This retrospective, observational study evaluated the effectiveness and optimal dosage of flomoxef (FMOX) against infections with extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBLPE) by performing pharmacokinetic/pharmacodynamic analysis. Patients with ESBLPE infections treated using FMOX for ≥ 4 days were included. The time above the minimum inhibitory concentration (MIC) (TAM) was calculated using the FMOX MIC for ESBLPE and simulated FMOX concentration. Ten patients including six women (median age: 76 years, interquartile range: 61–91) were included. Most ESBLPE infections were urinary tract infections (UTIs, 60%). Among the ESBLPE isolates, eight were of Escherichia coli, one was of Klebsiella pneumoniae, and one was of Proteus mirabilis. Four patients had bacteremia secondary to ESBLPE infection. The most frequent MIC for FMOX was ≤ 0.12 mg/L (50%), followed by 0.25 mg/L and 0.5 mg/L. Clinical effectiveness was noted in 77.8% of cases. Regarding UTIs, effectiveness was noted in all five cases. Regarding non-UTIs, only 50% of cases showed clinical effectiveness. Regarding microbiological effectiveness, both cases in which evaluation was possible showed effectiveness. Despite the use of different doses, TAM was 100% in most cases. FMOX may be a potentially effective option for UTIs caused by ESBLPE, though larger studies are needed. FMOX effectiveness in non-UTI cases needs further evaluation.

This study assessed social vulnerabilities, serious psychological distress (SPD), and socioeconomic impacts of the COVID-19 lockdown on slum dwellers and homeless individuals in Ho Chi Minh City (HCMC), Vietnam. It also examined the coverage and sources of cash and food support provided, community actors who assisted with such support, and the continuation of medication for chronic diseases. A cross-sectional survey of 415 participants (383 slum dwellers and 32 homeless individuals) was conducted using a structured questionnaire. Many participants faced social vulnerabilities, and 19.8% exhibited SPD. Job insecurity affected 58.8% of participants, and 60.7% reported income reductions due to the lockdown. During this period, 78.8% received cash support and 84.8% received food support; however, the coverage was significantly lower among homeless individuals, particularly for government-provided assistance. Community actors, most notably neighborhood heads, played key roles in assisting with the provision of cash and food support. The vast majority of patients with chronic illnesses were able to continue their medications during the lockdown, primarily through household drug storage and visits to health facilities. Receiving sufficient food support was significantly associated with reduced odds of SPD. These findings highlight the profound socioeconomic effects of the COVID-19 lockdown on populations with unstable housing in HCMC. The cash and food support, predominantly sourced from the government and donors, achieved high coverage through effective delivery by various community actors. Prescription regulations should be adjusted during lockdowns to allow patients with chronic conditions to stockpile sufficient medication. Mental health support is crucial for populations with unstable housing during pandemics.