cefamandole and Urinary-Tract-Infections

We report the results of a randomized, prospective study devised to assess the effectiveness of perioperative cefamandole prophylaxis on the remote infections rate in neurosurgery. Only two kinds of neurosurgical procedures were studied: shunt placement and craniotomy for brain tumour. In the treated patients cefamandole 1.5 g was given one hour before surgery, then repeated twice eight hourly. When the surgical procedure lasted more than three hours cefamandole 1.5 g was administered throughout the operation. No case of local infection was observed in either group, and the percentage of patients with remote infections was the same in both groups. Leucocytosis and temperature were measured during 15 days following the surgical procedure, and there were no differences between the treated and untreated groups in the evolution of these parameters. This study does not suggest that routine perioperative antibiotic prophylaxis is mandatory in neurosurgery.

Topics: Adolescent; Adult; Aged; Bacteremia; Brain Neoplasms; Cefamandole; Female; Humans; Lung Diseases; Male; Middle Aged; Postoperative Care; Postoperative Complications; Preoperative Care; Prospective Studies; Urinary Tract Infections; Wound Infection

This study compares a short antibioprophylaxis of 24 hours to a single injection treatment by cefamandole in endoscopic resection of the prostate. 122 patients were separated in two groups by randomisation. 61 patients received 1.5 g of cefamandole at induction of anaesthesia and 750 mg every six hours during 24 hours after surgery. The other 61 patients received a single injection of 1.5 g of cefamandole at the induction of anaesthesia. Both series were comparable in age, prostatic pathology, time of resection, weight to the resected prostate, the day of removal of the urinary catheter, the day of departure. In the first group, we found eight obvious infections and 10 occult infections with positive urinary microscopic examination; and in the second group, we found 11 obvious ans 4 occult infections with positive urinary microscopic examination. In both infected groups, we found mainly Pseudomonas aeruginosa. Both treatments were equally well accepted. The authors prefer the single injection treatment because of the low cost and absence of statistically significant differences between the two treatments.

Topics: Aged; Aged, 80 and over; Cefamandole; Clinical Protocols; Humans; Injections, Intravenous; Male; Middle Aged; Postoperative Care; Prostatectomy; Prostatic Neoplasms; Random Allocation; Urinary Tract Infections

The efficacy and safety of piperacillin were compared with those of cefamandole in 72 patients (mean age: 63 years) with complicated urinary tract infections. Efficacy was evaluable in 25/34 piperacillin-treated patients (12 Gm/day) and in 23/38 cefamandole-treated patients (6 Gm/day). Clinical cure or improvement was noted in all patients who were given piperacillin and in 96 per cent (22/23) of those who received cefamandole. Seventy-one per cent (41/58) of the organisms cultured pretherapy were gram-negative aerobic bacteria. Escherichia coli was the most frequently isolated organism (15/58, or 26%), followed by Pseudomonas species (8/58, or 14%), and Proteus species (8/58, or 14%). Adverse clinical experiences were few, and none was directly attributed to therapy with either antibiotic. The changes noted in the results of laboratory tests were considered to be unrelated to the antibiotics administered. Thus, both piperacillin and cefamandole were safe and effective in the treatment of patients with complicated urinary tract infections.

Topics: Cefamandole; Escherichia coli; Female; Follow-Up Studies; Humans; Male; Middle Aged; Piperacillin; Proteus; Pseudomonas; Random Allocation; Streptococcus; Urinary Tract Infections

Antibiotic prophylaxis in kidney transplantation is controversial. In a prospective controlled study, 34 cadaveric kidney transplant recipients were investigated. Antibiotic prophylaxis was given in a random order to 16 patients whereas 18 without prophylaxis served as controlls. In 4 of 20 investigated clinical parameters statistically significant differences were found between both groups: the controlls happened to have better initial conditions; perioperative and postoperative better initial conditions; perioperative and postoperative infections were less frequent in the prophylaxis group and more antibiotics postoperatively were needed in the controlls. These findings indicate that antibiotic prophylaxis has a beneficial effect in kidney transplantation.

Topics: Bacteriological Techniques; Catheters, Indwelling; Cefamandole; Clinical Trials as Topic; Humans; Kidney Transplantation; Premedication; Random Allocation; Sepsis; Surgical Wound Infection; Urinary Tract Infections

A randomized double-blind study was undertaken to determine which irrigation solution might be best at cesarean section. A saline placebo was compared with ampicillin sodium and one each of three generations of cephalosporins: cephapirin sodium, cefamandole nafate, and moxalactam disodium. A total of 360 cesarean sections were studied, and comparisons made between antibiotic and control groups relative to demographics, possible risk factors, and multiple measures of postoperative morbidity. The total group was further divided into high- and low-risk labor and repeat cesarean groups. Post-cesarean endometritis was diagnosed in the following frequencies for the group as a whole: placebo (24.6%), ampicillin sodium (8.5%), cephapirin sodium (11.4%), cefamandole nafate (4.6%), and moxalactam disodium (16.4%). Cefamandole nafate consistently demonstrated significant decreases in endometritis and other morbidity measures versus placebo both in laboring patients and the group as a whole.

Topics: Ampicillin; Cefamandole; Cephalosporins; Cephapirin; Cesarean Section; Double-Blind Method; Endometritis; Female; Humans; Moxalactam; Pregnancy; Premedication; Random Allocation; Solutions; Therapeutic Irrigation; Urinary Tract Infections

The possible advantages of the monobactam antibiotic aztreonam in the treatment of hospital-acquired urinary tract infection were assessed in a study comparing aztreonam (0.5 to 1 g twice daily or three times daily) to cefamandole (1 g three times daily) in 159 patients. Initial pathogens were eradicated in 91.7 percent of the patients of the aztreonam group who were treated three times daily, in 82.7 percent of the group treated twice daily, and in 78.3 percent of the patients receiving cefamandole. Reinfection and superinfection were most commonly caused by enterococci in the aztreonam groups and by Pseudomonas aeruginosa in the cefamandole group. In a second study, 35 patients infected with organisms resistant to other antibiotics were treated with aztreonam 1 to 6 g per day for eight days. The overall cure rates were 93 percent for Pseudomonas infections, 87.5 percent for Escherichia coli infections, and 100 percent for other pathogens.

Topics: Anti-Bacterial Agents; Aztreonam; Cefamandole; Cross Infection; Drug Resistance, Microbial; Escherichia coli Infections; Female; Humans; Male; Middle Aged; Random Allocation; Recurrence; Urinary Tract Infections; Urine

A randomized, prospective, double-blind study was designed to compare intravenous administration with intrauterine irrigation using an extended half-life (t1/2 = three hours) cephalosporin, ceforanide. Patients included in the study had a nonelective cesarean section with rupture of membranes for three hours or longer. Sixty-four patients received a single dose of ceforanide immediately after clamping the umbilical cord. Patients were similar in both groups in age, weight, length of labor, and duration of ruptured membranes. The group receiving the intravenous ceforanide had a significantly shorter duration of surgery than the patients receiving the intrauterine ceforanide. Endometritis infection rates were similar, 11.8% (intravenous) versus 11.1% (intrauterine), P greater than .1. Serum levels were as much as tenfold higher in the intravenous group versus the intrauterine group. Intrauterine irrigation with an antimicrobial agent provided no advantage over systemic administration.

Topics: Adult; Cefamandole; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Endometritis; Female; Humans; Injections, Intravenous; Postoperative Complications; Pregnancy; Premedication; Random Allocation; Risk; Therapeutic Irrigation; Urinary Tract Infections; Uterus

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

The in vivo efficacy and safety of aztreonam compared to that of cefamandole was randomly and prospectively studied in the treatment of 30 patients suffering from recurrent urinary tract infections with a patient ratio of 2 aztreonam to 1 cefamandole. The mean age was 51.6 +/- 15.4 and 59.8 +/- 13 years respectively. Both antibiotics were given at a dose of 1 g, 8 hourly i.m. for 7-13 days. Sixty-seven percent versus 70% of the patients given aztreonam and cefamandole respectively were suffering from upper urinary tract infections. X ray abnormalities predisposing to relapse or reinfections were present in 88% vs 80% of the patients, while all patients had typical symptoms of urinary tract infections, with high fever (greater than or equal to 38.5 degrees C) reported in 70% and 60% of the patients in the two treatment groups respectively. Escherichia coli and Proteus mirabilis were the predominant isolates in urine cultures. During treatment all patients responded favourably both clinically and bacteriologically, while after a 6-week follow-up 20% versus 30% relapsed clinically with 15% vs 30% bacteriologic relapses in the two groups, but only in patients suffering from upper urinary tract infections. No development of bacterial resistance was observed in the relapses, while mainly Enterococcus spp was implicated in reinfections. No appreciable side effects of toxicity were observed. It was concluded that aztreonam is a promising new antibiotic that deserves further clinical trials in systemic infections.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Aztreonam; Bacteria; Cefamandole; Female; Follow-Up Studies; Humans; Male; Middle Aged; Urinary Tract Infections

We conducted a randomized double blind comparison of cefamandole (CMD) and cefmetazole (CMZ) in the treatment of 193 patients with complicated urinary tract infections. The patients received 1 gram of CMD or CMZ twice a day intravenously by drip infusion over 1 hour for 5 days. Pretreatment urinary leukocyte counts and urinary bacterial counts were at least 5 cells/hpf and 10(4) bacteria/ml, respectively. Each patient was randomly allocated either to CMD or CMZ group. There were 93 patients in CMD group and 100 patients in CMZ group. Clinical efficacy was evaluated based on the effect of treatment on bacteriuria and pyuria according to the criteria set by the UTI Committee, Japan. The response to CMD treatment was excellent in 18 cases (19.4%), moderate in 38 cases (40.9%) and poor in 37 cases (39.8%) with an overall effectiveness of 60.2%, whereas the response to CMZ was excellent in 19 cases (19.0%), moderate in 40 cases (40.0%) and poor in 41 cases (41.0%) with an overall effectiveness of 59.0%. No statistical significant difference was found between 2 treatment groups. Comparison of the bacteriological response between 2 groups showed that the eradication rate for strains of Gram-positive cocci were significantly higher in those patients treated with CMD. Gram-negative rods were eradicated from 68.4% of cases treated with CMD, and 78.0% of those with CMZ, but the difference was not significant. Adverse reactions were observed in 3 patients receiving CMD 1 case each of diarrhea, eruption and epigastric pain. Abnormality in laboratory tests was found in 6 patients in each treatment group. The results indicate that CMD is effective, safe and useful in the treatment of patients with complicated urinary tract infections, and its efficacy, safety and usefulness are comparable with those of CMZ.

Topics: Adolescent; Adult; Aged; Bacteria; Cefamandole; Cefmetazole; Cephalosporins; Cephamycins; Clinical Trials as Topic; Double-Blind Method; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Urinary 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

The efficacy of single-dose therapy with cefonicid (1 g intramuscularly) and multidose therapy with amoxicillin (500 mg orally three times a day for 7 days) was compared for the treatment of uncomplicated lower urinary tract infection in women. Of 50 patients with symptoms of lower urinary tract infection randomized to receive either cefonicid or amoxicillin, 39 were infected with greater than or equal to 10(5) bacteria per ml. At early posttherapy follow-up (5 to 18 days), 19 of 21 (90%) cefonicid-treated patients and 16 of 18 (89%) amoxicillin-treated patients were cured. At late posttherapy follow-up (6 to 7 weeks), 16 of 18 (89%) cefonicid-treated patients and 14 of 15 (93%) amoxicillin-treated patients were cured. One patient was lost to follow-up in each late follow-up group. There were fewer side effects in the cefonicid-treated group. There were significantly more organisms resistant to amoxicillin than to cefonicid in the study population. Considering the small size of the series, single-dose therapy with cefonicid for lower urinary tract infection in women appears to be as safe and effective as conventional multidose therapy with amoxicillin.

Topics: Adult; Amoxicillin; Bacteria; Cefamandole; Cefonicid; Cephalosporins; Female; Humans; Middle Aged; Penicillin Resistance; Urinary Tract Infections

Topics: Cefamandole; Cefotaxime; Ceftizoxime; Cephalosporins; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Urinary Tract Infections

Topics: Adult; Aged; Cefamandole; Cefotaxime; Ceftizoxime; Cephalosporins; Female; Hospitalization; Humans; Male; Middle Aged; Pneumonia; Pyelonephritis; Random Allocation; Sepsis; Urinary Tract Infections

Topics: Acute Disease; Adult; Cefamandole; Cefotaxime; Ceftizoxime; Cephalosporins; Female; Humans; Time Factors; Urinary Tract Infections

Ceftizoxime, a new beta-lactamase-resistant, semisynthetic antibiotic, was compared to cefamandole in a prospective randomized trial to determine its efficacy and safety in 21 patients with acute, complicated urinary tract infections. Four patients randomized initially to receive cefamandole were found to have resistant organisms and were treated with ceftizoxime. Dosage for ceftizoxime was 1 gm. administered parenterally every 12 hours, while 1 gm. cefamandole was given every 6 hours. Urine cultures were obtained before the initiation of therapy, on day 4, after completion of therapy and 4 to 6 weeks after therapy. Specified laboratory tests were obtained. Of 14 patients receiving ceftizoxime 11 (79 per cent) and of 7 patients receiving cefamandole 7 (100 per cent) had negative cultures at the completion of therapy and 4 to 6 weeks later. No patient had any adverse reaction to ceftizoxime. Ceftizoxime is a safe and effective antibiotic agent when used as a single agent for complicated urinary tract infections. However, ceftizoxime is much more expensive than cefamandole therapy. Therefore, it is recommended that ceftizoxime be reserved for treatment of urinary tract infections stemming from pathogenic species resistant to the less expensive antimicrobials.

Topics: Adolescent; Adult; Aged; Cefamandole; Cefotaxime; Ceftizoxime; Cephalosporins; Clinical Trials as Topic; Enterobacteriaceae Infections; Female; Humans; Male; Middle Aged; Prospective Studies; Pseudomonas Infections; Random Allocation; Urinary Tract Infections

We compared the safety and efficacy of a six-dose regimen of cephalothin with a two-dose regimen of ceforanide for the prevention of infection after elective vaginal hysterectomy. A total of 150 patients were randomly assigned to either regimen. The overall incidence of documented pelvic infection was 5.3% and did not differ significantly between the prophylaxis groups when stratified by type of surgery. No serious adverse reactions were encountered in either group, but phlebitis was significantly more common in patients receiving cephalothin. We conclude that a two-dose regimen of ceforanide given intramuscularly is as effective as, and possibly better tolerated than, a six-dose regimen of cephalothin.

Topics: Cefamandole; Cephalosporins; Cephalothin; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Premedication; Risk; Urinary Tract Infections

Ten patients suffering from genital organ infections, urinary tract infections and symptomless bacteriuria were treated with cefamandole (CMD). CMD was administered intravenously and drip infusion at a dosage of 4.0 g/day for 4 approximately 10 days. Clinical results obtained were as follows: Of 6 patients with genital organ infections, excellent responses were seen in 2 patients, good responses in 4 patients. Of 3 patients with urinary tract infections, excellent responses were seen in 2 patients, and good response in 1 patient. The overall efficacy rate was 100%. In the cases of urinary tract infections and symptomless bacteriuria, 3 strains of E. coli and 1 strain of Streptococcus faecalis disappeared. On the other hand, in genital organ infections, we had no bacterial findings. No significant reaction was observed in clinical laboratory findings of hemogram or in test on renal and hepatic functions, except slight transient leukopenia observed in 1 patient.

Topics: Adult; Aged; Bacterial Infections; Cefamandole; Cephalosporins; Clinical Trials as Topic; Female; Genital Diseases, Female; Humans; Middle Aged; Urinary 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

The clinical efficacy and tolerance of cefamandole, a new cephalosporin antibiotic effective against indole-positive strains of Proteus, and cefazolin were studied after intramuscular administration of 500 mg of either of the two cephalosporins every 8 hr for seven days in a prospective, randomized study of 65 elderly male patients with complicated urinary tarct infections. Both antibiotics were effective in eradicating the infections, and there was no significant difference between the two groups in regard to tolerance and cure rate, as defined by a negative urine culture one week and four to six weeks following discontinuation of the treatment. Because of its broader antibacterial spectrum, cefamandole appears to represent an improvement over previously available cephalosporin antibiotics.

Topics: Aged; Cefamandole; Cephalosporins; Enterobacteriaceae Infections; Escherichia coli Infections; Humans; Klebsiella Infections; Male; Proteus Infections; Staphylococcal Infections; Streptococcal Infections; Urinary Tract Infections

Topics: Acute Disease; Adolescent; Adult; Aged; Cefamandole; Cephalosporins; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Time Factors; Urinary 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

The authors study the possibilities of cephalosporin antibiotic cefamandol, new for our clinical practice, in the treatment of uroinfections. The microbiological study on a total of 2301 bacterial strains, isolated from patients with uroinfections, reveals that cefamandol excels in its action against gram-positive microorganisms, all beta-lactam antibiotics, used in our country. As regards E. coli, Citrobacter, Klebsiella, Enterobacter, P. mirabilis and indole positive pro cefamandol is better than ampicillin, carbencillin and cefalotin. A resistance to the preparation showed the majority of the isolates of Enterococcus, Serratia, Acinebacter and Pseudomonas aeruginosa. Excellent result was attained in 60% of all the 35 patients with uroinfections treated, manifested in "sterilization" of urine and in 5.71% bacteruiria became insignificant. In parallel, the clinical and laboratory symptoms of uroinfection were favourably influenced. The preparation has a good tolerance. Finally it should be underlined that this antibiotic must be introduced in the routine clinical practice for the treatment of adequate forms of uroinfections.

Topics: Bacteria; Bacteriuria; Bulgaria; Cefamandole; Drug Evaluation; Female; Humans; Male; Microbial Sensitivity Tests; Urinary Tract Infections

Topics: Aged; Amoxicillin; Anti-Bacterial Agents; Cefamandole; Escherichia coli Infections; Humans; Hypoprothrombinemias; Male; Moxalactam; Prothrombin Time; Urinary Tract Infections; Vitamin K

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

Results of treatment of urinary tract infection in 110 patients using new beta-lactam antibiotics are presented in summary. While in the uncomplicated infections a cure rate approaching 100% was observed even with very small dosages, complicated cases required higher dosages to achieve satisfactory clinical cure rates and especially to achieve acceptable bacteriological cure rates. The continuous need for new, more potent antibiotics is becoming apparent due to the increasing resistance rates of pathogens to the existing agents. The group of beta-lactam antibiotics offers much hope due to the continuous development of numerous new compounds with better antibacterial and kinetic properties, offering at the same time a very high degree of safety, compared to aminoglycosides and most other antibiotic groups.

Topics: Anti-Bacterial Agents; Bacterial Infections; beta-Lactamase Inhibitors; Cefamandole; Ceftazidime; Humans; Penicillins; 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

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

7-D-Mandelamido-3-(1-methyl-1H-tetrazol-5-yl-thiomethyl)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene carbonic acid (cefamandole) a new cephalosporin derivative, was tested in a urological ward. 31 patients with complicated urinary tract infections (U.T.I.) were treated with this antibiotic. The patients were divided into three groups according to the dose received and route of administration (1 g i.v. injection, 3 g i.v. infusion, 1 g i.m.). The biological half-lives determined in the three groups ranged between 34 and 57 min. Cefamandole was found to be very active against most causative bacteria in patients with U.T.I. Its pharmacokinetic properties and therapeutic results make it appear a suitable antibiotic for treatment of U.T.I. In cases of complicated U.T.I., a dose regimen of 3 g three times daily seems to be superior to that of 1 g three times daily.

Topics: Aged; Bacteria; Cefamandole; Cephalosporins; Female; Humans; Kinetics; Male; Urinary 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

Therapy with cephamandole (1.0 g, every eight hours) for five days was effective in eliminating cephamandole-sensitive microorganisms from the urinary tract. A 75% cure rate was achieved in a group of 20 patients, 45% of whom had abnormalities of the urinary tract. Local pain (despite addition of lignocaine) was sufficiently prolonged and severe to make multiple-dose intramuscular administration unacceptable. No other toxic effects were encountered.

Topics: Anti-Infective Agents, Urinary; Cefamandole; Cephalosporins; Enterobacteriaceae Infections; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Pain; Staphylococcal Infections; Urinary Tract Infections

A single-dose intramuscular injection of cephamandole (1.0 g) is effective in eliminating cephamandole-sensitive microorganisms from the urinary tract. Single-dose therapy cured 70% of infections in a group of 46 patients, 56% of whom showed abnormalities on pyelography. Local pain was not a problem, provided lignocaine was added to the injection.

Topics: Cefamandole; Cephalosporins; Female; Humans; Injections, Intramuscular; Lidocaine; Male; Urinary Tract Infections

Topics: Bacterial Infections; Cefamandole; Cefazolin; Cephalosporins; Child; Child, Preschool; Drug Resistance, Microbial; Escherichia coli; Female; Humans; Infant; Infant, Newborn; Infusions, Parenteral; Male; Meningitis, Aseptic; Microbial Sensitivity Tests; Pneumonia; Staphylococcus aureus; Urinary Tract Infections

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, a new cephalosporin antibiotic, has greater activity against common pathogens, including Escherichia coli, Haemophilus influenzae, and Proteus (including indole-positive strains), than available cephalosporin drugs. We have evaluated the safety and pharmacokinetics of this drug in 30 infants and children. Blood levels and urinary excretion of the drug were similar to those previously found in adults. The only side effects were mild and transient elevation of serum glutamic oxalacetic transaminase in 12 patients and of blood urea nitrogen in 1 patient in whom serum creatinine remained normal and unchanged.

Topics: Adolescent; Cefamandole; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Pneumonia; Urinary Tract Infections

Clinical and bacteriologic results are reported for 80 patients treated with 1.5--12 g of cefamandole daily for a variety of infections caused by Enterobacter and indole-positive Proteus, organisms that have been resistant to most available cephalosporins. Of 45 patients with infections due to Enterobacter, 41 (91%) had satisfactory clinical responses; 36 were bacteriologic successes, and six cases of complicated urinary tract infections relapsed. Of 37 patients with infections due to indole-positive Proteus, 28 (88%) were clinical successes and 30 (81%) were bacteriologic successes. Fourteen cases of complicated urinary tract infection relapsed. Of 104 patients in whom the drug was evaluated for safety, use of cefamandole was discontinued in five; nine adverse reactions were considered drug-related. A summary of published in vitro data shows that the majority of strains of these organisms were susceptible to cefamandole at concentrations achievable in the serum. Minimal inhibitory concentrations are variable, and there is a significant inoculum effect, the clinical significance of which has not been determined.

Topics: Adult; Aged; Cefamandole; Cephalosporins; Enterobacter; Enterobacteriaceae Infections; Female; Humans; Infant; Male; Middle Aged; Proteus Infections; Pyelonephritis; Skin Ulcer; Surgical Wound Infection; Urinary Tract Infections