Tanno, Keiki et al. published their research in Japanese Journal of Antibiotics in 1982 | CAS: 66309-69-1

(6R,7R)-7-(2-(2-Aminothiazol-4-yl)acetamido)-3-(((1-(2-(dimethylamino)ethyl)-1H-tetrazol-5-yl)thio)methyl)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid dihydrochloride (cas: 66309-69-1) belongs to thiazole derivatives. The thiazole ring is notable as a component of the vitamin thiamine (B1). The nitrogen in thiazole is sp2 hybridized and the lone pair of electrons localized on the nitrogen is less reactive due to increased aromatic character and decreased basicity. It is protonated and alkylated/acylated at nitrogen forming hydrochloride and quaternary thiazolium salt.Synthetic Route of C18H25Cl2N9O4S3

Incompatibility of cefotiam dihydrochloride in parenteral preparations by high-performance liquid chromatography was written by Tanno, Keiki;Ikarashi, Kuniichi;Sasahara, Kazuhisa;Kato, Masami. And the article was included in Japanese Journal of Antibiotics in 1982.Synthetic Route of C18H25Cl2N9O4S3 This article mentions the following:

Changes in external appearance, pH, and residual antimicrobial potency of cefotiam-HCl (I) [66309-69-1] were examined in combination with infusion solutions and other injections. The combination of I with bromhexine-HCl  [611-75-6], dipyridamole  [58-32-2], and gabexate mesilate  [56974-61-9] was incompatible because of the turbidity produced. No change was observed in 34 other combinations. In the experiment, the researchers used many compounds, for example, (6R,7R)-7-(2-(2-Aminothiazol-4-yl)acetamido)-3-(((1-(2-(dimethylamino)ethyl)-1H-tetrazol-5-yl)thio)methyl)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid dihydrochloride (cas: 66309-69-1Synthetic Route of C18H25Cl2N9O4S3).

(6R,7R)-7-(2-(2-Aminothiazol-4-yl)acetamido)-3-(((1-(2-(dimethylamino)ethyl)-1H-tetrazol-5-yl)thio)methyl)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid dihydrochloride (cas: 66309-69-1) belongs to thiazole derivatives. The thiazole ring is notable as a component of the vitamin thiamine (B1). The nitrogen in thiazole is sp2 hybridized and the lone pair of electrons localized on the nitrogen is less reactive due to increased aromatic character and decreased basicity. It is protonated and alkylated/acylated at nitrogen forming hydrochloride and quaternary thiazolium salt.Synthetic Route of C18H25Cl2N9O4S3

Referemce:
Thiazole | C3H3NS – PubChem,
Thiazole | chemical compound | Britannica