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PubMed2000

Increasing minimum inhibitory concentration of cefazolin for Salmonella typhi.

Cefazolin resistance was observed in the disc diffusion method of antibiotic susceptibility testing of Salmonella typhi strains isolated from January to June 1999. Eighty six multi drug resistant (MDR) isolates were studied. Of these, 46 (53.5%) were found resistant to cefazolin by the disc diffusion test. The minimum inhibitory concentration (MIC) of cefazolin was determined for the 86 isolates of S. typhi by the agar dilution method. MIC of these strains ranged from 1.0 to 64.0 micrograms/ml. In comparison, 25 MDR S. typhi strains isolated between 1994-1998 (5 per year) also tested by the same method, gave MIC values of 0.5 to 4.0 micrograms/ml. Our findings indicate a definite upward shift in MIC of cefazolin to MDR S. typhi since 1999. This needs to be monitored since the second, third and fourth generation cephalosporins are therapeutic options for typhoid fever.

Anti-Bacterial Agents↗
PubMed2004

Effect of cefazolin loaded bone matrix gelatin on repairing large segmental bone defects and preventing infection.

OBJECTIVE: To explore the possibility of repairing long segmental bone defects and preventing infection with cefazolin loaded bone matrix gelatin (C-BMG). METHODS: C-BMG was made from putting cefazolin into BMG by vacuum absorption and lyophilization techniques. The sustaining period of effective drug concentration in vitro and in vivo was detected. The time of inhibiting bacteria, and the drug concentration in local tissues (bone and muscle) and plasma after implantation of C-BMG were examined by high performance liquid chromatography. RESULTS: The effective inhibition time to staphylococcus aureus of C-BMG was 22 days in vitro; while 14 days in vivo. The cefazolin concentration in local tissues was higher in early stage, and later it kept a stable and low drug release. C-BMG showed an excellent ability to repair segmental long bone defects. CONCLUSIONS: C-BMG can gradually release cefazolin with effective drug concentration and has excellent ability to repair segmental bone defects. It can be used to repair segmental long bone defects and prevent infection after operation.

Animals↗
PubMed2005

Cefazolin concentrations in serum during cardiopulmonary bypass surgery.

The objective of the study was to investigate possible changes in cefazolin serum levels induced by cardiopulmonary bypass (CPB). Six cardiac male patients who underwent cardiac surgery requiring CPB took part in the study. Cefazolin 2 g was intravenously infused over 60 min before anesthesia and blood samples were taken at appropriate times after drug administration (0, 0.25, 0.5, 1, 4, 6, 8 h), 2 min before and 5 min after the beginning and 2 min before and 5 min after the end of CPB. Drug serum concentrations were determined by means of a microbiological method. Five minutes after the start of CPB, cefazolin serum levels decreased on average by 46.6% and remained steadily low until 5 min after the end of CPB. Then, they rose on average by 37.3% at 4 h and then declined slowly until the last sampling at 8 h. Cefazolin serum concentrations were low during CPB but remained in a potentially effective range for antimicrobial prophylaxis for this surgery.

Aged↗
PubMed2005

[Sensitivity of nanoparticlized cefazolin sodium to the bacteria in vitro].

OBJECTIVE: To investigate whether the in vitro sensitivity of cefazolin sodium to the bacteria was altered after nanoparticlization. METHODS: The minimal inhibitory concentrations (MIC) of cefazolin sodium before and after nanoparticlization to S. aureaus and E. coli. were determined by microdilution. RESULTS: The MIC of nanoparticlized cefazolin sodium to S. aureaus and E. coli. had no significant change compared with that of non-nanoparticlized one. CONCLUSION: Nanoparticlization will not decrease the sensitivity of cefazolin sodium to the bacteria.

Anti-Bacterial Agents↗
PubMed2006

Use of fibrin sealants for the localized, controlled release of cefazolin.

BACKGROUND: Fibrin sealants are used increasingly in surgery to reduce bleeding and improve wound healing. They have great potential as biocompatible, biodegradable drug delivery systems, because the sealant may adhere to the target tissue and allow controlled release of the drug over an extended period. We investigated the encapsulation, stability and controlled release of erythromycin and cefazolin from Beriplast fibrin sealants (Aventis Behring Canada). METHODS: Drug-loaded clots were cast in glass vials and allowed to set. We observed the clots for drug precipitation and aggregation, and we assessed the effect of drug encapsulation on clot strength. Drug stability and release from the clots in phosphate buffered saline (PBS) was quantified by ultraviolet and visible violet absorbance spectroscopy and high-performance liquid chromatography. RESULTS: Erythromycin was found to release slowly from the fibrin clots over the first 2 hours but then degrade rapidly. Cefazolin was found to be very stable in clots in PBS (97% stable at 2 d and 93% stable at 5 d). The drug released in a controlled manner over 2 days, with most being released during the first day. The dose of drug released could be varied by changing the amount placed in the thrombin solution. Clot thickness had no effect on the rate of cefazolin release. CONCLUSION: Overall, the 2-day release profile and the excellent stability of the drug suggest that cefazolin-loaded fibrin sealants may offer an effective route of postoperative antibiotic delivery.

Anti-Bacterial Agents↗
PubMed1991

Initial treatment of dialysis associated peritonitis: a controlled trial of vancomycin versus cefazolin.

OBJECTIVE: To determine if intraperitoneal administration of vancomycin (a slowly absorbed antibiotic) improves the management of dialysis-associated peritonitis over that obtained by using cefazolin, an equally potent, rapidly absorbed antibiotic. SETTING: A university operated teaching hospital, with patient treatment initiated at home. PATIENTS: One hundred thirty-one patients trained to perform peritoneal dialysis (CAPD and CCPD) and followed at the University of Iowa Hospitals and Clinics Home Dialysis Treatment Center. DESIGN: Patients were prospectively allocated into groups adding either vancomycin 25 mgm/L, or cefazolin 50 mgm/L to their dialysate when signs or symptoms of peritonitis developed. Treatment results were analysed using chi-square testing. FINDINGS: Compared to cefazolin, initial peritonitis therapy with vancomycin improved the peritonitis resolution rate [67% vs 81%; p = 0.008], reduced the incidence of hospital admissions [68% vs 48%; p = 0.001], and decreased the risk of superinfection [4% vs 0%; p = 0.039]. CONCLUSION: Vancomycin appeared to be superior to cefazolin in the treatment of peritoneal dialysis associated peritonitis.

Adult↗
PubMed1990

The effect of tourniquet inflation on cefazolin tissue penetration during total knee arthroplasty.

Patients undergoing total knee arthroplasty were randomized to tourniquet inflation 1, 2, or 5 minutes after a 1-g dose of cefazolin. Serum, soft tissue, and bone samples were obtained at 10, 30, and 60 minutes after inflation, immediately prior to tourniquet release (PTR), and 5 minutes after release. Areas under the concentration-time curve (AUC10-PTR) were calculated using the linear trapezoidal method and normalized to actual body weight, creatinine clearance, and length of tourniquet inflation. The percentage of penetration was calculated using the normalized values for the respective AUCs. Differences among the groups were analyzed using analysis of variance or the Kruskal-Wallis test where appropriate. Groups were similar for age, actual body weight, duration of tourniquet inflation, and creatinine clearance (p greater than 0.05). The median percentages of penetration for soft tissue and bone at 5, 2, and 1 minute were 14.5% and 4.6%, 6.7% and 3.0%, and 5.9% and 4.6%, respectively. Only the percentage of soft tissue penetration between 5 and 1 minute was significantly different (p = 0.015). Gender and type of anesthesia (general, epidural) had no effect on cefazolin penetration into soft tissue or bone. Although increasing the time interval between cefazolin administration and tourniquet inflation resulted in higher soft tissue drug concentrations, a 1-minute interval resulted in soft tissue and bone cefazolin concentrations at or above the minimum inhibitory concentration for microorganisms likely to be encountered in this surgical procedure.

Adolescent↗
PubMed1990

Cefazolin levels after intravitreal injection. Effects of inflammation and surgery.

Cefazolin (2.25 mg) was injected into the vitreous cavity of phakic, aphakic, and aphakic/vitrectomized rabbits; inflamed eyes were compared to controls. Vitreous levels of cefazolin were determined at selected times from 2 to 48 hr, and the half-life was calculated. The effect of inflammation was to increase the half-life or to reduce the rate of elimination of cefazolin from the vitreous cavity. The drug was cleared substantially faster from aphakic/vitrectomized eyes than from phakic or aphakic eyes. Vitreous levels of cefazolin were above the MIC for most common gram-positive organisms causing endophthalmitis in all study groups at 24 hr, but in only the phakic inflamed eyes and in the aphakic eyes with intact vitreous at 48 hr.

Animals↗
PubMed1990

Cesarean prophylaxis: a comparison of cefamandole and cefazolin by both intravenous and lavage routes, and risk factors associated with endometritis.

This study included 207 patients in a double-blind, prospective randomized trial of cefazolin versus cefamandole single-dose prophylaxis by both intravenous (IV) and lavage routes in patients laboring with ruptured membranes who eventually had nonelective cesareans. No significant differences (P less than .05) were noted in the rates of infectious morbidity (cefazolin IV: six of 47, 13%; cefazolin lavage: nine of 59, 15%; cefamandole IV: six of 47, 13%; cefamandole lavage: six of 54, 11%). The incidence of operative complications in the patients developing endometritis (eight of 22, 36%) was significantly different (P less than .004) from that in the group who did not develop endometritis (21 of 185, 11%). Cefazolin by IV and lavage routes of administration appears to be as effective as cefamandole by either route of administration.

Cefamandole↗
PubMed1989

Susceptibility of clinical isolates to cephalexin, cefazolin and cefotaxime.

Three hundred and seventeen recent clinical isolates were tested for in vitro susceptibility to the three cephalosporins available in India--cephalexin, cefazolin and cefotaxime by the Kirby--Bauer disc diffusion method. Cefazolin was the most effective cephalosporin against Gram positive cocci (71.8% sensitive) followed by cefotaxime (62.7%) and cephalexin (52.7%). Cefotaxime was very effective against commonly isolated Gram negative bacilli with only 10 (8.8%) isolates being resistant to it while 44 (39%) and 65 (57.5%) were resistant to cefazolin and cephalexin, respectively. All isolates of Pseudomonas aeruginosa were resistant to cephalexin and cefazolin and only 29 (32.6%) were sensitive to cefotaxime.

Cefazolin↗
PubMed1978

Double-blind comparison of cefazolin and cephalothin in open-heart surgery.

Ninety-nine patients undergoing cardiac surgery were randomly assigned to treatment with cefazolin and cephalothin to compare the effectiveness of these cephalosporins in the prevention of postoperative infections. The incidence of infections was low with both antibiotics (cefazolin 2.1 percent, cephalothin 4.6 percent). Intraoperative serum cefazolin levels were more evenly distributed, whereas a wide dispersion of cephalothin levels was observed. There was no measurable antibiotic detected in cardiac tissue samples in the majority of the cases. Adverse reactions (skin rashes) occurred only in three patients, all receiving cephalothin. It is concluded that cefazolin is as safe and effective as cephalothin in the prevention of postoperative infection in patients undergoing open-heart surgery.

Adult↗
PubMed1986

[Preventive antibiotics in cardiac surgery: cefazolin versus cefamandole].

A prospective, randomized study was carried out to evaluate two antibiotic prophylactic regimens for patients undergoing cardiac surgery with cardiopulmonary bypass. Each patient of the first group (cefazolin) received four intravenous injections of 1 g cefazolin during 12 hours, patients of second (cefamandole), four doses of 750 mg. 155 patients scheduled for cardiac operation were included in the study. (May 1983 to April 1984). Patients were not admitted to the study in case of emergency, if their weight was less than 20 kg, if they had received antibiotics during the week before surgery or if they had a history of anaphylactic reactions to cephalosporins. There were no differences between the two groups on age, weight, height, sex, previous history of infectious disease, surgery and intensive care. There were no significant differences between the two groups in minor infections. The rate of urinary tract infection by streptococci was significatively higher (p less than 0.02) in the cefamandole group (38.3%) than in the cefazolin group (17.6%). There were no major infections (septicemia, mediastinitis, endocarditis). Patients temperature was the same during the first four postoperative days. Hospital stay was the similar in the two groups. The two antibiotics are similarly effective to prevent major infections in cardiac surgery. However cefazolin was preferred for antibiotic prophylaxis in cardiac surgery because of the higher rate of streptococcal urinary infections in patients given cefamandole.

Adult↗
PubMed1979

Decreased aminotransferase activity of serum and various tissues in the rat after cefazolin treatment.

Treatment of rats with cefazolin in vivo significantly suppressed activity of alanine and aspartate aminotransferases in serum and in the liver, brain, kidney, and heart. Simultaneous administration of pyridoxal further reduced enzyme activity except in the liver, where there was no change. Pyridoxal 5'-phosphate partly reversed the decreased enzyme activity in the serum, liver, and kidney, but did not return it to the amount observed in the control animals; enzyme activity remained suppressed in the brain and heart. The effect of cefazolin was dose related, but there was no sex-related difference. In contrast to its action on am-notransferase activity, cefazolin elicited no effect on alkaline phosphatase (pyridoxal-5'-phosphate hydrolase) in serum or on pyruvate carboxylase in the liver, heart, and kidney. Cefazolin exposed to the hepatic microsomal mixed-function oxidase system in vitro was partly converted into metabolites that inhibited serum alanine aminotransferase activity in vitro. The latter inhibition was reversed by the addition of pyridoxal 5'-phosphate.

Alanine Transaminase↗
PubMed1984

Ceftriaxone or cefazolin prophylaxis for the prevention of infection after vaginal hysterectomy.

A prospective, double-blind, perioperative prophylactic antibiotic study was performed in 127 women undergoing vaginal hysterectomy. Patients were randomly given a preoperative 1 g dose of ceftriaxone and then placebo 8 and 16 hours later or three 1 g doses of cefazolin over 16 hours. At surgery, blood samples were collected from 81 women and vaginal mucosa samples, from 49 women. Respective antibiotic concentrations were determined by high-pressure liquid chromatography. During the 10 months of this study, 64 patients received ceftriaxone and 63 received cefazolin. Clinical and surgical profiles of the two groups were similar, and the incidence of postoperative pelvic infection was identical, being 1.6 percent. The mean concentration of ceftriaxone was significantly higher than that of cefazolin in serum (p less than 0.001) and vaginal mucosa (p less than 0.05). A single dose of ceftriaxone before surgery was as effective in preventing major pelvic infection and urinary tract infection as were three perioperative doses of cefazolin given over 16 hours. The safety and tolerance of the two regimens were equivalent.

Adult↗
PubMedDate not supplied

Penetration of moxalactam and cefazolin into bone following simultaneous bolus or infusion.

The penetration of cefazolin and moxalactam into bone was studied in 20 adults scheduled for total hip arthroplasty. Patients randomly received both moxalactam and cefazolin (10 mg/kg of each) by either a rapid bolus or a 30-minute infusion. Serum and bone-extract concentrations were measured by HPLC. Serum concentrations of cefazolin were significantly greater than those of moxalactam at 15 minutes, 30 minutes, and at the time of bone removal for both rates of injection. Bone concentrations of cefazolin were significantly greater than those of moxalactam for both the bolus study (7.7 +/- 4.8 micrograms/g versus 5.4 +/- 3.4 micrograms/g) and the infusion study (5.6 +/- 3.4 micrograms/g versus 4.3 +/- 2.6 micrograms/g, respectively). There was no significant difference in the bone levels for the two drugs when penetration was expressed as a function of the simultaneous serum concentration (18% for each drug), and there were no significant differences in bone concentrations between the two rates of administration.

Adult↗
PubMed1982

Comparative efficacy of cefotaxime and cefazolin as prophylaxis against infections following elective hysterectomy.

The safety and efficacy of cefotaxime and cefazolin as prophylaxis against posthysterectomy infections were compared in a prospective, randomized study. A total of 118 women undergoing elective vaginal or abdominal hysterectomy were randomly assigned to receive either (1) cefotaxime perioperatively, (2) cefotaxime perioperatively and 24 hours postoperatively, or (3) cefazolin perioperatively and 24 hours postoperatively. In all regimens, the initial antibiotic dose was given intramuscularly and subsequent doses were given intravenously. No postoperative pelvic or wound infections developed in patients in any of the three study groups during the hospital stay or in the 30-day follow-up period. No side effects or changes in laboratory test values attributable to the antibiotics were noted. The results of the study indicate that (1) standard one-day regimens of cefotaxime and cefazolin are equally safe and effective as prophylaxis against posthysterectomy infections, and (2) a brief, three-dose perioperative course of cefotaxime is as effective as a standard one-day regimen of either cefotaxime or cefazolin and has the advantages of reduced cost and greater convenience.

Adult↗
PubMed1982

Cefotaxime, cefazolin, or ampicillin prophylaxis of febrile morbidity in emergency cesarean sections.

Cefotaxime, a new third-generation cephalosporin, was compared with ampicillin and cefazolin in a randomized double-blind trial to evaluate the efficacy of antibiotic prophylaxis of febrile morbidity associated with emergency cesarean sections. A 1-gm intravenous dose of one of the three antibiotics was given by bolus injection immediately after clamping of the umbilical cord and six and 12 hours later. All patients were in labor with membranes ruptured and had a temperature less than or equal to 37.8 C, and none had a history of penicillin or cephalosporin allergy. A total of 195 women were entered into the trial. Initially, the study included a placebo control group which was switched to ampicillin after 30 patients. Of the 188 evaluable patients, 51 of 59 (86.5%) ampicillin recipients, 59 of 67 (88.1%) cefazolin recipients, 48 of 55 (87.3%) cefotaxime recipients, and two of seven (28.5%) placebo recipients had uneventful postoperative courses. During the study, an additional 39 women who were in labor with ruptured membranes but who were allergic to penicillin or who declined antibiotic prophylaxis were classified as untreated patients and observed for postoperative complications. Standard febrile morbidity, primarily related to endometritis or wound infections, occurred in 6 of 59 (10.1%) ampicillin, 5 of 67 (7.5%) cefazolin, 5 of 55 (9.1%) cefotaxime, and 18 (40.0%) of placebo or untreated patients. Cefotaxime, cefazolin, and ampicillin were equally effective in reducing febrile morbidity in emergency cesarean sections.

Adolescent↗
PubMed1983

[Prevention of post-operative infections in urologic surgery. Comparative study of cotrimoxazole and cefazolin].

The main point of this study resides in comparing the efficiency and the disadvantages of using cefazoline and cotrimoxazole in the prevention of post-surgery infections of the low urinary tract. 91 patients who were about to undergo urologic surgery were divided in three groups for randomisation. 31 patients received 500 mg of intramuscular cefazoline every eight hours, the day before surgery, the day of surgery and five days following surgery. 30 others received 800 mg of intramuscular sulfametoxazole and 160 mg of trimetoprime every 12 hours during the same lapse of time. The third group of 30 patients did not receive any antibiotics. Age, sex, clinical pathology needing surgery and indwelling catheter were the same in the three groups. The group treated by cefazoline, presented 5 post surgery infections among which 3 transitory fevers and 2 isolated bacteriurias. In the group treated by cotrimoxazole, there were 7 post surgery infections among which 3 fevers and 4 isolated bacteriurias. Tolerance in both cases was similar. In the control group, there were 19 post-surgery infections with 2 cases of sepsis, 14 transitory fevers and 3 isolated bacteriurias. These results show the importance of antibiotic prophylaxy in urologic surgery of the low genital tract whether the patient has a urethral catheter or not and whatever the type of urologic surgery. But, there is no significant difference between cefazoline and cotrimoxazole.

Aged↗