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Query: UMLS:C0519030 (Klebsiella)
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Strains with the same number of resistances were arranged in so-called resistance classes. Nine classes of resistance (0 to greater to or equal to 8) were formed by means of ten standard chemotherapeutics; the four new cephalosporins were excluded. For every resistance class frequency of cephalosporinresistance was described as coefficient ranging from 0 to 1 (Fig. 1). In Cephalothin the coefficients were markedly rising only in 6 (7)-fold resistant strains of the species examined. Similar but somewhat reduced rising of coefficients was also observed in Cefaclor and Cefamandole. In Cefaclor this is particularly evident for E. coli, whereas in Cefamandole, it concerns Klebsiella spec. In the other species rising of coefficients of Cefaclor and Cefamandole are less marked. The probability of restance in multiresistant strains are therefore distinguished more clearly from that of Cephalothin. Cefuroxime and Cefoxitin take a special position because the probability of resistance does not rise in multiresistant strains. The coefficients of Cefoxitin do not show any recognizable dependance on multiresistance. For clinical purpose the following conclusions can be derived: Because of their effectiveness in multiresistant strains Cefoxitin and Cefuroxime are suitable for empiric use in intensive care units where many multiresistant Klebsiella-strains are to be expected. Cefamandole on the other hand is characterized by a rising probability of resistance in multiresistant strains. Therefore it should only be given after antibiotic testing. Cefaclor, a new oral cephalosporin, will be introduced specially for outpatients where multiresistant strains are rarely found.
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PMID:[Comparison of four recently introduced cephalosporins with respect to probability of resistance in multiresistant strains of Escherichia coli, Proteus mirabilis and Klebsiella spec. (author's transl)]. 4 85

Strains of a species were divided into two groups according to the number of resistances (less than or equal to 4, greater than or equal to 5) using 10 standard chemotherapeutics regularly examined, the new cephalosporins not being among them. These groups of less than or equal to 4- and greater than or equal to 5-fold resistant strains were compared for each cephalosporin tested (Fig. 1). The most different distributions of zone diameters (of both groups) were seen in Cephalothin, whereas in Cefoxitin and - with little limitations - also in Cefuroxime in the main these distributions did not differ; they covered the same field. The distributions of Cefaclor and Cefamandole took an intermediate position. With respect to the two groups similar observations were made for E. coli, proteus mirabilis and Klebsiella spec. The differences between the two groups were most marked in Klebsiella strains. E. coli exhibited the smallest differences (Fig 1). On the assumption that the distribution of zone diameters reflect that of MIC's it can be concluded that nearly all of the Cefaclor- and Cefamandole-sensitive multiresistant strains have more elevated MIC's than those with only less than or equal to 4 resistances. On the other hand it must not be expected that MIC'S OF Cefoxitin and Cefuroxim are rising in multiresistant strains. It could be demonstrated that the different qualities of the recently introduced cephalosporins revealed in multiresistant strains can be explained by different dependences on mechanisms of Cephalothin-resistance (Fig. 2). This resistance is much more frequent in greater than or equal to 5-fold resistant strains. Recommendations for clinical use derived from these results are discussed.
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PMID:[The distribution of minimal inhibitory concentrations of recently introduced cephalosporins in multiresistant strains of Escherichia coli, Proteus mirabilis and Klebsiella spec. as revealed by zone sizes of a standardized agar diffusion test (author's transl)]. 4 86

A comparative study was conducted on the in vitro activity of cefaclor and other oral cephalosporins against a large number of freshly isolated clinical strains of gram-negative and gram-positive bacteria. The activity of cefaclor against gram-positive pathogens is very similar to that of cephalexin. The action of cefaclor against Streptococcus pneumoniae is superior. Cefaclor is the most active antibiotic against strains of Haemophilus influenzae, and is also more active than cephalexin and cephradine against non-beta-lactamase producing strains of Escherichia coli, Klebsiella species and Proteus mirabilis.
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PMID:[In vitro activity of cefaclor (author's transl)]. 4 87

The agar diffusion method was used to test the antibacterial efficacy of cefaclor against bacterial strains isolated routinely from patients in two hospitals in Berlin. A comparison was made with the efficacy of oxacillin, azlocillin, amikacin, gentamicin, ampicillin, co-trimoxazole, tetracycline, penicillin, cefazolin, nalidixic acid and nitrofurantoin. A total of 1235 strains of Staphylococcus aureus, enterococci, Escherichia coli, Klebsiella, Enterobacter, Proteus species, Citrobacter and Pseudomonas aeruginosa were tested. Cefaclor was superior to the other substances in its activity against E. coli, Klebsiellae, and Proteus mirabilis. Co-trimoxazole and tetracycline, on the other hand, proved more effective against indole-positive Proteus species and Citrobacter. Tetracycline was also more effective against Enterobacter. Ampicillin was the most effective agent against enterococci, and oxacillin the most effective against S. aureus. Cefaclor showed good antibacterial activity against strains which were resistant to the orally administrable agents ampicillin, tetracycline and co-trimoxazole.
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PMID:[The antibacterial efficacy of cefaclor in routine testing of clinical material from two Berlin hospitals (author's transl)]. 12 30

Inhibitory activity of cephalexin, cephradine, and cefaclor was compared by the WHO-ICS agar dilution technique. Cefaclor was substantially more active against staphylococci, streptococci, gonococci, meningococci, Haemophilus, Escherichia coli, Klebsiella pneumoniae, Citrobacter diversus, Proteus mirabilis, salmonellae, and shigellae than was cephalexin, which in turn was more active than cephradine. Cefaclor appeared to be less resistant to staphylococcal penicillinase than did the other two agents. None of these cephalosporins was active against Enterobacter, Serratia, indole-positive Proteeae, Pseudomonas, or Bacteroides fragilis.
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PMID:Comparison of in vitro activity of cephalexin, cephradine, and cefaclor. 30 Oct 5

The antibacterial activity of cefotaxim and seven cephalosporins was determined in 1,112 fresh isolates using the microdilution technique. All of the cephalosporins tested were ineffective against enterococci. Cefalotin was the most effective agent against Staphylococcus aureus. Cefaclor was superior to cephalexin against Escherichia coli and Proteus mirabilis, and thus inhibited 20% more Enterobacteriaceae. Cefazolin was as effective as cefamandole against E. coli. Cefuroxime and cefoxitin were almost equally effective against E. coli, Klebsiella and P. mirabilis; more than 95% of the strains were sensitive. Cefuroxime and also cefamandole were much more effective than cefoxitin against Citrobacter and Enterobacter. Cefoxitin on the other hand was superior against Serratia and indol-positive Proteus species. Cefotaxim was by far the most active cephalosporin against Enterobacteriaceae, only 2% of the strains being resistant. More than 90% of the strains of E. coli, Klebsiella, P. mirabilis and Serratia were sensitive to 1 mg/l, the lowest degree of activity being displayed against Enterobacter; 82% of the strains were inhibited by 16 mg/l. Cefotaxim was the only cephalosporin which showed appreciable activity against Pseudomonas.
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PMID:[Antibacterial activity of cefotaxim in comparison with seven cephalosporins]. 38 4

Five hundred and eighty-six strains of eight species of Enterobacteriaceae were tested for their resistance against cefaclor, cefamandole, cephalothin, ampicillin, mezocillin, tetracycline and co-trimoxazole. Cefaclor showed a low rate of resistance against Escherichia coli (1.2%), Klebsiella (2%) and Proteus mirabilis (3.1%), but a high rate of resistance against indole-positive Proteus species (60%) and Serratia (80%). Cefamandole was also effective against cefaclor and ampicillin resistant strains. Multiresistant strains were predominant especially amongst Enterobacter, Serratia and indole-positive Proteus species. Of 266 ampicillin resistant strains, 198 strains (74.4%) proved to be sensitive to cefaclor. Among the orally administered antibiotics cefaclor exhibited the best result with 12.1% resistant strains compared to 14.8% strains resistant to co-trimoxazole and 45.4% resistant to ampicillin.
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PMID:[Resistance of gram-negative bacteria against cefaclor and other antibiotics (author's transl)]. 39 43

The determination of the minimal inhibitory concentration (MIC), which is usually performed after 18 to 24 hours of incubation, results in the case of cefaclor in a false picture of the actual activity. Cefaclor is chemically so unstable that after 24 hours only 2-5% of the substance is microbiologically active. In order to compare the activity of cefaclor and cephalexin, the effect of subinhibitory concentrations of both antibiotics against Escherichia coli and Klebsiella pneumoniae strains was studied by means of turbidimetry. After eight hours the absolute inhibitory concentration of cefaclor was lower than that of cephalexin with both methods. At the same time the effect of subinhibitory concentrations of both antibiotics was equal. Automatic measurement over 20 hours showed at the end of the experiment a higher MIC, and also a higher subinhibitory range, for cefaclor than for cephalexin. In our opinion the absolute inhibitory concentration after eight hours should be the criterion used to evaluate the effectiveness of cefaclor and cephalexin, and not the MIC which is usually used. The eight-hour criterion should also be applied in clinical use.
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PMID:[Subinhibitory activity of cefaclor and cephalexin (author's transl)]. 39 46

A comparative study on the antibiotic activity of cefaclor and cephradine was performed in an infection and therapy model of acute pyelonephritis in the rat. Pathogens were Escherichia coli and Klebsiella pneumoniae. The antibiotics, which were administered orally, both had a pronounced effect in comparison to the untreated control group. Cefaclor was superior to cephradine in infections caused by K. pneumoniae.
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PMID:[Influence of cefaclor on experimental pyelonephritis (author's transl)]. 39 49

The in vitro antibacterial activity of cefaclor, cephalothin, and cephalexin against 261 clinical isolates of Staphylococcus aureus and Enterobacteriaceae was compared. Cefaclor and cephalexin were about equally active against S. aureus. Cefaclor was the most active cephalosporin against Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae. The effect on the antimicrobial activity using a relatively high and low inoculum was pronounced for cefaclor when compared with that of cephalothin.
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PMID:In vitro activity of cefaclor, a new orally administered cephalosporin antibiotic. 90 37


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