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Freeze-drying of cephalothin sodium: granularly agglomerated crystallization during freezing. I.

Optimal conditions for the crystallization and subsequent freeze-drying of an aqueous cephalothin sodium (CET-Na) solution of supersaturated concentrations to obtain granular crystalline CET-Na have been discussed, as have the qualities of the product thus obtained. In general, CET-Na in supersaturated aqueous solution is barely recrystallized, even when in its frozen stage. Our previous report revealed that when the solution is kept at low temperatures for a long duration, the molecules begin to change structurally to as condensed a state as that of liquid crystals, and such change facilitates a spontaneous nucleation and seed-independent crystal growth in the frozen solution. These findings prompted the authors to investigate optimal CET-Na concentrations and thermal histories during the crystallization and subsequent freeze-drying process without seeding. It has subsequently been found out that optimization of the latter conditions gives granular agglomerated crystalline CET-Na contaminated with neither the amorphous nor the quasi-crystalline form. The optimized conditions are: 25-28% CET-Na concentrations; storage before the freezing process at 0 degrees C for 2 h, and subsequent storage at 20-25 degrees C for 1 h; cooling in the freezing process at a rate not faster than 0.5 degrees C/min; warming of the solution for facilitating crystallization prior to vacuum application for drying at -4 degrees C. Under these conditions, the freeze-dried product of CET-Na in granular form has been successfully obtained in a shorter freeze-drying cycle, exhibiting a faster reconstitution time than those of CET-Na prepared according to seeded crystallization followed by a conventional freeze-drying.

Cephalothin↗

Freeze-drying of cephalothin sodium: granularly agglomerated crystallization during freezing. II.

The mechanism of granularly agglomerated crystallization during freezing of cephalothin sodium (CET-Na) in aqueous solution has been discussed. Our previous report noted that strict control of the following is important in order to obtain crystalline granular agglomerates of CET-Na: (1) thermal history of the solution before receiving freezing, (2) cooling rate in freezing, and (3) aging temperature level in the crystal growth step. In order to clarify the physico/chemical meanings of the individual controls, further investigations have been made: 1) with varying thermal history, aqueous 30-% CET-Na solutions were prepared for storage, first at 0 degrees C with its supersaturation and secondly at 25 degrees C, in an unsaturated state for observing any structural changes by viscosimetry, refractometry, and surface tensiometry; 2) morphological changes in ice crystals during freezing at varying cooling rates, as well as those during the crystal growth step, were observed by polarized-light cryomicroscopy and scanning electron microscopy; 3) melting, as well as crystal growth, at several aging temperature levels were observed by electrical conductometry and also by the above-mentioned techniques.(ABSTRACT TRUNCATED AT 250 WORDS)

Cephalothin↗

Selective analysis of mutual displacement effects at the primary binding sites of phenoxymethylpenicillin and cephalothin bindings to human serum albumin.

In order to analyze the mutual displacement effects on the protein binding of beta-lactam antibiotics, binding experiments with the human serum albumin (HSA) were performed for cephalothin (CET) and phenoxymethylpenicillin (PCV) by using the centrifugal ultrafiltration method. The numbers of primary and secondary binding sites, n1 and n2, and the affinity constants for the primary and secondary binding sites, K1 and K2 were determined for CET to be 1.00 +/- 0.06 (mean +/- S.D.) and 4.54 +/- 0.12 and 2.59 x 10(3) +/- 0.10 x 10(3) (M-1) and 2.59 x 10(2) +/- 0.16 x 10(2) (M-1), respectively, and for PCV to be 0.94 +/- 0.10 and 5.41 +/- 0.40 and 3.52 x 10(3) +/- 0.25 x 10(3) (M-1) and 4.07 x 10(2) +/- 0.54 x 10(2) (M-1), respectively. Using the predicted optimum unbound concentration of PCV, i.e., 4.6 x 10(-4) M, the displacement effect of PCV to the binding of CET at the primary site has been demonstrated, while no significant effect was observed at the secondary binding site. Moreover, a competitive displacement effect of CET was also demonstrated for the binding of PCV to HSA at the primary binding site, suggesting that CET and PCV bound to HSA at the same primary binding site.

Binding Sites↗

Distribution of cephalothin to the exudate in comparison with the plasma or lymph concentrations in croton oil-induced inflammatory rats.

The transport of cephalothin (CET) to the exudate was investigated in croton oil-induced inflammatory rats following the intramuscular administration of CET-aqueous solution, CEt-O/W emulsion, or CET-W/O emulsion. The lymphatic transport of CET was the highest following the administration of W/O emulsion. The exudate level of CET was in a decreasing order of W/O emulsion, O/W emulsion, and aqueous solution. In the rat whose blood vessels at femoral rectus, the site of administration, were ligated, the plasma level was decreased by the administration of aqueous solution, but not by W/O emulsion. The exudate level of CET was significantly higher in case of W/O emulsion. Possible mechanisms involved are discussed.

Animals↗

[Non-crystallinity determination by thermal analysis of freeze-dried cephalothin sodium].

Cephalothin sodium (CET-Na) prepared according to the conventional freeze-drying methods is known to easily develop color during storage. Since amorphous CET-Na has been reported to be markedly unstable, the color development is thought to be due to the presence of traces of CET-Na in an amorphous state observed with scanning electron microscopy. Quantitation by use of the powder X-ray diffractometry of such traces of amorphous CET-Na has proved to be of little use. Thermogravimetry (TG) and differential scanning calorimetry (DSC) have demonstrated that the freeze-dried CET-Na by the conventional methods contains three types of CET-Na: amorphous (unstable phase), quasi-crystalline (metastable phase) and crystalline (stable phase). Pyrolysis initiation temperatures of these three types of CET-Na have been demonstrated to become higher in this order. A new parameter for the evaluation of non-crystallinity of CET-Na has been introduced, in which the ratio is calculated from the data of the total weight loss observed through the pyrolysis of both amorphous and quasi-crystalline CET-Na against the total weight loss of all components during the pyrolysis of sample specimen. The ratio thus calculated is defined as "non-crystallinity". This new parameter has successfully been introduced to establish a good correlation to the degree of increasing color intensity with aging of freeze-dried CET-Na.

Calorimetry, Differential Scanning↗

[Crystallization and subsequent freeze-drying of cephalothin sodium by seeding method].

Cephalothin sodium (CET-Na) in crystals can be obtained by freezing the aqueous solution and subsequent warming at a fixed temperature for facilitating crystallization prior to vacuum application for drying. The product has, however, been found to unavoidably contain traces of the amorphous CET-Na, which causes a rapid color development during storage. By using thermal analysis, differential scanning calorimetry (DSC), electric conductometry, and polarized light cryomicrographic techniques, the solubilities in water, freezing point, eutectic point, and melting behavior of CET-Na in aqueous solution were investigated. The investigation demonstrated that CET-Na in supersaturated aqueous solution is very stable, and that seeding with microcrystalline CET-Na to the supersaturated solution and subsequent cooling of the mixture till its freezing point gives neither any evidence for crystallization nor for growth of the seed crystals. The freeze-drying of CET-Na in the supersaturated solution after seeding has been demonstrated to give crystalline CET-Na containing neither of amorphous nor of quasi-crystalline form.

Cephalothin↗

Sex differences in immune responses to cephalothin in guinea pigs.

Guinea pigs of two strains, outbred Hartley and inbred Strain 2, were immunized subcutaneously with cephalothin (CET, 20 mg/body) alone, without adjuvant. Immune responses to the antibiotic were assessed by guinea-pig passive cutaneous anaphylaxis (GP-PCA) and active systemic anaphylaxis (GP-ASA) reactions. The immune response to CET in the female Hartley guinea pigs was higher than that in the males. In contrast, no difference in response to CET in Strain 2 guinea pigs was observed between males and females. These results suggested that female Hartley guinea pigs possessing a higher response should be employed in antigenicity studies involving the beta-lactam antibiotics.

Animals↗

Effect of cephalothin on growth patterns of micro-organisms.

Isolates of Staphylococcus aureus, Escherichia coli. Klebsiella pneumoniae and Proteus mirabilis were incubated in the presence of inhibitory concentrations of cephalothin. After destruction of the antibiotic, there was a lag phase before S. aureus began to proliferate again. When similar experiments were conducted with E. coli, K. pneumoniae, and P. mirabilis, no lag phase was observed. This data suggests that the inhibitory activity of cephalosporins may be different for gram-positive cocci and gram-negative bacilli.

Bacteria↗

Piperacillin (T-1220), a new semisynthetic penicillin: in vitro antimicrobial activity comparison with carbenicillin, ticarcillin, ampicillin, cephalothin, cefamandole and cefoxitin.

Piperacillin (T-1220) is a new semisynthetic penicillin with an unusually broad spectrum of antimicrobial activity. In vitro comparisons of this drug with 6 other beta-lactam antimicrobics (ticarcillin, carbenicillin, ampicillin, cephalothin, cefamandole and cefoxitin) were conducted. These included minimal inhibitory concentrations (MIC) against 394 bacterial isolates, the minimal lethal concentrations (MLC) against 79 of those, as well as the effect of inoculum size on the MIC and MLC of the drugs. Piperacillin had significantly greater activity than did the other penicillins against Pseudomonas species and Klebsiella pneumoniae. Against P. aeruginosa piperacillin was 8- and 16-fold more active than ticarcillin and carbenicillin, respectively. The MLC of piperacillin rarely differed from the MIC by more than one log2 dilutions except against P. aeruginosa in which the MLC was 4-fold greater or more than the MIC of 45% of isolates tested. Ticarcillin, carbenicillin and cefoxitin showed minimal inoculum size effects. Cefamandole results showed the greatest inoculum size variation with 55% and 37% of isolates showing an 8-fold increase in MIC and MLC respectively by increasing inoculum from 10(5) to 10(7) CFU/ml. Piperacillin was intermediately effected having 25% of strains greater than 8-fold increase in MIC.

Ampicillin↗

Nephrotoxicity of combined cephalothin-gentamicin regimen.

Two patients developed acute tubular necrosis, characterized clinically by acute oliguric renal failure, while they were receiving a combination of cephalothin sodium and gentamicin sulfate therapy. Patients who are given this drug regimen should be observed very carefully for early signs of nephrotoxicity. High doses of this antibiotic combination should be avoided especially in elderly patients. Patients with renal insufficiency should not be given this regimen.

Acute Kidney Injury↗

Serum levels and urinary excretion of parent antibiotics and desacetyl forms after parenteral administration of cephalothin and cephapirin.

When the antibacterial substances of cephalothin and cephapirin in the serum and urine after intramuscular injection were separated and assayed, desacetyl metabolities of both drugs were detected. These tendencies were especially apparent in the tissue concentrations. When both the drugs were given intravenously to healthy volunteers, the amounts of their desacetyl metabolites were not greater in man than in rats.

Animals↗

[Identification of a new penicillinase in a Klebsiella pneumoniae strain of which a mutant also produces an esterase hydrolyzing cephalothin and cefotaxime].

Klebsiella pneumoniae strain L 164 produces a penicillinase whose isoelectric point is 8.1, an unusual figure for this bacterial species. This strain exhibits resistance to conventional penicillins and a synergistic effect is seen with clavulanic acid. In contrast, susceptibility to cephalosporins is marked, as shown by the low minimum inhibitory concentrations (MICs). This phenotype is characteristic of strains with no acquired resistance. A first mutant with MICs for cephalothin and cefotaxime 8-fold to 16-fold those of the initial strain was obtained spontaneously. This mutant's MICs for the other beta-lactams were not substantially changed. In addition to the same penicillinase as the one produced by the parent strain, this mutant produced an acetyl-esterase capable of hydrolyzing the cephalosporins with an acetoxyl side-chain, i.e., cefalothin and cefotaxime, to deacetylated derivates which retain substantial antibacterial activity. Another mutant selected on an amoxicillin gradient produced ten times more penicillinase than the parent strain but no esterase. This second mutant exhibited very high MICs for penicillins and first and second generation cephalosporins. The MIC for cefotaxime was comparable to that seen with the esterase-producing mutant. Among the antimicrobials tested, only third generation cephalosporins and cefoxitin showed adequate activity.

Acetylesterase↗

[Antibacterial activity of carumonam and cefpirome on hospital strains resistant to gentamicin and cephalothin: comparison with other beta-lactam antibiotics, new fluoroquinolones, aminoglycosides and other antibiotics].

The antibacterial in vitro activity of carumonam, a new monobactam, and cefpirome, a new cephalosporin, was studied on 483 hospital strains resistant to gentamicin and cephalothin, in comparison with amikacin, azlocillin, aztreonam, cefmenoxim, cefoperazone, cefotaxim, cefsulodin (for Pseudomonas), ceftazidime, ceftriaxone, cefuroxim, chloramphenicol, ciprofloxacin, doxycycline, enoxacin, netilmicin, norfloxacin, pefloxacin, piperacillin, rifampicin, tobramycin and trimethoprim. In general the two compounds have a very good in vito activity on Enterobacteriaceae but are less active on non-fermenting microorganisms. For the Enterobacteriaceae the minimal inhibitory concentrations 90% for carumonam was less than or equal to 1.1 mg/l excepted for Enterobacter spp. (43,6 mg/l) and M. morganii (56.8 mg/l) . All the Enterobacteriaceae are susceptible to cefpirome (minimal inhibitory concentrations 90% less than or equal to 5.3 mg/l). The activity of carumonam and cefpirome on Enterobacteriaceae is comparable with that of the third generation cephalosporins. Carumonam is more active than cefpirome and other beta-lactams, ceftazidime excepted, on Pseudomonas aeruginosa and Pseudomonas spp. On the other hand, both compounds reveal to have only a low activity on the other non-fermenters which minimal inhibitory concentrations 90% values of 115.4 mg/l for carumonam and 32.0 mg/l for cefpirome.

Aminoglycosides↗

[In vitro antibacterial activity of tobramycin used in combination with cephalothin or carbenicillin (author's transl)].

Combinations of tobramycin (TOB) with cephalothin (CET) or carbenicillin (CBPC) were evaluated by in vitro test against 161 clinical isolates of Klebsiella pneumoniae, Escherichia coli, indole-positive Proteus, Enterobacter and Serratia marcescens which were not inhibited by 6.25 microgram/ml of CET. The combinations were considered to show synergy when there was a 4-fold or greater reduction in MIC values (FIC index less than or equal to 0.5) of both antibiotics when combined. Synergy of TOB with CET could be demonstrated against 83% of Klebsiella pneumoniae, 78% of E. coli, 44% of Proteus rettgeri and 39% of Proteus inconstans. Synergy of TOB with CBPC could be demonstrated against 78% of Proteus vulgalis, 45% of Serratia marcescens and 28% of Proteus inconstans. Bactericidal effect showing synergy of TOB with CET could be demonstrated against each 2 strains of Klebsiella pneumoniae and E. coli. Frequency of synergy of TOB with CET under the condition of large inoculum size was significantly higher than that of synergy of TOB with CET under the condition of small inoculum size. Synergy of bactericidal effect of TOB combined with CET against Klebsiella pneumoniae and E. coli was more active when they were combined at the same time, than those of when TOB was combined after 2 hours exposure by CET or when CET was combined after 2 hours exposure by TOB. No antagonistic action was observed in these studies.

Anti-Bacterial Agents↗

[Clinical laboratory approach for estimating effective administrative dose of cephalothin. Reevaluation of MIC break points in 4 category system of disc susceptibility test].

The reliability of the cephalothin (CET) disc susceptibility test in estimating approximate values of MICs was studied using various clinical isolates totaling 248 strains and using Showa discs (8 mm diameter containing 30 micrograms of CET) and Difco discs (6 mm diameter containing 30 micrograms of CET). Clinical significance of a 4 category system for the interpretation of the CET disc tests, which is widely used in Japan, was reevaluated to determine whether this system would be suitable or not for the evaluation of proper dose levels of administration. The results obtained with the disc methods were compared with MICs determined using the agar dilution method at an inoculum level of 10(6) CFU/ml. The results of the CET disc susceptibility test were well correlated with MICs, showing the reliability of the disc method to estimate approximate values of MICs. Break points in MIC values proposed for the classification of bacteria into 4 categories of susceptibility are ( ) MIC less than or equal to 3 micrograms/ml, (++) MIC greater than 3-15 micrograms/ml, (+) MIC greater than 15-60 micrograms/ml, (-) MIC greater than 60 micrograms/ml. With the Showa disc susceptibility test, 15 out of the 248 strains (6.0%) tested showed false positive results and 6 strains (2.4%) showed false negative results. With the Difco disc test, 18 out of the 248 strains (7.3%) tested showed false positive results and 6 (2.4%) showed false negative results. Excluding Enterococcus faecalis from the test, results because better in the quantitative estimation of MICs, resulting false positive rates of 3.2% (Showa), and 4.4% (Difco). A 3 category system of the interpretation of disc test is generally used in the USA and Europe. MIC break points proposed for the classification of the CET test are sensitive, MIC less than or equal to 8 micrograms/ml, and resistance, MIC greater than or equal to 32 micrograms/ml. With the Showa disc susceptibility test, 14 out of the 248 strains (5.6%) tested showed false positive results and 6 strains (2.4%) showed false negative results. With the Difco disc test 7 out of the 248 strains (2.8%) showed false positive results and 21 strains (8.5%) showed false negative results. In this study, MIC70S of CET against Staphylococcus aureus and Staphylococcus epidermidis were 1.56 and 0.78 micrograms/ml, respectively. CET was not so effective against Gram-negative rods except Klebsiella pneumoniae, Proteus mirabilis and Escherichia coli. MIC70S against K. pneumoniae, P. mirabilis, and E. coli were 6.25, 3.13, and 3.13 micrograms/ml, respectively.

Cephalothin↗

A multicentre study of the susceptibility of a variety of bacteria to cephalothin, cefamandole, tobramycin and gentamicin.

A multicentre study of antibiotic susceptibility was performed in South Africa. Sensitivity to cephalothin, cefamandole, tobramycin and gentamicin was tested on a variety of aerobic and anaerobic bacteria. Two disc susceptibility techniques were used, i.e. the Kirby-Bauer technique (aerobes) and the broth-disc method (anaerobes); minimum inhibitory concentrations (MICs) were determined according to the International Collaborative Study techniques, and regression lines for individual centres were constructed. Satisfactory lines were obtained for cephalosporins, but, in some centres, problems were experienced with the aminoglycosides. Variations in MICs for Haemophilus influenzae were probably due to an inoculum effect. Accumulative percentage tables of the number of strains inhibited were compiled, and the comparative performance of the antibiotics was assessed.

Anti-Bacterial Agents↗

[Clinical study of postoperative infection of gastrointestinal cancer. Randomized study of preventive efficacy of cefmetazole versus cephalothin in postoperative infection of gastric and colorectal cancer].

Effectiveness of prophylactic administration of cefmetazole (CMZ) (A) for postoperative infection was compared with that of cephalothin (B) using patients undergoing resection of gastric cancers or colorectal cancers as subjects in cooperation with 19 major hospitals in the Tohoku districts. Using the envelope method, each hospital allocated, at random, patients with each organ removed into groups A and B. Either drug was administrated at 4 g/day (in 2 divided doses) for 7 days. Registered patients with gastric cancers amounted to 114 in group A and 113 in group B; those with colorectal cancers were 63 each in groups A and B. As to background factors, advanced cancers were found more in group A with gastric cancers, and operations took more time on the average in this group; however, there were no significant differences in other factors between the 2 groups with gastric cancers and in the all factors between A and B groups with colorectal cancers. Rates of ineffective prophylaxis judged by physicians in charge were 3.9% and 21.0%, respectively, in groups A and B with gastric cancers, and 5.0% and 20.7%, respectively, in groups A and B with colorectal cancers. Rates of ineffective prophylaxis determined by committees were 16.7% and 31.0% among the former, and 8.3% and 29.3% among the latter, respectively. Ineffectiveness rates in group A with gastric cancers or colorectal cancers were significantly lower in all the evaluations, and CMZ was, therefore, comfirmed to have stronger efficacy.

Bacterial Infections↗

[Data averaging in pharmacokinetic analysis: the population pharmacokinetics of cephalothin and cefazolin].

Cephalothin and cefazolin pharmacokinetics was studied in cats after intravenous administration in doses of 20 and 75 mg/kg. The antibiotic serum concentrations were determined microbiologically. It was shown that the antibiotic pharmacokinetics within the above dose ranges was linear. The data on the antibiotic pharmacokinetics were described by bioexponential equations. Various methods for estimating population pharmacokinetic parameters were compared. Two approaches were used in estimating the population parameters: (1) averaging of individual concentrations followed by determining a single set of the parameters (naive pooled data approach) and (2) calculating of the parameters for an individual concentration/time set followed by the parameter averaging (two-stage approach). With the use of every approach the geometric mean of the parameters was calculated along with the arithmetic one. When the two-stage approach was used the population parameters were estimated with two procedures: averaging of the hybrid parameters (macroconstants) and averaging of the microconstants. Estimation of the population parameters as a geometric mean of the individual parameters, proved to be the most preferable approach.

Animals↗