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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-three infants and children, aged three months to 15 years, were treated with an average daily dose of 100 mg of cefamandole/kg intravenously. Of these patients, 47 had soft tissue cellulitis and six had pneumonia. Primary pathogens, including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae, were isolated from 43 of the 53 patients. Bacteremia was documented in six of the 53 patients. A satisfactory clinical and bacteriologic response to cefamandole was achieved in all cases except on (98%). The only treatment failure occurred in an infant with both periorbital cellulitis and bacteremia due to H. influenzae who developed meningitis while receiving cefamandole; no extravasation of the drug across the blood-brain barrier could be detected in spite of inflamed meninges. In general, the only aberrant effects of cefamandole were the appearance of eosinophilia in 28% of patients and a positive indirect Cooms' test without hemolysis in one patient. Cefamandole showed excellent in vitro activity against 87 ampicillin-resistant strains of H. influenzae. Because it has greater activity than any of the other cephalosporins against this important pediatric pathogen, cefamandole may have particular pertinence in the treatment of infections in infants and young children.
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PMID:Clinical and laboratory evaluation of cefamandole in infants and children. 30 2

A prospective, randomized, single-blind comparison of parenteral cefamandole and ampicillin was conducted in 27 hospitalized adult patients with pneumonia or purulent tracheobronchitis due to Haemophilus spp. Patients received either parenteral cefamandole or ampicillin in a dose of 1 g every 6 h. Cefamandole was as effective and safe as ampicillin. Of the 14 patients treated with cefamandole, 13 were considered cured, as were 12 of the 13 treated with ampicillin. One patient in each treatment group improved clinically but did not clear his sputum of Haemophilus spp. One patient treated with cefamandole had a recurrence of Haemophilus spp. bronchitis 9 days after cure. Adverse effects were more common in the cefamandole-treated group (50% versus 15%), but were mild and did not require discontinuation of therapy in any patient. The in vitro susceptibilities of 64 clinical isolates of Haemophilus spp. to 10 antibiotics were determined. Cefamandole was the most active of the cephalosporin-cephamycin antibiotics tested, inhibiting 98% of 61 non-beta-lactamase-producing isolates at 2 mug/ml and 100% at 4 mug/ml. Cefamandole inhibited the three ampicillin-resistant isolates at 2 mug/ml or less. Cephapirin, cefoxitin, and cephalothin were the next most active, whereas cefazolin and cephradine were the least active.
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PMID:Clinical and laboratory evaluation of cefamandole in the therapy of Haemophilus spp. Bronchopulmonary infections. 38 11

Laboratory and clinical studies of cefamandole (CMD), a new semisynthetic cephalosporin, were investigated and following results were obtained. 1) Absorption and excretion study following 25 mg/kg intravenous administration was carried out in pediatric patients. In 6 cases, mean serum levels of 116.7 +/- 24.0 micrograms/ml, 62.1 +/- micrograms/ml, 12.2 +/- 2.7 micrograms/ml, 2.9 +/- 1.1 micrograms/ml, 0.6 +/- 0.6 micrograms/ml and 0.1 +/- 0.2 micrograms/ml obtained after 15, 30 minutes, 1, 2, 4 and 6 hours administration. In 4 cases, mean urinary recovery of 68.2 +/- 17.2% (0 approximately 8 hours) was obtained. The mean half life of serum level was 0.36 +/- 0.08 hours. 2) The transfer of cefamandole was poor in infants with meningitis. 3) Cefamandole was given to 22 children with acute pyelitis (1 case), acute pneumonia (19 cases), and meningitis (2 cases). The dosage was 80.0 approximately 284.2 mg/kg/day, and it was divided into 4 approximately 6 times and given intravenous or intravenous drip. The duration of administration was from 3 to 17 days. The overall efficacy rate in 22 cases was 95.2%, i.e., excellent in 5, good in 15, poor in 1, and unknown in 1. In bacteriological examination, there were eradication of the organisms in 9 (52.9%), decrease in 4, unchange in 4 out of 17 strains. 4) Any noticeable adverse reaction was not observed.
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PMID:[Laboratory and clinical studies of cefamandole in children (author's transl)]. 50 21

The attack rate for pneumonia increases with increasing age and with residence in a nursing home. The rate of hospitalization of Halifax County, Nova Scotia, Canada, residents with pneumonia was 1 in 1,000, while for nursing home residents it was 33 in 1,000. The overall mortality rate for community-acquired pneumonia requiring hospitalization was 21.9%. Mortality was age-related: Seven percent of those 30 years of age or younger died, while 38% of those in the 81 to 90 year age group died. Comorbidities increased with increasing age from 0.73 +/- 0.81 for those 30 years old or younger to 2.75 +/- 1.47 for those 71 to 80 years of age. The most common comorbidities were chronic obstructive pulmonary disease, ischemic heart disease, hypertension, diabetes mellitus, malignancy, alcoholism, and neurological disease. The acquired immunodeficiency syndrome was a significant comorbidity among those 50 years of age or younger. Age-dependent trends were observed in the use of antimicrobial therapy: Cefamandole and aminoglycosides were prescribed more frequently with increasing age, whereas after the age of 61 years, the use of erythromycin declined. Penicillin usage was not age-dependent. Resource (hemograms, chest radiographs, blood chemistry, blood gases, and sputum culture) use peaked at the 50 to 60 year age group.
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PMID:Epidemiology of community-acquired pneumonia in the elderly. 209 71

One hundred seven patients with community-acquired pneumonia thought to be of bacterial etiology by the admitting physician but whose initial sputum Gram stain was inadequate to direct specific therapy were randomized to receive either intravenous ampicillin or cefamandole as empiric therapy. Patients were excluded if the initial sputum Gram stain was highly suggestive of infection with Streptococcus pneumoniae, Staphylococcus aureus, or an enteric gram-negative bacillus. The two study groups had comparable demographic and presenting clinical features. The mean age of the patients evaluable for determination of clinical efficacy was 69 years, and greater than 75% had at least one serious underlying medical disorder. In the 90 evaluable patients, there were 11 therapeutic failures (12%), including 5 deaths (5%). Cefamandole, a broad-spectrum antibiotic, was not more efficacious than ampicillin in producing a satisfactory clinical response or in shortening the duration of parenteral therapy. Patients received an average of only 4 days of intravenous antibiotics before changeover to oral therapy and were hospitalized for a mean of 7 days. No patient experienced a relapse of pneumonia following successful completion of parenteral drug therapy. We conclude that cefamandole is not a more effective agent than ampicillin for empiric therapy of community-acquired bacterial pneumonia of uncertain etiology.
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PMID:Ampicillin versus cefamandole as initial therapy for community-acquired pneumonia. 330 56

Cefamandole and cefoxitin, introduced only 7 years ago, are now the most commonly prescribed parenteral antibiotics in the United States. These drugs are similar to the first-generation cephalosporins in toxicity, but their in-vitro spectrum of activity is greater. Their serum half-lives are longer than those of cephalothin and cephapirin but shorter than that of cefazolin. Although cefamandole has been recommended in empiric therapy for patients with community-acquired pneumonia and as a prophylactic agent for patients having various surgical procedures, other regimens are less expensive and just as effective. Cefamandole should not be used to treat intra-abdominal, enterobacter, or ampicillin-resistant Haemophilus influenzae infections. Cefoxitin is effective in the treatment and prevention of mixed aerobic-anaerobic skin and soft-tissue, intra-abdominal, gynecologic, and penicillinase-producing, spectinomycin-resistant Neisseria gonorrhoeae infections. Cefoxitin represents a greater advance than cefamandole in our continuing search for safe and more effective antimicrobial agents.
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PMID:Cefamandole and cefoxitin. 389 Jun 58

Cefamandole was evaluated for the initial management of bacterial infections in 60 infants and children. Infections included cellulitis (22), pneumonia (21), cervical lymphadenitis (8), arthritis or osteomyelitis (6), otitis media (2), and epiglottitis 91). Appropriate bacterial cultures and laboratory tests were performed for all patients. Cefamandole, 100 to 150 mg/kg/day divided into four doses given every six hours, was administered by the intravenous route. All bacterial isolates were sensitive to cefamandole, and all patients had good clinical and bacteriological responses. Duration of cefamandole therapy ranged between three and 30 days. Some of the patients' treatments were changed to specific narrow-spectrum antimicrobials after availability of the bacterial sensitivities. Cefamandole was tolerated well by most patients. Mild leukopenia and neutropenia developed in one patient and slight eosinophilia in four patients. These hematological abnormalities resolved spontaneously. These data suggest that cefamandole is an effective agent for the initial treatment of nonmeningitic infections in children.
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PMID:Clinical evaluation of cefamandole in childhood infections. 662 87

The increasing incidence of pneumonia caused by H. influenza and the problem of beta lactamase production (18% of strains in recent reports) are important considerations in the therapy of pneumonia. An antibiotic that is effective for these strains and other common respiratory pathogens will be useful for the therapy of pneumonia. Cefamandole nafate is a new cephalosporin antibiotic with an antimicrobial spectrum similar to cephalothin with increased activity against Escherichia coli, Proteus spp., Enterobacter spp., and Haemophilus influenzae. Seventeen patients with pneumonia presumed to be due to susceptible gram-negative organisms isolated from transtracheal aspirate or sputum were treated with 6 to 8 g/day of parenteral cefamandole nafate. Organisms isolated were Haemophilus influenzae in 6, E. coli in 3, Proteus mirabilis in 2, Klebsiella pneumoniae in 1, Serratia marcescens in 1 and mixed gram-negative rods in 4. The Serratia were resistant (MIC greater than 100 microgram/ml and 50 microgram/ml): other MIC's ranged from 0.2 to 6.2 microgram/ml; median 1.6 microgram/ml. Satisfactory clinical response (improvement in pulmonary function; resolution of infiltrate; decrease in temperature, sputum production and white count) was noted in 13 of 17 patients. Two patients died from their underlying disease. Adverse clinical reactions questionably related to cefamandole included SGOT rises in 3 and rash in one. Serum antibiotic levels were 22.0 to 88.0 microgram/ml (peak) and 1.1 to 12.5 microgram/ml (trough). Sputum levels were 0.27 to 2.5 microgram/ml. Cefamandole appears to be an effective antibiotic for treatment of gram-negative pneumonia caused by susceptible organisms.
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PMID:Cefamandole treatment of pulmonary infection caused by gram-negative rods. 701 May 35