PubMed · 2763589
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A B Lesko, G P Sesin, R J Cersosimo. Ceftizoxime stability in i.v. solutions.. https://doi.org/10.1177/1060028089023007-825
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Application of the HPLC hyphenated techniques of LC-MS, LC-NMR and solvent-elimination LC-IR was demonstrated by the identification of the degradation products of a third generation cephalosporin antibiotic, cefpodoxime proxetil, in solid state, drug formulation and solution. Molecular weight and fragment information were obtained by LC-MS, and detailed structural information was confirmed by LC-NMR. Information on the carboxyl functional group obtained by solvent-elimination LC-IR was useful for confirmation of the ester hydrolysis. The degradation products were successfully identified without complicated isolation or purification processes.
In 2001, fluoroquinolone-resistant Escherichia coli isolates emerged in Japan in patients with uncomplicated urinary tract infection (UTI), and accounted for ca. 8% of isolates. This is a worldwide occurrence as reported by the ECO.SENS study. The number of fluoroquinolone- and cephem-resistant Enterobacteriaceae isolates from patients with complicated UTI is increasing. Most cephem-resistant isolates of E. coli, Klebsiella pneumoniae and Proteus mirabilis produce extended-spectrum beta-lactamases (ESBLs). The rates of ESBL-producing Enterobacteriaceae differ between countries but there are ESBL producers in urinary Enterobacteriaceae isolates in most countries. More seriously, most nosocomial ESBL producers are also resistant to non-beta-lactams, such as the fluoroquinolones, fosfomycin and co-trimoxazole. This causes serious problems in the chemotherapy of cystitis.