cefamandole and Respiratory-Tract-Infections

Topics: Bacterial Infections; Bacteroides Infections; Cefamandole; Cefazolin; Cefonicid; Cefoxitin; Cefuroxime; Cephalosporins; Gonorrhea; Haemophilus Infections; Humans; Respiratory Tract Infections; Structure-Activity Relationship

Antibiotic prophylaxis is currently recommended in clean-contamined surgery (type II of Altemeier classification). Pulmonary surgery belongs to this type. This prospective randomized and controlled study was designed to compare amoxicillin and cefamandole for prevention of pleural and bronchopulmonary infections after pulmonary resections. It included 256 patients, admitted between October 1st 1989 and July 1st 1991, for elective thoracotomy and probable pulmonary resection. The patients were allocated into two groups, group A (amoxicillin) and group C (cefamandole). The first intravenous antibiotic injection took place immediately after induction of anaesthesia (1 g of amoxicillin or 1.5 g of cefamandole). Postoperative injections were performed every 6 hours during 36 hours (i.e. a total of 6 injections). Infection was defined by the association of general signs including hyperthermia (> 38 degrees C), hyperleucocytosis (> 12,000/mm3), and local signs such as bronchitis (B), pneumonia (P), empyema (E), wound sepsis (W) and non thoracic infection (S). Follow-up included the hospital stay and a period of eight months after surgery for possible rehospitalisation for infection. Respiratory infections (bronchitis n = 35, pneumonia n = 5, empyema n = 2) occurred in 18% of the total population. No difference was seen between the two groups concerning the type of infection and the repartition of infection in relation to the type of pulmonary surgery. The causative bacterial organisms were Haemophilus influenzae (n = 4), Streptococcus pneumoniae (n = 2), Escherichia coli (n = 1), anaerobic bacteria (n = 1). Multiple bacteria were found in one case. The empyema and wound sepsis occurred in the amoxicillin group.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin; Cefamandole; Double-Blind Method; Empyema, Pleural; Female; Humans; Male; Middle Aged; Pneumonectomy; Postoperative Complications; Respiratory Tract Infections; Surgical Wound Infection

Infections of the lower respiratory tract pose an important problem in nursing homes. Despite the magnitude of this problem, few, if any, antibiotic studies have been targeted specifically at nursing home-acquired bronchopulmonary infections. Following the establishment of a teaching Extended-Care Nursing Home Program, which facilitated the early diagnosis and therapy of bronchopulmonary infections, a comparative trial of oral ciprofloxacin and intramuscular cefamandole was initiated in elderly patients with lower respiratory tract infections. In addition to assessing the relative efficacy and safety of ciprofloxacin and cefamandole, our goals were to identify problems and pitfalls associated with conducting clinical research in this nursing home setting, evaluate selected clinical and laboratory features of lower respiratory tract infection in this patient population, and measure outcomes in all study groups.. During a 20-month period, 40 patients with pneumonia and 20 patients with acute bronchitis were enrolled in this randomized study. Sixty-three patients with pneumonia who were ineligible for the randomized study were also followed prospectively. The mean age of the 111 participants (123 cases) was 80.8 years; all patients had at least one chronic medical condition.. Although Streptococcus pneumoniae was the single most common isolate, gram-negative bacteria were cultured from 81 percent of the cases that yielded pathogens from a satisfactory sputum specimen. The in-hospital mortality rate was strikingly low (6.5 percent), and a large majority of patients in all study groups were discharged safely back to their nursing homes well within the Diagnosis-Related Group length of stay.. Ciprofloxacin appeared to be as safe and effective as cefamandole in this nursing home program; however, additional studies are needed to determine its role in the treatment of elderly patients with bronchopulmonary infections.

Topics: Administration, Oral; Aged; Aged, 80 and over; Bronchitis; Cefamandole; Ciprofloxacin; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Nursing Homes; Pneumonia; Prospective Studies; Random Allocation; Respiratory Tract Infections

Topics: Bacteria; Cefamandole; Cefonicid; Clinical Trials as Topic; Humans; Microbial Sensitivity Tests; Random Allocation; Respiratory Tract Infections

Topics: Cefamandole; Clinical Trials as Topic; Drug Evaluation; Drug Therapy, Combination; Humans; Respiratory Tract Infections; Sepsis; Tobramycin

Eighty-two adult hospitalized patients suffering from respiratory tract infections were treated with cefotiam or cefamandole in an open comparative study. The patients were allocated randomly to one of the two treatments. The recommended dosage regimens (i.m. or i.v.) were used for both groups (cefotiam 1 g b.i.d., cefamandole 1 g t.i.d.). The duration of treatment was 7 to 14 days according to the response of the disease condition. 80 patients were analyzed. The tolerability of both drugs was good and comparable. The clinical and bacteriological efficacy of both drugs was equivalent. The radiological examinations showed a better improvement of the patients treated with cefotiam.

Topics: Adolescent; Adult; Aged; Cefamandole; Cefotaxime; Cefotiam; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Random Allocation; Respiratory Tract Infections

Two hundred twenty patients were randomly assigned to receive either ceforanide or cephalothin as perioperative antibiotic prophylaxis during cardiovascular surgery. More infections were seen among cephalothin recipients (8 deep, 32 total) than among ceforanide recipients (1 deep, 17 total). Among patients who had only coronary artery bypass grafting, more cephalothin recipients had infection than did ceforanide recipients (19 of 82 as opposed to 7 of 83; p = 0.001; relative risk, 2.7; 95% confidence interval, 1.22 to 6.18). The difference between the two regimens was attributable to fewer blood, wound, and urinary tract infections. Among patients who had other procedures, there was no difference in the efficacy of the two regimens. Cephalothin recipients who developed wound or blood stream infections had lower antibiotic levels in their atrial appendages than recipients not developing such infections (p = 0.02). If one assumes that cephalothin does not increase the risk of infection, then these data show that antibiotic prophylaxis prevents infection after coronary artery bypass surgery, and, in the dosages used, that ceforanide is superior to cephalothin.

Topics: Cefamandole; Cephalothin; Clinical Trials as Topic; Coronary Artery Bypass; Double-Blind Method; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Myocardium; Postoperative Complications; Premedication; Random Allocation; Respiratory Tract Infections; Risk; Sepsis; Surgical Wound Infection; Urinary Tract Infections

In a randomized comparative study, 113 patients were treated with cefoperazone or cefamandole for acute bacterial lower respiratory tract infections. Most patients had Streptococcus pneumoniae or Haemophilus influenzae infections, although five patients in the cefoperazone group had infections caused by other Gram-negative bacilli (two with Pseudomonas aeruginosa). The clinical responses and adverse effects were not significantly different between the two treatment groups. Satisfactory clinical responses occurred in 36/39 (92%) of evaluable patients in the cefoperazone group and 33/34 (97%) of evaluable patients treated with cefamandole. Two failures in the cefoperazone group were secondary to superinfection (Acinetobacter and Ps. aeruginosa). Bacteriological and symptomatic failure occurred in one patient with Ps. aeruginosa lung abscess treated with cefoperazone and in one patient with a polymicrobial empyema treated with cefamandole. The results of this study indicate that cefoperazone is safe and effective in the therapy of acute bacterial lower respiratory tract infections.

Topics: Acute Disease; Cefamandole; Cefoperazone; Cephalosporins; Humans; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections

Cefamandole sodium (CMD), a new cephalosporin-derivative, was synthesized in the Laboratory of Eli-Lilly Co. Ltd. U.S.A. in 1972. CMD, which is several times more active than cefmetazole (CMZ, a cephamycin antibiotic) against Gram-positive cocci, is only as active as the latter antibiotic against Gram-negative bacilli. Against Haemophilus influenzae, CMD exhibits an antimicrobial activity which is as strong as that of ampicillin sodium. Our previous comparative tests on efficacy and safety of CMD versus cefazolin (CEZ) demonstrated that CMD was as effective and safe as CEZ in the treatment of respiratory tract infections. In the present clinical trial, the efficacy and safety of CMD are evaluated by a comparative double blind method using CMZ, a more recently synthesized cephamycin antibiotic, as a reference drug. For this purpose, a comparative double blind study was carried out in 50 institutions and clinics in Tohoku and Hokkaido districts in Japan. A total of 272 inpatients, who was aged over 16 years and was diagnosed as having pneumonia, lung abscess or acute infectious exacerbation of chronic obstructive pulmonary diseases, was included in this trial. They received 2 g of CMD or CMZ twice a day by intravenous drip infusions, as a rule, for 14 days. Of these patients, 264 (133 received CMD and 131 CMZ) were available for the evaluation of safety and usefulness. Two hundred and thirty-eight patients (122 received CMD and 116 CMZ) were adopted for the evaluation of efficacy. Prior to the treatment, there was no significant difference with respect to age, sex, severity of infection and underlying diseases between subjects in 2 treatment groups. An excellent or good clinical response was obtained in 82% of the patients treated with CMD, and in 81% of those treated with CMZ. Thus, there was no significant difference in cure rate between 2 treatment groups. However, an excellent clinical response was found in 12.3% of the patients treated with CMD, whereas only in 4.3% of those treated with CMZ. This difference in percentage of excellent clinical response between 2 treatment groups was statistically significant (P less than 0.05). Of the 87 patients with moderate to severe infection who were treated with CMD, 13 showed an excellent response. Only 4 of 90 patients treated with CMZ showed an excellent response. Statistically the difference in the rate of excellent response between these 2 groups was significant (P less than 0.05).(ABSTRACT TRUNCATED AT 400

Topics: Adolescent; Adult; Aged; Cefamandole; Cefmetazole; Cephamycins; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Respiratory Tract Infections

Topics: Adult; Age Factors; Aged; Cefamandole; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Respiratory Tract Infections; Risk; Surgical Wound Infection; Tobramycin; Urinary Tract Infections

Topics: Adult; Aged; Cefamandole; Cefotaxime; Ceftizoxime; Cephalosporins; Clinical Trials as Topic; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Random Allocation; Respiratory Tract Infections

A cooperative study in 46 institutions and clinics in Tohoku and Hoddaido districts in Japan was carried out to compare the efficacy, usefulness and safety of cefamandole and cefazolin in treatment of repiratory tract infections by randomized double blind technique. Two grams of either of the two cephalosporins were given by intravenous drip infusion to the two groups of patients aged over 16 years twice a day for 14 days. Of a total of 232 patients included in the study, 120 patients were treated with cefamandole and 122 patients with cefazolin. Of these patients treated with either of the both drugs, 27 patients were excluded from evaluation for efficacy. All 232 patients were adopted for analysis of side effects. Characteristics of the population, sex and age distribution, severity of infections and infecting organisms before treatment were similar in each treatment group and no statistically significant differences could be found between the two groups. Both groups included nearly equal numbers of patients with underlying diseases or with complications. The patients pre-treated with other antibiotics before the start of the study or treated simultaneously with anti-inflammatory drugs were equally distributed in the both treatment groups. Clinical cure rate was 69.2% in groups of the patients treated with cefamandole, whereas that in cefazolin treatment group was 62.2%. Thus, there was a difference of 7% in clinical cure rate between two treatment groups, though it was not statistically significant. In groups of patients with acute bacterial pneumonia or lung abcess, clinical cure rate with cefamandole was 76.7%, whereas that with cefazolin was 67.7%. Thus, the clinical cure rate was 9% higher in the group of patients treated with cefamandole, though the difference was again statistically not significant. In the group of patients with infections associated with chronic respiratory diseases, cefamandole cured 50% of the patients treated, whereas cefazolin cured 48.1%. Comparison of the curves of cumulative distribution of MICs of cefamandole and cefazolin proved the superiority of cefamandole to cefazolin in antimicrobial activities against strains of various species isolated from the patients in the study. Rate of eradication of potential pathogenic microorganisms was 82.4% in the patients with pneumonia or lung abscess who were treated with cefamandole, whereas that with cefazolin was 83.3%. Taking efficacy and adverse effects into consideration, usef

Topics: Adult; Age Factors; Aged; Bacteria; Cefamandole; Cefazolin; Cephalosporins; Clinical Trials as Topic; Double-Blind Method; Drug Resistance, Microbial; Female; Humans; Lung Abscess; Male; Middle Aged; Pneumonia; Radiography; Respiratory Tract Infections

Seventy-nine patients about to undergo cardiac operations were randomly allocated to two treatment groups in an attempt to reduce postoperative chest infections. The group receiving a short peroperative course of cefamandole, an antibiotic effective against both the pneumococcus and Haemophilus influenzae, had a significantly lower postoperative chest infection rate than the group receiving a 3-day course of cephradine, an antibiotic previously chosen to prevent intracardiac infection during the operation. By selecting an appropriate antibiotic it is possible, using a short peroperative course, to reduce the postoperative chest infection rate in patients undergoing cardiac operations.

Topics: Adult; Cardiac Surgical Procedures; Cefamandole; Cephalosporins; Cephradine; Endocarditis, Bacterial; Humans; Intraoperative Period; Postoperative Complications; Respiratory Tract Infections; Surgical Wound Infection; Urinary Tract Infections

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

Topics: Cefamandole; Humans; Respiratory Tract Infections

The pharmacokinetics of cefonicid was studied in 17 children requiring antibiotic treatment for respiratory or urinary tract infections. After informed consent had been obtained from the parents, a single dose of cefonicid 50 mg/kg/body weight was given by intramuscular injection. The mean peak serum concentration of 212.63 micrograms/ml was reached at 1.00 h, as absorption occurred at a very fast rate with a mean constant of 3.24 h-1. Mean values for half-life, apparent volume of distribution (Vz), total body clearance (CL), and renal clearance (CLR) were 3.24 h, 0.21 l.kg-1, 16.67 ml.min-1 and 13.60 ml.min-1 respectively. There was an inverse relationship between age and Vz, whereas CL and CLR were positively correlated with age. Cefonicid concentrations in urine were many times higher than the MICs of susceptible strains of bacteria. The study demonstrated that i.m. cefonicid 50 mg.kg-1 gave serum concentrations well within the therapeutic range for susceptible bacteria, and that its pharmacokinetic properties allow single daily doses to be used to treat infections in children.

Topics: Absorption; Cefamandole; Cefonicid; Child; Child, Preschool; Female; Half-Life; Humans; Infant; Male; Metabolic Clearance Rate; Respiratory Tract Infections; Urinary Tract Infections

Topics: Adult; Aged; Aged, 80 and over; Cefamandole; Cefonicid; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

Cefonicid (Monocid) and ceftriaxone (Rocephin) are long half-life cephalosporins that may be used for serious infections in the outpatient setting. They may be used as an extension of initial hospital treatment, or therapy can be initiated and completed in many cases with the patient remaining at home. Sufficient clinical experience exists with both ceftriaxone and cefonicid to recommend these agents for selected patients having pyelonephritis, osteomyelitis, or soft tissue infections. Cefonicid, perhaps in combination with erythromycin, will provide excellent coverage for complicated community-acquired pneumonias. Ceftriaxone is effective as single-dose therapy for even complicated gonococcal infections. The use of long half-life cephalosporins in ambulatory practice may result in substantial cost savings for certain patients.

Topics: Ambulatory Care; Bacterial Infections; Cefamandole; Cefonicid; Ceftriaxone; Cellulitis; Cephalosporins; Gonorrhea; Half-Life; Humans; Injections, Intramuscular; Osteomyelitis; Pyelonephritis; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections

Topics: Biological Transport; Cefamandole; Cefonicid; Drug Stability; Drug Therapy; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Kidney Diseases; Kinetics; Respiratory Tract Infections; Tissue Distribution; Urinary Tract Infections

In 8 patients on no oral intake and with parenteral alimentation, administration of cephalosporins with N-methyl-thiotetrazole side chain (moxalactam, cefamandole), was associated with prolongation of prothrombin time, appearance in the circulation of descarboxy-prothrombin (counter immunoelectrophoresis and echis carinatus assay) and diminution of protein C. Acute administration of 10 mg vitamin K1 was followed by the transient appearance of vitamin K1 2,3-epoxide, indicating an impaired hepatocellular regeneration of vitamin K1 from the epoxide. Impaired hepatic vitamin K1 metabolism, tentatively ascribed to the N-methyl-thiotetrazole group, is one (but possibly not the only) cause of bleeding complications and depression of vitamin K1-dependent procoagulants in patients treated with the new class of cephalosporins.

Topics: Aged; Blood Coagulation Factors; Cefamandole; Female; Glycoproteins; Humans; Liver; Male; Moxalactam; Protein C; Prothrombin Time; Respiratory Tract Infections; Urinary Tract Infections; Vitamin K 1

Topics: Anti-Bacterial Agents; Bacterial Infections; Cefamandole; Cefazolin; Cefotaxime; Ceftizoxime; Cephalosporins; Humans; Respiratory Tract Infections; Skin Diseases, Infectious; Tobramycin; Urinary Tract Infections

Cefamandole 3 g daily gave poor results in the treatment of severe purulent respiratory infections in 50 patients. A further 71 patients were treated with 4 g daily and the results were excellent with 86% clinical success. Apart from muscle pain with the injection, side-effects were minimal.

Topics: Aged; Cefamandole; Cephalosporins; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

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

In an eight year period 16 cases of serious extrapulmonary Hemophilus influenzae infection in adults were identified, including cases of meningitis, pericarditis, epiglottitis, empyema, cellulitis, osteomyelitis, endometritis, urinary tract infection, orbital cellulitis, primary peritonitis, mesenteric lymphadenitis and aortic graft infection. An 18 month prospective study of H. influenzae infection in hospitalized adults identified 10 cases of bronchitis, 25 of pneumonia and 65 of respiratory tract colonization, but there were no extrapulmonary infections. In 29 percent of the respiratory tract infections, H. influenzae appeared to be a nosocomial pathogen; in 71 percent, the infection was mixed. Finally, 110 clinical isolates of H. influenzae were studied for antimicrobial susceptibility. Eight percent were ampicillin resistant, two strains were resistant to tetracycline and one to chloramphenicol, but all were susceptible to trimethoprim-sulfamethoxazole and cefamandole.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Cefamandole; Cross Infection; Drug Resistance, Microbial; Female; Haemophilus Infections; Haemophilus influenzae; Hospitalization; Humans; Male; Middle Aged; Prospective Studies; Respiratory Tract Infections; Sulfamethoxazole; Trimethoprim

Ten strains each of Staphylococcus aureus, Haemophilus influenzae, Enterobacter spp., Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Streptococcus pneumoniae were tested in vitro against erythromycin combined with ampicillin, cefamandole, or gentamicin. Antagonism by erythromycin occurred with 47% of the combinations involving strains of S. aureus and to a lesser degree with H. influenzae. Synergy occurred most commonly with H. influenzae (27%). The high frequency of antagonism and synergy with these organisms was associated with a broad range of bacteriostatic action by erythromycin against these same bacteria. The implications for the treatment of pneumonia are discussed.

Topics: Ampicillin; Anti-Bacterial Agents; Bacteria; Cefamandole; Erythromycin; Gentamicins; Humans; Microbial Sensitivity Tests; Respiratory Tract Infections

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

Topics: Adolescent; Adult; Aged; Airway Obstruction; Cefamandole; Cephalosporins; Female; Forced Expiratory Volume; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections; Sputum; Vital Capacity

Cefamandole, a new cephalosporin derivative, has been used in treatment of six patients who had diminished renal function and respiratory infections, and of 14 patients with urinary tract infections (UTI). Infection was eliminated in all patients with respiratory infections, and in seven of the patients with UTI. No serious side effects were encountered and, even in patients with pre-existing renal dysfunction, no reduction in renal function occurred.

Topics: Adolescent; Adult; Aged; Cefamandole; Cephalosporins; Child; Drug Evaluation; Humans; Kidney Diseases; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

In order to evaluate efficacy and safety, cefamandole, a new cephalosporin, was given intravenously to 12 children with respiratory tract infections (11 cases) and urinary tract infection (1 case), who ranged in age from 2 months to 5 years old. Cefamandole sodium was administered 74 approximately 112 mg/kg/day in three or four equally divided doses by one-shot injection. The overall efficacy rate was 83.3% in 12 cases, i.e., good in 8, fairly good in 2, and poor in 2 cases. No adverse reaction was noted on any of our 12 cases.

Topics: Cefamandole; Cephalosporins; Child, Preschool; Drug Resistance, Microbial; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

Clinical studies on cefamandole were carried out with the following results. (1) Cefamandole was administered 100 mg/kg/day (q.i.d.) by intravenous route to 29 cases of children. In 10 out of 29 cases bacteriological effect was observed. Bacteriological response was effective in 8 cases (80.0%). Clinical responses were effective in 27 cases (93.1%). (2) As to adverse reactions, granulocytopenia and elevation of S-GOT, S-GPT developed in each two cases.

Topics: Agranulocytosis; Alanine Transaminase; Aspartate Aminotransferases; Cefamandole; Cephalosporins; Child; Child, Preschool; Female; Humans; Infant; Infusions, Parenteral; L-Lactate Dehydrogenase; Male; Respiratory Tract Infections; Urinary Tract Infections

Laboratory and clinical studies were performed on a new semisynthetic cephalosporin, cefamandole (CMD), and following results were obtained. (1) Serum concentrations and urinary recovery rates of CMD were determined after an intravenous administration of CMD 30 mg/kg in 13 children with normal renal function. In 5 of 13 children, mean serum levels after a one shot intravenous injection were 112.5 micrograms/ml at 15 minutes, 52.2 micrograms/ml at 30 minutes, 23.3 micrograms/ml at 1 hour, 4.9 micrograms/ml at 2 hours and trace at 4 hours. In other 5 children, mean serum levels after drip infusion for 1 hour were 78 micrograms/ml at 30 minutes, 59 micrograms/ml at 1 hour, 9.8 micrograms/ml at 2 hours and trace at 4 hours, after the onset of drip infusion. In the remaining 3 children who received CMD by drip infusion for 2 hours, mean serum levels were 24.3 micrograms/ml at 30 minutes, 35.3 micrograms/ml at 1 hour, 30.2 micrograms/ml at 2 hours, 5.3 micrograms/ml at 3 hours and 1.5 micrograms/ml at 4 hours after the onset of drip infusion. Urinary recovery rates in 5 children were 154.7%, 98.3%, 93.2%, 111.8% and 66.9%, respectively, during 8 hours. (2) CMD was administered to 40 patients with various infections (acute U.T.I. 8, acute angina lacunaris; 2, acute bronchitis; 5, cervical purulent lymphadenitis; 2, post-measles bronchopneumonia; 3, acute bronchopneumonia; 18, pyothorax; 2, S.S.S. syndrome; 1) by one-shot intravenous injection at a dose of 40-120 mg/kg per day. The clinical efficacy rate was 92.5% and bacteriological efficacy rate was 79.2%. (3) As the side effect of CMD, eosinophilia was observed in 1 case, rash and elevation of GOT and GPT in 1 case, and proteinuria in 1 case.

Topics: Adolescent; Bacterial Infections; Cefamandole; Cephalosporins; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Infusions, Parenteral; Male; Respiratory Tract Infections; Urinary Tract Infections

Cefamandole sodium (CMD) was intravenously administered and following laboratoric and clinical results were obtained. (1) The peak blood concentration was 32 approximately 44 micrograms/ml when the drip infusion was finished. At 1 hour after the end of the drip infusion the blood concentration was 7.6 approximately 8.1 micrograms/ml. Half life was approximately 0.64 hours. (2) Urinary recovery rate was 84.5 approximately 95% in active state within 6 hours. (3) Penetration of cerebrospinal fluid was found in 2 cases. (4) In most of 170 strains of Streptococcus haemolyticus MICs of cefamandole were 0.05 microgram/ml. They were less susceptible to cefazoline, cefmetazole and ceftezole. (5) CMD was administered to 35 pediatric patients (upper or lower RTI, lymphadenitis, enteritis or UTI) at 100 mg/kg/day for 3 approximately 9 days, the efficacy rate was 97.1%. (6) Side effect: Rash occurred in one case, and eosinophilia was observed in 4 cases. No abnormal finding of renal and liver function was observed.

Topics: Bacterial Infections; Cefamandole; Cephalosporins; Child; Child, Preschool; Drug Resistance, Microbial; Female; Humans; Infant; Injections, Intravenous; Male; Respiratory Tract Infections; Streptococcus

Topics: Adult; Bacterial Infections; Cefamandole; Cellulitis; Cephalosporins; Enterobacteriaceae Infections; Enterococcus faecalis; Haemophilus Infections; Humans; Pneumococcal Infections; Respiratory Tract Infections; Skin Diseases, Infectious; Staphylococcal Infections; Streptococcal Infections; Streptococcus pyogenes

The combination of carbenicillin plus cefamandole was administered to 88 patients with cancer during 116 evaluable episodes of fever. The overall response rate to carbenicillin plus cefamandole for the 116 episodes was 57%. There were 60 documented infections, of which 60% responded to this combination of antibiotics. The response rate was only 43% in patients with pneumonia. The etiologic agent was identified during 38 infections, of which 74% responded to carbenicillin plus cefamandole. Responses occurred less frequently in patients with neutropenia than in those without neutropenia and less frequently in patients whose infection was caused by organisms resistant to both antibiotics than in those with infection caused by organisms sensitive to one or both of the drugs. No side effects could be attributed to the antibiotic regimen.

Topics: Adolescent; Aeromonas; Aged; Bacterial Infections; Carbenicillin; Cefamandole; Cephalosporins; Corynebacterium Infections; Drug Therapy, Combination; Enterobacteriaceae Infections; Female; Flavobacterium; Humans; Listeriosis; Male; Middle Aged; Neoplasms; Respiratory Tract Infections; Sepsis; Tobramycin