Cefepime is a new cephalosporin antibiotic which is highly active against both Gram-positive and Gram-negative organisms. The purpose of this study was to establish the in-vitro activity of cefepime and three other cephalosporins against recent clinical isolates from patients at the General Hospital Kuala Lumpur. A total of 334 strains comprising Enterobacteriaceae, non-fermentative Gram-negative bacilli and Staphylococcus aureus were tested for their sensitivity to cefepime, cefotaxime, ceftriaxone and ceftazidime. Minimum inhibitory concentrations of the antibiotics were established using an agar dilution method. With the exception of some strains of Flavobacterium meningosepticum, Xanthomonas maltophilia and other non-fermentative Gram-negative bacilli, cefepime was found to be active against a wide range of Gram-negative organisms. Cefepime was as or more active than the other cephalosporins against Acinetobacter, Enterobacteriaceae and methicillin-sensitive Staphylococcus aureus. Strains of Klebsiella and Salmonella that were resistant to the third generation cephalosporins were sensitive to cefepime. Cefepime could be a valuable alternative for the treatment of nosocomial infections due to multiply resistant organisms.
This work describes a RP-HPLC method for the determination and interaction studies of cefpirome with ACE-inhibitors (captopril, enalapril and lisinopril) in various buffers. The separation and interaction of cefpirome with ACE-inhibitors was achieved on a Purospher Star, C18 (5 μm, 250×4.6 mm) column. Mobile phase consisted of methanol: water (80:20, v/v, pH 3.3); however, for the separation of lisinopril, it was modified to methanol-water (40:60, v/v, pH 3.3) and pumped at a flow rate of 1 mL min(-1). In all cases, UV detection was performed at 225 nm. Interactions were carried out in physiological pH i.e., pH 1 (simulated gastric juice), 4 (simulated full stomach), 7.4 (blood pH) and 9 (simulated GI), drug contents were analyzed by reverse phase high performance liquid chromatography. Method was found linear in the concentration range of 1.0-50.0 μg mL(-1) with correlation coefficient (r(2)) of 0.999. Precision (RSD%) was less than 2.0%, indicating good precision of the method and accuracy was 98.0-100.0%. Furthermore, cefpirome-ACE-inhibitors' complexes were also synthesized and results were elucidated on the basis of FT-IR, and (1)H NMR. The interaction results show that these interactions are pH dependent and for the co-administration of cefpirome and ACE-inhibitors, a proper interval should be given.
The need for new therapeutics and drug delivery systems has become necessary owing to the public health concern associated with the emergence of multidrug-resistant microorganisms. Among the newly discovered therapeutic agents is cefiderocol, which was discovered by Shionogi Company, Japan as an injectable siderophore cephalosporin. Just like the other β-lactam antibiotics, cefiderocol exhibits antibacterial activity via cell wall synthesis inhibition, especially in Gram negative bacteria (GNB); it binds to the penicillin-binding proteins, but its unique attribute is that it crosses the periplasmic space of bacteria owing to its siderophore-like attribute; it also resists the activity of β-lactamases. Among all the synthesized compounds with the modified C-7 side chain, cefiderocol (3) presented the best and well-balanced activity against multi-drug resistant (MDR) Gram negative bacteria, including those that are resistant to carbapenem. İn this article, an overview of the recent studies on cefiderocol was presented.