Asunto(s)
Anafilaxia/diagnóstico , Errores Diagnósticos , Suplementos Dietéticos/efectos adversos , Ácidos Grasos/efectos adversos , Adulto , Anafilaxia/inducido químicamente , Antibacterianos/efectos adversos , Asma/diagnóstico , Asma/tratamiento farmacológico , Cefonicid/efectos adversos , Terapias Complementarias/efectos adversos , Ácidos Grasos/inmunología , Humanos , Masculino , Pruebas CutáneasRESUMEN
Community-acquired pneumonia is one of the most common infectious conditions that require hospitalization. When intravenous treatment is indicated, cefonicid is usually the drug of choice. The aim of this study was to find out if chloramphenicol, which is superior to the standard drugs from a financial point of view, could serve as an equally efficient treatment, especially in the elderly. The outcomes of 3 pneumonia patient groups who were either treated with cefonicid, chloramphenicol or penicillin-G (n = 59, 17, 24, respectively) were retrospectively compared. Data about demographic characteristics of the patients, clinical outcomes, rehospitalization rates, duration of improvement/treatment/ hospitalization and clinical laboratory tests were obtained from each patient's medical records. Only minor differences (even though occasionally significant) were found with respect to rehospitalization and improvement rates, duration of hospitalization, treatment and improvement, death rates and clinical laboratory tests. However, chloramphenicol patients were found to be significantly older than cefonicid patients. Moreover, no bone-marrow suppression was associated with chloramphenicol treatment. All 3 drugs tested seem to have the same efficacy. We conclude that since chloramphenicol is as safe as, and much cheaper than cefonicid, this antibiotic agent is not inferior to the others, its usage in older patients with pneumonia should be considered.
Asunto(s)
Antibacterianos/uso terapéutico , Cefonicid/uso terapéutico , Cloranfenicol/uso terapéutico , Penicilina G/uso terapéutico , Neumonía Bacteriana/tratamiento farmacológico , Antibacterianos/efectos adversos , Recuento de Células Sanguíneas , Cefonicid/efectos adversos , Cloranfenicol/efectos adversos , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/mortalidad , Humanos , Persona de Mediana Edad , Penicilina G/efectos adversos , Neumonía Bacteriana/mortalidad , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
We report a case of a male who was treated with cephonicid because of a surgical complication. Serum-sickness like symptoms were diagnosed two weeks later. Medical references are discussed.
Asunto(s)
Cefonicid/efectos adversos , Cefalosporinas/efectos adversos , Enfermedad del Suero/diagnóstico , Adulto , Diagnóstico Diferencial , Hernia Inguinal/cirugía , Humanos , Masculino , Complicaciones Posoperatorias/tratamiento farmacológicoAsunto(s)
Antibacterianos/efectos adversos , Hipersensibilidad a las Drogas/diagnóstico , Pruebas del Parche , Adulto , Amoxicilina/efectos adversos , Angioedema/inducido químicamente , Cefonicid/efectos adversos , Ácido Clavulánico , Ácidos Clavulánicos/efectos adversos , Cara/inervación , Femenino , Dermatosis de la Mano/inducido químicamente , Humanos , Persona de Mediana Edad , Parestesia/inducido químicamenteRESUMEN
OBJECTIVE: To evaluate the safety and effectiveness of antibiotics in reducing the infectious complications following closed tube thoracostomy for isolated chest trauma. DESIGN: Double-blind, randomized clinical trial. SETTING: Medical school affiliated large urban teaching hospital and trauma center. PATIENTS: One hundred nineteen of 159 patients over 18 years old presenting to the emergency department requiring closed tube thoracostomy for isolated chest injuries (113 penetrating, 6 blunt). INTERVENTION: Patients received either placebo or 1 g cefonicid daily intravenously started at chest tube insertion and stopped within 24 h of removal. MEASUREMENTS AND RESULTS: The development of wound infections, pneumonia (CDC criteria), or empyema; the incidence of adverse events; length of hospitalization. One nonspecific infection was seen in the cefonicid group (1.6 percent) and six respiratory tract infections (10.7 percent) in the placebo group (three empyema, one empyema with pneumonia, two pneumonia) (p = 0.0505; p = 0.0094 [excluding nonspecific infection]). No significant differences with antibiotic use were seen in the duration of chest tube use (p = 0.766), peak WBC counts (p = 0.108), lower peak temperatures (p = 0.063), or length of hospitalization (p = 0.165). Patients who developed infectious complications averaged approximately 8 days longer hospitalization than those without (p < 0.0001). CONCLUSION: This study showed that patients receiving antibiotics had a significantly reduced rate of infection than did patients administered placebo. No significant adverse events were seen in either group.
Asunto(s)
Cefonicid/uso terapéutico , Tubos Torácicos , Premedicación , Traumatismos Torácicos/cirugía , Toracostomía , Heridas no Penetrantes/cirugía , Heridas Penetrantes/cirugía , Adolescente , Adulto , Cefonicid/efectos adversos , Distribución de Chi-Cuadrado , Preparaciones de Acción Retardada , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Premedicación/estadística & datos numéricos , Estudios Prospectivos , Estadísticas no Paramétricas , Infección de la Herida Quirúrgica/prevención & control , Traumatismos Torácicos/complicaciones , Heridas no Penetrantes/complicaciones , Heridas Penetrantes/complicacionesRESUMEN
We report a case of delayed cutaneous reaction to intramuscular treatment with cefonicid, a second generation cephalosporin. An isolated late skin test response was observed to cefonicid only and not to other beta-lactams. A patch test with cefonicid 1% was positive after 48 and 96 hours.
Asunto(s)
Cefonicid/efectos adversos , Hipersensibilidad a las Drogas/etiología , Hipersensibilidad Tardía/inducido químicamente , Cefonicid/administración & dosificación , Femenino , Humanos , Inyecciones Intramusculares , Persona de Mediana Edad , Pruebas Cutáneas , Factores de TiempoRESUMEN
We compared cefonicid (2 g every 12 h) and ceftriaxone (2 g every 24 h) for their efficacy and safety in treating spontaneous bacterial peritonitis in cirrhotic patients in an open randomized clinical trial (30 patients in each group). Clinical, laboratory, and bacteriologic characteristics were similar in both groups. Ceftriaxone-susceptible strains were isolated on 44 occasions (94%), and cefonicid-susceptible strains were isolated on 43 occasions (91.5%). The antibiotic concentration in ascitic fluid/MIC ratio for ceftriaxone was > 100 throughout the dose interval (24 h), while it was lower for cefonicid (between 1 and 18). A total of 100% of patients treated with ceftriaxone, and 94% of those treated with cefonicid were cured of their infections (P was not significant). Hospitalization mortality was 37% in the cefonicid group and 30% in the ceftriaxone group (P was not significant). The time that elapsed between the initiation of treatment and the patient's death was shorter in the cefonicid group patients (5.3 +/- 3.90 days) than in the ceftriaxone group patients (11.8 +/- 9.15 days) (P < 0.05). None of the patients presented with superinfections, and only two patients treated with cefonicid and three patients treated with ceftriaxone developed colonizations with Enterococcus faecalis or Candida albicans. Ceftriaxone and cefonicid are safe and useful agents for treating cirrhotic spontaneous bacterial peritonitis, although the pharmacokinetic characteristics of ceftriaxone seem to be more advantageous than those of cefonicid.
Asunto(s)
Cefonicid/uso terapéutico , Ceftriaxona/uso terapéutico , Infecciones por Bacterias Gramnegativas , Cirrosis Hepática/tratamiento farmacológico , Cirrosis Hepática/microbiología , Peritonitis/tratamiento farmacológico , Anciano , Ascitis/microbiología , Cefonicid/efectos adversos , Cefonicid/farmacocinética , Ceftriaxona/efectos adversos , Ceftriaxona/farmacocinética , Esquema de Medicación , Femenino , Bacterias Gramnegativas/efectos de los fármacos , Humanos , Cirrosis Hepática/complicaciones , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Peritonitis/etiología , Peritonitis/microbiología , Estudios ProspectivosAsunto(s)
Coagulación Sanguínea/efectos de los fármacos , Cefonicid/efectos adversos , Cirrosis Hepática/complicaciones , Anciano , Pruebas de Coagulación Sanguínea , Cefonicid/uso terapéutico , Femenino , Humanos , Hipoprotrombinemias/inducido químicamente , Masculino , Persona de Mediana Edad , Neumonía/tratamiento farmacológico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones Urinarias/tratamiento farmacológicoRESUMEN
UNLABELLED: EFFICACY, renal effects and nephrotoxicity of the cephalosporin cefonicid (CEF) were evaluated in 11 adult patients with urinary tract infection and varying renal function (creatinine cl 19-161 ml/min, mean 75). CEF was administered i.m. for 7 days at a daily dose adjusted to renal function of the patients. EFFICACY: At the 4th day and at the end of the treatment urine cultures were negative in all cases; a recurrence of the infection was observed in 4 patients 10 days after completion of therapy. Renal effects and nephrotoxicity: CEF neither modified plasma creatinine, urea, uric acid and their renal clearances nor glomerular filtration rate. Only the urinary enzyme activity of alanine aminopeptidase increased slightly at the end of the therapy. It returned to basal values in the post-treatment period. Urinary enzyme activities of gamma-glutamyltransferase, alkaline phosphatase, N-acetyl-beta-D-glucosaminidase and lysozyme were unmodified during and after treatment with CEF. These results indicate that CEF is an effective antimicrobial agent which does not influence renal function, nor cause nephrotoxic effects.
Asunto(s)
Cefonicid/farmacología , Cefalosporinas/farmacología , Riñón/fisiología , Infecciones Urinarias/tratamiento farmacológico , Adulto , Anciano , Cefonicid/administración & dosificación , Cefonicid/efectos adversos , Cefalosporinas/administración & dosificación , Cefalosporinas/efectos adversos , Esquema de Medicación , Femenino , Humanos , Riñón/efectos de los fármacos , Masculino , Persona de Mediana Edad , Recurrencia , Resultado del TratamientoRESUMEN
The disulfiram-like reaction is linked to the assumption of ethyl alcohol during therapy with the cephalosporin latamoxef, cefamandole and cefoperazone. The reaction is commonly ascribed to the methyl-thiotetrazole group, resembling part of the disulfiram molecule. We describe the case of a patient who experienced on two different occasions a disulfiram-like effect during therapy with cefonicid. This cephalosporin contains the methylsulphothiotetrazole group in place of the methylthiotetrazole group. Our observation is the first related to cefonicid.
Asunto(s)
Cefonicid/efectos adversos , Anciano , Consumo de Bebidas Alcohólicas , Disulfiram , Interacciones Farmacológicas , Etanol/farmacología , Humanos , MasculinoRESUMEN
A single dose of cefonicid given 3.5-5.0 hours or 0.5-1.0 hour preoperatively was compared with cefoxitin given as five doses beginning 0.5-1.0 hour preoperatively for prophylaxis of infection in 202 patients undergoing vaginal or abdominal hysterectomy. The administration of cefonicid 3.5-5.0 hours preoperatively was intended to simulate situations where surgery may be delayed or prolonged. The trial was double-blind, and patients were randomized to one of the three regimens. Operative site infections were noted in 6.2 percent of patients (7/113) who received cefonicid 3.5-5.0 hours preoperatively, in 7.0 percent of patients (3/43) who received cefonicid 0.5-1.0 hour preoperatively, and in 4.3 percent of patients (2/46) who received cefoxitin (p greater than 0.05). Enterococci were isolated most frequently from operative-site infections. When administered 3.5-5.0 hours preoperatively, cefonicid was as effective as more traditional regimens.