The Experts below are selected from a list of 624 Experts worldwide ranked by ideXlab platform
Bernd Drewelow - One of the best experts on this subject based on the ideXlab platform.
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pharmacokinetics of Mezlocillin and sulbactam under continuous veno venous hemodialysis cvvhd in intensive care patients with acute renal failure
European Journal of Clinical Pharmacology, 1997Co-Authors: B Rohde, U Werner, H Hickstein, H Ehmcke, Bernd DrewelowAbstract:Objective: In intensive care medicine, continuous detoxication methods, such as continuous veno-venous hemodialysis (CVVHD), are used for treating acute renal failure. However, in contrast to conventional hemodialysis, little is known about the pharmacokinetics of many drugs administered in this setting and guidelines for dosages of drugs often do not exist. This holds particularly true for broad-spectrum antibiotics, which are often required during intensive care. Methods: In this study, we investigated the pharmacokinetics of the acylureidopenicillin Mezlocillin and the β-lactamase inhibitor sulbactam during CVVHD and deduced dosage recommendations from the kinetic parameters with the goal of maintaining trough levels of above 10 mg · l−1 for Mezlocillin and 5 mg · l−1 for sulbactam. Six intensive care patients with acute renal failure, receiving Mezlocillin (n=5) and/or sulbactam (n=4), were examined during CVVHD and during intervals between CVVHD. The serum concentrations and the amounts of the drugs excreted into the dialyzate and into the urine within one dosage interval were measured using high performance liquid chromatography (HPLC). Three of the patients were jaundiced, indicating functional impairment of the liver. Results: The clearances by CVVHD (CLCVVHD) for Mezlocillin ranged between 11.0 and 44.9 ml · min−1 and the half lives ranged between 1.12 and 8.84 h. Low CL and long half lives were observed in the patients with jaundice. For sulbactam, CLCVVHD ranged between 10.1 and 22.8 ml · min−1 and serum half lives were 4.25–6.11 h, independent of liver function. Conclusion: Due to high hepatobiliary clearance of Mezlocillin, dosage adjustments in patients with acute renal failure, treated by CVVHD, are needed only with concurrent impaired liver function. For sulbactam, the optimal dose was found to be 0.5 g, administered every 12 h, regardless of liver function.
Li Zhao - One of the best experts on this subject based on the ideXlab platform.
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severe asthmatic attack with cardiac arrest suspected to be induced by sulbactam sodium
European Respiratory Journal, 2014Co-Authors: Wei Zheng, Yu Chen, Li ZhaoAbstract:We reported one case of severe asthmatic attack with cardiac arrest suspected to be induced by sulbactam sodium. A 74-year-old female received intravenous administration of Mezlocillin sodium/sulbactam sodium for pulmonary infection complicated by bronchial asthma. After infusion of about 10 ml, the patient suddenly developed severe asthmatic attack and palpitations, then apnea and cardiac arrest. The patient was successfully rescued by glucocorticoids treatment and cardiopulmonary resuscitation. The above symptoms were considered to be caused by Mezlocillin sodium/sulbactam sodium. Detailed investigation showed that the patient9s past allergy history was significant for allergy to cefoperazone/sulbactam sodium. However, she was ever administered cefoperazone, penicillin, piperacillin/tazobactam intravenously without allergic reaction. We suspected the patient was allergic to sulbactam sodium. After the patient recovered completely, the intracutaneous susceptibility test of 0.9% sodium chloride, penicillin, sulbactam sodium was performed. The result of the former two agents was negative, but that of sulbactam sodium was positive. To our knowledge, this is the first report of life-threatening allergy probably induced by sulbactam sodium. Clinicians are usually cautious of allergy to penicillin and cephalosporins but ignore allergy to β-lactamase inhibitors. If a patient has a past history of allergy to compound antimicrobial agents, possible allergy to β-lactamase inhibitors should also be considered. In such a patient, the intracutaneous susceptibility test of the two preparations should be performed respectively for fear of possible serious outcomes.
Bingqi Zhu - One of the best experts on this subject based on the ideXlab platform.
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study of the impurity profile and polymerized impurity in Mezlocillin sodium by multiple heart cutting two dimensional liquid chromatography coupled with ion trap time of flight mass spectrometry
Rapid Communications in Mass Spectrometry, 2019Co-Authors: Jian Wang, Jinjin Zhou, Bingqi ZhuAbstract:RATIONALE Eleven impurities and one polymerized impurity in Mezlocillin were identified and their formation mechanisms were investigated in this study. The sources and reasons for the formation of impurities were revealed, which may guide industry to improve the manufacturing process and storage conditions and reduce the content of impurities in products. The results from this study also provided a scientific basis for the improvement of official monographs in pharmacopoeias. METHODS The impurity profiles and polymerized impurity in Mezlocillin were studied by multiple heart-cutting two-dimensional liquid chromatography coupled with ion trap time-of-flight mass spectrometry (2D-LC/IT-TOF MS) in both positive and negative modes of electrospray ionization. Target eluents from the first dimensional chromatography with a non-volatile mobile phase were trapped and sent to the second dimensional chromatography with a volatile mobile phase by a switching valve. The structures of the impurities in the Mezlocillin drug substance were deduced based on the high-resolution MSn data. RESULTS In the environment of water, oxygen, high temperature, acid and base, a series of degradation products could be easily produced from Mezlocillin. Mezlocillin was hydrolyzed into impurities I, IV, V and X, and was degraded into impurity III by methanolysis. Mezlocillin was oxidized into sulfoxide by producing impurity XI. Furthermore, impurities VI, VII, VII and IX were all isomers of Mezlocillin. The proposed formation pathways of these products were demonstrated in this study. CONCLUSIONS Eleven degradation impurities and one polymerized impurity in Mezlocillin were separated and characterized. Based on characterization of impurities, this study discovered the mechanism of impurity production and provided guidance for manufacturers to improve the process and storage conditions and reduce levels of impurities.
J. M. Andrews - One of the best experts on this subject based on the ideXlab platform.
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Mezlocillin and azlocillin: an evaluation of two new p-lactam antibiotics
2016Co-Authors: C. J. Ellis, R. Wise, J. M. Andrews, A. M. Geddes, P. G. Darey, R. P. GrimleyAbstract:Mezlocillin and azlocillin are broad spectrum penicillins for parenteral adminis-tration. In this study it was shown that they were very active against a wide range of pathogenic bacteria. Thirty-five patients were treated with Mezlocillin, and 5 patients were treated with azlocillin (in combination with cefoxitin in 3 cases). The serum, bile and CSF levels of the drugs were measured. Both antibiotics would appear to be safe and efficacious in treating serious infections by sensitive pathogens. Infections caused by unknown pathogens could be treated by one of these agents in combination with a broad spectrum P-lactamase stable cephalosporin or cephamycin
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Activity of Mezlocillin against Gram-negative and Gram-positive organisms: comparison with other penicillins
2016Co-Authors: R. Wise, J. M. AndrewsAbstract:The activity of Mezlocillin was compared with that of carbenicillin, ticarcillin and azlocillin against a wide range of Gram-negative organisms. Mezlocillin was considerably more active than carbenicillin against Klebsiella species and Escherichia coli. Carbenicillin was twice as active against Proteus mirabilis as Mezlocillin and four times as active as azlocillin. Against Pseudomonas aeruginosa, azlocillin was eight times as active as carbenicillin. Azlocillin and Mezlocillin were twice as active as carbenicillin against Bacteroides fragilis, and these drugs showed a high degree of activity against. Haemophilus influenzae and Neisseria gonorrhoeae. Against Staphylococcus aureus Mezlocillin was highly active against the penicillin susceptible strains. Group A /?-haemolytic streptococci were susceptible to 0-06 mg/1; enterococci to 1-2 mg/1 of Mezlocillin. The stability of Mezlocillin in different fluids was also studied
B Rohde - One of the best experts on this subject based on the ideXlab platform.
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pharmacokinetics of Mezlocillin and sulbactam under continuous veno venous hemodialysis cvvhd in intensive care patients with acute renal failure
European Journal of Clinical Pharmacology, 1997Co-Authors: B Rohde, U Werner, H Hickstein, H Ehmcke, Bernd DrewelowAbstract:Objective: In intensive care medicine, continuous detoxication methods, such as continuous veno-venous hemodialysis (CVVHD), are used for treating acute renal failure. However, in contrast to conventional hemodialysis, little is known about the pharmacokinetics of many drugs administered in this setting and guidelines for dosages of drugs often do not exist. This holds particularly true for broad-spectrum antibiotics, which are often required during intensive care. Methods: In this study, we investigated the pharmacokinetics of the acylureidopenicillin Mezlocillin and the β-lactamase inhibitor sulbactam during CVVHD and deduced dosage recommendations from the kinetic parameters with the goal of maintaining trough levels of above 10 mg · l−1 for Mezlocillin and 5 mg · l−1 for sulbactam. Six intensive care patients with acute renal failure, receiving Mezlocillin (n=5) and/or sulbactam (n=4), were examined during CVVHD and during intervals between CVVHD. The serum concentrations and the amounts of the drugs excreted into the dialyzate and into the urine within one dosage interval were measured using high performance liquid chromatography (HPLC). Three of the patients were jaundiced, indicating functional impairment of the liver. Results: The clearances by CVVHD (CLCVVHD) for Mezlocillin ranged between 11.0 and 44.9 ml · min−1 and the half lives ranged between 1.12 and 8.84 h. Low CL and long half lives were observed in the patients with jaundice. For sulbactam, CLCVVHD ranged between 10.1 and 22.8 ml · min−1 and serum half lives were 4.25–6.11 h, independent of liver function. Conclusion: Due to high hepatobiliary clearance of Mezlocillin, dosage adjustments in patients with acute renal failure, treated by CVVHD, are needed only with concurrent impaired liver function. For sulbactam, the optimal dose was found to be 0.5 g, administered every 12 h, regardless of liver function.