Antibiotics cefoxitin

The use of zeolites can also be very helpful in removing a reaction product that unfavourably influences the yield of the desired product. Thus, in the manufacture of antibiotic cefoxitin, the amide acylation results in the generation of HCI, which can be removed by the addition of molecular sieve 3 A or 4 A, which has a large capacity for HCI (Weinstock, 1986). Other examples are reactions in which products like methanol or water retard the rate and prevent the reaction to reach the desired degree of completion. Molecular sieves capture methanol or water very well. 

Patients with serious injuries or clenched-fist injuries should be started on IV antibiotics (cefoxitin 1 g every 6 to 8 hours), ampiciUin-sulbactam (1.5 to 3 g every 6 hours), or ertapenem (1 g every 24 hours). 

In another study, the antibiotic cefoxitine was incorporated in DMPC/Chol (2 1) liposomes prepared using the reverse-phase evaporation technique in order to... 

Merck process chemists showed that an acid-regulated, one-pot transformation of a cephalosporin derivative to the antibiotic cefoxitin was complex (Weinstock, 1986). Not only did it entail eight discrete chemical reactions at least, but some of them had to occur synchronously to maximize the antibiotic yield. Moreover, the concentration of hydrochloric acid reached an optimum at 0.004 molar. The rates of some of the eight reactions were proportional to this concentration and others to its square. 

Zeolite 3A has been used to catalyse transacylation by selective removal of HCl in the synthesis of the antibiotic cefoxitin (e.g. equation 4.7) [51]. 

Antibiotics. Cephaloridine and Cephalothin (Glaxo) were early thiophene-containing, cephalosporin antibiotics. They have largely been replaced by later products, of which Cefoxitin [35607-66-0] (Merck) (51) is the principal thiophene-containing example (see Antibiotics). 

Cephalosporins first entered the marketplace in 1964, when cephalothin (27) and cephaloridine (51), which are both injectable, were launched. By the late 1970s, the injectable cephalosporins had become important therapeutic agents in the hospitals. Also in 1964 the first oral cephalosporin, cephaloglycin [3577-01 -3] C gH N OgS, was launched only to be displaced by the end of the year by cephalexin (12). For years cephalexin was the leading oral cephalosporin on the market. It has since been displaced by cefaclor (13). With the advent of the more -lactamase stable cephalosporins such as cefoxitin (23) and cefuroxime (35), and the more potent agents such as cefotaxime (36) and other third-generation compounds, cephalosporins now dominate the antibiotic market worldwide. 

Although most /3- lactam antibiotics bind covalently to some or all of the same six proteins, there are decided differences among them in terms of their relative affinities. For example, cefoxitin (see Table 1 for structures) fails to bind to protein 2 while cephacetrile binds very slowly to proteins 5 and 6. Cephaloridine binds most avidly to protein 1, the transpeptidase, and inhibits cell elongation and causes lysis at its minimum inhibitory concentration. On the other hand, cephalexin binds preferentially to protein 3 and causes inhibition of cell division and filament formation (75PNA2999, 77MI51002). 

In a recent study, the bacterial populations contaminating the upper gut in SIBO patients and their antibiotic susceptibility were determined. Amoxicillin-clavulanic acid and cefoxitin were effective against >90% of anaerobic strains, while aminopenicillins, cephalosporins and cotrimoxazole were effective against the microaerophilic population. Erythromycin, clindamycin and rifampicin were ineffective. Data on metronidazole and fluoroquinolones are not available [32]. 

Both cefazolin and antianaerobic cephalosporins (e.g., cefoxitin, cefote-tan) have been studied extensively for abdominal hysterectomy. Singledose cefotetan is superior to single-dose cefazolin. The antibiotic course should not exceed 24 hours in duration. 

Antibiotics based on a related ring system, termed the cephems (figure 23.2), are highly useful. Here the five-membered ring has been expanded to six and the double bond of the penems retained. These are the cephalosporins and include such important antibiotics as cephalothin (Keflin), cefazolin (Ancef), cephalexin (Keflex), cefamandole (Cefam), cefuroxime (Zinacef), cefeclor (Ceclor) and cefoxitin (Mefoxin). 

Action Monobactam, -1- cell wall S5mth Dose Adul. 1—2 g IV/EM q6-12h Peds. Premature 30 mg/kg/dose IV ql2h Term children 30 mg/kg/dose q6-8h X in renal impair Caution [B, +] Disp Inj SE NA /D, rash, pain at inj site Interac tions T Effects W/probenecid, aminoglycosides, i-lactam antibiotics X effects W7 cefoxitin, chloramphenicol, imipenem EMS Monitor for S/Sxs of super Infxn may cause aUCTgic Rxns rare cross-sensitivity Rxns to penicillins and cephalosporins have been rqwrted OD May cause Szs symptomatic and supportive... 

FIGURE 4-10. Comparison of retention on different phases. Columns 8 mm x 10 cm Radial Pak containing Nova-Pak bonded phases, (a) The mobile phase for the C,8 column is acetonitrile water (17.5 82.5) with 5 mM tetrabutylamine (PIC A) the mobile phase for the phenyl column is acetonitrile water (17.5 82.5) with 5 mM tetrabutylamine (PIC A). Flow rate 4 mL/min. Detection 254 nm. Sample—cephalosporin antibiotics 1. cephradine 2. cefotaxime 3. cefazolin 4. cefuroxime 5. cefoxitin 6. cefoperazone 7. cefamondole 8. cephalothin. (b) The mobile phase for the C)8 column is tetrahydrofuran methanol water (10 27.5 62.5) with 5 mM octane-sulfonic acid (PIC B8) the mobile phase for the CN column is tetrahydrofuran methanol water (5 22 73) with 5 mM octanesulfonic acid (PIC B8). Flow rate 2 mL/ min. Detection 254 nm. Sample—Beta-adrenergic blockers 1. atenolol 2. nadolol 3. pindolol 4. metoprolol 5. timolol. 

---