cefamandole and Chronic-Disease

The safety and efficacy of treatment with cefamandole were evaluated in 77 patients (from 33 institutions) with serious bone and joint infections. The antibiotic was given intramuscularly or intravenously in doses ranging from 1.5 to 12 g/day for 6 to 58 days. Seventy-three of the 77 patients responded satisfactorily, and 63 (of 70 from whom material for culture was obtainable) patients had a bacteriologic cure. Forty-one of 81 isolates were identified as Staphylococcus aureus. Other pathogens included Streptococcus epidermidis, Haemophilus influenzae, Enterobacter sp., Escherichia coli, aerobic and anaerobic cocci, as well as Bacteroides fragilis. The drug was well tolerated. Pharmacological studies indicated that cefamandole penetrated the bones and joints. Cefamandole would seem to be a safe and efficacious drug, for the treatment of serious bone and joint infections due to a wide variety of gram-positive and gram-negative microorganisms.

Topics: Acute Disease; Bacteria; Bacterial Infections; Bone Diseases; Bursitis; Cefamandole; Cephalosporins; Chronic Disease; Clinical Trials as Topic; Female; Humans; Joint Diseases; Male; Middle Aged; Osteomyelitis

Postoperative infection is a regular complication in coccygectomy. The authors propose the use of a topical skin adhesive on the postoperative wound as a contribution to the prevention of this complication. It was used on the first 56 patients in this study. The rate of infection was 3.6% compared with the 14% rate of infection in a previous study. The 80 following patients had, in addition to the skin adhesive, two prophylactic antibiotics for 48 hours (cefamandole and ornidazole), a preoperative rectal enema, and closure of the incision in two layers. The rate of infection dropped to 0.0%. Topical skin adhesive constitutes a significant contribution in the prevention of infection after coccygectomy.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefamandole; Chronic Disease; Coccyx; Female; Humans; Joint Instability; Low Back Pain; Male; Middle Aged; Ornidazole; Suction; Surgical Wound Infection; Tissue Adhesives; Young Adult

The relationship between the degree of chronic middle ear inflammation and pneumatization was investigated in the pig as an animal model, since its tympanic bulla closely resembles the human mastoid air cell system. Ten piglets (sire: Landrace-Hampshire crossbreed; dam: Duroc) were used for this experiment. Four ears of two animals served as the normal control group and 16 ears of eight animals were the experimental group. In this latter group, otitis media was induced by injecting glycerin into the middle ear clefts 1 months after birth, and the degree of inflammation was varied by administering or withholding antibiotics (cefamandole and dibekacin) and adjusting the dosage regimen. The animals were sacrificed 6 months after birth and examined for the relationship between the degree of chronic middle ear inflammation present and tympanic bulla pneumatization. Various degrees of inflammation were successfully induced by injecting the antibiotics: the more severe the inflammation found, the greater was the inhibition of pneumatization. Findings demonstrated that the degree of inhibition of pneumatization produced was directly proportional to the severity of chronic middle ear inflammation.

Topics: Animals; Bone Resorption; Cefamandole; Chronic Disease; Dibekacin; Disease Models, Animal; Ear, Middle; Epithelium; Glycerol; Image Processing, Computer-Assisted; Injections, Intramuscular; Osteoblasts; Osteoclasts; Osteosclerosis; Otitis Media; Swine; Temporal Bone

Topics: Cefamandole; Child; Chronic Disease; Humans; Premedication; Uveitis; Vitrectomy

Four perforated capsules were implanted into the abdominal cavity of each of three rabbits. After 4 to 5 weeks, single doses of cefazolin (30 mg/kg) or cefamandole (90 mg/kg) were administered intramuscularly. Peak levels of the respective drugs in serum were 104 +/- 10 and 127 +/- 5 micrograms/ml (mean +/- standard error); corresponding peak levels in capsule fluid were 6.3 +/- 2.3 micrograms/ml. Sixteen weeks after implantation, 2 X 10(6) colony-forming units of a strain of Escherichia coli susceptible to cefazolin (minimum inhibitory concentration, 1.0 microgram/ml) and cefamandole (minimum inhibitory concentration, less than 0.125 microgram/ml) was introduced into each of the 12 capsules. Chronic infection was established in seven of the capsules. At 4 to 6 weeks after infection, cefazolin and cefamandole were again administered. Peak serum concentrations were 102 +/- 3.3 micrograms/ml for cefazolin and 148 +/- 6.7 micrograms/ml for cefamandole. Peak concentrations in noninfected capsules were 7.5 +/- 3.4 and 12.1 +/- 2.1 micrograms/ml, respectively, not statistically different from the first study (P greater than 0.2). However, peak concentrations in infected capsules (less than 0.3 microgram/ml) were strikingly lower than in uninfected capsules (P less than 0.002). In keeping with the latter finding, quantitative cultures of E. coli in the infected capsules remained unchanged. Administration of [14C]cefamandole indicated that low drug levels were a result of poor drug penetration rather than drug inactivation or binding. Lack of vascularity and capsule wall necrosis may be responsible for poor drug penetration.

Topics: Abdomen; Abscess; Animals; Cefamandole; Cefazolin; Cell Membrane Permeability; Cephalosporins; Chronic Disease; Escherichia coli Infections; Rabbits; Time Factors