Stone, H H; Guest, B S; Geheber, C E; Kolb, L D
Cefamandole was evaluated as the sole antimicrobial agent used to treat bacterial peritonitis in 113 patients. Dosage varied between 1 and 2 g given intravenously every 6 hr. Laparotomy for excision of infected or gangrenous tissues, closure of gastrointestinal perforations, or drainage of an established abscess was required in 99 of the cases. A good clinical response was obtained in 107 patients, or 95% of the total group. Of the six deaths only one could be attributed to infection. No evidence of renal, hepatic, or hematopoietic toxicity was noted. There were no allergic reactions, although 13 patients (12%) developed phlebitis in a vein used for antibiotic administration. Bacteriological studies revealed aerobic peritonitis in 99% of the patients, with anaerobe participation in 60% of these cases. Sensitivity testing by the disk diffusion and tube dilution methods confirmed the appropriateness of cefamandole therapy; 91% of the gram-negative rods and 61% of the anaerobes were susceptible. From results of this study, it would appear that cefamandole is a reliably effective antibiotic for use in treatment of most forms of acute peritonitis. Its role in surgical prophylaxis may be even more promising. PMID:649995
Jacobs, G.P.; Dobrilovic, L.; Raghavan, N.; Carpenter, D.
The feasibility of the radiation sterilization of two ..beta..-lactam antibiotic powders, cefamandole nafate and oxacillin sodium, has been examined by subjecting them to a range ..gamma..-radiation doses, followed by chemical and microbiological analyses. It would appear feasible to radiation sterilize oxacillin sodium. The radiation sterilization of cefamandole nafate may be realistic at low doses or under conditions that minimize radiolysis.
The feasibility of the radiation sterilization of two β-lactam antibiotic powders, cefamandole nafate and oxacillin sodium, has been examined by subjecting them to a range γ-radiation doses, followed by chemical and microbiological analyses. It would appear feasible to radiation sterilize oxacillin sodium. The radiation sterilization of cefamandole nafate may be realistic at low doses or under conditions that minimize radiolysis. (author)
Levi, J U; Martinez, O V; Malinin, T I; Zeppa, R; Livingstone, A.; Hutson, D; Calhoun, P.
The biliary penetration of cefamandole was studied in six patients with total biliary obstruction before and after placement of a transhepatic bile drainage catheter. Biliary levels of cefamandole remained depressed even when the drug was administered as late as 7 days after decompression of the biliary tract.
Agnelli, G.; Del Favero, A.; Parise, P; Guerciolini, R; Pasticci, B; Nenci, G G; Ofosu, F
The reported high incidence of vitamin-K-reversible hypoprothrombinemia associated with the new beta-lactamase-stable cephalosporins prompted us to evaluate the effect on hemostasis of three cephalosporins (cefamandole, ceftriaxone, and ceftazidime) in 30 patients with serious infections. Cefamandole and ceftriaxone, both containing a sulfhydryl group, induced a significant and similar prolongation of prothrombin time and decrease in factor VII activity. Ceftazidime, in contrast, had no effec...
Smith, D J; Kaplan, R L; Landau, W; Trenholme, G M
During a six month period, 191 isolates of coagulase-negative staphylococci from blood, urine, cerebrospinal fluid and heart valves were identified to species level and tested for antimicrobial susceptibility. Seventy-one percent of isolates were Staphylococcus epidermidis, 8% Staphylococcus warneri, 7% Staphylococcus hominis, 7% Staphylococcus haemolyticus, 4% Staphylococcus capitis, 2% Staphylococcus saprophyticus and 1% Staphylococcus cohnii. Approximately 4% of isolates were felt to be associated with infection. Overall, 18% of isolates were susceptible to penicillin G, 61% oxacillin, 98% cephalothin, 98% cefamandole, 72% cefotaxime, 95% cefsulodin, 76% gentamicin, 64% clindamycin and 98% rifampicin. All isolates were susceptible to vancomycin. Vancomycin, rifampicin, cephalothin and cefamandole showed excellent activity against oxacillin-resistant isolates. With one exception, speciation was not helpful in determining whether or not an isolate was associated with infection. PMID:7173185
Dubois, J; Pechère, J C
The disc diffusion technique was evaluated with 178 strains of anaerobes and four cephalosporins (cephalothin, cefamandole, cefazolin and cefoxitin). Good correlation in results was found in comparison with the agar dilution technique (p less than 0.001) with the exception of cefamandole and cefazolin against anaerobic cocci (p greater than 0.05). Choosing a breakpoint of 8 microgram/ml for distinguishing susceptible and resistant strains, we determined corresponding incubation, the rate of error is less than 1% for false susceptible and less than 5% for false resistant. However, some strains of anaerobic cocci required a 48 hour incubation period for allowing visible growth. Moreover, a great deal (60.5%) of overlapping zone diameters made interpretation of disc diffusion test difficult among Bacteroides fragilis strains classed as susceptible, intermediate and resistant occuring with cefoxitin. The results have shown that the cephalothin disk will not accurately predict susceptibility of B. fragilis to cefoxitin. PMID:730395
Huber, T W; Thomas, J. S
Thirty-six of 36 strains of Enterobacter cloacae and E. aerogenes with inducible beta-lactamase developed resistance when cefoxitin (inducer) was added to cefuroxime disks. Constitutive beta-lactamase producers (n = 23) were all resistant to cefuroxime. Cefuroxime resistance correlated with the amount of induced or constitutive beta-lactamase. Cefuroxime was a better indicator of induced resistance than cefamandole, cefazolin, cephalothin, ceftriaxone, cefotaxime, ticarcillin with or without ...
Murray, P R; Niles, A C
We determined the effect of performing antimicrobial susceptibility tests in five different anaerobic incubation systems: GasPak jar, large GasPak jar, evacuated-gassed anaerobic jar, anaerobic chamber, and Bio-Bag. Growth of the anaerobes was equivalent in all five incubation systems. The results of testing 38 anaerobes against 11 antimicrobial agents were comparable for the anaerobic jars and anaerobic chamber. However, discordant results were observed for metronidazole and cefamandole test...
Hinkle, A M; Bodey, G P
The in vitro activity of a new investigational cephalosporin, Ro 13-9904, was compared with those of four cephalosporins (cephalothin, cefamandole, cefoxitin, and moxalactam), five semisynthetic penicillins (mezlocillin, piperacillin, carbenicillin, ticarcillin, and azlocillin), and the aminoglycoside tobramycin. Ro 13-9904 inhibited 75% of all isolates of Enterobacteriaceae at a concentration of 6.25 micrograms/ml, including Enterobacter spp., Serratia marcescens, and indole-positive Proteus...
Stamm, John M.; Girolami, Roland L.; Shipkowitz, Nathan L.; Bower, Robert R.
The in vitro activity of cefmenoxime (SCE-1365 or A-50912), a new semisynthetic cephalosporin antibiotic, was compared with those of cefazolin, cefoxitin, and cefamandole against a broad spectrum of 486 organisms and with that of cefotaxime against 114 organisms. Cefmenoxime and cefotaxime exhibited nearly equivalent activities against those organisms tested and were the most active of these cephalosporins against all aerobic and facultative organisms except Staphylococcus aureus. The minimum...
Neu, H C; Meropol, N J; Fu, K P
The in vitro activity of ceftriaxone (Ro 13-9904), a parenteral cephalosporin, was compared with that of other beta-lactam antibiotics. the compound was less active against Staphylococcus aureus and Staphylococcus epidermidis than was cephalothin or cefamandole, but it was comparable to cefoxitin, cefotaxime, and moxalactam in inhibiting most isolates of S. aureus at 3.1 microgram/ml. Ro 13-9904 inhibited Streptococcus pyogenes and Streptococcus pneumoniae at concentrations below 0.25 microgr...
Jorgensen, J H; Crawford, S. A.; Alexander, G A
The in vitro activities of two new beta-lactam antibiotics, moxalactam disodium (LY 127935) and cefotaxime (HR-756), were compared with cefoxitin, cefamandole, cefuroxime, cephalothin, and, in some instances, carbenicillin, gentamicin, and amikacin against aerobic gram-negative bacilli. Test isolates included normally cephalosporin-resistant members of the Enterobacteriaceae and Pseudomonas spp. and a variety of nonfermentative or oxidase-positive bacteria. Both moxalactam and cefotaxime demo...
Hoellman, Dianne B.; Spangler, Sheila K.; Jacobs, Michael R.; Appelbaum, Peter C.
The agar dilution MIC method was used to test the activity of cefminox, a β-lactamase-stable cephamycin, compared with those of cefoxitin, cefotetan, moxalactam, ceftizoxime, cefotiam, cefamandole, cefoperazone, clindamycin, and metronidazole against 357 anaerobes. Overall, cefminox was the most active β-lactam, with an MIC at which 50% of isolates are inhibited (MIC50) of 1.0 μg/ml and an MIC90 of 16.0 μg/ml. Other β-lactams were less active, with respective MIC50s and MIC90s of 2.0 and 64.0...
Martín, M A; Castillo, A M; Liébana, J; Marín, A; Alados, J C; Piédrola, G
We compared the "in vitro" activity of imipenem with 14 beta-lactams, both alone and in combination with clavulanic acid, and sulbactam against 110 beta-lactamase-producing strains of Bacteroides fragilis. The following antibiotics were tested: amoxycillin, penicillin, mezlocillin, piperacillin, cephalothin, cephazolin, cefamandole, cefmetazole, cefonicid, cefoxitin, cefotaxime, ceftazidime, ceftizoxime, and ceftriaxone. In all cases, except those of cefoxitin and cefmetazole, these combinations showed a statistically significant increase in beta-lactam activity, which was, however, never higher than that of imipenem, the antibiotic which performed best against Bacteroides fragilis. PMID:1940333
Chen, C H; Yang, M H; Lin, J S; Lee, Y C; Perng, R P
Although there are reports that the addition of a beta-lactamase inhibitor to ampicillin or amoxicillin greatly improves their in vitro activity against M. tuberculosis, there are no written reports about the antituberculosis effects of beta-lactamase inhibitors in combination with cephalosporins against M. tuberculosis. In this report, we have determined the minimal inhibitory concentrations (MIC) of 5 cephalosporins with or without combination with beta-lactamase inhibitor against M. tuberculosis strains isolated from patients before antituberculosis treatment and checked the production of beta-lactamase by bacteria before this procedure. Four strains of M. tuberculosis were contaminated during the experiment, and all the other 16 strains hydrolyzed the nitrocefin disc, thus indicating a beta-lactamase producer. The MICs of cephalosporins alone against M. tuberculosis were 200-400 micrograms/ml for ceforanide, 100-400 micrograms/ml for cephapirin, 400-1600 micrograms/ml for cefamandole, 200-1600 micrograms/ml for cefotaxime, and 800-1600 micrograms/ml for ceftriaxone. After adding the equimolar concentrations of sulbactam, the MICs were reduced to 100-200 micrograms/ml for ceforanide, 12.5-100 micrograms/ml for cephapirin, 100-400 micrograms/ml for cefamandole, 25-200 micrograms/ml for cefotaxime, and 100-800 micrograms/ml for ceftriaxone. We concluded that sulbactam enhanced the antituberculosis effect of cephalosporins. PMID:7624446
Hoellman, D B; Spangler, S K; Jacobs, M R; Appelbaum, P C
The agar dilution MIC method was used to test the activity of cefminox, a beta-lactamase-stable cephamycin, compared with those of cefoxitin, cefotetan, moxalactam, ceftizoxime, cefotiam, cefamandole, cefoperazone, clindamycin, and metronidazole against 357 anaerobes. Overall, cefminox was the most active beta-lactam, with an MIC at which 50% of isolates are inhibited (MIC50) of 1.0 microg/ml and an MIC90 of 16.0 microg/ml. Other beta-lactams were less active, with respective MIC50s and MIC90s of 2.0 and 64.0 microg/ml for cefoxitin, 2.0 and 128.0 microg/ml for cefotetan, 2.0 and 64.0 microg/ml for moxalactam, 4.0 and > 128.0 microg/ml for ceftizoxime, 16.0 and > 128.0 microg/ml for cefotiam, 8.0 and >128.0 microg/ml for cefamandole, and 4.0 and 128.0 microg/ml for cefoperazone. The clindamycin MIC50 and MIC90 were 0.5 and 8.0 microg/ml, respectively, and the metronidazole MIC50 and MIC90 were 1.0 and 4.0 microg/ml, respectively. Cefminox was especially active against Bacteroides fragilis (MIC90, 2.0 microg/ml), Bacteroides thetaiotaomicron (MIC90, 4.0 microg/ml), fusobacteria (MIC90, 1.0 microg/ml), peptostreptococci (MIC90, 2.0 microg/ml), and clostridia, including Clostridium difficile (MIC90, 2.0 microg/ml). Time-kill studies performed with six representative anaerobic species revealed that at the MIC all compounds except ceftizoxime were bactericidal (99.9% killing) against all strains after 48 h. At 24 h, only cefminox and cefoxitin at 4x the MIC and cefoperazone at 8x the MIC were bactericidal against all strains. After 12 h, at the MIC all compounds except moxalactam, ceftizoxime, cefotiam, cefamandole, clindamycin, and metronidazole gave 90% killing of all strains. After 3 h, cefminox at 2 x the MIC produced the most rapid effect, with 90% killing of all strains. PMID:9517922
Mouton, Y; Caillaux, M; Brion, M; Fourrier, A
The second generation cephalosporins are those drugs that are totally or partially resistant to betalactamases (cefamandole, cefuroxime) or the cephamycins (cefoxitine). This property allows them to destroy the enterobacteria resistant to cefalotine and they may have a place in the treatment of certain post-operative infections (abdominal, gynaecological, urinary) on their own or in combination with an aminoglycoside. They also may be of use in combination with an aminoglycoside in the management of secondary septicaemia infections. Outside of these indications which are dependent on the bacteriological findings, their use should be limited even when there is an absence of organisms that are Cefalotine sensitive on the antibiogram. This careful approach (which applies particularly for cefotaxine) may be abandoned once a certain quantity of resistant strains have emerged. For the time being, the second generation cephalosporins ought to be used only for specific indications, and as a general rule should not be first line antibiotic treatment. PMID:44971
Johnson, David M.; Jones, Ronald N.
OBJECTIVE: To evaluate the potential spectrum of activity of two novel dual-action compounds with carboxamido bonds (CQ-397 and CQ-414; Laboratorios Aranda, San Rafael, Mexico) against human pathogens. METHODS: Approximately 800 Gram-positive and Gram-negative aerobic clinical bacteria were tested in vitro using the Mueller-Hinton broth microdilution method of the National Committee of Clinical Laboratory Standards. RESULTS: CQ-397 (cefamandole+enrofloxacin) and CQ-414 (cefamandole+norfloxacin) were equally potent against Enterobacteriaceae (MIC90 range, 0.06--0.5 microg/mL and 0.06--1 microg/mL, respectively). Citrobacter freundii (MIC90, 4 microg/mL) and Providencia spp. (MIC90, >32 microg/mL) exhibited elevated study drug MICs. Enterobacteriaceae resistant to fluoroquinolones generally remained resistant. CQ-397 and CQ-414 were active against Stenotrophomonas maltophilia (MIC90, 4 microg/mL) and oxacillin-susceptible staphylococci (MIC90, 0.25 microg/mL), but not oxacillin-resistant Staphylococcus aureus (MIC90, >32 microg/mL), Staphylococcus epidermidis (MIC90, 8 microg/mL), and enterococci (MIC90s, 8 to >32 microg/mL). There was no difference in the dual-action drug activity (MIC90, 2 microg/mL) between penicillin-susceptible and -resistant pneumococci. Haemophilus influenzae and Moraxella catarrhalis were very susceptible (MIC range, less-than-or-equal0.015--0.06 microg/mL) to both compounds. CONCLUSIONS: The activity of these novel dual-action compounds, formed from the bonding of older antimicrobials, warrants further investigation for potential human and/or animal health use, including toxicology and pharmacokinetics. PMID:11864130
Full Text Available Background: The emergence of beta-lactam resistance in Pseudomonas aeruginosa is a major global challenge, particularly, the rise in the resistance to 3rd and 4th generation cephalosporins. Aim: This study was carried out to determine the resistance pattern of Pseudomonas aeruginosa to different generations of cephalosporins. Methods: A total number of one hundred clinical isolates of Pseudomonas aeruginosa were collected from June to November 2014 at University Teaching Hospital Ibadan, Oyo State. These were tested for their sensitivity to antibiotics by means of disc diffusion method using prepared antibiotics disc containing different μ of antibiotics; Cefotaxine (30μ, Cefaclor (30μ, Cefamandole (30μ, Cefixime (5μ, Cefepime (30μ, Cefpodoxime (30μ and Ceftazidime (30μ. Results: Pseudomonas aeruginosa showed absolute resistance to all antibiotics used except Ceftazidime, and Cefepime which are third and fourth generation of cephalosporin respectively. Ceftazidime had minimal resistant of 21% and higher susceptibility rate of 76%, Cefepime had the highest susceptibility rate of 90% and minimal resistance of 6%. Cefotaxime and Cefpodoxime had minimal intermediate of 1%, Ceftazidime of 3% and Cefepime of 4%. Conclusion: The result from this study provided more evidence that among third generation of cephalosporins used, some are more active than the other while fourth generation is still the most effective of all other generations. Knowledge on the distribution of cephalosporin-resistant organisms is of ultimate importance as a guide in empirical therapy, taking note of preventive strategies as well as control measures against the spread of resistant microorganisms.
Jones, R N; Barry, A L; Fuchs, P C; Thornsberry, C
Cefmetazole, formerly CS-1170, was found to have antimicrobial activity slightly superior to that of cefoxitin but a clinically usable antimicrobial spectrum that should be considered identical to that of cefoxitin. Disk diffusion and dilution test methods with cefmetazole correlated highly (r, greater than or equal to 0.95) with cefoxitin results. The recommended 30-micrograms cefmetazole disk interpretive breakpoints for susceptibility and resistance were greater than or equal to 18 mm (MIC, less than or equal to 8.0 micrograms/ml) and less than or equal to 14 mm (MIC, greater than or equal to 32 micrograms/ml), respectively. Cefmetazole and cefoxitin should be considered to be in the same antimicrobial spectrum class, requiring separate testing for other cephalosporins such as cephalothin, cefamandole, cefuroxime, and cefotetan. Recommended interpretive criteria performed well for fastidious organisms (Haemophilus influenzae, Neisseria meningitidis, and Branhamella catarrhalis) and for broth microdilution tests with anaerobes. Cefmetazole and cefoxitin broth disk elution tests for anaerobic bacteria produced higher rates of false susceptibility results. PMID:3097064
Full Text Available Background: Staphylococci are major cause of nosocomial blood stream infections.This local surveillance study was carry out to monitor frequency of occurrence of Staphylococcus aureus and coagulase-negative staphylococci (CoNS in blood stream infections and the incidence of methicillin-resistant (MET-R strains. Materials and methods: During the period January – December 2006, 9840 blood specimens were analyzed and microrganisms from positive samples were collected. Bacterial identifications were performed according to the standard methods (Murray, 2003.We evaluated, in particular, the antibiotic-resistance phenotype of staphylococci employing disk diffusion test as suggested by the CLSI (2006. The following antimicrobial agents were tested: oxacillin, penicillin, amoxiciclin-clavulanate, cefalotin, cefamandole, imipenem, teicoplanin, linezolid, ciprofloxacin, erythromycin, clindamicin, rifampicin, trimethoprim-sulfamethoxazole, gentamicin, doxiciclin, fosfomycin. Results: The microrganisms isolated were 551: 370 Gram-positives (67%, 131 Gram-negatives (24%, 11 anaerobes (2% and 39 mycetes (7%. In particular, 121 S. epidermidis, 75 S. aureus, 42 S. haemolyticus and other 39 CoNS were analyzed: methicillin-resistance occurred in more than 80% of S.aureus strains collected from Intensive Care Units (ICU and in about 50 % of those isolated from other divisions. In CoNS the incidence of MET-R ranged from 30 to 80 %, the higher values were registered among S. epidermidis and S. haemolyticus. MET-R strains were characterized by high resistance rates even to ciprofloxacin (from 47 to 100%, erythromycin (from 70 to 100%, and in same cases to gentamicin (from 23 to 86% also. Conclusions: Staphylococci are the prevalent cause of blood stream infections.The distinctive feature of MET-R strains is their resistance not only to all b-lactam antibiotics, but also to a wide range of other antimicrobial agents. However, the glycopeptide teicoplanin remains 100
Zeng, Dexin; Zhang, Xiaoping; Xue, Feng; Wang, Yanhong; Jiang, Luyan; Jiang, Yuan
In this study, we investigated the distribution, phenotypic and molecular typing characters of Campylobacter jejuni in domestic fowl, and livestock populations in East China, to provide some reference for researches on its molecular epidemiology. A total of 1250 samples were collected from different animal sources, and C. jejuni strains were then isolated and tested for antibiotic sensitivity. Antibiotics-resistance gene and pathogenic genes were detected by polymerase chain reaction. Phylogenic analysis on the C. jejuni strains was performed by multilocus sequence typing (MLST) method. The results showed that 108 out of the 1250 samples (mean 8.64%) were C. jejuni positive. These 108 C. jejuni strains were highly sensitive to antibiotics such as chloramphenicol, amoxicillin, amikacin, cefotaxime, and azithromycin, whereas they were highly resistant to antibiotics such as cefoperazone, cotrimoxazole, cefamandole, sulfamethoxazole, and cefradine. Pathogenicity related gene identification indicated that the mean carrying rate of adhesion related gene cadF and racR, flagellin gene flaA, toxin regulating gene cdtA, cdtB, cdtC, wlaN and virB11, heat shock proteins and transferring proteins related genes dnaJ and ceuE, CiaB and pldA were 92.45%, 38.69%, 73.58%, 71.70%, 52.83%, 96.23%, 12.26%, 1.89%, 0.94%, 65.09%, 39.62% and 9.43%, respectively. A total of 58.82% of these strains contained more than 6 pathogenicity-related genes. MLST typed 58 ST types from the 108 isolated C. jejuni strains, including 24 new types, and ST-21 was the major type, accounting for 39.3% of the total strains. PMID:26565657
王怡苹; 秦侃; 汪永宏; 范鲁雁
目的：调查介入手术患者围手术期预防使用抗菌药物情况，分析存在的问题。方法回顾性分析医院2012年1月至12月介入手术患者抗菌药物使用情况，剔除原有感染已使用抗菌药物的病例，同时实施干预管理。结果监测患者415例，预防使用抗菌药物27例，使用率6.51%；用药天数1～7 d，平均1.78 d；使用频率排名前5位的依次为头孢孟多、头孢西丁、青霉素、头孢哌酮他唑巴坦、头孢拉定。结论介入手术患者抗菌药物预防性使用情况比较合理，但仍存在用药时间过长、选取不正确等情况，需进一步提高临床医师对抗菌药物使用知识的了解，提高抗菌药物预防性应用的合理性。%Objective To investigate the perioperative prophylactic antibacterial drug use in the patients with intervention surgery and to analyze the existing problems. Methods The retrospective analysis was performed to investigate the perioperative antibacterial drug use in the patients with intervention surgery from January to December 2012. The cases of original infection treated by the antibacterial drugs were excluded and at the same time the intervention management was implemented. Results A total of 415 cases were monitored, 27 cases used the prophylactic antibacterial drugs with the use rate of 6. 51%,the medication time ranged 1-7 d, average 1. 78 d. The top 5 of antibacterial drug use frequency in turn were cefamandole, cefoxitin, penicillin, cefoperazone tazobactam and cephradine. Conclusion The use of perioperative prophylactic antibacterial drug use in the patients undergoing intervention surgery is basically rea-sonable, but there are still some conditions such as too long time of antibacterial drug use and incorrect selection of antibacterial drugs, which needs to further increase the clinical doctors' understanding on the use knowledge of prophylactic antibacterial drugs for enhanc-ing the rationality of prophylactic