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High-Performance Liquid Chromatography
Published in Adorjan Aszalos, Modern Analysis of Antibiotics, 2020
Joel J. Kirschbaum, Adorjan Aszalos
Cefamandole in serum and urine was analyzed using an octadecylsilane column and a mobile phase of methanol-0.2 M sodium acetate, pH 5.2 (60:40), flowing at 2 ml/min into a detector adjusted to 270 nm. Cephalothin was used as internal standard. The minimum concentration detectable was 0.3 µg/ml [217].
Cefotiam, Cefuzonam, Cefamandole, Cefonicid, and Ceforanide
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
Hisashi Baba, David L. Paterson
Cefamandole is active against S. aureus (but not MRSA), S. pyogenes, S. pneumoniae, group B streptococci, and alpha-hemolytic streptococci (viridans streptococci). Enterococcus faecalis is resistant. This activity against Gram-positive cocci is similar to that of the first-generation cephalosporins, although cefamandole is marginally less active, particularly against S. aureus (Neu, 1974; Bodey and Weaver, 1976; Dan et al., 1983). However, it can be considered to have been a reliable antistaphylococcal drug (Fong et al., 1976; Chapman and Steigbigel, 1983; Sabath, 1989).
Pharmacokinetic/Pharmacodynamic Modeling of Antibiotics
Published in Hartmut Derendorf, Günther Hochhaus, Handbook of Pharmacokinetic/Pharmacodynamic Correlation, 2019
Arno Nolting, Hartmut Derendorf
Bodey et al.55 compared different dosing regimens for aminoglycosides and cephalosporins in neutropenic patients. Neutropenia was defined as an absolute neutrophil count of less than 100/mm3. Aminoglycosides (gentamicin, tobramycin, and amikacin) and cephalosporins (cephalotin, cefamandole, and cefazolin) were administered as continuous infusion or intermittent doses (infusion every 6 h). The authors found greater efficacy for the constant administration of antibiotics. For patients who received the intermittent gentamicin or tobramycin the cure rate was 23% compared to 71% for patients who received continuous amikacin or netilmicin. Cure rates for Gram-negative infections were 74% (constant) and 59% (intermittent) for cefamandole. It was assumed that the dosage schedules of antibiotics which result in subinhibitory serum concentrations could also result in persistent growth of the infecting organisms and that the continuous infusion schedule could also reduce the frequency of nephrotoxicity. These findings were not confirmed by other authors. Powell et al.,56 for instance, criticized the design because the intermittent infusions were given over a period of 0.5 to 2 h. There was little difference in the oscillation of blood concentrations. To investigate the efficacy of different dosing regimens, Powell treated 52 cystic fibrosis patients with tobramycin given 9 to 14 mg/kg once a day or 11 mg/kg per day in continuous infusion. The mean blood levels ranged from 4.04 to 5.19 mg/l. There were no significant differences between the two regimens with respect to efficacy. Since intermittent dosing produced less toxicity in this study (measured as change in the glomerular filtration rate and changes in high-frequency audiology examinations) the authors advocated less frequent administration of aminoglycosides in order to improve the benefit/risk ratio. Suggested potential uses for less frequent dosing include: Urethral gonorrheaInitiation of therapy of life-threatening infectionsSimplification of aminoglycoside therapy (improved patient compliance)
Cefazolin-induced hypoprothrombinemia
Published in Baylor University Medical Center Proceedings, 2022
Mallory Smith, James Doyle, Cameron Crane, Charles Bussell
Coagulopathy is a known side effect of cephalosporins whose chemical structure contains the MTT side group, such as moxalactam, cefamandole, and cefoperazone.7–10 In the vitamin K cycle, gamma-carboxylation of glutamic acid oxidizes vitamin K, allowing activation of clotting factors. MTT or MTD side chains form thiol-containing metabolites that inhibit the gamma-carboxylation of glutamic acid. However, these metabolites can also undergo S-methylation by thiopurine methyltransferase (TPMT) to become less potent inhibitors of glutamic acid gamma-carboxylation1(Figure 3). Therefore, patients with loss-of-function mutations in TPMT who are treated with MTT- or MTD-containing cephalosporins may be more prone to coagulopathy. TPMT mutation status was not known in our patient.
Allergic reactions to penicillins and cephalosporins: diagnosis, assessment of cross-reactivity and management
Published in Expert Review of Clinical Immunology, 2019
Natalia Blanca-Lopez, Teodorikez Wilfox Jimenez-Rodriguez, Maria L. Somoza, Enrique Gomez, Mona Al-Ahmad, Dolores Perez-Sala, Miguel Blanca
For many years there was considered to be a high degree of CR with first-generation cephalosporins, with some exceptions [10,20,21]. In the early 1990s studies by our group showed that the side chain of AX could contribute in a relevant way to induce side-chain-specific reactions, as shown in the mechanisms sections [21]. Although the formation of the hapten-carrier complex requires the whole structure, the side chain seems to be critical for the final recognition and the induction of symptoms [33,34]. This implies that AMP may react with the other penicillins because of the recognition of the common antigenic determinant (the BPO) or only with AX because of the similarities of side chains, phenyl glycine in AMP versus parahydroxyphenylglicine in AX. For CR of penicillins versus cephalosporins in the case of primary sensitization to penicillins, this thinking is required to assess CR. Similarities between penicillins and first-generation cephalosporins (See Table 1) explain CR [10,21]. In one study of subjects with immediate allergic reactions to penicillins, only the 10% of the cases responded after challenging with cephamandole [97].
Research on the relationship between cephalosporin structure, solution clarity, and rubber closure compatibility using volatile components profile of butyl rubber closures
Published in Drug Development and Industrial Pharmacy, 2019
Xiao-Meng Chong, Xin Dong, Shang-Chen Yao, Chang-Qin Hu
All kinds of cephalosporins for injection were obtained from national evaluation inspection in China. Except for some samples that did not meet the requirement for clarity of reconstituted solutions provided in Chinese Pharmacopoeia, all the other items qualified. The cephalosporins for injection included seven batches of cefodizime sodium for injection from one manufacturer. Among the seven batches, the clarity of three batches did not meet the requirement of clarity of solution provided in Chinese Pharmacopoeia. Among the six batches of ceftriaxone sodium for injection from two different manufacturers, the clarity of three batches did not meet the requirement of clarity of solution provided in Chinese Pharmacopoeia. Although the clarity of seventeen batches of cefpiramide sodium for injection from six different manufacturers met the requirement of clarity of solution, the extent of turbidity of each batch was different when measured with a nephelometer. The clarity of all four batches of cefamandole nafate for injection from two different manufacturers met the requirement of clarity of solution; however, the extent of turbidity of each batch was different when measured with a nephelometer. The clarity of one batch of cefmenoxime for injection and one batch of cefoperazone sodium for injection met the requirement of clarity of solution.