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Specific extended spectrum -lactamase (ESBL) testing was not performed by the laboratory; however, using zone of clearance interpretation for third-generation cephalosporins and monobactams, 29% of the K. pneumoniae and 65% of E. coli isolates may be ESBLs, as well as one MRSA isolate.17

There are several limitations to this study. This was a single-site study with 200 samples from women; for a full review of empiric therapy of UTIs, a broader representation of the population with more samples should be included. There was also a potential for recall bias in the survey, as the history of UTIs and previous antibiotic prescriptions were self-reported. Also, the data indicated that MSF prescribing guidelines were not rigorously followed. The mis-treatment could be due to poor diagnostic quality and the inability to differentiate between cystitis and pyelonephritis, or a weak implementation of the guidelines. Furthermore, interpreting ESBLs based on clearance zone measurements rather than performing a specialized ESBL test limits ESBL detection within the community. A specific survey on MDROs in this population is needed.

Patients suffering from dysphagia have trouble in swallowing conventional oral dosage forms and there is also risk of choking, which may cause patient noncompliance. This study aimed to develop an orodispersible film (ODF) containing cefixime trihydrate (CFX) to cope with the above-mentioned problems as well as to enhance water solubility and masking the bitter taste of the drug. The freeze-drying and kneading methods were used for the formation of inclusion complexes. The physicochemical evaluation revealed that T7 was the best film for the incorporation of pure drug and inclusion complexes. Films were further characterized for physical and mechanical properties. Drug content, dissolving time of the film and drug release tests were performed. In vivo taste and disintegration time studies were also conducted in healthy human volunteers. FTIR spectra of the individual ingredients and prepared formulations have confirmed the chemical compatibilities of the ingredients. The solubility of CFX was increased by complexation with tag_hash_114-CD and optimized freeze-dried inclusion complex (FD1) was selected for the formation of ODF. C4 was selected as an optimized film for the delivery of CFX as this film has released 95.52% drug at the end of 10 min. Dissolution kinetics of FD1 showed that it followed zero-order kinetics while drug release from films, exhibits first-order kinetics; however, both showed non-Fickian transport. In vivo taste evaluation revealed that taste was masked by inclusion complexation with -CD. However, selected ingredients and employed methodology enabled to formulate film, capable of delivering taste-masked CFX with improved solubility and better patient compliance. e24fc04721