Renal disease
David M. Luesley, Mark D. Kilby in Obstetrics & Gynaecology, 2016
All bacteriuria in pregnancy requires treatment to prevent pyelonephritis and preterm delivery (Cochrane guideline A) (Box 13.1). Treatment for 3 days is sufficient for asymptomatic bacteriuria [E].2 Regular urine cultures should be taken following treatment to ensure eradication of the organism. About 15 percent of women will have recurrent bacteriuria during the pregnancy and will require a second course of antibiotics. The choice of antibiotic depends on the sensitivities of the causative organism, but, in suspected pyelonephritis, treatment should begin before the results of culture are available. Penicillins (amoxicillin) and cephalosporins are safe and appropriate antibiotics in pregnancy. Augmentin (co-amoxiclav) increases the risk of necrotising enterocolitis in the neonate. Cefadroxil 500 mg twice daily is effective against the majority of urinary pathogens. Nitrofurantoin should be avoided in the third trimester as it may cause haemolytic anaemia in the neonate and trimethoprim should be avoided in the first trimester because of its antifolate action. For acute cystitis, a 7-day course of antibiotics is recommended and antibiotics should be continued for 10–14 days for pyelonephritis [E].2
Fungi and Water
Chuong Pham-Huy, Bruno Pham Huy in Food and Lifestyle in Health and Disease, 2022
Here are some examples of the antimicrobial activity of some cephalosporins. Cefadroxil, cephradine, cefaclor, and cephalexin are used orally for the therapy of both acute and chronic upper and lower respiratory tract infections associated with Haemophilus influenzae, Streptococcus pyogenes, Klebsiella, Streptococcus pneumoniae, and S. aureus (144). Cefoxitin is more potent against the Bacteroides fragilis species and many Gram-negative and Gram-positive bacteria. Cefoxitin is also used in the treatment of pelvic and intraabdominal infections and is frequently employed as a preventive agent in patients subjected to pelvic or colorectal surgery (144).
Information on level of drugs into breastmilk
Wendy Jones in Breastfeeding and Medication, 2018
Although higher concentrations of cefadroxil were reported in breastmilk compared with cefalexin, no adverse events have been reported as the dose received by the baby is still considerably smaller than the level licenced to be given directly (25 mg per kilogramme per day) (Kafetzis et al. 1981). Relative infant dose is quoted as 0.8–1.3% (Hale 2017 online access). The BNF states that it is present in breastmilk in low concentrations but that it is appropriate to use in breastfeeding mothers.
Oral step-down therapy in patients with uncomplicated Staphylococcus aureus primary bacteremia and catheter-related bloodstream infections
Published in Journal of Chemotherapy, 2022
Seok Jun Mun, Si-Ho Kim, Kyungmin Huh, Sun Young Cho, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck
Thirty-four of 103 isolates were methicillin-resistant S. aureus (MRSA), and MRSA bacteremia was more common in the IAT group than in the OAT group. Furthermore, the IAT group showed a higher tendency in the proportion of patients with chronic kidney disease (CKD) or mental change. The total duration of antibiotic therapy was similar between groups (median 15 days in OAT and 14 days in IAT). The median duration of intravenous antibiotic treatment was significantly shorter in the OAT group (median seven and 14 days, P < 0.001). Vancomycin (94%) and nafcillin (39.1%) were the most common intravenous antibiotics used as definite therapy in patients with MRSA and methicillin-susceptible S. aureus (MSSA), respectively. Among 32 patients in the OAT group, 27 patients had MSSA bacteremia. Cefadroxil was most commonly used as OAT (Table 2). Five patients with MRSA bacteremia were switched to trimethoprim/sulfamethoxazole (TMP/SMX) (two patients), levofloxacin + rifampin (two patients), and clindamycin (one patient).
Treatment of urinary tract infections in the era of antimicrobial resistance and new antimicrobial agents
Published in Postgraduate Medicine, 2020
Mazen S. Bader, Mark Loeb, Daniela Leto, Annie A. Brooks
Oral cephalosporins (cephalexin, cefpodoxime, ceftibuten, cefadroxil, cefixime) are the fourth most active antimicrobial agents, after nitrofurantoin, fosfomycin, and pivmecillinam, against E. coli (Table 1) [7,8,26–28]. However, cephalexin is among the broad-spectrum antibiotics that are associated with increased rates of drug-related adverse events and antibiotic-associated diarrhea [29]. For unclear reasons, elderly patients with UTIs who were prescribed cephalexin had greater risk of hospitalization due to sepsis and death [30]. The outcome was not adjusted for the severity of infection and patients who received cephalexin might have more severe infection than patients who received nitrofurantoin. However, oral cephalosporins can be used as empiric or definitive treatment of uncomplicated cystitis in case of resistance and allergy to first-line antibiotics (nitrofurantoin and fosfomycin), kidney dysfunction (creatinine clearance <30 mL/min), UTIs due to Enterobacteriales other than E coli (Klebsiella pneumoniae, proteus mirabilis) [8].
The war against bacteria, from the past to present and beyond
Published in Expert Review of Anti-infective Therapy, 2022
Lucrezia Bottalico, Ioannis Alexandros Charitos, Maria Assunta Potenza, Monica Montagnani, Luigi Santacroce
Bacterial sensitivity and representative drugs – Based on their resistance to the β-lactamases (in this case termed cephalosporinases) and their effectiveness to treat infections by Gram-positive or Gram-negative bacteria, they are divided into five groups or generations: (a) first generation includes cephalosporins such cephalexin, cefadroxil, all sensitive to cephalosporinases, and mostly effective against Gram-positive bacteria; (b) second-generation cephalosporins, such as cefuroxime, which are more resistant to cephalosporinases, may be effective toward Gram-negative bacteria but less active in Gram-positive-dependent infections; (c) third-generation cephalosporins, also resistant to β-lactamases, such as ceftiofur, cefquinom, and cefoperazone, are more effective against Gram-negative bacteria compared to both the first and second generations (d) fourth-generation cephalosporins, such as cefepime and cefpirome, resistant to β-lactamases and used for more severe bacterial infections; (e) ceftaroline is one fifth-generation cephalosporin used to treat infections, including MRSA infections, that are resistant to other antibiotics [91,98].
Related Knowledge Centers
- Cephalosporin
- Streptococcal Pharyngitis
- Urinary Tract Infection
- Cefalexin
- Broad-Spectrum Antibiotic
- Gram-Positive Bacteria
- Gram-Negative Bacteria
- Streptococcus Pyogenes
- Reproductive System Disease
- Skin & Skin Structure Infection