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PubMed1986

A comparison of piperacillin, cephalothin and cefoxitin in the prevention of postoperative infections in patients undergoing vaginal hysterectomy.

A randomized, double-blind, multicenter trial was initiated to compare the safety and efficacy of piperacillin, cephalothin and cefoxitin in the prophylactic treatment of patients undergoing vaginal hysterectomy. The total dose of each antibiotic was 6 grams given in three equally divided doses. A satisfactory prophylactic response was obtained in 143 of 151 (95 per cent) patients treated with piperacillin, in 82 of 87 (94 per cent) patients treated with cephalothin and in 57 of 60 (95 per cent) patients treated with cefoxitin. The pooled data indicated that the piperacillin treatment group did not differ from the combined cephalosporin treatment groups with respect to prophylactic response, presence of febrile morbidity, fever index, duration of postoperative hospitalization and incidence of reported adverse experiences.

Adult↗
PubMed1987

The effect of cephalothin prophylaxis on postoperative ventriculoperitoneal shunt infections.

Postoperative infection is an important complication after insertion of a ventriculoperitoneal (VP) shunt in children with hydrocephalus. A randomized double-blind placebo-controlled study was performed to determine the efficacy of cephalothin in preventing postoperative shunt infection. Sixty-three children who presented for elective VP shunt insertion between January 1982 and December 1985 and who did not have a history of shunt infections were randomly assigned to receive four doses of prophylactic cephalothin, 25 mg/kg (32 patients), or of a multivitamin placebo (31 patients). Postoperative infection developed in 6% of the treatment group, compared with 10% of the placebo group, a difference that was not statistically significant, although a clinical significance may have been masked by the small sample size. A large multicentre trial is needed to determine the efficacy of antibiotic prophylaxis in reducing the incidence of postoperative VP shunt infections.

Bacterial Infections↗
PubMed1986

Comparative study of cefamandole versus cephalothin as antibiotic prophylaxis for open heart surgery.

Cefamandole nafate and cephalothin sodium were administered as prophylaxis in a randomized, prospective study to 80 consecutive patients undergoing open heart surgery. The two groups matched well in age, sex, and type of operation. Postoperative infection developed in 2 of 40 patients (5%) in the cefamandole-treated group and in 11 of 40 patients (27.5%) in the cephalothin-treated group (p less than 0.01). The two patients in the former group had respiratory tract infections. There were no instance of endocarditis, mediastinitis or bacteraemia in any of the two groups. Both antibiotics were well tolerated with no adverse reactions. Cefamandole appears to be an effective and preferable prophylactic antibiotic for use during cardiac surgery.

Adolescent↗
PubMed1979

Resistance types in Escherichia coli. I. Occurrence and resistance to ampicillin, carbenicillin and cephalothin.

An investigation of the resistance types in lactose fermenting E. coli is presented. The frequency and sensitivity to beta-lactam antibiotics of different resistance types was investigated. The strains were divided into three groups according to sensitivity to penicillin derivatives. Group 1 contained the ampicillin-carbenicillin sensitive (A-s/Ca-s), group 2 the ampicillin resistant-carbenicillin sensitive (A-r/Ca-s) and group 3 the ampicillin-carbenicillin resistant (A-r/Ca-r). A-s/Ca-r were not observed. One third of the A-r strains were sensitive to carbenicillin. The distribution of resistance types was different in the three groups. Group 1 was dominated by the usual sensitive E. coli. Group 3 contained a very high proportion of multiresistant types. The IC50 against ampicillin, carbenicillin and cephalothin of 55 strains was determined. Group 3 (A-r/Ca-r, 25 strains) was much more ampicillin resistant than group 2 (A-r/Ca-s, 16 strains). Group 2 was less sensitive to carbenicillin than group 1 (A-s/Ca-s, 14 strains). Group 3 did not differ significantly from group 1 with respect to cephalothin sensitivity, while group 2 was much more resistant than the others.

Ampicillin↗
PubMed1979

A comparison of the in vitro activity of a new cephalosporin, cefuroxime, and cephalothin against 810 clinical isolates.

810 strains of eight species: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus faecalis, Escherichia coli, Klebsiella sp, Enterobacter sp, Proteus mirabilis and Proteus vulgaris, were tested by the disc diffusion method against cephalothin and cefuroxime. The activity of the two drugs was comparable to S aureus and S epidermidis, and a little in favour of cefuroxime regarding S faecalis. Cefuroxime turned out to be superior to cephalothin against the gram negative rods investigated. This pattern was most pronounced when Enterobacter was investigated.

Bacteria↗
PubMed1979

Comparison of cefazedone with cefazolin and cephalothin in treatment of experimental infections in mice.

The chemotherapeutic efficacy of (6R,7R)-7-(2-[3,5-dichloro-4-oxo-1(4H)-pyridyl]-acetamido)-3-([(5-methyl-1,3,4-thiadiazol-2-yl)-thio)-8-oxo-5-thia-1-azabicyclo[4,2,0]oct-2-ene-2-carboxylic acid (cefazedone, Refosporen) was assayed in comparison to cefazolin and cephalothin in experimental bacterial murine infections with 6 gram-positive and 8 gram-negative strains of the genera Staphylococcus, Streptococcus, Pneumococcus, Escherichia, Klebsiella, Proteus, Pasteurella and Salmonella. In 5 out of 14 strains (Staphylococci, Streptococci, E. coli, Klebsiella) cefazedone was markedly superior to cefazolin, whereas both compounds were of similar activity against the remaining 9 isolates. As compared to cephalothin, cefazedone exhibited highly superior effectiveness in all organisms tested.

Animals↗
PubMed1976

Residues in antibiotic preparations, ii: effect of pH on the nature and level of particulate matter in sodium cephalothin intravenous solutions.

The effect of pH on the extent and nature of particulate contamination in sodium cephalothin intravenous solutions was studied. The extent of particulate contamination was determined by microscopic and automatic electronic counting procedures, and the physical nature of the particles was determined using scanning electron microscopy. At low pH values (i.e., 4.9--5.9), an amorphous residue was predominant, while at higher pH values (6.9--7.8), the gelatinous nature of the residue disappeared and small crystalline particulates of varying sizes were predominant. The level of particulate contamination (particles over 10 mum in size) decreased with an increase in pH to a minimum level between pH 7 and 8. Advice is given to practitioners regarding the preparation of sodium cephalothin solutions.

Cephalothin↗
PubMed1980

A comparison of the activity in vitro of different cephalosporins: cephalothin, cephradine, cephacetrile, cefaclor, cefuroxime and cefotaxime.

6-cephalosporins (cephalothin, cephradine, cephacetrile, cefaclor, cefuroxime, cefotaxime) has been tested in vitro against 212 gram negative bacteria and 60 Staphylococci. Cefuroxime and especially Cefotaxime showed the highest activity against the gram negative bacteria, with a very low MIC. Cefotaxime also acted fairly well against several strains of Pseudomonas. Of the six cephalosporins tested, cephalothin gave the best results against the Staphylococci.

Cefaclor↗
PubMed1978

Intravitreal cephalothin in experimental staphylococcal endophthalmitis.

Intravitreal cephalothin was used to treat experimentally induced bacterial endophthalmitis in rabbit eyes. A dose of 2 mg and less was apparently nontoxic to all intraocular structures. Thirty-two hours after injection of a 2 mg dose, the level remaining in the vitreous was above the minimal inhibitory concentration for most susceptible organisms. Treatment of experimentally induced staphylococcal infections of the vitreous was successful with early intravitreal injection. When therapy was delayed, vitreous bands and posterior lens cataracts developed. Eyes of control animals receiving intramuscular and subconjunctival injections of cephalothin all progressed to phthisis bulbi.

Animals↗
PubMed1983

Mechanism of cefoxitin and cephalothin interference with the Jaffé method for creatinine.

Some cepha antibiotics interfere positively in the Jaffé method for determining creatinine. The extent of this interference differs with the modification used, and its mechanism is unknown. We studied the spectrophotometric and thermodynamic properties of the reaction of picrate with creatinine and two cepha antibiotics, cefoxitin and cephalothin. The absorbance spectra of the chromophore produced by each of the three compounds when reacted with picrate were essentially identical, with an absorbance maximum at 485 nm. We determined the molar absorptivity, rate constant, and equilibrium constant for the reaction of the three compounds with picrate. The molar absorptivity was similar for creatinine and cefoxitin but about fourfold smaller for cephalothin. The rate constant and equilibrium constant for the reaction with picrate were respectively 20- and 10-fold greater for creatinine than for either of the two cepha antibiotics. Thus, these differences indicate the mechanism by which these two cepha antibiotics interfere with the Jaffé procedure for creatinine, and explain why the degree of interference depends on details of the procedure.

Autoanalysis↗
PubMed1983

[Model studies of the antibiotic release of gentamycin, tobramycin and cephalothin polymethylmethacrylate beads in vivo].

Gentamycin-, tobramycin-, and cephalothin-polymethylmethacrylat beads were implanted into a bone cavity of the rabbit tibia. The antibiotic release of the implants was observed by measure of the antibiotic concentration of the secretion respectively of the neighbouring bone tissue in the surroundings of the beads produced by punction. An antibiotic concentration about 1 microgram/ml could be measured with gentamycin and tobramycin for 120 to 150 days and with cephalothin for 30 to 50 days in the surroundings of the beads.

Animals↗
PubMed1982

Cephalothin prophylaxis for midtrimester abortion.

A randomized prospective double-blind study was conducted to determine the efficacy of prophylactic antibiotics as compared with placebo in 198 women undergoing second-trimester intraamniotic injection abortions. Patients received either sodium cephalothin or placebo intravenously before the procedure and for up to 8 additional doses. In 11 patients postabortion endometritis developed; 2 had received the antibiotic and 9 had received a placebo (P less than .05). Prophylactic cephalothin decreased the incidence of endometritis in patients undergoing midtrimester injection abortion. An injection-abortion interval greater than 24 hours appears to identify patients at risk for the development of postabortion endometritis.

Abortion, Induced↗
PubMed1981

[In vitro studies on the activities of cephalothin against selected bacteria (author's transl)].

Cephalothin antimicrobial activities were studied against selected bacteria with special reference to the time of exposure of microbes to the drug assessed in broth medium. The minimal concentration of this drug producing 10(0)-10(1) reduction of colony forming unit (CFU) per ml after given exposure times -an approximation to the theoretical bacteriostatic concentration inhibiting increase or decrease of CFU- was designated as minimally reducing concentration (MRC). The concentration was determined after 6 h, 18 h and 42 h of incubation and designated as 6-h, 18-h and 42-h MRC, respectively. Conventional minimal inhibitory concentration (MIC) with 18 h exposure time was also studied. The minimal concentration of the drug yielding 99.9% reduction of CFU after an exposure to the drug was determined and designated as minimal lethal concentration (MLC). The determinations were made at 6 h, 18 h and 42 h of incubation and designated as 6-h, 18-h and 42-h MLC, respectively. The data indicated that the bacteriostatic concentration for Escherichia coli and Klebsiella sp. with brief exposure time (6-h MRC) was 2-4 times lower than the MIC. If the exposure time was prolonged (18-42 h), the bacteriostatic concentration increased and almost agreed with the MIC. A significant effect of inoculum size was observed on the MRC values for the Gram-negatives when the values were determined with the inoculum concentrations at 10(6)-10(7) CFU/ml and 10(3)-10(4) CFU/ml. In contrast to these Gram-negatives, the 6-h MRC for most strains of Staphylococcus aureus and Enterococcus roughly agreed with the MIC. If the ratio of bacteriostatic to bactericidal concentrations was used as the criterion, the mode of action of cephalothin appeared to be bactericidal for most of the Gram-negatives. This drug was bacteriostatic for a number of the Gram-positive strains, in particular to those of Enterococcus, especially when microbes were exposed to the drug over a brief period of time.

Bacteria↗
PubMed1982

Resistance types in Enterobacter cloacae. Occurrence and resistance to Ampicillin, Carbenicillin, Cephalothin and Mecillinam. Transfer of ampicillin Resistance.

An investigation of the resistance types in Enterobacter cloacae is presented. The frequency of the different resistance types was determined. The strains were divided into three groups according to sensitivity to penicillin derivatives. The ampicillin-carbenicillin-sensitive (A-s/Ca-s) group 1 comprised 20% of the E. cloacae strains received in this laboratory. The ampicillin resistant-carbenicillin-sensitive (A-r/Ca-s) group 2 comprised 38.5% of the strains and the A-r/Ca-r group 3 comprised 41.5% of the strains. Group 3 contained a high proportion of multi-resistant strains. The log 2 IC50 against ampicillin, carbenicillin, cephalothin and mecillinam was determined for 28 strains. The group 3 strains were more ampicillin-resistant than the group 2 ones. Group 1 and 2 did not differ as regards carbenicillin sensitivity. The cephalothin resistance increased from group 1 to group 2 and further on to group 3. Mecillinam sensitivity did not differ between the three groups. The ability to transfer ampicillin resistance was investigated in the 24 A-r strains. The 8 group 2 strains were not able to transfer resistance, while 9 of 16 strains in groups 3 could transfer A-resistance with frequencies ranging from 10-0.2 to 10-5.7. Resistance to sulphonamide, tetracycline and streptomycin was also transferred, often with the same frequency as the ampicillin resistance.

Amdinocillin↗
PubMed1981

Comparison of systemic prophylaxis with metronidazole-fosfomycin and metronidazole-cephalothin in elective colorectal surgery.

A comparative randomized study was designed to evaluate the prophylactic effect of two different combinations of antimicrobials, i.e. metronidazole-fosfomycin (n = 30) and metronidazole-cephalothin (n = 28), in elective colorectal surgery. The study was strictly consecutive and the treatment groups comparable. The total rate of surgical septic complications was low (10%) in both treatment groups. No anaerobic infections could be demonstrated and the clinical course was mild in all patients developing septic complications. No other antimicrobial therapy was given. Peroperative bacteriological sampling yielded aerobes and anaerobes in 51 and 32, respectively, of 58 patients. A high percentage of the isolated aerobes and anaerobes were cephalothin-resistant, whereas most aerobes were sensitive to fosfomycin. Only aerobes were isolated from surgical septic sites. The absence of anaerobic sepsis must be ascribed to the metronidazole prophylaxis; the probable reason for the low rate of surgical aerobic septic complications is that antimicrobials, active against aerobes, were included in the prophylactic regimens. The combination, metronidazole-fosfomycin, seems adequate and safe for continued evaluation.

Anti-Bacterial Agents↗
PubMed1980

Therapeutic implications of doxycycline and cephalothin concentrations in the female genital tract.

The pharmacokinetics of doxycycline and cephalothin in genital tissues and serum were evaluated in 38 patients undergoing hysterectomy. Antibiotic concentrations in the ovary, fallopian tube, myometrium, cervix, and endometrium were measured at varying intervals after antibiotic administration. Cephalothin concentrations in tissues were critically dependent on the time interval between preoperative antibiotic administration and removal of the genital tract tissues, whereas doxycycline concentrations in tissues were consistently reproducible in the time frame evaluated (1/2 to 4 1/2 hours after drug administration). Doxycycline endometrial concentrations were consistently higher than those measured elsewhere in the genital tract (P less than 0.05). These results are of importance in a reassessment of traditional approaches to antibiotic use in gynecologic surgery and in the management of pelvic inflammatory disease (PID).

Adult↗
PubMed1980

Comparison of six methods of preparing piggyback doses of cephalothin sodium.

Labor, equipment, and materials costs for six methods of reconstituting cephalothin sodium piggyback doses (System 1--Pharm-Aid Fluid Dispensing System + manufacturer's bottle; System 2--transfer unit + manufacturer's bottle; System 3--pressure infuser + manufacturer's bottle; System 4--gravity flow + manufacturer's bottle; System 5--transfer needle + partial-fill bottle; and System 6--Pharm-Aide Fluid Dispensing System + partial-fill bottle) were compared. Individual 2-g doses of cephalothin were prepared in batches of 20 doses by a technician. Times for assembling equipment and supplies, reconstituting and transferring the antibiotic, and fitting the container with protective caps were measured five times for each system. Mean total personnel time was lowest for System 2 and highest for System 5. Pull-tab caps (Burron) were fitted more quickly than were caps with the peel-around design (Cutter). System 3 had the lowest material cost followed in order by Systems 4, 1, 2, 5 and 6. Labor costs did not influence the rank order established by material costs. Systems 3 and 4 were preferred because they required the least manipulation and were lowest in total expense.

Cephalothin↗
PubMed1979

Allergic reaction to transfused cephalothin antibody.

Antibodies to cephalothin sodium (Keflin) can be transferred passively via whole blood transfusion. In one case a mild allergic-type reaction was initiated in a patient who was receiving cephalothin therapy. This case is differentiated from a penicillin-caused allergic reaction. All patients that demonstrate allergic-type transfusion reactions should give drug histories. Investigation of passive transfer of antibodies to these drugs might be of benefit in any evaluation made.

Aged↗