cefamandole and Skin-Diseases--Infectious

Forty-seven adults with infected cutaneous lesions including decubitus ulcers, leg ulcers, cellulitis, pyoderma, and infected dermatitis were treated in a randomized single-blind study with ceftizoxime (2 gm/day, administered intravenously) or cefamandole (4 gm/day, administered intravenously). The duration of treatment ranged from five to 17 days with ceftizoxime and from six to 14 days with cefamandole. Both gram-positive cocci (mostly Staphylococcus sp) and gram-negative bacilli were cultured from the infected areas before treatment. Clinical and bacteriological responses to both drugs were excellent. Ceftizoxime at a dosage of 1 gm twice daily proved to be at least as effective as 1 gm of cefamandole given four times daily. Both drugs were well tolerated, effective, and safe in the treatment of skin and skin-structure infections. Neither drug therapy had to be discontinued because of adverse effects.

Topics: Adult; Aged; Cefamandole; Cefotaxime; Ceftizoxime; Cellulitis; Clinical Trials as Topic; Dermatitis; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pressure Ulcer; Proteus Infections; Proteus mirabilis; Psoriasis; Pyoderma; Random Allocation; Skin Diseases, Infectious; Staphylococcal Infections; Time Factors

The response of serious skin and skin structure infections to ceforanide 1 gm every twelve hours or cefazolin 1 gm every eight hours was evaluated in ninety-six patients hospitalized for treatment. Most of the patients had decubitus ulcers; predominant pathogens were Staphylococcus aureus, Escherichia coli, and Proteus mirabilis. Ceforanide produced a satisfactory clinical response in 89 percent (forty-eight of fifty-four) of the patients evaluated and eradicated 90 percent (seventy-four of eighty-two) of the pathogens. Although the clinical response of forty-two cefazolin-treated patients was similar (satisfactory response in 86 percent, thirty-six patients), only 81 percent (forty-eight of fifty-nine) of the pathogens were eradicated. Both ceforanide and cefazolin were very well tolerated systemically and locally.

Topics: Adult; Aged; Bacterial Infections; Cefamandole; Cefazolin; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Pressure Ulcer; Skin Diseases, Infectious

Twenty patients with skin and soft-tissue infections were treated with parenteral cefonicid. Cultures obtained in cellulitis cases from an aspirate of a leading edge of inflammation were positive in 42% of these patients. Pathogens isolated were Staphylococcus aureus (six strains), Proteus mirabilis (one strain), and Streptococcus agalactiae. Adverse effects were pain on intramuscular injection (two patients), rash (one patient), and positive Coombs test (one patient). All side effects were mild and none required discontinuing antibiotic therapy. A single treatment failure occurred in a patient with an undrained perirectal abscess. Cefonicid may be a useful drug in the treatment of skin and soft-tissue infections. The long half-life of cefonicid (4.8 h) is a valuable advantage and may facilitate patient compliance and convenience.

Topics: Adult; Cefamandole; Cefonicid; Cellulitis; Cephalosporins; Clinical Trials as Topic; Female; Humans; Male; Skin Diseases, Infectious

A randomized, prospective study of 200 consecutive established hand infections was designed to compare the efficacy of two antibiotics, cefamandole and nafcillin. Bacteriologic data revealed 63.5% of the patients grew multiple organisms (2.3 organisms per culture) and 26% of the patients had anaerobic infections. Complications were noted in 13% of all patients--26% in patients who grew aerobes and anaerobes and 9.8% in patients who grew aerobes alone (p less than 0.05). Despite the fact that 95% of all organisms were sensitive in vitro to cefamandole whereas only 67% of organisms were sensitive to nafcillin (p less than 0.01), complications occurred more frequently in patients treated with cefamandole. We conclude that the empirical selection of a broad-spectrum antibiotic is reasonable based on in vitro sensitivity studies; however, other factors such as treatment delay, initial extent of infection, anatomic location of infection, cause of infection, and extent of surgical debridement are important in the development of complications.

Topics: Adolescent; Adult; Aged; Bacteria, Anaerobic; Bacterial Infections; Cefamandole; Clinical Trials as Topic; Female; Hand Dermatoses; Humans; Male; Middle Aged; Nafcillin; Prospective Studies; Random Allocation; Skin Diseases, Infectious; Staphylococcal Infections; Streptococcal Infections

Topics: Abscess; Adolescent; Adult; Aged; Bacterial Infections; Cefamandole; Cephalosporins; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Skin Diseases, Infectious; Wound Infection

Selected patients with community-acquired infections can be discharged from the hospital, when afebrile and stable, with parenteral antibiotic therapy continued on an ambulatory basis. This therapy is currently possible because of the availability of long-acting cephalosporins that can be administered once daily, often with substantial reductions in hospital costs. Cefonicid and ceftriaxone both have sufficiently long half-lives and either may be administered intramuscularly once daily. Their antibacterial spectra encompass many of the pathogens encountered in community-acquired infections of the lower respiratory tract, skin and soft tissue, bone, and urinary tract. Ceftriaxone, a third-generation cephalosporin, has a broader spectrum than the second-generation agent cefonicid. Ceftriaxone should generally be reserved for the treatment of gonococcal disease and of community- or hospital-acquired infections due to organisms resistant to the narrower-spectrum and less expensive long half-life agent cefonicid.

Topics: Ambulatory Care; Cefamandole; Cefonicid; Ceftriaxone; Costs and Cost Analysis; Humans; Osteomyelitis; Pneumonia; Pyelonephritis; Skin Diseases, Infectious

The disposition of cefonicid (2 g intravenously every 24 h) was assessed in 15 patients with skin and skin structure infections. Trough and peak concentrations in serum were measured on two successive days to verify the attainment of steady state; and 1 trough and 12 postdose values of the concentration in serum were collected on the following day. Cefonicid concentrations in serum were determined by high-performance liquid chromatography. The cefonicid serum concentration versus time profile after intravenous infusion was clearly biexponential in all patients. The terminal elimination half-life determined by nonlinear regression analysis was 4.63 +/- 1.49 h (mean +/- standard deviation). The steady-state volume of distribution and total body clearance were 0.12 +/- 0.04 liter/kg and 0.369 +/- 0.110 ml/min per kg, respectively. These results are comparable to parameters derived from previous studies in noninfected normal volunteers. Thus, the disposition of cefonicid is not altered in patients with severe skin and skin structure infections.

Topics: Adult; Cefamandole; Cefonicid; Chromatography, High Pressure Liquid; Female; Half-Life; Humans; Infusions, Intravenous; Male; Middle Aged; Skin Diseases, Infectious

Topics: Ampicillin; Cefamandole; Cloxacillin; Drug Therapy, Combination; Humans; Skin Diseases, Infectious; Staphylococcal Infections

Hand lacerations, especially when inadequately treated, may result in infections caused by aerobic or anaerobic bacteria. Anaerobic infections most commonly result from human bite injuries in which there is contact between hand and mouth. The search continues for an ideal antibiotic to employ when anaerobic organisms are suspected. In this study cefamandole, a new cephalosporin antibiotic, was employed whenever anaerobic hand infections were suspected following trauma. In each patient quantitative cultures for both aerobic and anaerobic organisms were obtained. All organisms isolated were tested by standard susceptibility assays for both aerobes and anaerobes. In the case of anaerobes, minimum inhibitory concentration assays were also performed. After the initial culture was obtained, each patient received approximately 1.5 gm of cefamandole every 6 hours for a period of 5 days. This therapy was changed only if susceptibility studies indicated resistance to cefamandole. In our patients, 58% of the infectious organisms were aerobic and facultative anaerobic and 42% were obligate anaerobes. The predominant organisms isolated were Staphylococcus aureus and Peptostreptococcus anaerobius, which accounted for 42% of the infections. In most of the aerobic infections a single organism was isolated, whereas multiple organisms were identified in the anaerobic infections. All but one of the infections responded to cefamandole; the one that didn't was caused by Enterobacter cloacae and required treatment with an aminoglycoside. Because of its broad-spectrum coverage, which includes both aerobes and anaerobes, cefamandole is useful in treating infections, especially those resulting from human bites.

Topics: Adolescent; Adult; Bacterial Infections; Cefamandole; Enterococcus faecalis; Female; Hand Dermatoses; Humans; Male; Peptostreptococcus; Skin Diseases, Infectious; Staphylococcal Infections; Streptococcal Infections

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

The results of this study suggest that the enhanced in vitro spectrum of cefamandole may be clinically advantageous, particularly when complex mixtures of aerobic and aerobic-anaerobic bacteria are present in the lesions of serious skin and skin structure infections. The reported incidence of satisfactory clinical and bacteriologic responses appears to justify the use of cefamandole as a single agent for the treatment of these infections.

Topics: Adolescent; Adult; Aged; Cefamandole; Cephalosporins; Enteritis; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Skin Diseases, Infectious; Surgical Wound Infection

Cefamandole, a new parenteral cephalosporin antibiotic, was administered to 23 newborn infants with pustular skin infection due to Staphylococcus aureus for an average duration of 7.5 days. All the patients improved clinically. Elevation of serum glutamic oxaloacetic transaminase and eosinophilia were observed in nine infants each transiently during treatment. There were no abnormalities of renal functions and Coombs' test results remained negative. The levels of cefamandole in serum after either intravenous or intramuscular administration were higher and the mean life was longer than those previously reported in older infants, children, and adults.

Topics: Cefamandole; Cephalosporins; Female; Half-Life; Humans; Infant, Newborn; Infant, Newborn, Diseases; Kinetics; Male; Skin Diseases, Infectious; Staphylococcal Infections

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