Introduction and objective: A rising number of group A streptococcal infections has been observed all over Europe since 2022. In addition to the high number of patients, the increase in the proportion of progressive, severe, invasive cases has been noticed as an alarming problem. The aim of our study was to describe the characteristics of the Hungarian Streptococcus pyogenes epidemic in the paediatric primary care setting, based on a questionnaire covering a large cohort of paediatric patients. Methods: A 21-item structured questionnaire was sent out on the general physician network platform to primary care paediatricians nationwide in May 2024. The questionnaire was retrospective, assessing actual diagnostic and treatment strategies for streptococcal diseases identified between 1 January and 31 December 2023. Results: Based on data from a total of 71,600 children in 72 paediatric practices, 8.5% (95% confidence interval: 7.1–9.9%) of the enrolled children were diagnosed with streptococcal tonsillitis and/or scarlet fever (n = 6110), of which a quarter of the infected children (2.1%; 95% confidence interval: 1.74–2.46%) showed symptoms of scarlet fever (n = 1515). 82% of the patients were in the age group 5–10 years. Peritonsillar abscesses developed in 0.6% of patients (41 cases), invasive disease was diagnosed in 9 children, post-streptococcal glomerulonephritis occurred in 2 children, while reinfection was observed in an average of 15%. In nearly half of the suspected cases (47%), diagnostic microbiological tests were carried out. In terms of therapeutic strategy, the most commonly used antibiotic was amoxicillin-clavulanic acid (41%), but the combined use of narrower spectrum beta-lactams (penicillin, amoxicillin, cefprozil) reached 50%. Macrolide was used by 6%, cefixime by 3%. Discussion: In the current streptococcal epidemic point-of-care diagnosis, early recognition of invasive diseases and appropriate antibiotic selection are crucial for both clinical outcome and antibiotic stewardship. Our results suggest that greater use of rapid testing and the promotion of early, narrow-spectrum antibiotic treatment in proven cases should be encouraged. Conclusion: Our study provides feedback to primary care paediatricians on diagnostic and therapeutic practices and emphasizes the importance of adequate antibiotic selection and early recognition of invasive S. pyogenes infections. Orv Hetil. 2025; 166(19): 719–727.

Botulinum toxin serotype A (BTX-A) is commonly used for treating facial dynamic wrinkles. The clinical safety of BTX-A has been proven, and it has few side effects; despite this, BTX-A has the potential to cause an allergic reaction. This case raises concerns about a possible interaction between botulinum toxin serotype A (CBTX-A) and β-lactam antibiotics, contributing to the limited literature on hypersensitivity reactions. Herein, we described the case of a 35-year-old woman who was injected with Chinese botulinum toxin serotype A (CBTX-A) to treat crow's feet. The treatment was performed after the patient had taken cefprozil for an upper respiratory tract infection. Subsequently, the patient developed urticaria-like symptoms that completely resolved within 24 hours after administration of antihistamines. This case emphasises the need for careful medication history review before botulinum toxin administration, especially in patients receiving β-lactam antibiotics, as hypersensitivity reactions may occur.

Limited information indicates that cefprozil produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. Cefprozil is acceptable in nursing mothers.

This study employed a green microwave synthesis technique to produce carbon quantum dots (CQDs) from araucaria heterophylla gum extract. The produced CQDs emit a distinct blue fluorescent light, contributing a remarkable quantum yield of 14.69%. Their average particle size measures at 1.62 ± 0.39 nm. Furthermore, these CQDs demonstrate excellent water solubility and maintain high fluorescence stability despite ionic strength, pH and time variations. Moreover, we present here for the first time that the synthesized CQDs demonstrate a rapid, exceptionally sensitive, and discerning fluorescence quenching phenomenon (IFE) concerning Cefprozil (CPR). The fluorescent probe was sensitive and specific with good linear relationships for CPR in the 0-18 µM range. The limit of detection for relationships for CPR was 2.51 µM. This study provides novel opportunities for producing high-quality luminescent CQDs that meet the requirements for various biological and environmental applications.

BACKGROUND Foreign body aspiration (FBA) is a common and serious problem in childhood that requires early recognition and treatment. Common complications include asphyxia, hemorrhage, infection, and pneumothorax. In severe cases of foreign body obstruction, death can result from asphyxia. We report an interesting case in which a forgotten cotton ball was inhaled into the lungs. CASE REPORT A 5-year-old boy presented to the local hospital with coughing for 6 days and fever for 4 days, without any information of foreign body aspiration upon admission. Laboratory findings indicated an elevated white blood cell; therefore, cefprozil was given as anti-infective treatment. However, the child's condition did not improve. A computed tomography scan showed left pulmonary atelectasis. Considering that the child's condition was serious, he was referred to our hospital for diagnosis and treatment. After referral, auscultation revealed decreased breath sounds over the left lung. After multidisciplinary discussion, combined with the results of auxiliary examination, the possibility of a foreign body was considered. He underwent rigid bronchoscopy, which confirmed a yellow-white foreign body in the left main bronchus that was later verified as a cotton ball. The operation was very successful. Eventually, his condition improved and he was discharged, without additional complications. CONCLUSIONS For children with unclear history of foreign body aspiration, bronchoscopy is recommended if there is recurrent pulmonary infection, low auscultation breath sounds, or abnormal imaging. The choice of surgical method depends on the location and type of foreign body and the experience of the surgeon, which is also very important.

The dengue virus (DENV) infects approximately 400 million people annually worldwide causing significant morbidity and mortality. Despite advances in understanding the virus life cycle and infectivity, no specific treatment for this disease exists due to the lack of therapeutic drugs. In addition, vaccines available currently are ineffective with severe side effects. Therefore, there is an urgent need for developing therapeutics suitable for effective management of DENV infection. In this study, we adopted a drug repurposing strategy to identify new therapeutic use of existing FDA approved drug molecules to target DENV2 non-structural proteins NS3 and NS5 using computational approaches. We used Drugbank database molecules for virtual screening and multiple docking analysis against a total of four domains, the NS3 protease and helicase domains and NS5 MTase and RdRp domains. Subsequently, MD simulations and MM-PBSA analysis were performed to validate the intrinsic atomic interactions and the binding affinities. Furthermore, the internal dynamics in all four protein domains, in presence of drug molecule binding were assessed using essential dynamics and free energy landscape analyses, which were further coupled with conformational dynamics-based clustering studies and cross-correlation analysis to map the regions that exhibit these structural variations. Our comprehensive analysis identified tolcapone, cefprozil, delavirdine and indinavir as potential inhibitors of NS5 MTase, NS5 RdRp, NS3 protease and NS3 helicase functions, respectively. These high-confidence candidate molecules will be useful for developing effective anti-DENV therapy to combat dengue infection.

Aim: The study aimed to develop and evaluate an aquasome drug-delivery system for controlled drug delivery of cefprozil monohydrate. Materials & methods: Aquasomes were prepared by the spinal method with a calcium phosphate core, sugar-coated using cellobiose and drug-loaded by adsorption. The formulations were characterized for size, morphology and drug release. An antibacterial study was conducted for Gram-positive and -negative bacteria. Results: It showed particle size of 2791.9 nm, zeta potential of -0.3 mV with good stability, and 99.08% of drug loading and drug release were controlled and prolonged, achieving 56% within 8 h and possessing potential for 100% release beyond 12 h. Conclusion: An aquasome drug-delivery system was developed for novel controlled drug delivery for pharmaceutical antibiotic therapeutics.

This study aimed to assess the bioequivalence of 2 cefprozil dispersible tablet formulations (250 mg) in healthy Chinese volunteers under fasting and fed conditions and to determine the pharmacokinetics of cefprozil. A randomized, single-dose, open-label, 2-formulation, 2-period study was conducted. The elimination period for this study was 7 days. Forty-eight healthy volunteers received 250-mg cefprozil dispersible tablets in each study period under both test and reference conditions. The test and the reference cefprozil were bioequivalent in healthy Chinese volunteers, and there was no significant food effect in individuals receiving either formulation. No serious adverse event was recorded, and no volunteers withdrew from the study.

Laccases or laccase-like multicopper oxidases have great potential in bioremediation to oxidase phenolic or non-phenolic substrates. However, their inability to maintain stability in harsh environmental conditions and against non-substrate compounds is one of the main reasons for their limited use. The gene (mco) encoding multicopper oxidase from Bacillus mojavensis TH309 were cloned into pET14b(+), expressed in Escherichia coli, and purified as histidine tagged enzyme (BmLMCO). The molecular weight of the enzyme was about 60 kDa. The enzyme exhibited laccase-like activity toward 2,6-dimethoxyphenol (2,6-DMP), syringaldazine (SGZ), and 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS). The highest enzyme activity was recorded at 80 °C and pH 8. BmLMCO showed a half-life of ~ 305, 99, 50, 46, 36, and 20 min at 40, 50, 60, 70, 80, and 90 °C, respectively. It retained more than 60% of its activity after pre-incubation in the range of pH 5-12 for 60 min. The enzyme activity significantly increased in the presence of 1 mM of Cu[2+]. Moreover, BmLMCO tolerated various chemicals and showed excellent compatibility with organic solvents. The Michaelis constant (Km) and the maximum velocity (Vmax) values of BmLMCO were 0.98 mM and 93.45 µmol/min, respectively, with 2,6-DMP as the substrate. BmLMCO reduced the antibacterial activity of cefprozil, gentamycin, and erythromycin by 72.3 ± 1.5%, 79.6 ± 6.4%, and 19.7 ± 4.1%, respectively. This is the first revealing shows the recombinant production of laccase-like multicopper oxidase from any B. mojavensis strains, its biochemical properties, and potential for use in bioremediation.

A 37-year-old man attended a medical clinic at the confluence of the Appalachian and the St. Lawrence Valley after 2 weeks of coughing greenish sputum and progressive dyspnea on exertion. In addition, he reported fatigue, fevers, and chills. He had quit smoking a year earlier and was not a drug user. He recently had spent most of his free time outdoors, mountain biking, but had not travelled outside of Canada. Medical history was unremarkable. He did not take any medication. Upper airway samples taken for SARS-CoV-2 proved negative; he was prescribed cefprozil and doxycycline for presumed community-acquired pneumonia. He returned to the emergency room 1 week later with mild hypoxemia, persisting fever, and a chest radiography consistent with lobar pneumonia. The patient was admitted to his local community hospital, and broad-spectrum antibiotics were added to the regimen. Unfortunately, his condition deteriorated over the following week, and he experienced hypoxic respiratory failure for which he required mechanical ventilation before his transfer to our medical center.