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The present study proposes the synthesis and characterization of graphene oxide (GO) and its application in the adsorption of the antibiotic cephalexin (CFX) in aqueous solution. The characterization of graphene oxide was obtained by scanning electron microscopy (SEM), transmission electron microscopy (TEM), and zeta potential. The influence of pH on the batch adsorption process was investigated by analysing adsorption equilibrium isotherms and adsorption kinetics. The images obtained by SEM and TEM presented the typical morphology attributed to GO sheets. The kinetic adsorption tests showed that equilibrium was reached in 420 min, and an adsorption capacity of 164 mg g −1 was obtained. The models that best fit the experimental data were pseudo-second as well as the Langmuir isotherm. Therefore, GO was effective for removing the CFX antibiotic from aqueous solution by using a batch adsorption process.

Background. Community-associated methicillin-resistant S. aureus (CA-MRSA) is the most common organism isolated from purulent skin infections. Antibiotics are usually not beneficial for skin abscess, and national guidelines do not recommend CA-MRSA coverage for cellulitis, except purulent cellulitis, which is uncommon. Despite this, antibiotics targeting CA-MRSA are prescribed commonly and increasingly for skin infections, perhaps due, in part, to lack of experimental evidence among cellulitis patients. We test the hypothesis that antibiotics targeting CA-MRSA are beneficial in the treatment of cellulitis. Methods. We performed a randomized, multicenter, double-blind, placebo-controlled trial from 2007 to 2011. We enrolled patients with cellulitis, no abscesses, symptoms for <1 week, and no diabetes, immunosuppression, peripheral vascular disease, or hospitalization (clinicaltrials.gov NCT00676130). All participants received cephalexin. Additionally, each was randomized to trimethoprim-sulfamethoxazole or placebo. We provided 14 days of antibiotics and instructed participants to continue therapy for ≥1 week, then stop 3 days after they felt the infection to be cured. Our main outcome measure was the risk difference for treatment success, determined in person at 2 weeks, with telephone and medical record confirmation at 1 month. Results. We enrolled 153 participants, and 146 had outcome data for intent-to-treat analysis. Median age was 29, range 3–74. Of intervention participants, 62/73 (85%) were cured versus 60/73 controls (82%), a risk difference of 2.7% (95% confidence interval, −9.3% to 15%; P = .66). No covariates predicted treatment response, including nasal MRSA colonization and purulence at enrollment. Conclusions. Among patients diagnosed with cellulitis without abscess, the addition of trimethoprim-sulfamethoxazole to cephalexin did not improve outcomes overall or by subgroup. Clinical Trials Registration. NCT00676130.

The effects of hyperuricemia on the expression of kidney drug transporters and on the pharmacokinetics of several substrate drugs were examined. We first established a rat model of hyperuricemia without marked symptoms of chronic kidney failure by 10-day co-administration of oxonic acid (uricase inhibitor) and adenine (biosynthetic precursor of uric acid). These hyperuricemic rats showed plasma uric acid concentrations of up to 6 mg/dL, which is similar to the serum uric acid level in hyperuricemic humans, with little change of inulin clearance. The mRNA levels of multidrug and toxin extrusion 1 (Mate1, Slc47a1), organic anion transporter 1 (Oat1, Slc22a6), organic cation transporter 2 (Oct2, Slc22a2), urate transporter 1 (Urat1, Slc22a12) and peptide transporter 1 (Pept1, Slc15a1) were significantly decreased in kidney of hyperuricemic rats. Since Oct2, Mate1 and Oat1 are important for renal drug elimination, we next investigated whether the pharmacokinetics of their substrates, metformin, cephalexin and creatinine, were altered. The plasma concentration of metformin was not affected, while its kidney tissue accumulation was significantly increased. The plasma concentration and kidney tissue accumulation of cephalexin and the plasma concentration of creatinine were also increased. Furthermore, the protein expression of kidney Mate1 was decreased in hyperuricemic rats. Accordingly, although multiple factors may influence renal handling of these drugs, these observations can be accounted for, at least in part, by downregulation of Mate1-mediated apical efflux from tubular cells and Oct2-mediated basolateral uptake. Our results suggest that hyperuricemia could alter the disposition of drugs that are substrates of Mate1 and/or Oct2.

The widespread use of antibiotics in veterinary and medical applications has increased the possibility of water contamination, which causes adverse effects such as increased bacterial resistance in humans and other organisms. This study, investigates the efficient removal of cephalexin (CPX) using Fe doped TiO 2 –Bi 2 O 3 nanocomposite, synthesized via the simple sol–gel method as a visible active photocatalyst. The weight fraction of Fe (3–7 wt%), and Bi 2 O 3 (7–11 wt%) was optimized. The Fe–TiO 2 –Bi 2 O 3 nanocomposite with a weight fraction of 3 and 11% for Fe and Bi 2 O 3 has the best photocatalytic activity for Cephalexin degradation. The characteristics of photocatalyst with optimum composite (3 wt% of Fe and 11 wt% Bi 2 O 3 ) were also investigated by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), diffuse reflectance spectra (DRS) and FTIR. The DRS spectra approved that the adsorption wavelength of Fe-doped TiO 2 –Bi 2 O 3 is in the visible light range. The influence of amount of catalyst (0.5–1.5 g/L), Cephalexin concentration (5–15 mg/L) and initial pH of the solution (3–9) in on CPX photodegradation was modeled and optimized using central composite design based on response surface methodology. Maximum cephalexin degradation Under visible light irradiation (50 W LED, 395–400 nm) was achieved about 74% at 5 mg/L of CPX, 1.5 g/L catalyst loading and pH of 9 in 240 min. Moreover, using a 15W UV lamp under the same conditions increased the degradation efficiency to 96% at 120 min. Considering the high potential of Fe–TiO 2 /Bi 2 O 3 nanocomposite in removing Cephalexin antibiotics, it can be considered a suitable candidate for removing antibiotics from contaminated water sources.

Studies assessing the impact of surgery on the canine gut microbiota are limited. This study assessed the fecal microbiota before and up to 3 months after elective orthopedic surgery. Fourteen client-owned dogs >1 year of age undergoing elective orthopedic surgery were recruited. Dogs received perioperative antibiotics only (perioperative cefazolin, n = 7) or were discharged with oral cephalexin following surgery for 5-7 days (n = 7) in conjunction with perioperative antibiotics. Fecal samples were collected at baseline and at recheck 1 (13-50 days post-operatively) and recheck 2 (55-90 days post-operatively). The fecal microbiota was analyzed using 16S amplicon sequencing. Alpha diversity was assessed with the Sobs Index, Shannon Diversity Index, and Inverse Simpson Index, whereas beta diversity was assessed with the Bray-Curtis Index and Jaccard Index. In the perioperative and post-operative antibiotic groups, the Inverse Simpson and Shannon Diversity Index differed between baseline and recheck 1 (p < 0.05), baseline and recheck 2 (p < 0.05), but not between recheck 1 and recheck 2 (p > 0.05). The Sobs Index was only significantly different between baseline and recheck 1 (p = 0.02) in both groups. The Bray-Curtis and Jaccard Index were significantly different at rechecks 1 and 2 compared to baseline (p > 0.05) in the post-operative antibiotic group but not in dogs that received only perioperative antibiotics. Both the Bray Curtis and Jaccard Index were significantly different between the antibiotic prescription types (p = 0.001) although measures of alpha diversity were not (p > 0.05). Alterations in community structure, richness, and diversity were identified in dogs undergoing elective orthopedic surgery, with many changes persisting at least 2-3 months post-operatively in dogs receiving perioperative and/or post-operative antibiotics.

Background The prevalence of substandard and falsified (SF) medicines hinders progresses towards sustainable development goals in providing quality health care. It is posed as major public health threat. Cephalosporin are beta-lactam antibiotics used for treating penicillin resistant infections and are widely prescribed. Three tiered level approach is a quality assessment methodology that consists of visual and physical inspection of labelling, packaging, and inserts of the dosage form and then performing rapid screening and finally carrying out full pharmacopoeial tests. Objectives It is aimed at assessing the quality of three cephalosporin medicines marketed in Addis Ababa city, Ethiopia. Methods Different cephalosporin products for post market quality survey were collected from different health care systems in Addis Ababa, Ethiopia. Purposive sampling was employed for sample collection using the WHO and National Regulatory Authority (NRA) guidelines. A total of 56 samples (13 cefuroxime axetil tablets, 21 cephalexin capsules, and 22 samples of ceftriaxone powder for injections) were collected. All samples had been subjected to visual inspection, then screening test with GPHF-minilab™ protocol, and later confirmatory physicochemical tests per U.S. Pharmacopoeia monograph (USP 44-NF39) methods. Finally, antimicrobial effectiveness tests were carried out. Results All samples had passed visual inspections and screening test with GPHF-minilab™. Twenty-four samples were subjected for further confirmatory tests. All samples complied for the dissolution and assay tests with USP 44-NF39 specifications. However, two samples, each from cephalexin capsule and ceftriaxone powder for injection failed to meet the uniformity of dosage units’ test. Cephalexin capsule and cefuroxime axetil tablets were found to be more active against S. aureus (with zone of inhibition (Z.O.I.) as 28.7 mm and 32.1 mm, respectively), while ceftriaxone was found to be most effective against P. mirabilis (Z.O.I. as 33.39 mm). For antimicrobial assays, 24 (samples) multiplied by 5 (microorganism types) with total amount of 120 antibiograms were generated. Eighty-five (85) were found to be sensitive, 15 intermediate and 20 resistants. Conclusion The tested medicinal products were of good quality. However, there are differences in the antimicrobial activity effectiveness results against tested bacterial strains. It implies that resistance to Cephalosprins’ is emerging in the study area.

Cephalexin is an oral cephalosporin approved for the treatment of urinary tract infections (UTIs). Data regarding the optimal dosing interval for cephalexin in UTIs, including uncomplicated UTIs (uUTI) and complicated UTIs (cUTI), remains limited. The primary objective of this study was to compare the rates of treatment failure between patients prescribed cephalexin twice daily versus four times daily for the management of uUTIs and cUTIs once discharged from the emergency department (ED). This retrospective, single-center cohort study conducted between July 31st, 2016 and July 31st, 2023, included patients who were ≥ 18 years of age, discharged from the ED with a diagnosis of UTI, prescribed cephalexin 500 mg twice or four time daily, and a urine culture positive for Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis susceptible to cefazolin. Treatment failure was defined as return to the ED or outpatient clinic with similar or worsening UTI symptoms or change in antibiotic therapy within 30 days of the initial ED visit. Sub-group analyses were performed for both uUTI and cUTIs. In total, 214 patients were included in this analysis (50.0 % in each group). Treatment failure rates between the twice daily and four times daily dosing groups were 18.7 % versus 15.0 % (P = 0.465). Treatment failure rates in those with uUTI were 14.9 % versus 8.1 % (P = 0.197) and those with cUTI were 27.3 % versus 30.3 % (P = 0.786). For patients with UTIs, there was no statistically significant difference in treatment failure rates between patients prescribed cephalexin twice daily versus four times daily. These findings suggest cephalexin dosed twice daily may be a reasonable option for the outpatient management of UTIs diagnosed in the ED, thus increasing adherence and decreasing cost without statistically compromising effectiveness.

Poly(vinyl chloride), PVC, has many attractive properties, including low cost of manufacture, resistance to acid and alkali corrosion, and ease of molding. However, PVC suffers from aging in harsh conditions, leading to the shortening of its useful life. Stability to irradiation, for example, can be improved through the incorporation of additives to PVC. The design, synthesis, and application of new stabilizers continue to attract attention. The current work investigates the effect of three tin–cephalexin complexes on the stability of PVC on irradiation with ultraviolet (UV) light (λ = 313 nm) at 25 °C for a long duration. The PVC was blended with tin–cephalexin complexes at low concentrations (0.5% by weight), and thin films (around 40 µm) were made from the mixed materials. Various methods, including weight loss, infrared spectroscopy, and surface inspection of irradiated films were used to investigate the role played by these additives in the inhibition of PVC photodecomposition. The results confirmed that the additives led to a significant reduction in the rate of photodecomposition of the PVC blends. Tin–cephalexin complexes can absorb harmful radiation, deactivate hydrogen chloride, and scavenge high-energy species such as peroxides, therefore acting as stabilizers for PVC.

This study aimed to understand the adsorption process of cephalexin (CPX) from aqueous solution by a biochar produced from the fiber residue of palm oil. Scanning electron microscopy, Fourier transform infrared spectroscopy, Boehm titration, and the point of zero charge were used to characterize the morphology and surface functional groups of the adsorbent. Batch tests were carried out to evaluate the effects of the solution pH, temperature, and antibiotic structure. The adsorption behavior followed the Langmuir model and pseudo-second-order model with a maximum CPX adsorption capacity of 57.47 mg g−1. Tests on the thermodynamic behavior suggested that chemisorption occurs with an activation energy of 91.6 kJ mol−1 through a spontaneous endothermic process. Electrostatic interactions and hydrogen bonding represent the most likely adsorption mechanisms, although π–π interactions also appear to contribute. Finally, the CPX removal efficiency of the adsorbent was evaluated for synthetic matrices of municipal wastewater and urine. Promising results were obtained, indicating that this adsorbent can potentially be applied to purifying wastewater that contains trace antibiotics.

One of the most serious effects of micropollutants in the environment is biological magnification, which causes adverse effects on humans and the ecosystem. Among all of the micro-pollutants, antibiotics are commonly present in the aquatic environment due to their wide use in treating or preventing various diseases and infections for humans, plants, and animals. Therefore, an aluminum-based electrocoagulation unit has been used in this study to remove cephalexin antibiotics, as a model of the antibiotics, from water. Computational and statistical models were used to optimize the effects of key parameters on the electrochemical removal of cephalexin, including the initial cephalexin concentration (15–55 mg/L), initial pH (3–11), electrolysis time (20–40 min), and electrode type (insulated and non-insulated). The response surface methodology-central composite design (RSM-CCD) was used to investigate the dependency of the studied variables, while the artificial neural network (ANN) and adaptive neuro-fuzzy inference system (ANFIS) methods were applied for predicting the experimental training data. The results showed that the best experimental and predicted removals of cephalexin (CEX) were 88.21% and 93.87%, respectively, which were obtained at a pH of 6.14 and electrolysis time of 34.26 min. The results also showed that the ANFIS model predicts and interprets the experimental results better than the ANN and RSM-CCD models. Sensitivity analysis using the Garson method showed the comparative significance of the variables as follows: pH (30%) > electrode type (27%) > initial CEX concentration (24%) > electrolysis time (19%).