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PubMed1983

Comparison of the antibacterial spectra of cephalexin and cefaclor with those of cephalothin and newer cephalosporins: reevaluation of the class representative concept of susceptibility testing.

The validity of the class representative concept for in vitro susceptibility testing of older cephalosporins was reevaluated. Two oral cephalosporins, cephalexin and cefaclor, were compared with the established cephalosporin class representative, cephalothin, by using reference microdilution minimal inhibitory concentrations of 528 isolates of a wide variety of gram-positive and gram-negative bacterial pathogens. For each comparison, there were only 15 (2.8%) random major and very major interpretive discrepancies. Additional comparisons confirmed the need to test second-generation (cefamandole) and third-generation (cefotaxime) cephalosporins separately. These results provide reasonable assurance that the use of cephalothin as an in vitro predictor of qualitative bacterial susceptibility to these two oral cephalosporins remains an acceptable alternative to testing each antibiotic individually.

Bacteria↗
PubMed1985

Cephalothin susceptibility as a potential marker for the Aeromonas sobria group.

Fifty-four motile Aeromonas strains, composing the three currently recognizable species, were tested for susceptibility to cephalothin by broth dilution and disk agar diffusion assays. Cephalothin susceptibility was significantly associated with Aeromonas sobria (P less than 0.001) and may be an additional phenotypic marker useful in the identification of this species.

Aeromonas↗
PubMed1991

Inability of cephalothin testing to predict cefprozil susceptibility.

The 30-micrograms cefprozil disk and the cephalosporin class (30-micrograms cephalothin) disk were compared for their abilities to predict cefprozil susceptibility by agar disk diffusion testing. High error (5.02% major and 14.11% minor) rates were encountered with the cephalothin disk and were most frequently observed for Escherichia coli and Enterococcus faecalis. The cefprozil disks resulted in rates of 0.05% very major, 0% major, and 3.72% minor errors. Thus, the 30-micrograms cefprozil disk is more desirable for predicting cefprozil susceptibility.

Cephalosporins↗
PubMed1982

Severe nephrotoxicity: a probable complication of cis-dichlorodiammineplatinum (II) and cephalothin-gentamicin therapy.

A 53-year-old patient with metastatic testicular choriocarcinoma died of renal failure after treatment with cis-platinum and antibiotics. Serum creatinine was first noted to be elevated on day 8 of cis-dichlorodiammineplatinum (DDP) therapy. However, a sharp rise in its level occurred soon after the start of antibiotic therapy with cephalothin, gentamicin and carbenicillin. Renal failure was progressive in nature and persisted until death occurred on day 24 of therapy and after 8 days of antibiotic treatment. The most likely explanation for the progressive worsening of renal function in this patient was renal injury incurred by DDP and antibiotics. The combination of cephalothin-gentamicin should be discouraged in the treatment of patients receiving platinum.

Acute Kidney Injury↗
PubMed1979

In vitro susceptibility of pseudomonas to four beta-lactamantibiotics (ampicillin, cephalothin, carbenicillin, piperacillin), to four aminoglycosides (kanamycin, amikacin, gentamicin, tobramycin) and to colimycin.

Of 97 well-defined strains of Pseudomonas, isolated from sputum of patients with cystic fibrosis (CF), the minimum inhibitory concentration (MIC) of several antibiotics was determined with a broth dilution method. The majority of the strains were resistant to ampicillin and cephalothin, moderately susceptible to carbenicillin (70% to 100 microgram/ml) and highly susceptible to piperacillin (100% to 25 microgram/ml, 88% to 6.25 microgram and 60% to 3.12 microgram/ml). If the pharmacological properties of piperacillin are comparable with those of carbenicillin, it can be expected that the sputum level of this drug will be adequate to treat Pseudomonas pulmonary infections. At the lowest concentration tested (0.78 microgram/ml) 3% of the strains were susceptible to kanamycin, 85,5% to amikacin, 95% to gentamicin, 98% of tobramycin, and 80% to colimycin. With regard to clinically attainable concentrations, 98.9% of the strains were susceptible to gentamicin and tobramycin 97.9% to amikacin, 96.9% to colimycin, 88.6% to piperacillin, 38% to carbenicillin, 25.7% to kanamycin, 12.3% to ampicillin, and 1% to cephalothin.

Amikacin↗
PubMed1982

Assessment of timed bacteriostatic and bactericidal activities of cephalothin against gram-positive and gram-negative bacteria.

The comparative bacteriostatic and bactericidal activities of cephalothin were assessed in broth medium with special reference to the period of exposure of microbes to the drug. The bacteriostatic concentration with a brief period of exposure (6 h) was lower than the conventional MIC for Escherichia coli and Klebsiella sp. When the period of exposure was prolonged (18-42 h), the bacteriostatic concentration almost corresponded with the MIC. In contrast to these gram-negatives, the bacteriostatic concentration with a brief period of exposure roughly corresponded with the MIC for strains of Staphylococcus aureus and was higher for enterococcus. When a comparison of the bacteriostatic and the bactericidal concentrations was used as the criterion for assessment, the mode of action of cephalothin appeared to be bactericidal to most of the gram-negatives. This drug was bacteriostatic to a number of strains of gram-positives, in particular to enterococcus, especially when microbes were exposed to the drug over a brief period of time.

Cephalothin↗
PubMed1984

Ceftazidime: in vitro comparison with cephalothin, cefuroxime, and netilmicin. A Norwegian study.

The in vitro activity of ceftazidime has been compared with those of cephalothin, cefuroxime, and netilmicin against a variety of gram-positive and gram-negative bacteria in order to register sensitivity patterns in the western part of Norway. An agar dilution method was used for minimal inhibitory concentration (MIC) determination. Ceftazidime was the most active agent against Enterobacteriaceae; all isolates being inhibited by 2 mg/l or less, whereas netilmicin was slightly less active, especially against Providencia. Cephalothin and cefuroxime were markedly less active than the other two agents against Enterobacteriaceae. Ceftazidime and netilmicin were active against our Pseudomonas aeruginosa isolates (MICs less than or equal to 4 and less than or equal to 8 mg/l, respectively). Only netilmicin had useful activity against Acinetobacter calcoaceticus. Ceftazidime was the least active agent against Staphylococcus aureus; nearly all the isolates had MICs of 4-8 mg/l. Cefuroxime was the most active agent against Bacteroides fragilis, whereas ceftazidime was inactive. Ceftazidime may, in the future, be a useful alternative to the aminoglycosides in the treatment of serious gram-negative infections, particularly when P. aeruginosa might be involved.

Anti-Bacterial Agents↗
PubMed1986

Heterogeneity of cross-reactivity of mouse anti-benzylpenicilloyl antibodies against cephalothin haptens or polymers.

The cross-reactivity of mouse anti-benzylpenicilloyl antibodies against cephalothin-haptens and cephalothin-polymers was divergent depending on the source and isotype of antibodies and the methods to raise them. High cross-reactivity nearly equal to the reactivity to homologous haptens and polymers was obtained only with the IgE antibody of C57BL/6J mouse raised shortly after an immunizing injection of the emulsion containing Freund's complete adjuvant and benzylpenicilloyl-bovine gamma-globulin conjugate. With the other antibody preparations, cross-reactivity was moderate to negligible.

Animals↗
PubMed1975

Meningitis developing during cephalothin therapy of septicaemia.

A 63-year-old woman developed pneumococcal meningitis during cephalothin treatment for pneumococcal septicaemia. The poor penetration of this antibiotic over the blood-brain barrier makes it unsuitable for the therapy of meningitis. If cephalothin is used in other serious infections, the patient should be closely observed for the development of meningitis.

Blood-Brain Barrier↗
PubMed1980

Empiric treatment of fever in acute leukaemia with tobramycin-cephalothin, and the escape clause provision of corticosteroids.

29 episodes of suspected septicaemia in patients with acute leukemia were treated empirically with tobramycin 180--240 mg/day intravenously together with cephalothin 12 g/day. Patients without documented infection who did not respond to antibiotics and whose fever developed after a course of cytotoxic drugs, were given the provision of high dose corticosteroid therapy. Infection was documented microbiologically or clinically in 13/29 episodes. Septicaemia was proven in 7, and 6 had pneumonia. Neutropenia was present in 18/29 episodes. A satisfactory response to initial therapy was achieved in 7/13 with documented infection and in 9/16 without proven infection. The overall good response was 55%, 5/7 cases with septicaemia, but only 2/6 with pneumonia responded well. The 2 septicaemia patients who did not respond had Pseudomonas aeruginosa sepsis. In 16 episodes without documented infection 7 did not respond to initial therapy. To 4 of them, who were subject to recent cytotoxic drug administration, high dose corticosteroid therapy was given, and 3 of them responded well. Of the remaining 3 non-responders, one became afebrile after cytostatic and one after prednisolone treatment. Serum assays of tobramycin were done on the 1st and 5th day of therapy and no difference in concentration was observed on these 2 occasions. Five patients developed renal failure, but this was attributed to antibiotic therapy only in 1, who initially had an elevated serum creatinine. It is concluded, that in hospitals where pseudomonas is not a dominating pathogen, tobramycin--cephalothin may be a good combination to start empiric therapy with. In patients without proven infection, who have recently been subjected to cytotoxic therapy, and who do not respond to the initial course of antibiotics, a high dose of corticosteroids may be tried, provided the patient is monitored for the hazard of bacterial infection.

Adrenal Cortex Hormones↗
PubMed1986

Comparison of ceforanide and cephalothin prophylaxis in patients undergoing total joint arthroplasty.

One hundred one patients undergoing total hip and knee arthroplasty were randomly assigned to receive either two 1 gm doses of ceforanide or five doses of cephalothin perioperatively. Simultaneous plasma and cancellous bone specimens were obtained intraoperatively and assayed for antibiotic concentration. Ceforanide plasma and bone levels remained sustained over six hours. Cephalothin plasma and bone levels obtained three to four hours post administration were 91% lower than levels obtained one hour post-dose. Patients were examined for infection for up to 18 months following surgery. None of the patients developed an infected implant. The sustained plasma and bone levels achieved with ceforanide obviate the need for intraoperative dosing necessary with other agents.

Adult↗
PubMed1977

In vitro susceptibility of cephalothin-resistant Enterobacteriaceae to cefoxitin and BL-S786.

The in vitro antibacterial activity of two agents relatively resistant to beta-lactamases, BL-S786 and cefoxitin, was tested against 123 recent different clinical isolates of cephalothin-resistant Enterobacteriaceae. BL-S786 showed considerable activity against Escherichia coli and lesser activity against Klebsiella pneumoniae with, respectively, 68% and 41% inhibited at 32 microng/ml. Cefoxitin showed more activity in vitro against E. coli, K. pneumoniae, Serratia marcescens and Providencia stuartii. Cefoxitin appears to be a more promising agent for treating infections caused by cephalothin-resistant Enterobacteriaceae.

Cefoxitin↗
PubMed1975

Effectiveness of carbenicillin - aminoglycoside and of cephalothin-aminoglycoside combinations against enterococci in vitro.

Combination of carbenicillin and cephalothin with various aminoglycosides (gentamicin, sisomicin, tobramycin, kanamycin and amikacin) were studied in vitro using 20 strains of enterococci isolated from clinical material. The addition of the aminoglycosides to carbenicillin increased the rate of bactericidal action of carbenicillin on most strains. Little benefit was obtained by adding the aminoglycosides to cephalothin and antagonistic action has been observed on some strains.

Amikacin↗
PubMed1975

Mass reconstitution of neutral cephalothin sodium using tandem sequence filling.

A procedure is described for reconstituting and packaging neutral cephalothin sodium in large numbers of underfilled minibags for i.v. bolus administration. A special rack to hold six 20-g Keflin vials was designed for the procedure which employs an automatic pipetting device in a laminar air flow hood. A reconstitution deck and needle holder are used in the admixing stage. The minibags are frozen and later thawed prior to dispensing. The average labor and material cost (excluding drug and minibag) ranges from $0.195 to $0.124 per minibag depending on batch size. The 20-g neutral cephalothin sodium vial improves speed of reconstitution and does not require transfer into an intermediate container during the packaging cycle.

Cephalothin↗
PubMed1989

The use of cephalothin and triphenyltetrazolium chloride impregnated filter paper strips in the identification of Campylobacter species.

Filter paper impregnated strips using cephalothin at 30 and 60 micrograms/ml and triphenyltetrazolium chloride at 20 mg/ml were prepared and used in the typing of catalase-positive Campylobacter species. There was no difference in the sensitivity of campylobacters to cephalothin at 30 micrograms/ml and 60 micrograms/ml. Results were as reported by other workers except for a C. jejuni strain which was resistant to the triphenyltetrazolium. The technique is nevertheless inexpensive and the results are consistent and easy to interpret.

Animals↗
PubMed1978

Studies on the pharmacokinetics of cefoxitin, cefuroxime, cephaloridine and cephalothin using subcutaneous tissue cages.

The present study was undertaken to compare the ability of three cephalosporins--cephalothin, cephaloridine and cefuroxime--and a cephamycin--cefoxitin--to penetrate into extravasal compartments. The study was performed using female adult rabbits with subcutaneously implanted steel net cages. All antibiotics were given in a dose of 50 mg/kg b.w. parenterally as i.v. injections. The concentrations of the different antibiotics were determined simultaneously in serum and in fluid obtained from the cages. The concentrations were followed after single doses as well as after repeated doses using an agar well technique for the assays. To control the experimental conditions electrolyte and protein contents of the fluid in the different cages were followed and were found to be stable during the experimental period. All antibiotics were rapidly eliminated from serum. The concentrations in the cages reached its maximum 1.5-3 hours after administration. The highest concentrations in the extravasal compartments were obtained with cephaloridine and the lowest with cephalothin with the values of the other antibiotics ranging in between.

Animals↗
PubMed1985

[Urinary enzyme excretion in cephalothin therapy in pregnancy].

A damage of the kidney, particularly of the proximal tubular cells, can be indicated by an increased concentration of distinct enzymes in urine. During cephalothin treatment of pyelonephritis in pregnant women the daily excretion of 4 brush-border enzymes was measured, to detect a tubulotoxic effect of this drug. The present results do not demonstrate a marked alteration of tubular cells. The use of cephalothin during pregnancy is possible, but the risk of nephrotoxic side effects should be considered.

Adolescent↗
PubMed1977

Effect of prophylactic systemic administration of cephalothin in colorectal surgery.

The effect of standardized prophylactic treatment with systemically administered cephalothin (Keflin) was studied in a series of 120 consecutive patients in whom elective colorectal surgery was planned. The patients were divided by random selection into one treatment group and one control group. The same mechanical cleansing with cathartics and tap water enemas was performed in both groups. The patients in the treatment group received intravenously 2 g cephalothin 2 hours prior to the operation, 2 g during the operation and then 2 g every 6th hour during 4 days. 14 cases were excluded for various reasons. In 19 cases only minor operations were performed, such as laparotomy with or without simultaneous colostomy. The overall frequency of infections was 17.5% in the treatment group and 53.1% in the control group. In the 87 cases undergoing major operations, infections were registered in 17.4% of the treated patients and 58.5% of the control patients. The difference is highly significant (p less than 0.001) in both cases. Escherichia coli was present in about 70% of the infections, often together with other aerobic or anaerobic organisms.

Adult↗