cefamandole and Intestinal-Perforation

Costs associated with treating patients for gangrenous or perforated appendicitis were compared. Patients received single agent therapy with cefoperazone or cefamandole or combination antibiotics consisting of clindamycin and serum level-adjusted gentamicin. Forty-eight patients received cefamandole, 47 received cefoperazone, and 52 received combination clindamycin and gentamicin. Costs to the pharmacy for drugs were greater for the combination therapy; however, the higher failure rate associated with the cephalosporins created greater expenses for the single agent therapy than for combination therapy.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Appendicitis; Cefamandole; Cefoperazone; Clindamycin; Costs and Cost Analysis; Double-Blind Method; Drug Therapy, Combination; Gangrene; Gentamicins; Humans; Intestinal Perforation; Middle Aged; Retrospective Studies; Rupture, Spontaneous

One hundred and five patients with penetrating abdominal injuries were treated with single-antibiotic regimens. Forty-seven patients were treated with intravenous (IV) cefamandole and for comparison 58 patients were treated with IV carbenicillin previously shown to be effective against postoperative infections associated with abdominal trauma. The overall incidence of deep infection on a single antibiotic therapy was 8.6 per cent, including two patients on cefamandole alone (4.3%) and seven (12.1%) on carbenicillin alone. One in each antibiotic group died of sepsis with a total mortality of 1.9 per cent. The authors concluded that cefamandole when used alone was found to be safe and more effective than carbenicillin alone in preventing sepsis in patients with abdominal trauma.

Topics: Abdominal Injuries; Adult; Bacterial Infections; Carbenicillin; Cefamandole; Colon; Female; Fever; Humans; Infusions, Parenteral; Intestinal Perforation; Length of Stay; Male; Premedication; Prospective Studies; Random Allocation; Rectum; Wound Infection; Wounds, Penetrating

A study of 130 adult patients with surgically treated gangrenous or perforated appendicitis was undertaken to evaluate the efficacy of three antibiotic regimens. Forty-eight patients received cefamandole, 40 were given the combination of clindamycin and gentamicin, and 42 were treated with cefoperazone. Side effects from these antibiotics were infrequent and mild. When all cases were compared for infectious failure, clindamycin-gentamicin showed a clear advantage over cefamandole. Because of the heterogeneity of the total study population, patients with perforation and peritonitis were compared separately. This analysis confirmed the advantage of clindamycin-gentamicin over cefamandole. In addition, it appears that clindamycin-gentamicin is more efficacious than cefoperazone.

Topics: Adolescent; Adult; Aged; Appendicitis; Cefamandole; Cefoperazone; Cephalosporins; Clindamycin; Clinical Trials as Topic; Double-Blind Method; Drug Therapy, Combination; Female; Gangrene; Gentamicins; Humans; Intestinal Perforation; Male; Middle Aged; Peritonitis; Random Allocation

Antibiotics can be associated with hypoprothrombinaemic haemorrhages in risk patients. Risk factors are: poor nutrition, impaired liver- or renal function, coagulation depleting medical therapy or illness. Pathogenetically there is a vitamin K deficiency with reduction of vitamin K dependent clotting factors; mainly by decreased vitamin K synthesis in intestinal bacterias. In consequence every risk patient under antibiotics should receive vitamin K prophylactically and in a parenteral way, because of unreliable resorption in gastrointestinal tract. Prothrombin-time-monitoring is essential to recognize the hypoprothrombinemia in every risk patient under antibiotics.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Appendicitis; Cefamandole; Diverticulitis, Colonic; Female; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Hypoprothrombinemias; Intestinal Perforation; Male; Ornidazole; Postoperative Complications; Premedication