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PubMed1976

[A clinical evaluation of the effect of cephacetrile on bacterial pneumonia. A comparative test with cefazolin by a double blind method (author's transl)].

The therapeutic efficacy of cephacetrile (CEC) in bacterial pneumonia was evaluated in contrast with that of cefazolin (CEZ) by a double blind method. Both drugs were administered via intravenous route at a dose of 1 g twice daily for 14 days. 1) Of 81 patients, each 2 from both groups were eliminated from the study because of unknown results. In CEC group, 36 out of 38 obtained a slightly effective or better results (94.7% of effectiveness). In CEZ group, 31 out of 39 showed a similar result and there was no significant difference between the two groups. 2) In more detail, CEC achieved significantly better results in AaDo2 and cardiac insufficiency than CEZ, and this trend was also seen in dyspnea. 3) Regarding background factors, pretreatment severity was slightly in favor of CEC. However, so long as supplementary analysis is concerned, we could not find any relation between the pretreatment severity of symptom and drug efficacy or improvement of symptom. 4) Since there was a slight bias in the background factors, it is difficult to conclude that CEC is better than CEZ in terms of effectiveness. However, we consider CEC is superior to CEZ if compared in details. 5) Both drugs had the same incidence of side effect (6.25%, 3/48 in both groups). When clinical efficacy of CEC in bacterial pneumonia is evaluated together with the incidence of side effect, we may consider that CEC is an effective antibiotic agent equal to or better than CEZ.

Age Factors↗
PubMed1994

["Single shot" prevention in abdominal surgery. Antibiotics with long half-life (ceftriaxone, ornidazole) vs. antibiotics with short half-life (cefazolin, metronidazole, clindamycin)].

Single-shot antibiotic prophylaxis is well established in abdominal surgery. There is evidence suggesting that it prevents wound infections and some authors report also prevention against postoperative urinary tract infection and pneumonia. From April 1988 to December 1990 we randomly assigned 429 patients with gastro-intestinal operations to a defined protocol: 210 patients (5 drop-outs) with elective operations of the upper GI-tract were given Ceftriaxone (half-life 8 hours, 102 patients) or Cefazolin (half-life 2 hours, 103 patients). 117 (12 drop-outs) patients with operations of the lower GI-tract were given Ceftriaxone/Ornidazole (half-life 13 hours, 50 patients) or Cefazolin/Metronidazole (half-life 8 hours, 55 patients). 102 (20 drop-outs) patients with appendicitis were given Ornidazole (40 patients) or Clindamycin (42 patients). There were no differences in sex, age or type of operation in the different groups. The overall postoperative infection-rate was low. In the upper GI-tract we found one wound infection in both groups, in the lower GI-tract two wound infections in the Ceftriaxone/Ornidazole-group vs. nine in the Cefazolin/Metronidazole-group (p < 0.05). In patients with appendicitis there were three infections in the Ornidazole-group and four in the Clindamycin-group. There was no statistically significant difference in pulmonary or urinary tract infections in all groups. Although the protocol for antibiotics with a short half-life included a second dose of antibiotics in cases of operations with a duration of more than four hours, this was forgotten in 19 of 39 concerned patients (49%!).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Anaphylactic reaction to intravenous cefazolin.

Allergic responses to cefazolin occur in approximately 3% to 5% of patients. The responsibility of the health care professional includes developing an awareness that histamine release in varying degrees can occur with the administration of a variety of drugs utilized throughout the perioperative period. The authors discuss the cardiopulmonary manifestations resulting from the release of histamine during an allergic reaction. Differentiation of diagnosis of the causative agent, the effective treatment of the anaphylactic response during anesthesia, and preventive measures to reduce anesthesia morbidity are examined.

Anaphylaxis↗
PubMed1993

[Enhancement of in vitro antimicrobial activity of cefmetazole and cefazolin in combination against methicillin-resistant Staphylococcus aureus studies by checkerboard MIC method and disc diffusion method using discs containing both drugs].

Antimicrobial activities of cefmetazole (CMZ) and cefazolin (CEZ) in combination were studied against clinical isolates of Staphylococcus aureus (9 methicillin-sensitive and 47 methicillin-resistant strains) using the checkerboard MIC method and the disc diffusion test using Mueller-Hinton agar with or without addition of 4% NaCl. MICs of CMZ and CEZ individually against 9 methicillin-sensitive strains (MSSA) were 0.78-1.56 micrograms/ml and 0.39-0.78 micrograms/ml without 4% NaCl, and 1.56-3.13 micrograms/ml and 0.39-0.78 micrograms/ml with 4% NaCl, respectively. In combination of CMZ and CEZ, the MICs of CMZ and CEZ against these MSSA decreased to 0.012-0.39 micrograms/ml and 0.10-0.20 micrograms/ml without 4% NaCl, and 0.20-0.78 micrograms/ml and 0.20-0.39 micrograms/ml with 4% NaCl, respectively, showing minimum FIC indexes of 0.385 to 1.013. Minimum FIC indexes < or = 0.5 were seen in 7 out of 9 strains. MICs of CMZ and CEZ individually against 47 methicillin-resistant strains (MRSA) were 3.13-100 micrograms/ml and 3.13-400 micrograms/ml without 4% NaCl, and 6.25-50 micrograms/ml and 50-400 micrograms/ml with 4% NaCl, respectively. In combination of CMZ and CEZ, MICs of these drugs against MRSA were reduced to 0.10-50 micrograms/ml and 0.39-200 micrograms/ml without addition of 4% NaCl and 0.39-12.5 micrograms/ml and 3.13-100 micrograms/ml with 4% NaCl, respectively. Minimum FIC indexes observed were 0.047 to 0.625, and those with values < or = 0.5 were observed in 43 out of 47 strains. By the disc diffusion method, between the CMZ disc and CEZ disc, a synergistic interaction against MRSA was well observed. In addition, discs containing both drugs showed a greater inhibitory zone diameter than discs containing the equivalent amount of CMZ or CEZ alone. These in vitro observations reported here suggest that the use of CMZ and CEZ in combination is more effective than the use of these drugs individually for the treatment of MSSA and slight to moderate resistant MRSA infection, as well as for surgical prophylaxis. Therefore, further study was carried out to assess the synergistic enhancement of antimicrobial activity of CMZ and CEZ in combination using discs containing various amounts of these drugs at various ratios. Using discs containing CMZ/CEZ (20 micrograms/10 micrograms), disc inhibitory zone diameters against MSSA and MRSA were well correlated negatively with MICs of CMZ or CEZ in combination. From inhibitory zone diameters obtained with these combination discs, enhanced MICs of CMZ or CEZ in combination can be assessed.

Cefazolin↗
PubMed1993

Clinical trial of cefamandole, cefazolin, and cefuroxime for antibiotic prophylaxis in cardiac operations.

A relatively large number of comparative trials of antibiotic prophylaxis in cardiac surgery have been published, many of which have serious design flaws. Despite the large number of studies, no single antibiotic regimen has emerged as clearly superior in preventing postoperative site infections. To determine if a superior regimen could be identified with a study designed to avoid flaws found in previous studies, we undertook a randomized, double-blind clinical trial of three cephalosporins. From March 1987 to February 1990, 2759 adults underwent median sternotomies: 1641 completed study participation, 203 were enrolled but were dropped from the study for protocol violations, and 815 were excluded. The characteristics of all 2759 patients were recorded with respect to case mix and infection risk factors, and the patients were followed-up by the same nurse throughout hospitalization and for 6 weeks after discharge for the assessment of infection outcome status. Of the 1641 participants, 141 (8.6%) had one or more operative site infections: 46 of 549 (8.4%) cefamandole recipients, 46 of 547 (8.4%) cefazolin recipients, and 49 of 545 (9.0%) cefuroxime recipients (p = 0.92). The sites of infection and the depth of tissue involvement were not significantly different across groups. Because no differences in effectiveness in preventing postoperative site infections were demonstrated in a rigorously designed trial, the costs of the drugs, including the costs of their preparation and delivery, may be the only variables by which to choose among these three antibiotic prophylaxis regimens.

Adult↗
PubMed1997

Cefazolin and netilmycin versus vancomycin and ceftazidime in the treatment of CAPD peritonitis.

In spite of several recommendations, choosing the initial antibiotic to treat continuous ambulatory peritoneal dialysis (CAPD) peritonitis remains difficult. In our prospective randomized study we attempted to evaluate the efficacy and safety of less toxic combinations of cephalosporins with vancomycin or netilmycin. From November 1993 to September 1996 we treated 52 episodes of peritonitis in 34 patients. Peritonitis was diagnosed according to the valid criteria. Patients were treated for 14 - 28 days with a combination of either cefazolin plus netilmycin or vancomycin plus ceftazidime. The most frequent bacteria causing peritonitis in the two groups were comparable. The efficacy of the cefazolin/netilmycin combination was 91.6% (22/24) without yeasts and 84.0% (21/25) in the vancomycin/ceftazidime combination. There were no statistically significant differences between the two otherwise efficient combinations of antibiotics. No side effects were observed. We believe that the frequent use of vancomycin could be avoided thus reducing the risks of resistance and ototoxicity.

Cefazolin↗
PubMed1978

Cefamandole and cefazolin in the therapy of complicated urinary tract infections.

The clinical efficacy and tolerance of cefamandole, a new cephalosporin antibiotic effective against indole-positive strains of Proteus, and cefazolin were studied after intramuscular administration of 500 mg of either of the two cephalosporins every 8 hr for seven days in a prospective, randomized study of 65 elderly male patients with complicated urinary tarct infections. Both antibiotics were effective in eradicating the infections, and there was no significant difference between the two groups in regard to tolerance and cure rate, as defined by a negative urine culture one week and four to six weeks following discontinuation of the treatment. Because of its broader antibacterial spectrum, cefamandole appears to represent an improvement over previously available cephalosporin antibiotics.

Aged↗
PubMed1979

Treatment of experimental Staphylococcus aureus abscesses: comparison of cefazolin, cephalothin, cefoxitin, and cefamandole.

Cefazolin (CZ), cephalothin (CF), cefoxitin (CX), and cefamandole (CM) were evaluated in therapy of Staphylococcus aureus infection produced in perforated table tennis balls placed intraperitoneally in rabbits. Four weeks after placement of two balls in each rabbit, a beta-lactamase producing strain of S. aureus was injected into one of the balls. Twenty-four hours later therapy was initiated with 40 mg of CZ or 80 mg of CF, CX, or CM per kg intramuscularly every 6 h. After 24 h of treatment, the mean log(10) colony-forming units per ml were 7.1 for CZ, 6.7 for CF, 6.5 for CX, and 7.2 for CM. After 72 h the mean log(10) colony-forming units per ml were 5.0 for CZ, 4.1 for CF, 3.6 for CX, and 5.6 for CM. After 8 days, the titers were 1.6/ml for CZ, 1.0 for CF, 1.9 for CX, and 3.6 for CM. CZ serum levels were about double CF and CX levels and about two-thirds of CM levels. In sterile ball fluid CZ and CM levels were more than double CF or CX concentrations. Concentrations of all four antibiotics were lower in infected balls.

Abscess↗
PubMed1974

In vitro studies with cefazolin.

Susceptibilities of 259 isolates of pathogenic bacteria to cefazolin were measured by broth and agar dilution procedures. Beta-hemolytic streptococci were inhibited by 0.25 mug/ml, whereas Staphylococcus aureus and alphahemolytic streptococci were inhibited by 2.0 mug/ml. Enterococci were resistant to less than 32 mug/ml. Wide variation was seen with gram-negative species. Most isolates of Klebsiella species and Proteus mirabilis were inhibited by 4.0 or 8.0 mug/ml. Escherichia coli were less susceptible, and most isolates of Pseudomonas aeruginosa, Serratia species, and Enterobacter species were resistant to 128 mug/ml.

Bacteria↗
PubMed1998

Affinity Chromatography of Urokinase Using Cefazoline as a Ligand.

Sepharose 4B-based affinity adsorbent was prepared using cefazoline as a ligand, and epichlorohydrin as an activator. The density of the ligand in the affinity adsorbents was about 43 &mgr;mol/g wet gel. The optimal adsorption pH for urokinase was 6.0, and the optimal adsorption salt concentration was 1.0 mol/L NaCl. The optimal conditions of elution were 0.1 mol/L glycine buffer, pH 9.0, containing 0.5 mol/L NaCl. A crude urokinase with specific activity 500 u/mg protein was purified on an affinity chromatography column (1 cm x 12 cm), yielding a product of specific activity of 49 300 u/mg with 78% recovery and 98.6-fold purification.

Journal Article↗
PubMed2002

In vitro activity of cefazoline and cefuroxime in presence of essential and trace elements.

Present research focuses to evaluate changes in antimicrobial activity of cefazolin sodium and cefuroxime after interactions with essential and trace elements. The minimum inhibitory concentration (MIC) was observed and subsequently compared with the standard MIC's of the respective drug by agar dilution method against a variety of Gram positive and Gram negative organisms. It was observed that these metal elements are essential for our body, either present within the body or co-administered with vitamins or otherwise, markedly influence the MIC's of antibiotics by producing synergism or antagonism.

Journal Article↗
PubMed1981

[In vitro activity of cefotaxime against enterobacteriaceae. Comparison with cephalothin, cefazolin, cefamandole, cefoxitin and cefuroxime on 117 strains isolated from neutropenic patients (author's transl)].

The considerable activity of cefotaxime on enterobacteriaceae is especially useful in neutropenic patients who are particularly at risk of septicaemia complications. The rapidly fatal development of this type of infections necessitates the use of a presumably efficacious therapy even before the result of blood cultures are obtained. The in vitro activity of cefotaxime in enterobacteriaceae has been compared to that of cephalothin, cefazolin, cefamandole, cefoxitin and cefuroxime.

Cefotaxime↗