitis caused by bacterial infection in Shaoxing Central Hospital were randomly selected .The control group(33 cases) received intravenous infusion of cefuroxime.The observation group (33 cases) was treated with intravenous infusion of cefuroxime ,after the abdominal pain disappeared and the peripheral blood cell count returned to normal,the cefuroxime axetil tablet was given orally.The clinical efficacy of the two groups was evaluated , and the treatment costs and adverse reactions of the two groups were counted .Results The total effective rate of the observation group was 96.97%(32／33),compared with 90.91%(30／33) of the control group,the difference was not statistically significant(χ2 ＝1.26,P＝0.53).The total cost of treatment in the observation group was (326.85 ± 51.88)CNY,which was lower than that of the control group [(576.82 ±72.17)CNY],the difference was statistically significant(t＝16.15,P ＝0.00).There were no significant adverse reactions in the two groups during treatment periods.Conclusion Sequential therapy with cefuroxime and venous infusion of cefuroxime for the treatment of acute mesenteric lymphadenitis in children with bacterial infection is safe , but sequential therapy is less expensive and therefore recommended.

Effects of different medication time of cefuroxime sodium on nosocomial infections of surgical incision and C-reactive protein in patients of Department of Obstetrics and Gynecology / 中国基层医药

Objective To study the effect of different medication time of cefuroxime sodium on nosocomial infections of surgical incision and C-reactive protein (CRP) in patients of Department of Obstetrics and Gynecology.Methods A total of 158 surgery patients in Department of Obstetrics and Gynecology who were treated in the People ~ Hospital of Qing County from July 2015 to November 2017 were enrolled in the study.According to random number method,they were randomly divided into control group and observation group,with 79 cases in each group.The observation group received the treatment of cefuroxime sodium in the perioperative period,the control group was given cefuroxime sodium treatment after surgery.The differences of the probability of a nosocomial infection and CRP between the two groups who chose different medication time were compared.Results The observation group had 45 patients appearing abnormal temperature after surgery,and the temperature restoring normal time was (40.17 ± 10.35)h.The control group had 59 patients appearing abnormal temperature after surgery,and the temperature restoring normal time was (56.35 ±9.87)h,which of the observation group were less than that of the control group,the differences were statistically significant (x2 =5.513,P =0.019;t =8.163,P =0.000).The levels of CRP and procalcitonin of the observation group after surgery were (2.34 ± 0.66) mg/L,(2.48 ± 0.79) mg/L,respectively,which were lower than those of the control group [(3.46 ± 0.84) mg/L,(3.19 ± 0.96) mg/L],the differences were statistically significant (t =9.260,P =0.000;t =5.104,P =0.000).The observation group had 2 patients appeared incision infection after surgery,the control group had 9 patients appeared incision infection after surgery,there was statistically significant difference between the two groups(x2 =4.788,P =0.029).The hospitalization time of the observation group was (6.70 ± 1.04) d,which was shorter than (8.26 ± 1.25)d of the control group,there was statistically significant difference between the two groups(t =8.513,P =0.000).The quality of life score of the observation group after surgery was (85.63 ± 15.30) points,which was higher than (71.29 ± 11.07) points of the control group,there was statistically significant difference between the two groups (t =-6.748,P =0.000).Conclusion Using cefuroxime sodium in the perioperative period can reduce the probability of nosocomial infection in surgical patients,improve the level of inflammation in vivo,shorten the hospital stay and improve the quality of life of patients.

Application of flash nanoprecipitation to fabricate poorly water-soluble drug nanoparticles

Nanoparticles are considered to be a powerful approach for the delivery of poorly water-soluble drugs. One of the main challenges is developing an appropriate method for preparation of drug nanoparticles. As a simple, rapid and scalable method, the flash nanoprecipitation (FNP) has been widely used to fabricate these drug nanoparticles, including pure drug nanocrystals, polymeric micelles, polymeric nanoparticles, solid lipid nanoparticles, and polyelectrolyte complexes. This review introduces the application of FNP to produce poorly water-soluble drug nanoparticles by controllable mixing devices, such as confined impinging jets mixer (CIJM), multi-inlet vortex mixer (MIVM) and many other microfluidic mixer systems. The formation mechanisms and processes of drug nanoparticles by FNP are described in detail. Then, the controlling of supersaturation level and mixing rate during the FNP process to tailor the ultrafine drug nanoparticles as well as the influence of drugs, solvent, anti-solvent, stabilizers and temperature on the fabrication are discussed. The ultrafine and uniform nanoparticles of poorly water-soluble drug nanoparticles prepared by CIJM, MIVM and microfluidic mixer systems are reviewed briefly. We believe that the application of microfluidic mixing devices in laboratory with continuous process control and good reproducibility will be benefit for industrial formulation scale-up.

Preparation and characterization of cefuroxime axetil solid dispersions using poloxamer 188

The main objective of the present work was to enhance the solubility and dissolution rate of poorly water-soluble drug cefuroxime axetil (CA) by formulating it into solid dispersions (SDs) with water soluble carrier poloxamer 188. Different methods were employed to prepare the dispersion, such as: Solvent method (SM), Kneading method (KM), Melt evaporation method (MEM) and Physical mixture (PM) in different drug: carrier ratios 1:1, 1:2 and 1:3 (cefuroxime axetil: poloxamer 188). The physical mixture(s) and solid dispersion(s) were characterized for drug carrier interaction, drug content, solubility, dissolution rate, differential scanning calorimetry (DSC) and FT-IR study. The dissolution rate of the prepared solid dispersion systems was determined in phosphate buffer (pH 6.8) for 1 h. The solubility of drug from different systems was also determined in water. All SD formulations were found to have a higher dissolution rate comparatively to pure CA. The dissolution rate was enhanced in the following order SM > MEM > KM. The enhancement of dissolution rate may be caused by increase wettability, dispersibillity reduction in particle size or the formation of CA ß crystalline. The FT-IR study probability revealed that there was no chemical interaction between drug and poloxamer 188

Prevalencia de infección de la vía urinaria y perfil microbiológico en mujeres que finalizaron el embarazo en una clínica privada de Lima, Perú / Prevalence of urinary tract infection and microbiological profile in women who end their pregnancy in a private clinic in Lima, Peru

Resumen Objetivo: Describir la prevalencia de infección de la vía urinaria en mujeres que finalizaron el embarazo en una clínica privada (nivel II-2) de Lima, Perú, además de conocer el perfil microbiológico e identificar la resistencia a los antibióticos. Materiales y métodos: Estudio retrospectivo, observacional y transversal efectuado en pacientes que finalizaron el embarazo en la Clínica Jesús del Norte del distrito de Independencia de Lima, Perú, entre enero de 2016 y diciembre del 2017. Criterio de inclusión: pacientes con al menos seis citas médicas de control prenatal en la clínica. Se obtuvo el resultado de los urocultivos y el de resistencia a los antibióticos. Se buscaron medidas de tendencia central como promedios, desviación estándar y frecuencias. Resultados: Se registraron 1455 pacientes que cumplieron con el criterio de inclusión; de éstas 108 (7.4%) tuvieron infección de la vía urinaria con urocultivo positivo. El microorganismo aislado con más frecuencia fue Escherichia coli en 70 (63.6%) casos, con resistencia a ampicilina (60.8%), ciprofloxacina (34.7%) y norfloxacina (34.7%), y sensibilidad a amikacina, nitrofurantoína y cefuroxima. En 13 (11.8%) pacientes también se identificó Escherichia coli y enterobacterias productoras de betalactamasas de espectro extendido resistentes a cefalosporinas. Conclusión: La prevalencia de infección de la vía urinaria estuvo dentro del valor de referencia expresado en los reportes internacionales (7.4%). Los microorganismos aislados con mayor frecuencia fueron E. coli y E. coli productora de betalactamasas de espectro extendido.

Abstract Objective: To describe the prevalence of urinary tract infections (UTI) and their microbiological profile in pregnant women attended in a private clinic of level II-2 of Lima, Peru. Materials and methods: An analytical cross-sectional observational study was conducted, in women they had their delivery in a private clinic during January 2016 to December 2017. Inclusion criteria were those who had at least 06 prenatal care. Results of urocultures and their respective antibiotic resistance were obtained. In the statistical analysis, central tendency measures such as averages, standard deviation and frequencies were found. Results: 1455 met the selection criteria. We found 108 patients (7.4%) with UTI with a positive urine culture. The 70 cases (63.6%) were Escherichia coli resistant to antibiotics such as: ampicillin (57.6%), ciprofloxacin (30.7%) and norfloxacin (30.7%), and sensitive to: amikacin, nitrofurantoin and cefuroxime. However, was is found that 13 (11.8%) had Escherichia coli BLEE resistant to cephalosporins. Conclusion: The prevalence of urinary infection was within what was expected in relation to international reports. The most commonly isolated uropathogen was Escherichia coli, followed by Escherichia coli BLEE.

Application of Powder Comprehensive Properties Characterization in Batch Changes of Cefuroxime Axetil / 中国药师

Objective:To study the application of powder comprehensive properties characterization of cefuroxime axetil in batch changes .Methods:The stability and change of the powder before the batch change of cefuroxime axetil were measured by an FT 4 mul-tifunctional powder flow tester .The flow rate, compression rate, shear property, air inflation and air permeability were measured .The corresponding powder index was established .After the batch change , the above indices were detected to assess whether meeting the re-quirements.Results:The volume index of three batches of products after the batch change was within the optimal range .Conclusion:The batch changes of cefuroxime axetil have no effect on the smooth progress of cefuroxime axetil production , which provides a new rap-id verification method for preparation manufacturers .

Evaluation of intracameral cefuroxime injection for endophthalmitis prophylaxis following phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the clinical effect of intracameral cefuroxime injection on prevention of endophthalmitis following phacoemulsification. <p>METHODS: This was a retrospective clinical study. The clinical records were reviewed for 3112 patients(4210 eyes)with cataract phacoemulsification in our hospital from January 2015 to June 2018; 1810 patients(2250 eyes)without intracameral cefuroxime injection were treated as control group from January 2015 to April 2017; 1302 cases(1960 eyes)with intracameral cefuroxime injection were treated as experimental group from May 2017 to July 2018. Patients in both groups were treated with phacoemulsification and intraocular lens implantation. The follow-up period was 1-8mo and the visual acuity and the infectious endophthalmitis were observed and compared. <p>RESULTS:There were 1 344 eyes with best corrected visual acuity >1.0, 696 eyes with 0.5-0.9, 151 eyes with 0.1-0.4, 59 eyes with <0.1 in control group within 6mo after operation; those in experimental group were 1 136 eyes, 624 eyes, 146 eyes, 54 eyes. No postoperative endophthalmitis case occurred in experimental group. Three postoperative endophthalmitis cases(3 eyes)occurred in control group, 0.13%(3/2250). There was no significant difference between the two groups(<i>P</i>=0.15). All the cases with endophthalmitis were cured. No sever complication was reported with intracameral cefuroxime, corneal endothelium decompensation, retinal toxicity. <p>CONCLUSION: Intracameral cefuroxime injection is safe and effective in prevention of endophthalmitis following phacoemulsification.

Perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on multiple antihypertensive medications / Choque anafilático refratário perianestésico com cefuroxima em paciente com história de alergia à penicilina recebendo vários medicamentos anti-hipertensivos

Abstract We report a case of perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on regular therapy with atenolol, losartan, prazosin and nicardipine. Severe anaphylactic shock was only transiently responsive to 10 mL of (1:10,000) epinephrine and needed norepinephrine and dopamine infusion. Supportive therapy with vasopressors and inotropes along with mechanical ventilation for the next 24 hours resulted in complete recovery. She was successfully operated upon 2 weeks later with the same anesthetic drugs but intravenous ciprofloxacin as the alternative antibiotic for perioperative prophylaxis.

Resumo Relatamos um caso de choque anafilático refratário no período perianestésico com cefuroxima em paciente com história de alergia à penicilina em terapia regular com atenolol, losartan, prazosina e nicardipine. O choque anafilático grave foi apenas transitoriamente responsivo a 10 mL de epinefrina (1:10000) e precisou de infusão de norepinefrina e dopamina. A terapia de apoio com vasopressores e inotrópicos, juntamente com ventilação mecânica por 24 horas, resultou em recuperação completa. A paciente foi operada com sucesso duas semanas mais tarde, com os mesmos agentes anestésicos, mas com ciprofloxacina intravenosa como antibiótico opcional para a profilaxia perioperatória.

Effects of High-fat and High-calorie Diets on Pharmacokinetics of Cefuroxime Axetil Tablets / 中国药学杂志

OBJECTIVE: To investigate the effect of high-fat and high-calorie diets on pharmacokinetics of cefuroxime axetil in healthy Chinese subjects. METHODS: A randomized, open-label, single dose and two-way crossover clinical study was conducted. Twelve healthy subjects were randomly divided into two groups, each of which includes six males, then they were given 250 mg of cefuroxime axetil respectively before and after meal. Blood samples were collected at different time points before and after drug administration. The concentration of cefuroxime in plasma was determined by HPLC-MS/MS. The pharmacokinetic parameters were calculated by DAS3.2.8 and were analyzed by DAS3.2.8 and SPSS19.0. RESULTS: The main pharmacokinetic parameters of fasting and postprandial were as follows: AUC0-t was (11 402.8±3 556.7) and (18 565.7±2 917.9) ng·h·mL-1, AUC0-∞ was (11 492.5±3 581.8) and (18 754.7±2 885.6) ng·h·mL-1, ρmax was (3 406.7±1 188.9) and (5 439.2±1 118.2) ng·mL-1, tmax was (2.01±0.64) and (2.08±0.79) h, t1/2 was (1.66±0.38) and (1.60±0.60) h, respectively. The main pharmacokinetic parameters between fasting and high-fat meal groups were analyzed by SPSS19.0 software. There was significant difference in AUC0-t, AUC0-∞ and ρmax(P0.05). The ρmax and AUC were increased by 59.7% and 63.2% respectively, tmax is almost unchanged. The equivalence analysis was performed with DAS.3.2.8 software, the 90% confidence intervals for the ratios of AUC0-t, AUC0-∞ and ρmax for the postprandial/fasting were 137.6%-217.5%, 138.4%-217.3%, 135.4%-207.6%, respectively. None of them fall within the acceptable interval of 80%-125%. CONCLUSION: High-fat and high-calorie diets can significantly improve the extent of absorption of cefuroxime axetil in vivo, but does not affect the absorption rate of cefuroxime axetil.

Use of cefuroxime for women with community-onset acute pyelonephritis caused by cefuroxime-susceptible or -resistant Escherichia coli

BACKGROUND/AIMS: Efforts to decrease the use of extended-spectrum cephalosporins are required to prevent the selection and transmission of multi-drug resistant pathogens, such as extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. The objectives of this study were to assess the clinical efficacy of intravenous cefuroxime as an empirical antibiotic for the treatment of hospitalized women with acute pyelonephritis (APN) caused by Escherichia coli. METHODS: We analyzed the clinical and microbiologic database of 328 hospitalized women with community-onset APN. RESULTS: Of 328 women with APN, 22 patients had cefuroxime-resistant E. coli APN, and 306 patients had cefuroxime-susceptible E. coli APN. The early clinical success rates were significantly higher (p = 0.001) in the cefuroxime-susceptible group (90.8%, 278/306) than in the cefuroxime-resistant group (68.2%, 15/22) at 72 hours. The clinical cure rates at 4 to 14 days after completing antimicrobial therapy were not significantly different in the cefuroxime-resistant or -susceptible groups, with 88.2% (15/17) and 97.8% (223/228; p = 0.078), respectively. The microbiological cure rates were not significantly different and were 90.9% (10/11) and 93.4% (128/137), respectively (p =0.550). The median duration of hospitalization in the cefuroxime-resistant and -susceptible groups was 10 days (interquartile range [IQR], 8 to 13) and 10 days (IQR, 8 to 14), respectively (p =0.319). CONCLUSIONS: Cefuroxime, a second-generation cephalosporin, can be used for the initial empirical therapy of community-onset APN if tailored according to uropathogen identification and susceptibility results, especially in areas where the prevalence rate of ESBL-producing uropathogens is low.

Clinical Observation of Shuanghuanglian Oral Liquid Combined with Cefuroxime Axetil in the Treatment of Bacterial Respiratory Tract Infection / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of Shuanghuanglian oral liquid combined with cefuroxime axetil in the treatment of bacterial respiratory tract infection. METHODS:184 patients with bacterial respiratory tract infection were randomly divided into test group and control group. Test group was orally given 250 mg Cefuroxime axetil tablet,twice a day+20 ml Shuanghuanglian oral liquid,3 times a day. Control group was only given Cefuroxime axetil tablet (the same dosage as test group). The treatment course for 2 groups was 2 weeks. The cough duration,body temperature recovery time and runny nose disap-pearing time before and after treatment and bacterial clearance rate in 2 groups were observed,clinical efficacy and incidence of ad-verse reactions were recorded. RESULTS:After treatment,the total effective rate in test group was significantly higher than control group,cough duration,body temperature recovery time and runny nose disappearing time were significantly shorter than control group,the differences were statistically significant(P0.05). CONCLUSIONS:The efficacy of Shuanghuanglian oral liquid combined with ce-furoxime axetil is superior to cefuroxime axetil alone in the treatment of bacterial respiratory infections,with similar safety.

Effect of low-dose cefuroxime combined with dexamethasone on postoperative urinary tract infection and quality of life in cervical cancer patients / 中国生化药物杂志

Objective To investigate the effect of low-dose of cefuroxime combined with dexamethasone on postoperative urinary tract infection and quality of life in cervical cancer.Methods 90 cases of cervical cancer patients from July 2015 to July 2016 in the first affiliated hospital of wenzhou medical university were selected and divided into two groups,44 patients in control group received cefuroxime sodium 1.5 g and metronidazole 0.5 g biw in five days,furacilin 250 mL bladder irrigation biw after five days,and fourteenth days out of indwelling catheter.46 cases in the experiment group received more with cefuroxime 125 mg and dexamethasone 0.75 mg oral,and two groups were treated for 14 days.Results After treatment,the incidence rate of urinary tract infection rate,the first urination time>three hours and residual urine ≥100 mL in the experiment group were lower than the control group (P<0.05);the total effective rate of the experiment group was significantly higher than the control group (P <0.05);the scores of physical function,physical life, mental health and social adaptation in the experiment group were significantly higher than the control group ( P <0.05 ) . Conclusion Low dose cefuroxime combined with dexamethasone have better prevention effect on urinary tract infection after cervical cancer operation , can significantly improve the quality of life of patients and treatment efficiency.