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PubMed1992

Cefonicid versus cefuroxime: an in vitro study of 1,000 Enterobacteriaceae.

Cefuroxime and cefonicid, two common representatives of the second-generation cephalosporins, were compared for their spectrum of activity against 1,000 isolates of gram-negative Enterobacteriaceae. Cefuroxime had an overall advantage of 6.3% over cefonicid. Upon investigation, we found that this was mainly due to Escherichia coli: 11.2% of the E. coli strains proved resistant to cefonicid whilst only 0.4% were cefuroxime resistant.

Cefonicid↗
PubMed1994

Comparison of cefonicid and cefazolin prophylaxis in abdominal hysterectomy.

One hundred and sixty-four patients undergoing abdominal hysterectomy for benign diseases were prospectively evaluated. The efficacy and safety of surgical prophylaxis with a single dose of the long-acting cefonicid was compared to the standard three dose regimen of cefazolin. Prophylaxis was successful in 82 of 85 (96.5%) patients receiving cefonicid and in 77 of 79 (97.5%) patients receiving cefazolin. No serious adverse effects were encountered with both drugs. It is concluded that single dose intravenous cefonicid, when given preoperatively, is as safe and effective as the standard multiple dose regimen of cefazolin in patients undergoing elective abdominal hysterectomy.

Adult↗
PubMed1985

Review of the new second-generation cephalosporins: cefonicid, ceforanide, and cefuroxime.

The new second-generation cephalosporins, cefonicid, ceforanide, and cefuroxime, have recently become available. These agents are generally less active against gram-positive cocci than first-generation cephalosporins and, at best, equal to cefoxitin and cefamandole against many gram-negative bacteria. Cefuroxime, however, is the most active cephalosporin for beta-lactamase-producing Haemophilus influenzae. These newer agents have superior pharmacokinetic characteristics over cefoxitin and cefamandole. Smaller doses, longer dosing intervals and, potentially, a reduction in total drug cost may be the real advantage of these agents. Open trials and a limited number of comparative studies have documented the effectiveness of cefonicid, ceforanide, and cefuroxime in the treatment of most mild-to-serious infectious diseases, although failures with cefonicid in the treatment of staphylococcal infections have been reported. Notably, cefuroxime has received approval for the treatment of common pediatric bacterial meningitis infections. Replacement of cefamandole or cefoxitin with one of these "longer-acting" agents may be cost-beneficial; however, clinicians must be on alert for the development of bacterial resistance or decreased efficacy.

Bacteria↗
PubMed1987

Antimicrobial prophylaxis for arthroplasty: a comparative study of cefonicid and cefazolin.

A double-blind, multicenter trial compared cefonicid and cefazolin for prophylaxis against postoperative infection in 117 patients undergoing joint replacement. Cefonicid, which has an extended serum half-life, was administered once daily, while cefazolin was given every eight hours. The drug was administered one half to one hour before surgery and continued for up to 72 hours. Patients were observed throughout their hospitalization period and followed for 30 days after discharge. No evidence of wound or joint infection was observed in any of the patients who met the criteria for evaluation. Adverse reactions consisted mainly of infrequent gastrointestinal symptoms and laboratory abnormalities. Three patients died from causes unrelated to study medication. No differences between the two regimens were found with respect to safety or efficacy in the prevention of postoperative infection after arthroplasty. The effectiveness of once-daily administration should make cefonicid a highly cost-effective alternative to many of the more expensive first- and second-generation cephalosporin antibiotics currently used in hospital practice.

Adult↗
PubMed1981

Cefonicid: a stable beta-lactamase inhibitor.

The stability of cefonicid (SK&F 75073) towards representatives of six major classes of beta-lactamases was determined using a spectrophotometric assay. Cefonicid was stable to hydrolysis by the Type I enzyme from Enterobacter cloacae and by the enzyme from the anaerobe, Bacteroides fragilis. It was 6 to 7 times more stable than cefamandole to the Type IIIA and B enzymes from Escherichia coli, a little less stable than this antibiotic to the Type V enzyme from E. coli, and of equal stability to the Type IV enzyme from Klebsiella aerogenes. Cefonicid was a non-competitive inhibitor (Ki of 0.8 x 10(-6)M) of cephalothin hydrolysis by the Type I enzyme.

Cefamandole↗
PubMed1990

Cefmetazole and cefonicid. Comparative efficacy and safety in preventing postoperative infections after vaginal and abdominal hysterectomy.

A single 1-g dose of cefmetazole was compared with a single 1-g dose of cefonicid for prophylaxis in vaginal and abdominal hysterectomy to determine their efficacy and safety. The antibiotics were administered intramuscularly 15-90 minutes before the incision was made. Cefmetazole and cefonicid had similar activity against most of the aerobic organisms recovered, but cefmetazole was significantly more active against anaerobic gram-negative microorganisms. The patterns of regrowth of vaginal flora were similar in the two treatment groups. Patient demographic characteristics and surgical procedures were similar in both groups. The difference in primary prophylactic failure (e.g., cuff cellulitis) with the two study drugs (1 of 53 [1.9%] with cefmetazole and 2 of 28 [7.1%] with cefonicid) did not reach statistical significance, and the results were similar for the two routes of hysterectomy. Cefmetazole, at a dose of 1 g intramuscularly preoperatively, is a safe and effective agent for prophylaxis during hysterectomy.

Adult↗
PubMed1989

The effects of cefonicid on the pharmacokinetics of a once-a-day theophylline formulation.

The authors have explored the effects of cefonicid on the steady-state pharmacokinetics of a new sustained-release theophylline formulation in 12 adult patients suffering from chronic obstructive lung disease, by comparing the pharmacokinetic data obtained following four days of medication with theophylline alone with those found at the end of seven days of combined treatment with the same theophylline preparation plus cefonicid. Blood theophylline levels were assessed in duplicate by polarized immunofluorescence with a TDx analyser. Theophylline kinetics were totally unaffected by simultaneous cefonicid treatment, showing that the two drugs may be administered together without any need for adjustment of the theophylline dosage.

Adult↗
PubMed1988

A comparison of cefonicid and cefoxitin for preventing infections after vaginal hysterectomy.

One hundred women who underwent vaginal hysterectomy were randomly and prospectively divided into two study groups, one to receive a single, 1-g preoperative dose of cefonicid and the other to receive 2 g of cefoxitin preoperatively and postoperatively for a total of four doses. There were no differences between the two groups in the rates of febrile morbidity, urinary tract infection, serious infection, noninfectious morbidity or duration of hospitalization. Both cefonicid and cefoxitin were equally effective in preventing postoperative infectious morbidity and demonstrated little difference in side effects. The single-dose regimen of cefonicid provides the advantages of decreased cost and prolonged therapeutic tissue levels when compared to cefoxitin. Perioperative antimicrobial prophylaxis with this single-dose cephalosporin provides a cost-effective regimen that is both safe and prophylactically effective.

Adult↗
PubMed1987

Cefonicid concentration in lung tissue after intramuscular administration.

A long-acting cephalosporin, cefonicid, was given as a single 1 g dose to sixteen patients hospitalized for lung carcinoma and undergoing thoracic surgery. Lung and serum specimens were obtained approximately 2, 4, 6 and 12 h after injection. Antibiotic assay was made by means of a microbiological method. Effective concentrations of cefonicid in the serum and lung tissue were achieved during the sampling time (12 h). The data suggest that a single dose of cefonicid may be useful for antibiotic prophylaxis in thoracic surgery.

Cefamandole↗
PubMed1987

Single-dose cefazolin versus cefonicid for antibiotic prophylaxis in cesarean delivery.

The purpose of this prospective investigation was to compare a single intravenous dose of cefazolin to a single dose of cefonicid as prophylaxis for women having unscheduled cesarean delivery. In a double-blind, randomized design, 96 patients were assigned to receive a 1-g dose of cefazolin and 103 patients were designated to receive a 1-g dose of cefonicid. The antibiotics were administered after delivery of the infant. The two groups were comparable with respect to recognized risk factors for postcesarean infection. There were no statistically significant differences between the groups in the incidence of standard febrile morbidity, endomyometritis, urinary tract infection, wound infection, and bacteremia. There were also no significant differences between the groups in the fever index or the duration of hospitalization. We conclude that cefazolin and cefonicid provide a similar degree of prophylaxis against infection in patients having unscheduled cesarean delivery.

Bacterial Infections↗
PubMed1984

Cefonicid as therapy for uncomplicated gonococcal urethritis caused by penicillinase-producing Neisseria gonorrhoeae.

Young men with uncomplicated gonococcal urethritis were treated with 1 gram of cefonicid given intramuscularly plus 1 gram of probenecid by mouth. Of 53 evaluable patients, 33 (62%) had penicillinase-producing Neisseria gonorrhoeae. All but one of these patients were cured. All men who had penicillin-sensitive infections were cured. Cefonicid was highly effective in the treatment of both penicillin-sensitive and penicillin-resistant N gonorrhoeae. Other than moderate pain at the site of injection, there were no adverse side effects. Cefonicid can be added to the group of newer cephalosporins that are effective in the treatment of gonococcal urethritis caused by either penicillin-sensitive or penicillin-resistant strains.

Adolescent↗
PubMed1994

Delayed allergic reaction to cefonicid.

We report a case of delayed cutaneous reaction to intramuscular treatment with cefonicid, a second generation cephalosporin. An isolated late skin test response was observed to cefonicid only and not to other beta-lactams. A patch test with cefonicid 1% was positive after 48 and 96 hours.

Cefonicid↗
PubMed1987

The hematopathology of cefonicid- and cefazedone-induced blood dyscrasias in the dog.

Cephalosporin treatment in man has been associated with blood dyscrasias that include a time- and dose-related anemia, neutropenia, and thrombocytopenia, the hematopathology of which remains poorly characterized. A similar hematologic syndrome can be produced in dogs following daily intravenous injections of 540-840 mg/kg cefazedone or 400-500 mg/kg cefonicid for 1-3 months. Using this animal model, histologic and cytologic changes in blood, bone marrow, spleen, and liver were studied over the course of the cephalosporin-induced cytopenias. Peripheral blood cytologic observations included an absence, generally, of erythroid regenerative changes, increased numbers of macroplatelets, spherocytosis, erythroblastemia, and toxic neutrophil morphology. Interim and postmortem cytologic and histologic observations of bone marrow included hypoplastic and toxic changes, primarily in cytopenic dogs receiving high doses of cefonicid, and regenerative changes in hematopoietic tissue of affected cefazedone-treated animals. The latter included variable erythroid hyperplasia, increased megakaryocytes, and decreased marrow fat and was accompanied by evidence of extra-medullary hematopoiesis and increased hemosiderin and hemophagocytosis in liver and splenic tissue. The incidence and severity of these changes were dose-dependent, corresponded with the cytopenias observed peripherally, and, like the cytopenias, were fully reversible. These observations suggest that the hematologic syndrome associated with cephalosporin treatment in the dog has multiple toxicologic mechanisms, which include peripheral cytotoxic effects and bone marrow damage with depressed or ineffective hematopoiesis.

Animals↗
PubMedDate not supplied

An overview: evaluation of cefonicid in infections of the urinary tract, lower respiratory tract, and skin and soft tissue.

Infections of the urinary and lower respiratory tracts and of skin and soft tissue constitute a large proportion of infections requiring antimicrobial therapy. For many antimicrobial agents, one dose will cure lower urinary tract infection. In contrast, relapse of upper tract infection is common even after two weeks of treatment. In comparing the efficacy of antimicrobial agents in urinary infection, it is critical that patients assigned to different agents be equivalent. The questions about cefonicid in urinary infection that must be addressed concern (1) adverse effects and tolerability, (2) cost, and (3) rationale for the use of a parenteral preparation in uncomplicated urinary infection. In lower respiratory tract infections, therapeutic efficacy is difficult to evaluate primarily because of the difficulty in determining the causative role of the organisms isolated from sputum. The inclusion of information from gram-stained preparations reduces the diagnostic error. As far as cefonicid in treatment of pneumonia is concerned, the high serum protein binding reported and the relatively high minimal inhibitory concentrations for gram-positive cocci must be addressed. In skin and soft-tissue infections, therapeutic efficacy is difficult to evaluate because of the lack of isolates and the self-limited nature of many cutaneous infections.

Bacterial Infections↗
PubMedDate not supplied

A double-blind study comparing cefonicid with cefazolin as prophylaxis in patients undergoing total hip or knee replacement.

In a randomized double-blind design, cefonicid, an investigational cephalosporin, was compared with cefazolin as prophylaxis in 76 patients undergoing total hip or knee replacement. Risk factors were similar in both groups, and no toxicity was seen with either the control drug, cefazolin, or the test drug, cefonicid. In this small group of patients followed for a short period (four months to one year), no wound sepsis or early or delayed prosthetic sepsis was found, and no superiority of one drug over the other could be demonstrated. Because of the already low incidence of prosthetic infection in patients given appropriate prophylaxis, a larger sample size and a more extended follow-up would be necessary to show increased efficacy of a new compound relative to that of an accepted and proven older drug.

Adult↗
PubMed1982

Comparative in vitro bactericidal activity of cefonicid, ceftizoxime, and penicillin against group B streptococci.

The minimal inhibitory and bactericidal concentrations for 108 group B streptococcal strains were determined for two new cephalosporins, cefonicid and ceftizoxime, and compared to those of penicillin G. Penicillin G was the most active inhibitory and bactericidal agent. Ceftizoxime was a significantly more active inhibitory and bactericidal agent than cefonicid (P less than 0.0005, P less than 0.025, respectively.

Cefamandole↗
PubMed1983

Cefonicid concentrations in serum and atrial tissue during open-heart surgery.

Cefonicid was administered intramuscularly 1 h before open-heart surgery to seven patients in doses of 1 g each and to six patients in doses of 2 g each. Cefonicid concentrations were measured in the right atrial biopsy and in serum at onset of surgery, at time of atrial biopsy, 15 min after starting cardiopulmonary bypass, and at completion of cardiopulmonary bypass. Concentrations in the atrial biopsy and in serum at all periods exceeded the minimal inhibitory concentrations for organisms most frequently responsible for postoperative infections.

Aged↗