China
Africa
Explore chapters and articles related to this topic
Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Cephalosporins should be used with caution during pregnancy. Cefoxitin is a second-generation cephalosporin that does not contain the MTT side chain and, at least theoretically, is a better choice when a broad-spectrum cephalosporin is indicated during pregnancy.
Preterm Prelabor Rupture Of Membranes
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Anna Locatelli, Sara Consonni, Annalisa Inversetti
Cephalosporins have few side effects and a broad-spectrum antibacterial effect [62]. A randomized trial comparing cefazolin plus macrolide (erythromycin or clarithromycin) versus cefazolin alone in PPROM showed no difference among the three antibiotic regimens in terms of newborn outcome [49]. In a large trial, amoxicillin/clavulanate was associated with an increased risk of neonatal NEC, although there is no consistent trend toward a positive or negative effect of broad-spectrum antibiotics for NEC in the literature [45, 47]. According to a Cochrane review, co-amoxiclav should be avoided in women at risk of PTB due to an increased risk of neonatal NEC (RR 4.72, 95% CI 1.57–14.23). Possible antibiotic regimens are listed in Table 20.5. Our preference is ampicillin 2 g IV, then 1 g every 6 hours and azithromycin 1000 mg PO single dose, or 500 mg PO single dose every 24 hours for 3 days, followed by amoxicillin 500 mg PO every 8 hours for 4 days.
Fungi and Water
Published in Chuong Pham-Huy, Bruno Pham Huy, Food and Lifestyle in Health and Disease, 2022
Chuong Pham-Huy, Bruno Pham Huy
Cephalosporin compounds were first isolated from the mold Cephalosporium acremonium (nowadays this fungus is known as Acremonium chysogenum) from a sewage outfall in Sardinia in 1948 by Italian scientist Giuseppe Brotzu (142, 144). Cephalosporins have bactericidal properties, and their structure contains a β-lactam ring, as do penicillins (144). Cephalosporins are β-lactam antibiotics. Cephalosporins can be administrated by oral, intramuscular, or intravenous mode. The cephalosporin antibiotics interfere with cell-wall synthesis of bacteria, leading to the breakdown of infectious bacteria (144). Cephalosporins are classified into five generations according to their microbial spectrum (142, 144). Each generation contains about some cephalosporin compounds and has preferential antimicrobial activity against Gram + or Gram – bacteria. Some cephalosporins can be active against both kinds of Gram bacteria (144).
Quantitative insights into effects of intrapartum antibiotics and birth mode on infant gut microbiota in relation to well-being during the first year of life
Published in Gut Microbes, 2022
Roosa Jokela, Katri Korpela, Ching Jian, Evgenia Dikareva, Anne Nikkonen, Terhi Saisto, Kirsi Skogberg, Willem M. de Vos, Kaija-Leena Kolho, Anne Salonen
At 6 weeks, both CS birth (P = .006) and cephalosporin exposure (P = .01) were independently associated with increased defecation rate. The gut microbiota composition was associated with the defecation rate, explaining 51% of the variation. The effects of CS birth and cephalosporin appeared to be mediated by the decreased abundances of Bifidobacterium and Finegoldia (Figure 5B). Cephalosporin exposure was significantly associated with the parent's perceived stomach pain (P = .005). The association between cephalosporin exposure and stomach pain was mediated by the reduced abundance of Collinsella and the increased abundances of Escherichia and Streptococcus in the CS-born and cep-exposed infants (including VD-cep) (Figure 5B). Gut microbiota composition explained 30% of the variation in stomach pain intensity.
Cefazolin-induced hypoprothrombinemia
Published in Baylor University Medical Center Proceedings, 2022
Mallory Smith, James Doyle, Cameron Crane, Charles Bussell
A rare side effect of some cephalosporins, especially those in the earlier generations, is coagulopathy. Originally, this was attributed to destruction of colonic microbiota, which produce the vitamin K necessary for coagulation, but it is now attributed to inhibition of vitamin K–dependent gamma-carboxylation of glutamic acid by a heterocyclic group, 1-methyltetrazole-5-thiol or MTT1,2(Figure 1a). Cefazolin lacks the MTT group but possesses a chemically similar group: 2-methyl-1,3,4-thiadiazole-5-thiol or MTD1,3(Figure 1b). Although numerous reports have described cephalosporin-induced coagulopathy, few implicate cefazolin and all occurred in patients with severe renal dysfunction.4–6 Here, we present the case of a patient with normal renal function and no known risk factors for coagulopathy who developed a spontaneous retroperitoneal hematoma while on cefazolin.
Pharmacological and clinical profile of cefiderocol, a siderophore cephalosporin against gram-negative pathogens
Published in Expert Review of Clinical Pharmacology, 2021
Anselm Jorda, Markus Zeitlinger
CREDIBLE-CR (NCT02714595, EudraCT 2015–004703–23) was a phase 3 randomized, open-label, pathogen-focused, descriptive, phase 3 trial examining cefiderocol versus best available therapy (BAT) for the treatment of serious infections caused by carbapenem-resistant gram-negative microorganisms [83]. This study complemented the two site-specific trials (APEKS-cUTI and APEKS-NP) that excluded carbapenem-resistant pathogens. The trial enrolled 150 patients (101 in the cefiderocol and 49 in the BAT group) with cUTI (n = 36), NP (n = 67), BSI (n = 31), or sepsis (n = 16). In addition, evidence of a carbapenem-resistant gram-negative pathogen was required. About half of patients (52%) were admitted to an intensive care unit at enrollment. As with APEKS-NP, 2 g of cefiderocol were infused over 3 hours three times daily for 7 to 14 days. For patients with NP, sepsis, or BSI, one antibiotic could be added to cefiderocol. However, most of the patients (83%) received cefiderocol monotherapy. The BAT had to be pre-specified by the investigator before randomization and consist of up to three antibiotics. In this group, two-thirds of patients (66%) received colistin-based regimens. The rest received combinations of cephalosporins with β-lactamase inhibitors, aminoglycosides, carbapenems, tetracyclines, or co-trimoxazole.