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High-Performance Liquid Chromatography
Published in Adorjan Aszalos, Modern Analysis of Antibiotics, 2020
Joel J. Kirschbaum, Adorjan Aszalos
Cefmetazole was assayed in serum using an octadecylsilane column with a mobile phase of 10–15% acetonitrile in 0.005 M citrate buffer, pH 5.4, flowing at 1 ml/min into a 254 nm detector. Responses were linear between 0.4 and 100 µg/ml, the minimum limit of detection was 0.4 µg/ml, and recoveries averaged 100% [231].
Cefoxitin, Cefotetan, and Other Cephamycins
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
A recent anaerobic survey from Taiwan showed cefmetazole susceptibility approximating Taiwanese cefoxitin susceptibilities from 2000. The exception to this pertained to Fusobacterium nucleatum and the Peptostreptococcus spp. (micros and non-micros groups), for which cefmetazole MIC90 distributions were routinely more susceptible at 1, 0.5, and 8 μg/ml, respectively (Wang et al., 2014). Greater than 90% of Fusobacterium spp., Peptostreptococcus spp. and Prevotella spp. were susceptible to cefmetazole and flomoxef in this Taiwanese series, decreasing to less than 60% for the Bacteroides group (Wang et al., 2014).
Acute Cholangitis
Published in Stephen M. Cohn, Matthew O. Dolich, Kenji Inaba, Acute Care Surgery and Trauma, 2016
Adrian W. Ong, Shannon M. Foster
There is no high level evidence recommending a fixed duration of antibiotic treatment as opposed to a duration tailored to response to therapy. Kogure et al. [22] studied 18 patients prospectively where cefmetazole and meropenem were used as initial antibiotic therapy for patients with moderate and severe acute cholangitis, respectively. Patients underwent endoscopic biliary drainage within 24 h of diagnosis. When patients had a body temperature of 37°C maintained for 24 h, the antibiotics were stopped. The primary endpoint was the recurrence of acute cholangitis within 3 days after the withdrawal of antibiotic therapy. The median durations of antibiotic therapy were 3 days in patients with moderate cholangitis and 3.5 days for severe cholangitis. No patient developed recurrent cholangitis. There was no difference in the antibiotic duration between the bacteremic and nonbacteremic patients. Antibiotics were discontinued after 4 days in 14 of the 18 patients. Similarly, Van Lent et al. [23] studied 80 patients who received varying durations of different antibiotic regimens before or after ERCP. Forty-one patients received antibiotic therapy for 3 days or less, 19 for 4–5 days, and 20 patients longer than 5 days. The median period of follow-up was 6 months. The proportion of patients with recurrent cholangitis (24%) was not statistically different for the three groups. Death occurred in 6 of 41 (15%) patients with ≤3 days of antibiotics versus 1 of 20 (5%) with >5 days of antibiotics but this was not statistically significant. The authors concluded that short-term antibiotics (≤3 days) was adequate provided that endoscopic drainage was successful and that clinical improvement was seen.
Management of infections caused by extended-spectrum β–lactamase-producing Enterobacteriaceae: current evidence and future prospects
Published in Expert Review of Anti-infective Therapy, 2018
Chau-Chyun Sheu, Shang-Yi Lin, Ya-Ting Chang, Chun-Yuan Lee, Yen-Hsu Chen, Po-Ren Hsueh
Although rarely used in many countries, cephamycins, such as cefmetazole and flomoxef, are known to be stable against the hydrolytic activity of ESBLs [14,133]. A comparison of cefmetazole (CMZ) to meropenem for the treatment of UTI caused by ESBL-producing Enterobacteriaceae showed no differences in clinical or microbiological cure rates or adverse events [134]. However, bacteremic patients were not included in the CMZ group in this study. A study from Japan compared CMZ to carbapenems for the treatment of bacteremia related to ESBL-producing Enterobacteriaceae, with CTX-M-9 being the predominant strain (59%). The survival rates in both groups were not significantly different (96 vs. 84%, respectively, P = 0.24) [135].
Clinical Characteristics of 17 Patients with Moraxella Keratitis
Published in Seminars in Ophthalmology, 2018
Yui Tobimatsu, Noriko Inada, Jun Shoji, Satoru Yamagami
Moraxella keratitis treatments comprised the administration of antimicrobial agents in addition to the abrasion of corneal ulcers. Medical treatment details for the 17 patients are shown in Table 4. The combination of medicaments most commonly administered for the treatment of Moraxella keratitis was ceftazidime intravenous feeding, levofloxacin or aminoglycoside ophthalmic solution, and ofloxacin ophthalmic ointment. In addition, cefmetazole intravenous feeding, cefmenoxime ophthalmic solution, or tetracycline ophthalmic ointment were administered in some patients.