PMID: 6971925Jun 1, 1981Paper

The role of cefamandole in the treatment of Haemophilus influenzae infections in infants and children

The Journal of Pediatrics
P H Azimi, P A Chase

Abstract

Forty patients with suspected non-CNS Hib infections were treated with cefamandole at a dosage of 100 to 150 mg/kg/day. Hib was isolated from 19 patients; three of the isolates were Blac+. All patients responded well without complications except for two children, both infected with Blac+ organisms, who subsequently developed meningitis, one three weeks following treatment for buccal cellulitis and bacteremia, the other while being treated with cefamandole for empyema. All strains of Hib were uniformly susceptible to cefamandole regardless of beta-lactamase production when tested with an inoculum of 10(4) cfu/ml. With 10(7) cfu/ml an inoculum effect was seen which was more pronounced with Blac+ strains. Moreover, "heavy" inoculum of Blac+ strains inactivated cefamandole in four to eight hours resulting in bacterial overgrowth. Similar results were obtained for ampicillin; chloramphenicol killed all strains regardless of inoculum size or beta-lactamase production. We conclude that cefamandole may be hydrolyzed by Blac+ organisms when present in large numbers, resulting in treatment failure. Extreme care should be taken in the choice of cefamandole for young infants with Hib infections, since this antibiotic neither cures nor prev...Continue Reading

References

Feb 1, 1978·Antimicrobial Agents and Chemotherapy·J H Jorgensen, G A Alexander
May 1, 1978·The Journal of Infectious Diseases·E A SteinbergJ M Leedom
Oct 1, 1979·Antimicrobial Agents and Chemotherapy·V P SyriopoulouA L Smith
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Nov 1, 1974·Antimicrobial Agents and Chemotherapy·C Thornsberry, L A Kirven

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Citations

Feb 1, 1982·Antimicrobial Agents and Chemotherapy·R J WallaceS B Greenberg
Mar 1, 1982·Antimicrobial Agents and Chemotherapy·P H Azimi, M G Dunphy
Nov 1, 1982·Antimicrobial Agents and Chemotherapy·R M LevinM G Dunphy
Feb 1, 1984·Antimicrobial Agents and Chemotherapy·S SirinavinS Lolekha
Aug 29, 1983·The American Journal of Medicine·J D NelsonS Shelton
Jun 28, 1985·The American Journal of Medicine·J A Washington
Aug 9, 1985·The American Journal of Medicine·J D Nelson
Jan 1, 1983·The Journal of Pediatrics·A V BartlettR S Daum
Nov 1, 1984·Psychological Medicine·I LeudarM A Jeeves
Jul 1, 1982·Pharmacotherapy·R C Moellering
Apr 1, 1982·Drug Intelligence & Clinical Pharmacy·D A Powell, M C Nahata
Sep 1, 1984·Drug Intelligence & Clinical Pharmacy·M D ReedJ L Blumer
Apr 1, 1988·Clinical Microbiology Reviews·C A Needham

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