cefamandole and cefamandole-nafate

To determine the value of antibiotic prophylaxis for the prevention of infection following postoperative T-tube cholangiography.. A prospective, controlled study.. A tertiary care center.. The role of antibiotic prophylaxis during postoperative T-tube cholangiography was prospectively evaluated in 164 patients.. Sixty-two patients were administered antibiotic prophylaxis treatment (1 g of cephalothin sodium was infused intravenously 30 minutes before the procedure and 500 mg of cephalexin was given orally every 6 hours for 3 days after the procedure). Seventy-one patients were in the control group and did not receive antibiotic therapy.. Complications and adverse reactions following postoperative T-tube cholangiography were recorded and compared between the two groups.. There was no significant difference between the groups in regard to age, sex, serum amylase level before T-tube cholangiography, white blood cell count, and liver function. The results of the bacteriologic culture specimens of the bile were also comparable between the groups. One patient who had received antibiotic therapy and one patient in the control group had fever (temperature, > 38 degrees C) and chills after the procedure. Two patients who had received antibiotic therapy and one patient in the control group had mild abdominal pain. These complications were treated conservatively without any event. No significant difference was found in the rates of complications and the success of postoperative T-tube cholangiography between the groups.. Routine antibiotic prophylaxis for the prevention of infection following postoperative T-tube cholangiography is not necessary under selected conditions.

Topics: Bacterial Infections; Cefamandole; Cephalothin; Cholangiography; Cholangitis; Drug Therapy, Combination; Drug Utilization Review; Female; Humans; Male; Middle Aged; Postoperative Period; Premedication; Prospective Studies; Taiwan

A prospective, randomized, double-blind study was conducted to determine the efficacy of cefamandole nafate in reducing infections in general orthopedic procedures. Of 743 patients initially entered into the study, 715 (362 on cefamandole, 353 on placebo) fulfilled the requirements of the protocol. The infection rate was 1.6% for the cefamandole-treated group and 4.2% for the placebo group. In operations lasting longer than two hours, there were two infections in the cefamandole group and seven infections in the placebo group (p less than 0.05). Staphylococcus aureus and gram-negative bacilli were the common pathogens. Adverse side effects were limited to transient elevations in liver enzymes.

Topics: Adult; Bacterial Infections; Cefamandole; Double-Blind Method; Female; Humans; Male; Middle Aged; Placebos; Prospective Studies; Random Allocation; Surgical Wound Infection

The efficacy of intraoperative irrigation with cefamandole nafate at cesarean section was evaluated in a prospective, randomized double-blind study. Two hundred and eight patients were treated with antibiotic irrigation and intravenous placebo or with perioperative intravenous cefamandole and irrigated with normal saline. The rate of endometritis was 10.9% in the irrigation group and 14% in the intravenous group, but the difference was not statistically significant. The rate of any infection, the number of days with fever, additional hospitalization days, and number of antibiotics used for treatment were similar in the two groups. It thus was concluded that irrigation with antibiotic is equal but not superior to perioperative intravenous antibiotics.

Topics: Adult; Bacterial Infections; Cefamandole; Cesarean Section; Double-Blind Method; Female; Humans; Injections, Intravenous; Intraoperative Care; Pregnancy; Premedication; Prospective Studies; Random Allocation; Therapeutic Irrigation

Intrauterine lavage using broad-spectrum antibiotics after cesarean section has been reported to reduce maternal morbidity, but many such patients are not at high risk for postoperative infection. This study tested intrauterine antibiotic lavage in patients at risk for infectious morbidity. The patients were randomly assigned to one of three groups based on the last digit of the hospital admission number. Group I received no lavage, group II received lavage with 800 ml of saline plus 2 gm of cefamandole nafate in the intrauterine incision, bladder flap and peritoneal cavity, and group III received a similar lavage using 800 ml of saline alone. There was a significant decrease in maternal hyperpyrexia (simple morbidity) as well as serious infection in both lavage groups as compared to the control group (p less than 0.01 and 0.05, respectively). Also, there was significantly reduced morbidity when the antibiotic lavage was compared to the saline technique (p less than 0.001). The use of intrauterine lavage with saline, with or without antibiotics, appears helpful in reducing postoperative morbidity in patients at high risk for infectious morbidity after cesarean section.

Topics: Anti-Bacterial Agents; Cefamandole; Cesarean Section; Female; Humans; Pregnancy; Random Allocation; Risk; Surgical Wound Infection; Therapeutic Irrigation; Uterus

The role of prophylactic antibiotic lavage in elective biliary tract operations is controversial. To investigate this question, a prospective, randomized study was undertaken between 1979 and 1983. All patients more than 18 years of age who underwent elective biliary operations were included. Eighty-eight patients were enrolled in the study and were stratified into the following antibiotic groups: (1) cefamandole nafate 2 gm administered intravenously preoperatively and 6 hours postoperatively in four doses; (2) cefamandole nafate 0.4% solution: 250 ml to irrigate the abdominal wound on opening, 500 ml to irrigate the peritoneal cavity, and 250 ml to irrigate the wound on closing; and (3) systemic plus topical administrations as in Nos. 1 and 2. Age, sex, type of operation, and underlying diseases were comparable in all groups. The patients were then evaluated for postoperative infections. In the intravenous cefamandole group there was only one patient who developed a urinary tract infection after operation. In the topical cefamandole group there were four postoperative infections: wound-one, urinary tract--two, and cholangitis--one. In the intravenous plus topical cefamandole group there were four postoperative infections: wound--one, urinary tract--two, and pneumonia--one. No deaths occurred in any group. Blood, subcutaneous, and peritoneal drug levels were sampled 1 hour after opening and before closing. Therapeutic serum levels of cefamandole are 1 to 16 micrograms/ml and adequate serum levels were achieved in all groups. However, higher levels were obtained in the subcutaneous tissue and peritoneum when topical cefamandole was used. We conclude: (1) Topical cefamandole lavage alone is adequate prophylaxis in elective biliary operations and achieves comparable results as perioperative systemic administration; (2) topical cefamandole resulted in higher subcutaneous tissue and peritoneal levels than intravenous cefamandole and also achieved therapeutic serum levels; and (3) there is no advantage to the use of systemic plus topical antibiotics in elective biliary operations.

Topics: Administration, Topical; Adult; Aged; Bacteria, Aerobic; Bacteria, Anaerobic; Bacterial Infections; Bile; Biliary Tract Surgical Procedures; Cefamandole; Cephalosporins; Drug Evaluation; Female; Humans; Injections, Intravenous; Intraoperative Care; Male; Middle Aged; Peritoneum; Postoperative Complications; Random Allocation; Risk; Therapeutic Irrigation

After double-blind controlled studies demonstrated cefamandole nafate irrigation of the uterus during cesarean section to be effective in reducing the rate of endomyometritis, antibiotic irrigation was adopted as a standard procedure at Tripler Army Medical Center. The present study analyzes the outcome in patients undergoing cesarean section before (comparison group) and after (treatment group) routine use of antibiotic irrigation began. The incidence of endomyometritis in 100 patients from the comparison group was 20% and in 298 patients from the treatment group 1.7% (P less than .0001). Serum analysis for cefamandole nafate demonstrated little systemic absorption of the antibiotic. Cefamandole nafate intrauterine irrigation at cesarean section effectively prevents endomyometritis.

Topics: Adult; Cefamandole; Cephalosporins; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Endometritis; Female; Humans; Intraoperative Care; Pregnancy; Premedication; Puerperal Infection; Therapeutic Irrigation

The effectiveness of intrauterine irrigation with an antibiotic solution of cefamandole nafate in reducing the incidence of endometritis after cesarean section was studied in a prospective, double-blind fashion. Ninety patients who underwent cesarean section at Tripler Army Medical Center were divided into three equal groups. Each group received one of the following treatments at the time of operation: (1) intrauterine irrigation with the antibiotic solution, (2) irrigation with normal saline solution, or (3) no irrigation. The resulting incidences of endometritis were 0%, 26.7%, and 23.3%, respectively. Intrauterine irrigation with cefamandole nafate solution at the time of cesarean section significantly reduced the incidence of endometritis.

Topics: Cefamandole; Cephalosporins; Cesarean Section; Double-Blind Method; Endometritis; Female; Humans; Postoperative Complications; Pregnancy; Prospective Studies; Risk; Sodium Chloride; Therapeutic Irrigation

Intrahepatic foreign bodies are extremely rare before 6 months of age. We reported a case of a 5-month-old boy with a needle-like foreign body in the liver. The foreign body was incidentally found in the right hepatic lobe on the x-ray image. He was asymptomatic, with neither a history of swallowing a needle nor an abdominal cutaneous scar. Three-dimensional reconstruction of spiral computed tomographic scan showed an intrahepatic needle, close to the base of the heart, with its proximal end close to the gallbladder fossae. Because of the localization of the needle and subsequent risks of complications, surgical removal was recommended. At laparotomy, a tiny scar was recognized in the upper surface of the right lobe of the liver, confirming the migration route. Postoperative course was uneventful, and the child was discharged on postoperative day 10 and is thriving perfectly 2 months after surgery. We reviewed the clinical issues of intrahepatic foreign bodies and briefly discussed its approach and implications.

Topics: Abdominal Injuries; Anti-Bacterial Agents; Asymptomatic Diseases; Cefamandole; Emergencies; Foreign Bodies; Foreign-Body Migration; Humans; Image Processing, Computer-Assisted; Incidental Findings; Infant; Laparotomy; Liver; Liver Function Tests; Male; Needles; Respiratory Tract Infections; Tomography, Spiral Computed; Wound Infection

Water mobility plays a crucial role in determining transport properties of small molecules in polymer matrices. In particular, in drug delivery systems, water state affects the pharmacokinetics, especially drug absorption, diffusion and release. In the present study, the state of water in an antibiotic-loaded composite consisting of albumin nanoparticles (BSA(np)) dispersed into a carboxylated polyurethane (PEUA) has been investigated and compared with that of the single drug-loaded components. The antibiotic cefamandole nafate was used as a model drug. DSC analysis, used to evaluate the freezing and non-freezing water fractions in the hydrated samples, showed that in BSA(np) water can adsorb both in the inter-particles regions and inside the particles. With increasing of total adsorbed water amount, the contribution of the freezing water fraction was higher than the non-freezing one. As for PEUA, the majority of water molecules absorbed is in a mobile freezing state (about 60% of the W(tot)). As for the PEUA/BSA(np) composite, the higher polyurethane phase segregation induced by the nanoparticles as well as the higher non-freezing water fraction significantly enhanced drug uptake with respect to PEUA. Moreover, the greater non-freezing water fraction allowed the drug to penetrate within BSA nanoparticles and to give rise then to a controlled drug release. Indeed, the diffusion barrier exerted by nanoparticles and the matrix prolonged the antimicrobial activity from 4 to 9 days. Finally, the higher polyurethane phase segregation also improved composite mechanical properties, as evidenced in stress-strain experiments and dynamic mechanical analysis.

Topics: Anti-Bacterial Agents; Calorimetry, Differential Scanning; Cefamandole; Delayed-Action Preparations; Diffusion; Freezing; Microbial Sensitivity Tests; Nanoparticles; Polyurethanes; Serum Albumin, Bovine; Time Factors; Water

Antibiotic therapies to eradicate medical device-associated infections often fail because of the ability of sessile bacteria, encased in their exopolysaccharide matrix, to be more drug resistant than planktonic organisms. In the last two decades, several strategies to prevent microbial adhesion and biofilm formation on the surfaces of medical devices, based mainly on the use of antiadhesive, antiseptic, and antibiotic coatings on polymer surfaces, have been developed. More recent alternative approaches are based on molecules able to interfere with quorum-sensing phenomena or to dissolve biofilms. Interestingly, a newly purified beta-N-acetylglucosaminidase, dispersin B, produced by the gram-negative periodontal pathogen Actinobacillus actinomycetemcomitans, is able to dissolve mature biofilms produced by Staphylococcus epidermidis as well as some other bacterial species. Therefore, in this study, we developed new polymeric matrices able to bind dispersin B either alone or in combination with an antibiotic molecule, cefamandole nafate (CEF). We showed that our functionalized polyurethanes could adsorb a significant amount of dispersin B, which was able to exert its hydrolytic activity against the exopolysaccharide matrix produced by staphylococcal strains. When microbial biofilms were exposed to both dispersin B and CEF, a synergistic action became evident, thus characterizing these polymer-dispersin B-antibiotic systems as promising, highly effective tools for preventing bacterial colonization of medical devices.

Topics: Anti-Bacterial Agents; Bacterial Proteins; Biofilms; Cefamandole; Cell Line, Tumor; Drug Interactions; Glycoside Hydrolases; Humans; Microbial Sensitivity Tests; Polyurethanes; Prosthesis-Related Infections; Staphylococcus; Staphylococcus aureus; Staphylococcus epidermidis

The European Pharmacopoeia (Ph.Eur.) monograph for Cefamandole Nafate (CFN) and the revised monograph prescribe the identification of the antibiotic in solid state by infrared (IR) absorption spectrophotometry using potassium bromide (KBr) disc technique. But, this technique may cause unwanted solid-solid transformations in the crystalline structure of the beta-lactam antibiotic CFN. The latter is a drug with proven polymorphism/pseudopolymorphism. In this context we have examined the suitability of the two techniques (KBr disc and Nujol mull) for IR spectral analyses to identify the antibiotic CFN in solid state. The results of our examinations show that KBr disc technique alters the crystalline state of CFN during the preparation of its KBr disc samples by the tribomechanical treatments (grinding and compression pressure). On the contrary, the Nujol mull technique does not cause such transformations and it is estimated as a better, more suitable technique to be employed for identification of CFN. For a greater precision, in solving the possible difficulties due to the KBr disc technique a second record of IR spectra is necessary to be provided by the Nujol mull technique with use of an internal standard (the stretching vibration of vC = 0 of the condensed beta-lactam cycle).

Topics: Anti-Bacterial Agents; Cefamandole; Spectrophotometry, Infrared; Technology, Pharmaceutical

The influence of temperature and relative humidity (RH) on the stability of cefamandole (CM) nafate sodium in the solid phase was investigated. Changes in the concentration of cefemandole nafate sodium were recorded using HPLC with UV detection. The method was validated for the following parameters: selectivity, linearity, precision, limit of detection and sensitivity. It showed good linearity (r=0.9996) in the range 0.4 x 10(-4)-5.6 x 10(-4) g ml(-1) using a LiChrospher RP-18 column and as mobile phase acetonitryle-triethylamine (10% v/v, adjusted to pH 2.5 with phosphoric acid (84%) and diluted with water) (35:65). The degradation of CM occurring at 0% RH of the ambient air and at air humidity RH>50% is a first-order reaction relative to substrate concentration. The first-order rate constants (k) were determined for CM degradation in dry air at 373, 383, 388 and 393 K, at air humidity RH=76.4% at 323, 333, 343 and 353 K, and at 353 K at air humidity RH>50%. The kinetic and thermodynamic parameters of the decomposition were calculated.

Topics: Cefamandole; Chromatography, High Pressure Liquid; Drug Stability; Humidity; Kinetics; Temperature; Thermodynamics

A sensitive, accurate, precise and the same time simple and rapid method for the colorimetric determination of some cephalosporins of the second and third generations, such as: cefoxitin sodium (CFXT), cefaclor (CFCL), cefamandole nafate (CFMD), ceforanide l-lysine (CFRN), cefotaxime sodium (CFTX), and cefurozime sodium (CFRX) was described. The new method proposed is based: a) On the reduction of Fe(III) to Fe(II) by the drug analysed and b) On complexation of Fe(II) formed with o-Phenanthroline (O-Phen) consistently the formation of the well known highly stable orange-red coloured chelate complex [Fe(II)-(o-Phen)3]2+ which exhibits an absorption maximum at lambda = 510 nm (pH 4.50 +/- 0.2). Beer's law is obeyed for: 1.0 - 37.5 microgram mL-1 for CFX, 1.0 - 25.0 microgram mL-1 for CFMD, CFRN, and CFTX and 2.0 - 37.5 microgram mL-1 for CFTX and CFCL, while the apparent molar absorptivity ( epsilon in L mol-1cm-1) and the Sandell's sensitivity in (ngcm-2) both referred to the drug analyzed, are 1.29 x 10(4); 34.7 (CFXT), 7.61 x 10(3); 50.7 (CFCL), 3.33 x 10(4); 15.4 (CFMD), 2.60 x 10(4); 17.6 (CFRN) respectively. The regression line equation for each one of the above studied cephalosporins were calculated with a correlation coefficient 0.9997 < r < 1.0000; the accuracy and the precision of the method was considered as very satisfactory, while the results of a statistical analysis by means of the Student's t-test and the variance ratio F-test prove that no significant difference was observed between the results of the proposed method and those of official one.

Topics: Cefaclor; Cefamandole; Cefotaxime; Cefoxitin; Cefuroxime; Cephalosporins; Colorimetry; Indicators and Reagents; Molecular Structure; Sensitivity and Specificity

A rapid isocratic technique was developed for the analysis of cephamandole nafate and cephamandole in parenteral solutions using high-performance liquid chromatography (HPLC) with UV detection and C18 column. The availability and compatibility of drugs from solutions infused via plastic infusion bags through plastic administration sets have been examined. No significant drugs loss was observed during simulated infusions (n = 4) for 1 h using PVC infusion bags and administration sets. No significant difference was found between infusion solutions (5% glucose or 0.9% NaCl). The stability of drugs was also studied in solution in PVC bags after storage at room temperature and at 4 degrees C without protection from light. The results show the stability of cephamandole nafate during 24 h at room temperature and 7 days storage at 4 degrees C to be satisfactory, irrespective of the infusion solution (5% glucose or 0.9% NaCl). However, an almost immediate and total transformation of cephamandole nafate to cephamandole in 5% glucose has been observed, whereas in 0.9% NaCl both forms were found in similar proportions.

Topics: Calibration; Cefamandole; Chromatography, High Pressure Liquid; Drug Packaging; Drug Stability; Drug Storage; Humans; Hydrolysis; Infusions, Parenteral; Light; Polyvinyl Chloride; Reproducibility of Results; Spectrophotometry, Ultraviolet; Temperature

Prophylactic intravenous cefamandole nafate was administered by the systemic, systemic with probenecid (causing renal tubular blockade of antibiotic excretion), and intravenous regional routes. Bone antibiotic levels were assayed 15 minutes and 12 hours after administration, and hematoma concentrations after 8 hours. Bone concentrations after intravenous regional administration were significantly greater than systemic after 15 minutes, but were not detectable after 12 hours. Probenecid produced inhibitory concentrations in bone after 12 hours and also increased hematoma antibiotic concentrations to three times those achieved by systemic administration. Adequate prophylaxis may be possible with two rather than three doses of cefamandole if probenecid is used.

Topics: Cefamandole; Chemotherapy, Cancer, Regional Perfusion; Humans; Infusions, Intravenous; Kidney Tubules; Knee Prosthesis; Premedication; Probenecid

A high-performance liquid chromatographic method with column switching has been developed for the simultaneous determination of cefamandole and cefamandole nafate in plasma and urine. The plasma and urine samples were injected onto a precolumn packed with Corasil RP C18 (37-50 microns) after simple dilution with an internal standard solution in 0.05 M phosphoric acid. Polar plasma and urine components were washed out using 0.05 M phosphoric acid. After valve switching, the concentrated drugs were desorbed in back-flush mode and separated by a reversed-phase C8 column with methanol-5 mM tetrabutylammonium bromide (45:55, v/v) as the mobile phase. The method showed excellent precision with good sensitivity and speed, and a detection limit of 0.5 microgram/ml. The total analysis time per sample was less than 30 min, and the mean coefficients of variation for intra- and inter-assay were both less than 4.9%. The method has been successfully applied to plasma and urine samples for human volunteers after intravenous injection of cefamandole nafate.

Topics: Cefamandole; Chromatography, High Pressure Liquid; Humans; Reproducibility of Results

Hemorrhagic shock has been associated with an increased risk of infection after injury. The immediate and long term effects of hemorrhagic shock without tissue injury on the susceptibility of an animal to infection and the efficacy of antibiotic prophylaxis to prevent infection in this setting were examined. Sprague-Dawley rats were subjected to hemorrhagic shock (LD15) by bleeding to a mean arterial pressure of 45 millimeters of mercury for 45 minutes and were resuscitated with shed blood and normal saline solution. In one experiment, dorsal wounds were inoculated one hour before or after shock with either 10(6), 10(8) or 10(10) Staphylococcus aureus. In a second experiment, rats were infected at one hour, or one, three or five days after shock with 10(6), 10(7) or 10(8) S. aureus. Equivalent numbers of rats received cefamandole nafate prior to bacterial challenge. Hemorrhagic shock increased the susceptibility to wound infection at all inocula. Infection increased whether rats were wounded before or after shock, and this effect was sustained for up to three days. Antibiotic prophylaxis was of limited value in reducing the incidence of wound infection after shock.

Topics: Animals; Cefamandole; Disease Models, Animal; Disease Susceptibility; Female; Rats; Rats, Inbred Strains; Shock, Hemorrhagic; Staphylococcal Infections; Time Factors; Wound Infection

Acute massive intestinal ischemia is an abdominal catastrophe. Prompt diagnosis and restoration of blood flow is essential; otherwise, massive intestinal resection occurs, leading to death or, in the survivors, intestinal cripples. In this study, the time of warm reversible ischemia in the canine intestine was explored. After this time was established, fluids and antibiotics were administered to note change in survival times. Massive intestinal ischemia (superior mesenteric artery was clamped) was tolerated without death for five hours (20 dogs in each group). With six hours of ischemia, a 10 per cent mortality rate occurred; with seven hours of ischemia, a 90 per cent mortality rate occurred. These dogs had a maintenance of 75 milliliters of fluid administered per hour. Using this group of dogs as the control (that is, the group with seven hour clamping time of the superior mesenteric artery with maintenance intravenously administered replacement), fluids were given to dogs in the experimental group to keep the pulmonary artery wedge pressure at a normal value (average of 300 milliliters per hour). This group of dogs had an increased survival rate of 40 per cent (ten dogs). Antibiotics were given to the dogs in the experimental group both before and after clamping, increasing the over-all survival rate to more than 80 per cent (46 dogs). Aggressive fluid replacement and antibiotic coverage may lengthen the so-called golden period in which intestinal ischemia may be reversed by revascularization.

Topics: Animals; Anti-Bacterial Agents; Cefamandole; Dogs; Fluid Therapy; Intestines; Ischemia; Pulmonary Wedge Pressure

The feasibility of the radiation sterilization of two beta-lactam antibiotic powders, cefamandole nafate and oxacillin sodium, has been examined by subjecting them to a range gamma-radiation doses, followed by chemical and microbiological analyses. It would appear feasible to radiation sterilize oxacillin sodium. The radiation sterilization of cefamandole nafate may be realistic at low doses or under conditions that minimize radiolysis.

Topics: Cefamandole; Gamma Rays; Oxacillin; Staphylococcus aureus; Sterilization

The effects of antibiotics and other commonly used medications on the human polymorphonuclear neutrophil leukocytes' (PMNs) nicotinamide-adenine dinucleotide phosphate-reduced (NADPH) oxidase activity have been investigated in vitro. Five antibiotics (penicillin G sodium, cefamandole nafate, metronidazole hydrochloride, clindamycin phosphate, and tobramycin sulfate, and a triple combination of penicillin G sodium-metronidazole hydrochloride-tobramycin sulfate) and two sedatives (morphine sulfate and diazepam) were incubated with normal human PMNs at therapeutic, infratherapeutic, and supratherapeutic drug levels. The superoxide dismutase-inhibitable, NADPH-dependent reduction of cytochrome C in the PMNs was studied after stimulation with formyl-methionyl-leucine-phenylalanine. Tobramycin sulfate and the triple combination of penicillin G sodium-metronidazole hydrochloride-tobramycin sulfate significantly reduced the NADPH oxidase activity at all dosages studied. Clindamycin phosphate, morphine sulfate, and diazepam also showed significant reduction at therapeutic and supratherapeutic concentrations. Penicillin G sodium, cefamandole nafate, and metronidazole hydrochloride did not cause a decrease in enzyme activity at any levels tested. We conclude that NADPH oxidase activity can be adversely affected by the circulating levels of common antibiotics and sedatives.

Topics: Adult; Anti-Bacterial Agents; Cefamandole; Clindamycin; Diazepam; Female; Humans; Hypnotics and Sedatives; In Vitro Techniques; Male; Middle Aged; Morphine; N-Formylmethionine Leucyl-Phenylalanine; NADH, NADPH Oxidoreductases; NADPH Oxidases; Neutrophils; Penicillin G; Stimulation, Chemical; Tobramycin

Topics: Administration, Topical; Bacterial Infections; Cefamandole; Drainage; Escherichia coli Infections; Female; Humans; Hysterectomy; Parametritis; Postoperative Complications; Premedication; Random Allocation; Therapeutic Irrigation

The chemical stabilities of cefamandole nafate and metronidazole, when mixed together for intravenous infusion, have been studied using a stability-indicating, high-performance liquid chromatographic method of assay. Cefamandole nafate was stable for 5 days at 25 degrees C and at least 14 days at 5 degrees C. The addition of metronidazole did not affect the stability of cefamandole nafate. In a 2% solution of cefamandole in metronidazole injection (0.5%), metronidazole lost about 9.1% of potency in less than 2 h at 25 degrees C and in less than 6 h at 5 degrees C. The per cent loss was directly related to the initial concentration of cefamandole nafate. Change in the concentration of metronidazole did not affect the per cent of metronidazole lost.

Topics: Cefamandole; Chromatography, High Pressure Liquid; Drug Combinations; Drug Stability; Infusions, Parenteral; Metronidazole

Mycoplasma pneumoniae is one of the most common causes of community-acquired pneumonia. Infection is usually self-limited, but fulminant pneumonia and extrapulmonary complications can supervene. Usually, unilateral confluent, patchy, or nodular infiltrates of the lower lobe are seen on roentgenograms. Diagnosis is achieved by isolation of the organism or by serologic methods. Treatment with either erythromycin or tetracycline is effective, although organisms can be recovered during therapy. In the three cases of mycoplasmal pneumonia reported here, infection was resistant to initial therapy but patients recovered when appropriate antimicrobial therapy was instituted.

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Cefamandole; Cefazolin; Doxycycline; Erythromycin; Female; Humans; Male; Middle Aged; Pneumonia, Mycoplasma; Radiography; Serologic Tests

Eighty-six women with suspected acute salpingitis were treated with parenteral cefamandole. From 53 (62%) of these Neisseria gonorrhoeae was recovered from an anogenital site(s) at admission. These women were younger, of lower parity, had pain for a shorter period of time, responded more rapidly to therapy, and required less antimicrobial agent for clinical cure than those from whom N gonorrhoeae was not recovered. The clinical success observed in these women was 94%, and only 2% of 122 gonococcal isolates were resistant to cefamandole in vitro.

Topics: Adolescent; Adult; Cefamandole; Cephalosporins; Cervix Uteri; Contraception Behavior; Ethnicity; Female; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Pharynx; Rectum; Salpingitis; Urethra

Ersipelas, a common disease of swine, is caused by Erysipelothrix rhusiopathiae. The organism was isolated in a blood culture taken from an infected captive dolphin. The dolphin showed typical subacute symptoms of square- and diamond-shaped skin lesions as seen in swine. It was surmised, in retrospect, that the disease was secondary to a primary pneumonia. The symptoms, clinical pathology and other special examinations, treatment and response are discussed.

Topics: Animals; Anti-Bacterial Agents; Cefamandole; Chloramphenicol; Cloxacillin; Dolphins; Drug Therapy, Combination; Erysipelothrix Infections; Female; Gentamicins; Leucomycins; Penicillin G Benzathine; Tylosin

Topics: Adolescent; Adult; Bacterial Infections; Cefamandole; Cephalosporins; Cesarean Section; Female; Genital Diseases, Female; Humans; Middle Aged; Postoperative Complications

Topics: Biological Assay; Cefamandole; Cephalosporins; Chromatography, High Pressure Liquid; Drug Combinations; Drug Incompatibility; Drug Stability; Hydrogen-Ion Concentration; Injections, Intramuscular; Solutions

Topics: Bacteria; Bacterial Infections; Cefamandole; Cephalosporins; Child; Child, Preschool; Enteritis; Female; Humans; Infant; Infant, Newborn; Male; Microbial Sensitivity Tests; Otitis Media; Respiratory Tract Infections; Tonsillitis; Urinary Tract Infections

High-pressure liquid chromatographic (HPLC) methods for the quantitative determinations of cefamandole, cefamandole nafate, and cefoxitin sodium were developed and used to study the stabilities of reconstituted solutions of the latter two antibiotics. Results from the HPLC procedures were compared with those from a previously reported colorimetric procedure. Solutions (2%) of cefamandole nafate and cefoxitin sodium in 0.9% sodium chloride injection and in 5% dextrose injection were studied at 24 degrees C and 5 degrees C. The colorimetric method, which is supposed to be specific for compounds with beta-lactam rings, gave misleading results because of the hydrolysis of the antibiotics. The results obtained by HPLC were reproducible and the procedure separated cefamandole, the hydrolyzed compound, from its ester (cefamandole nafate), which was essential for conducting these studies. The cefamandole solutions were stable for approximately five days at 24 degrees C and 44 days at 5 degrees C. The cefoxitin solutions were stable for 24 hours at 24 degrees C and for at least 13 days at 5 degrees C.

Topics: Cefamandole; Cefoxitin; Cephalosporins; Chromatography, High Pressure Liquid; Colorimetry; Drug Stability; Hydrolysis; Solutions; Temperature

The results of a pharmacokinetic and clinical study of cephamandol naphate indicated that the drug quickly reaches high plasma concentration after both i.m. and i.v. bolus administration. Urinary excretion of the biologically active form is as much as 84--90% of the total dose and mostly takes place in the first 6 hr. The therapeutic response was good: clinical cure in 90%, marked improvement in 6.6%, no change in 3.3%.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefamandole; Cephalosporins; Child; Female; Humans; Male; Middle Aged; Mumps; Otitis; Respiratory Tract Infections; Scarlet Fever; Urinary Tract Infections

An increase in the hydrolysis rate of the formyl moiety of cefamandole nafate was observed when the commercial product was reconstituted in 5% dextrose in water relative to the rate when the formulation was dissolved in water for injection or in 0.9% saline. The increase in ester cleavage was the result of nucleophilic attack of glucose on the formyl ester moiety. This transesterification produced small amounts of D-glucose-6-formate and other D-glucose diformates. The formation of these products is of no clinical significance since the antibiotic potency and stability of cefamandole are unaffected and no toxicological differences were observed in animal studies or in clinical trials when formulated cefamandole nafate was administered with or without glucose.

Topics: Cefamandole; Cephalosporins; Chemical Phenomena; Chemistry; Formates; Glucose; Hydrogen-Ion Concentration; Hydrolysis; Magnetic Resonance Spectroscopy