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Synergistic effect of cephalexin with mecillinam.

In vitro and in vivo synergistic effects of cephalexin and mecillinam against Escherichia coli, Klebsiella pneumoniae, Enterobacter sp., Serratia marcescens and Proteus sp. were demonstrated and their action mechanism were also discussed. The growth curve after the exposure of cephalexin and mecillinam at the concentrations at which these antibiotics had no effects when given alone showed a decreased of the turbidity and the presence of a bactericidal effect. In experimental infection in mice, the combination of both drugs showed a synergistic effect and excellent therapeutic effect. The blood concentration ratio of cephalexin to mecillinam was coincident with the concentration ratio of these antibiotics at which the synergistic effect was observed in vitro. Phase-contrast and scanning electron somewhat elongated bacteria and formation of spindle cells with swelling in the central part. A leakage of the cellular contents from part of the swelled cell wall was observed by transmission electron microscope. Cephalexin showed an affinity for penicillin binding proteins (PBPs)-1a and 3 in Escherichia coli and mecillinam showed an affinity for PBP-2. When these antibiotics were used concurrently, they exerted an additive effect to increase the affinity for PBPs. The lytic activity was increased much more after the combination of two antibiotics than after a single exposure.

Amdinocillin↗

Evaluation of antibacterial activities of cephalosporin antibiotics: cefazolin, cephaloridine, cephalothin, and cephalexin.

The antibacterial activities of 4 cephalosporin antibiotics, cefazolin, cephaloridine, cephalothin and cephalexin, against 330 isolates of bacteria from patients at National Taiwan University Hospital, were determined by an agar plate dilution technique. Cephalosporins possess strong antibacterial activity against gram-positive bacteria except Enterococci. Staphylococcus aureus is the most susceptible among the organisms tested. More than 90% of Staphylococcus aureus strains are suppressed by cefazolin, cephaloridine and cephalothin at the concentrations of 3.13 mug/ml or less, except that 49.1% are suppressed by cephalexin. The relative potency of cephalosporins against Staphylococcus aureus in decreasing order is cephaloridine, cephalothin, cefazolin, and cephalexin. The gram-negative bacilli, Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis are less susceptible to cephalosporins than the gram-positive cocci. Among the cephalosporins, cefazolin is the most active against the gram-negative pathogens tested. The relative potency of antibacterial activity of cephalosporins against E. coli in decreasing order is cefazolin, cephaloridine, cephalexin, and cephalothin. One hour after the intramuscular injection of 500 mg of cefazolin, the maximum concentration of 33.3 mug/ml is reached in the serum. The sufficient high levels are sustained for 8 hours. Very high concentrations of cefazolin are also found in the urine.

Adult↗

Ultrastructural changes of pancreas of white rats after experimental administration of ethanol and cephalexin.

The experiment was carried out on Wistar rat males weighting about 200 g. Animals from experimental group I received 20% ethanol for drinking (ad libitum), animals from experimental group II--cephalexin in the dose of 42 mg/24 h, animals from experimental group III--cephalexin and ethanol in the mentioned doses. After 10 days the animals were decapitated and pancreases were collected for ultrastructural examinations in electron microscope. The performed experiments showed that 10-day administration of ethanol causes mainly the decrease of amount of ribosomes and zymogen granules in pancreatic exocrine cells, whereas cephalexin causes increase of amount of these organelles. Administration of both ethanol and cephalexin causes reversible degenerative changes including distinct decreasing of the number of ribosomes, swelling of many mitochondria and the presence of myelinic structures inside cells.

Animals↗

Production of cephalexin by Gluconobacter oxydans CCRC 10383.

Intact cells of Gluconobacter oxydans CCRC 10383 produced cephalexin from 7-amino-3-deacetoxy cephalosporanic acid (7-ADCA) and D-alpha-phenylglycine methylester HC1 (PGM). Factors affecting the production of cephalexin by G. oxydans CCRC 10383 were studied. The optimum pH and temperature for the synthetic reaction of cephalexin were 6.0 and 42 degrees C, respectively. A higher concentration of PGM than 7-ADCA was required to obtain a good yield of cephalexin.

Acetobacter↗

Disposition kinetics and dosage of cephalexin in cow calves following intramuscular administration.

Cephalexin was administered im to cow calves at a dose rate of 10 mg/kg bw. After im administration, the disposition kinetics of cephalexin followed a 1-compartment open model. The values of elimination half-life, volume of distribution and total body clearance were 2.00 +/- 0.13 h, 0.32 +/- 0.02 l/kg and 1.899 +/- 0.199 ml/kg/min, respectively. 58.8% of cephalexin administered was recovered in the urine within 24 h. A satisfactory intramuscular dosage regimen of cephalexin in cow calves would be 15 mg/kg administered at 9-h intervals.

Absorption↗

Histological changes of white rat kidney after experimental administration of ethanol and cephalexin.

The experiment was carried out on Wistar rat males weighing about 200 g. Animals from the control group received water and standard granulated fodder ad libitum. Animals from control group II received 20% ethanol ad libitum instead of water. Animals from experimental group I received cephalexin in the single dose of 42 mg/24h, Animals from experimental group II received cephalexin in the dose of 42 mg/24h and 20% ethanol ad libitum. After 10 days animals were decapitated. Histological examinations (H+E staining and PAS reaction) were made on 7 micro thick paraffin slices. It was stated that ethanol causes hyperemia of the renal parenchyma and cephalexin stimulates diuresis. However, concomitant administration of ethanol and cephalexin causes functional changes (inhibition of diuresis) and degenerative changes in capillary loops of some renal corpuscles apart from hyperemia.

Animals↗

Histological examinations of chief and parietal cells of the rat gastric glands after experimental administration of cephalexin and ethanol.

The experiment was carried out on Wistar rat males weighting about 200 g. Animals from experimental group I received 20% ethanol for drinking (ad libitum), animals from experimental group II--cephalexin in the dose of 42 mg/24 h, animals from experimental group III--cephalexin and ethanol in mentioned doses. After 10 days animals were decapitated and specimens of the stomach were taken from the greater curvature. It was stated that 10-day administration of 20% ethanol causes hyperemia of the gastric mucous membrane and the decrease of secretory activity of the glands. On the contrary, cephalexin causes the increase of secretory activity of chief and parietal cells. Concomitant administration of ethanol and cephalexin damages the gastric mucous membrane causing its narrowing, flattening of gastric pits and atrophy of secretory cells in the glands.

Alcohol Drinking↗

The influence of experimental administration of ethanol and cephalexin on stomach mucous barrier of rat.

The Wistar rat males weighing approximately 200 g were administered 20% ethanol ad libitum during 10 days, cephalexin in the dose of 42 mg/24 h, and simultaneously ethanol and cephalexin in the above-mentioned doses. After 10 days the animals were decapitated and stomach specimens were taken from the major curvature region for examinations. They were fixed in 10% formalin, dehydrated and immersed in paraffin. For the purpose of estimation changes in activity of gastric gland mucous cells Mc Manus's PAS reaction was performed on 7 micro-thick sections. It was found that ethanol causes functional decrease in the activity of mucous cells. However, cephalexin increases the activity of superficial mucous cells and orifice mucous cells of gastric glands, and inhibits the activity of cervix mucous cells. A simultaneous administration of ethanol and cephalexin causes atrophic changes in gastric glands, and thereby strong reduction of mucous cells activity.

Alcohol Drinking↗

Synthesis and antimicrobial activities of some new tetrahydro-2H-1,3,5-thiadiazine-2-thione derivatives of cephalexin.

In this study, compounds with a 7-[2-(dihydro-5-substituted 6-thioxo-2H-1,3,5-thiadiazine-3[4H]-yl)-2-phenyl]acetamido-3 -methyl-3- cephem-4-carboxylic acid structure were synthesized by reacting cephalexin monohydrate with formaldehyde and dithiocarbamic acid salts prepared from some primary amines. The structure of the compounds was confirmed by spectral data and elementary analysis. The antimicrobial activities of the compounds were investigated against some bacteria (Staphylococcus aureus, Streptococcus faecalis, Escherichia coli and Pseudomonas aeruginosa) and some Candida sp. (C. albicans, C. parapsilosis, C. stellatoidea and C. pseudotropicalis) by using tube dilution method. In microbiological studies, cephalexin monohydrate was used as reference standard. Both compounds were synthesized and cephalexin monohydrate was found ineffective against S. faecalis and P. aeruginosa in the concentrations studied. While most of the compounds showed bacteriostatic activity against S. aureus, compounds 1, 3 and 7 showed the same activity against E. coli. On the other hand, compound 3, 5, 6, 7 and 10 showed anticandidal activity, whereas cephalexin monohydrate was not active against any Candida sp. Compound 11 was found effective against C. stellatoidea and C. pseudotropicalis.

Anti-Bacterial Agents↗

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↗

Comparative study of the efficacy of co-trimoxazole and cephalexin in respiratory infections.

An open, randomized trial was carried out in 50 patients with severe respiratory tract infections due to various pathogens to compare the effectiveness and tolerability of co-trimoxazole and cephalexin. Patients were divided into two groups, each of 25, and treated for 15 days with either 1 tablet of co-trimoxazole (160 mg trimethoprim plus 800 mg sulphamethoxazole) every 12 hours or 1 capsule of cephalexin (500 mg) every 6 hours. The results of bacteriological and radiological investigations before and after 10 and 15 days of treatment showed that, although response to cephalexin was somewhat faster, both drugs were equally effective and well-tolerated over the full treatment period and there was good correlation between the laboratory findings as well as clinical improvement in symptoms. Taking the cost-benefit ratio into consideration, it is suggested that co-trimoxazole should be used for first-line therapy in respiratory tract infections and cephalexin only as a reserve drug for infections which do not respond to the routine use of co-trimoxazole.

Adult↗

[Electron microscopic study of the combined action of ampicillin and cephalexin on E. coli].

The data of electron microscopy study of morphological variation of E. coli, strain 423 in the logarithmic phase after exposure to ampicillin (2 gamma/ml) and cephalexin (4 gamma/ml) are presented. Pronounced ultrastructural changes not only in the cell wall but also in the cytoplasm were found. After exposure to ampicillin alone changes of the same type were observed. However, after exposure to the combination of the 2 antibiotics these changes were more pronounced and observed in the predominating part of the cells. Examination of ultrathin slices of the strain treated with cephalexin revealed no ultrastructural changes. The morphological changes in the cells of E. coli, strain 423 after its treatment with ampicillin and cephalexin combination were due mainly to ampicillin effect, while cephalexin increased the level of the changes.

Ampicillin↗

[Oral cephalexin therapy of osteomyelitis (author's transl)].

40 patients with chronic osteomyelitis were treated per os with the bactericidal beta-lactam-antibiotic cephalexin during 3 to 60 weeks. In 16 patients, who were operated simultaneously, bacterial spreading was prevented by a combination of cephalexin and parenteral cephaloridin during operation and in the postoperative period. In these patients no recurrence occurred during the follow up time (2 to 5 years). In 34 patients general and local signs of inflammation diminished under cephalexin therapy and a complaint-free interval of at least 6 months followed. No serious side effects forcing a stop of therapy were observed. According to the gained experiences oral cephalexin in combination with perenteral cephaloridin is indicated for prevention of bacterial spreading during operations in chronic bone infections and in patients with acute febrile recurrence of chronic osteomyelitis refusing a surgical intervention.

Administration, Oral↗

[Comparative study of cephalexin and cephradine distribution in the body of rats].

Distribution regularities of cephalexin and cephradine, 2 semisynthetic cephalospor in antibiotics for oral use were studied on rats. It was found that the cephalosporins had a capacity for satisfactory penetration through the histochematological barriers. The drugs were rather rapidly absorbed from the gastrointestinal tract of the rats into the blood. Their maximum blood levels were determined 1 hour after the administration. The highest cephalosporin concentrations were detected in the kidneys and liver. Still, the level of cephradine in the kidneys was lower and that in the liver was higher than the levels of cephalexin. The lowest concentrations were found in the skeletal muscles. The character of cephradine distribution in the lungs, heart and spleen differed from that of cephalexin; the maximum concentrations of cephradine in these organs were achieved 1 hour after its administration, while those of cephalexin were achieved in 30 minutes. The antibiotics were not detected in the brain tissue. No increase in the concentration gradient with time was observed.

Administration, Oral↗

Controlled study of brodimoprim and cephalexin in the treatment of patients with acute sinusitis in general practice.

Brodimoprim, a new dehydrofolate reductase inhibitor, was compared with cephalexin in the treatment of patients with acute sinusitis. A total of 49 patients were randomly assigned to receive either brodimoprim 200-mg tablets once a day (400 mg on the first day as a loading dose) or cephalexin 500-mg tablets three times a day for 8 to 12 days. Nearly all patients treated were judged clinically cured/improved; in fact, only one failure (in the cephalexin group) was noted. In the 45 assessable patients, the time until disappearance of the symptoms and the duration of treatment did not differ significantly between the two groups. A bacteriologic examination was performed in all patients at baseline as well as at the end of therapy. Bacteriologic eradication was obtained in 88% of the patients treated with brodimoprim and in 76% of those receiving cephalexin. Both compounds were generally well tolerated (one patient in the brodimoprim group complained of skin reactions). These results suggest that once-daily treatment with brodimoprim represents safe and effective therapy for adults with acute bacterial sinusitis.

Acute Disease↗

[Studies on the in vitro bactericidal effects of cephalexin against Staphylococcus aureus (author's transl)].

The effect of cephalexin on the numbers of viable cells was studied. Two strains of Staph. aureus and 6 strains of Escherichia coli at their logarithmic phase were exposed to various concentrations (1 approximately 4 MICs) of cephalexin for 1 approximately 24 hours in vitro. The numbers of viable cells were determined by the colony-counting method during and after the exposure of cephalexin. The following results were obtained: 1. When exposure time was short (3 hours or less), the numbers of viable cells were not decreased even at the high concentration (4 MICs). And more exposure time (4 hours or more) was needed for decreasing the number of cells. 2. "Concentration" was not strong influencing factor for decreasing the numbers of cells as compared with "Exposure time". 3. From the point of decreasing the numbers of cells for 12 hours, 4-hour exposure to 1 MIC was more effective than 2-hour twice exposure at 4-hour nonexposure interval to 4 MICs of cephalexin.

Cephalexin↗

[Studies of sustained release cephalexin (S-6437) in pediatrics (author's transl)].

S-6437 is granule of sustained-release cephalexin which is prepared as longer acting cephalexin. Each gram of the granule contains 200 mg of cephalexin. Absorption and excretion study of this preparation was performed in 8 patients (3 school children, 3 infants and 2 babies). Mean blood levels of cephalexin following a single oral administration of 25 mg/kg in the school children, for instance, were 1.73, 2.47, 3.11, 2.28, 3.84 and 2.86 mcg/ml at 0.5, 1.0, 2.0, 4.0, 6.0 and 8.0 hours, respectively. Fifty-two patients with acute respiratory tract infections were treated with this preparation and out of the 52, 33 were evaluable cases. The daily dose used was 50 mg/kg divided in two doses. Of the 33 patients 29 responded to this preparation showing 87.8% of effectiveness. Four patients who did not respond were 1 with acute pharyngitis, 2 with acute tonsillitis, and 1 with acute bronchitis. No severe side effects due to this preparation were observed.

Administration, Oral↗

Cephalexin: human studies of absorption and excretion of a new cephalosporin antibiotic.

1. Serum levels, half-lives and urine concentrations of cephalexin, an oral cephalosporin antibiotic which is unique in its absorption and excretion, are reported in human volunteers, fasting, non-fasting and non-fasting plus probenecid. Accumulation does not seem to occur.2. Cephalexin clearance was 376 ml./min and the ratio of cephalexin/creatinine clearances was 2.6 in one volunteer.3. Cephalexin had no effect on the urinary excretion of leucocytes, red cells or protein.4. The very high rate of absorption giving high serum levels and urine concentrations suggest cephalexin will be a useful antibiotic in susceptible bacterial infections in man.

Adult↗