Appraisal of multifarious brands of Cephradine for their in vitro antibacterial activity against varied microorganisms

The astounding and exceptional growth of generic pharmaceutical Industry in Pakistan has raised certain questions for drug regulatory authorities contemplating their efficacy and quality. The current study focuses on assessing the in-vitro antimicrobial activity of 24 brands of Cephradine 500mg capsules against 4 different strains by employing standardized methods. Disk diffusion method was performed on all brands to look into the susceptibility and resistance patterns. Standard disk of 5 micro g Cephradine powder were used during evaluation. The zones of inhibitions were ranged from 24-40mm against S. aureus, 24-40mm against E. coli, 20-25mm against K. pneumonia and 19-23mm P. mirabilis. On the basis of mean value, the multinational brands were found to have better zone of inhibitions and were better than local Pharmaceutical companies but ANOVA cooperative study showed that all brands of Cephradine showed similar comparable results. Further investigations by employing MIC method, quality of raw material with special emphasis on the shelf-life, excepients and method of manufacturing will be needed to obtain more authenticated results. The price of National and Multinational brands ranges from Rs.156.00-212.00 for 10 capsules. It is concluded that Public health is at risk because of noticeable growing widespread curse of the manufacture and trade of sub-standard or below par pharmaceuticals. The pecuniary accountability of management of pharmaceutical agents is additionally apparent. The results of the study need to be made public to boost the confidence of medical profession about the quality of locally manufactured pharmaceuticals. It will succor the foreign exchange being incurred on the trade in of medicines

Antimicrobial resistance; comparison of Escherichia coli in different areas of Lahore

Since the development of antibiotics there is a growing concern about the increasing incidence of antibiotic resistance. As a result the therapeutic value of originally effective antibiotics become significantly reduced overtimes. Extensive data is available on antibiotic susceptibilities of hospital isolates but very little information is available about the susceptibilities of community strains. Descriptive. July 2004 to June 2005. Department of Microbiology, Shaikh Zayed Hospital Lahore. Hence the present study was design to assess the environmental load of the antibiotic resistance using fecal flora as an indicator of overall problem. It will also provide guidance in antibiotic protocol for antibiotic policy. Objective of the present study was to determine the developing resistance to beta - Lactam Antibiotics which is the commensal microbe of enteric tract. One hundred samples were collected from ten different areas of Lahore city [10 samples from each area] and were inoculated on Mac Conkey's agar. Five morphologically distinct lactose fermenting colonies were selected and identified using standard laboratory methods. Five hundred different colonies of E.coli were identified and analyzed for their susceptibility to b-lactam antibiotic. Out of 500 isolates, the resistant isolates with ampicillin [48%], coamoxiclav [40%] and cephradine [37%] were detected, with cheaper oral agents high prevalence of resistance was detected. Ampicillin, co-amoxiclav and cephradine are not much useful for the treatment of urinary tract infection and septicemia caused by E-coli and other Members of fecal flora

Relationship between route of antibiotic administration and post-surgical complications following removal of lower third molars

This prospective clinical trial aims at evaluating the effects of antibiotic therapy following different administration routes on the postoperative complications of surgical removal of lower impacted third molars. Two hundred and fourty eight consecutive patients [100 males and 148 females] aged 18 to 38 years old [mean=24 +/- 5 years] were recruited into this study. The lower third molars of all recruited patients were surgically extracted. Participants received preoperative antibiotic cover either as intravenous Cephradine injection [1 gram] or oral dose of 500 mg Cephalexin. Immediate and late complications following the surgery; including pain, swelling, trismus, paraesthesia, bleeding, dry socket, infection and fracture of mandible; were assessed 3 days and 7-14 days following the surgery. The most frequent complications were slight pain, swelling, and trismus. Oral route of antibiotic administration was associated with more immediate and late complications [p<0.001]. Oral route of antibiotic administration was associated with more pain, swelling, trismus, and dry socket [p<0.05]. Following surgical extraction of third molars, intravenous antibiotic administration was more effective in reducing the post surgical complications than oral antibiotic administration

Feasibility of the extended application of near infrared universal quantitative models / 药学学报

Construction of a successful near infrared analysis model is a complex task. It spends a lot of manpower and material resources, and is restricted by sample collection and model optimization. So it is important to study on the extended application of the existing near infrared (NIR) models. In this paper, cephradine capsules universal quantitative model was used as an example to study on the feasibility of its extended application. Slope/bias correction and piecewise direct standardization correction methods were used to make the universal model to fit to predict the intermediates in manufacturing processes of cephradine capsules, such as the content of powder blend or granules. The results showed that the corrected NIR universal quantitative model can be used for process control although the results of the model correction by slope/bias or piecewise direct standardization were not as good as that of model updating. And it also indicated that the model corrected by slope/bias is better than that by piecewise direct standardization. Model correction provided a new application for NIR universal models in process control.

Chemoprophylaxis in caesarean section

To determine the usefulness of two different regimens of antibiotics on post caesarean infectious morbidities. A comparative study drug trial. Department of Obstetrics and Gynaecology Lyari General Hospital and private hospitals of Karachi, from January 2009 to June 2009. Patients who underwent caesarean section were recruited. The patient were divided into two groups of 74 each. Group A received triple antibiotic therapy including injection cephradine, aminoglycoside and metronidazole for first 48 hours. Followed by oral therapy for 5 days. Group B received injection ceftriaxone and metronidazole for first 48 hours followed by oral therapy for 5 days. In both groups therapy was started before skin incision. Those who had established infection prior to surgery or who received antibiotics in last 24 hours or allergic to any of the infection prior to surgery or who received antibiotics in last 24 hours or allergic to any of the antibiotics used, were excluded. Patients were assessed post operatively for infectious complications including febrile illness, dysuria, offensive lochia and abdominal wound infection. No significant difference was found between the two groups. Complications found were febrile morbidity [23.0% Vs 18.7%], urinary tract infection [13.3% Vs 16.0%] wound infection [14.7% Vs 10.7%] and lochia [6.7% Vs 8.0%] respectively in Group A and Group B. There was a significant difference in terms of cost effectiveness of 3[rd] generation cephalosporin that was more. Both first and third generation cephalosporins are equally effective in caesarean section as prophylaxis

Microcalorimetric investigation of two cephalosporins on colon bacteria activity / 药学学报

The effects of cephradinum and ceftazidime on the metabolism of Escherichia coli (E. coli) DH5alpha was determined by microcalorimetry. The microbial activity was recorded as power-time curves through an ampoule method with a TAM Air Isothermal Microcalorimeter at 37 degrees C. The parameters such as the growth rate constant (k), inhibitory ratio (I), the maximum power output (Pm) and the time (tm) corresponding to the maximum power output were calculated. The results show that the ceftazidime has a better inhibitory effect on E. coli DH5alpha than cephradinum.

Analysis of multiple cephalosporins in blood and urine by HPLC / 法医学杂志

OBJECTIVE@#To establish a new high performance liquid chromatography (HPLC) method for determining the concentration of cefazolin, cefradine, cefoperazone and cefotaxime in blood and urine, as well as to investigate its applicability.@*METHODS@#Protein in blood and urine was precipitated directly by acetonitrile with acetanilide was used as the internal standard using Agilent Zorbax SB-Aq column (250 mm x 4.6 mm, 5 microm). The mixed solvents of water (triethylamine 0.12%, acetic acid 0.12%) and acetonitrile were used as the mobile phase to separate cephalosporins using gradient elution method at 1 mL/min (flow rate) and 254 nm (detection wavelength).@*RESULTS@#The working curve of four cephalosporins showed a good correlation (r = 0.9993), with the detection limit up to 0.01 microg/mL. The recovery rate was more than 81.2%.@*CONCLUSION@#This method is fast, easy and accurate. It is suitable for biological analysis of the 4 cephalosporins of the blood and urine in practical cases.

Single dose versus multi dose cephradine as antibiotic prophylaxis in elective abdominal hysterectomy: a randomized control trial

To compare the efficacy of single dose versus 7 days cephradine prophlaxis for the prevention of post operative infection in patients undergoing elective abdominal hysterectomy. This study was conducted in the department of Obstetrics and Gynaecology, Lady Reading Hospital from January 2006 to March 2007. Twenty patients each were randomly allocated by card method to either group I or group II. Patients in group-I were given one gram of cephradine intravenously 30 minutes before surgery while patients in group-II were given one gram of intravenous cephradine 30 minutes before surgery 2 nd dose of one gram was repeated after 12 hours followed by 500 mg of oral dose for next 6 days. Wound was examined on 2nd, 4th and 7th day then after 2 weeks and after 6 weeks. The efficacy was measured in terms of febile morbidity, surgical and nonsurgical site infection and duration of hospital stay. The statistical analysis was carried out by chi square test. Febrile morbidity was equal in both groups [20%], surgical site infection was 10% in group I and 5% in group II, and duration of hospital stay was equal in both groups. Non surgical site infection occurred in 5% of patients in group-I. There was no statistically significant difference in out come in two groups. Single dose prophylactic antibiotic is as effective as multiple dose antibiotics in elective abdominal hysterectomy

Profilaxis antibiótica y morbilidad post cesárea en el Hospital Materno-Infantil de la Caja Nacional de Salud La Paz-Bolivia 2004 / Antibiotic prevention and morbilidad post Caesarean operation in the Maternal-infantile Hospital of the National Caja of Health The Peace-Bolivia 2004

Profilaxis antibiótica y morbilidad post ce´sárea en el Hospital Materno-Infantil de la Caja Nacional de Salud de La Paz-Bolivia 2004. Objetivo. Determinar si la utilización de profilaxis antibiótica modifica la morbilidad infecciosa pst cesárea. Diseño de Investigación. Ensayo clínico controlado aleatorio. Lugar. Sevicio de Obstetricia del Hsopital Materno-Infantil de la Caja Nacional de La Paz, Bolivia. del 01 de noviembre del 2003 al 31 de enero del 2004. Participantes. 314 pacientes aleatorizados en tres grupos de estudio. Grupo A: PAC Cefradina 104 pacientes. Grupo B: PAC Ampicilina 107 pacientes Grupo C: sin antibióticos profilaxis 103 pacientes. Intervenciones. Previo consentimiento informado, se administro posterior al pinzamiento y sección del cordón umbilical 2 gramos de cefradina VEV (dosis única) a pacieantes del grupo A, 2 gramos de Ampicilina VEV (dosis única) a pacientes del grupo B y no se administró antibiotico profilaxis a pacientes del grupo C. Medición de los resultados principales. Utilizando formularios diseñados para este fin para la emdición de las variables de estudio corroborado por la historia clínica, exámenes laboratoriales, expamenes de gabinete (ecográfia). Se procesó y analizó la información a través del programa EPIINFO 2002 versión 6.4. Resultados La administración de antibiótico profilaxis a mujeres a quienes se les practicó cesárea redujo en forma significativa la incidencia de infección de herida operatoria, endometritis, infección urinaria y fiebre. El índice de infección en el grupo que utilizó PAC cefradina fue 2,88 por ciento, PAC ampicilina 3.73 por ciento y en el grupo que no utilizó PAC 11,65 por ciento. Se efectuaron las siguientes compaciones (RR): las gestantes que no utilizaron PAC preentaron infección post cesárea n2,73 veces más en comparación con gestantes que utilizaron PAC (Cefradina, Ampicilina) 3,03 comparando con gestantes que utilizaron PAC (Cefradina), 2.49 en coparación con gestantes que utilizaron PAC (ampicilina). Las gestantes que utilizaron PAC (Ampicilina) presentaron infeción post cesárea 1.21 veces más en comparación con gestantes que recibieron PAC (cefradina).

Atypical Duodenal Ulcer after Anaphylactic Shock / 대한소화기내시경학회지

Anaphylaxis is an acute life-threatening event, presenting with various clinical symptoms. However, each pathophysiologic mechanism has not been completely understood. We report a case of atypical duodenal ulcers after cephradine induced anaphylactic shock. A 33-year-old woman was injected intravenously of cephradine and propofol for genoplasty, and anaphylactic reaction developed. After the recovery of shock, the patient who complained severe epigastric pain showed unusual endoscopic findings which were are multiple, irregular and shallow ulcerations at the bulb and the second portion of the duodenum. The symptom got improved after ulcer treatment. Histologically, the ulcerating inflammation was detected with eosinophilic infiltration and vascular thrombi. The skin provocation test for cephradine was positive. We suggest that the atypical duodenal ulcer was induced by transient ischemic mucosal injury and chemical damage due to the anaphylactic reaction.

Antibioticoterapia profiláctica con cefradina en cesárea segmentaria / Prophilactic antibiotherapy with cephradine in cesarean section

Con el objetivo de determinar la eficacia de cefradina para prevenir la infección de la herida quirúrgica en pacientes previamente sanas sometidas a césarea segmentaria, se condujo un estudio clínico prospectivo y abierto con 50 pacientes con embarazo a término con indicaciones para resolución de la gestación mediante este procedimiento. Todas ellas recibieron por vía intravenosa, 1 gramo de cefradina media hora antes de ser intervenidas y un gramo inmediatamente después de pinzar el cordón umbilical. Solo una paciente desarrolló infección de la herida quirúrgica (2 por ciento); sin embargo esto se atribuyó a la falta de apego a las indicaciones médicas en el postoperatorio. Ninguna otra paciente presentó complicación postoperatoria. Con base en nuestros resultados, concluimos que la antibioticoprofilaxis quirúrgica con 1 gramo de cefradina aplicada vía endovenosa media hora antes de la intervención y 1 gramo inmediatamente después de pinzar el cordón umbilical evita el desarrollo de infección en la herida quirúrgica en pacientes previamente sanas sometidas a césarea segmentaria.

Evaluación de la sensibilidad in vitro al cefadroxilo y cefradina en Venezuela (1990-2000) / Evaluation of the sensibility in vitro to cephadroxyl and cefradine in Venezuela

En este estudio retrospectivo realizado en Venezuelase analizó la evolución, desde el año 1990 al año 2000, de los índices de sensibilidad de staphylococcus aureus, estreptococos beta hemolíticos del grupo A y streptococcus pneumoniae a cefadroxilo y cefradina, cefalosporinas de primera generación, mediante antibiogramas utilizando discos de papel impregnados con antibiótico. Los datos de cefadroxilo y cefradina se obtuvieron por inferencia de acuerdo a los criterios de la NCCLS (National Commitee for Clinical Laboratory Standards) del año 2001. Noventa por ciento de las cepas de staphylococcus aureus, 100 por ciento de las estreptococcus beta hemolíticos del grupo A y 78 por ciento de las de streptococcus pneumoniae fueron sensibles a ambos antibióticos. Concluimos que, con base en los estudios de tejidos blandos y faringoamigdalitis estreptocóccica; nuestros resultados coinciden con reportes internacionales.

Estudio prospectivo, randomizado, comparativo de la eficacia, seguridad y costos de cefuroxima vs cefradina en la pielonefritis aguda del embarazo / Efficacy, safety and cost of cefuroxime compared with cephradine in the treatment of acute pyelonephritis during pregnancy

Background: Second generation cephalosporins (CFPs) are more active in the treatment of acute pyelonephritis during pregnancy but their cost is considerably higher than their predecessors. Cefuroxime, a second generation CFP with oral and parenteral presentations, might offer significant advantages and become a first choice antimicrobial in this setting. Aim: To compare the efficacy, safety and cost of cefuroxime and cephradine in the treatment of acute pyelonephritis in pregnancy. Patients and methods: Hospitalized women with 12 to 34 weeks of pregnancy, with clinical and bacteriological diagnosis of acute pyelonephritis, were randomly assigned to receive cefuroxime (Curocef (r), GlaxoWellcome) 750 mg t.i.d, i.v or cephradine 1 g q.i.d., i.v. If the isolated organism was resistant to the assigned drug the patient was excluded. Once patients were afebrile, they were switched to an oral form of the same antimicrobial. They were discharged according to the clinical status and treated for a total of 14 days. Laboratory tests, including urine culture were requested during controls and at the end of follow-up at 28 days. Results: One hundred and one patients were randomized: 49 to receive cephradine and 52 to receive cefuroxime. Patients in the cefuroxime group had fewer febrile days (mean 1.7 vs 2.2, p<0.05), faster clinical recovery (mean 2.7 vs 3.1 days, p<0.05), a higher rate of bacteriological cure at 28 days (78.8 percent and 59.2 percent, p<0.05) and lower rate of failure (21.2 percent vs 40.8 percent p<0.05). The rate of resistance of isolated uropathogens was l4 percent to cephradine and 1 percent to cefuroxime. Conclusions: Cefuroxime can be considered as a first choice option in the treatment of acute pyelonephritis during pregnancy due to its tolerance, microbiological activity and efficacy

Infección cervico vaginal en la pielonefritis aguda del embarazo: relación con los resultados del tratamiento antibiótico y con la contractilidad uterina anormal / Cervix-vaginal infection in acute pyelonephritis in pregnancy: it relation with the results of antibiotic treatment and with abnormal uterine contractility

Antecedentes. La embarazada desarrolla fácilmente infecciones de la vía urinaria por cambios funcionales y por ubicación del meato uretral. En la pielonefritis aguda del embarazo no es muy conocida la participación de la infección del tracto genital inferior en los resultados del tratamiento antibiótico y en la presencia de contracción uterina del aborto y parto prematuro. Objetivos. Conocer la microbiología de la vía uterina y del tracto genital en la pielonefritis aguda del embarazo y su relación con los resultados del tratamiento y con la existencia de contracción uterina. Diseño del estudio. Embarazada entre 12 y 34 semanas de gestación con el diagnóstico de pielonefritis aguda se enrolaron. Se tomaron muestras de orina y cervicovaginales para cultivo. Recibieron randomizadamente cefuroxima o cefradina. Se observó la contracción uterina. En el seguimiento se pidieron cultivos de orina como controles. Resultados. 97 mujeres cumplieron con los criterios de inclusión. Escherichia coli se aisló del urocultivo en el 94,8 por ciento de los casos. La vaginosis bacteriana se presentó en el 32,0 por ciento y la infección cervicovaginal en el 57,7 por ciento de las pacientes. En la infección cervicovaginal E. coli se aisló en el 65,2 por ciento. El fracaso en la erradicación de la bacteria de la vía urinaria, se asoció con infección cervicovaginal (76,9 por ciento vs 52,9 por ciento, p< 0.05) y con leucocitos aumentados en la muestra cervical (76,9 por ciento vs 47,1 por ciento, p< 0,01). La contracción uterina se asoció significativamente con: infección cervicovaginal (p < 0,01), vaginosis bacteriana (p < 0,001) y con hallazgo en la muestra cervical de : leucocitos aumentados (p < 0,01), flora polimicrobiana (p < 0,001), aislamiento de E. coli (p < 0.001) y disminución de Lactobacillus sp (p < 0.01). Conclusiones: La infección del tracto genital inferior existente en la pielonefritis aguda del embarazo se relaciona con el fracaso de la terapia antimicrobiana en la erradicación de la bacteria de la vía urinaria y con contracción uterina presente

Monoterapia en cirugía de cadera con cefradina / Surgery in monotherapic of hip cephradine

La cefradina es una cefalosporina semisintética de primera generación, eficaz contra la mayoría de bacterias gram positivas y gram negativas, que puede ser administrada por vía parenteral y oral. Este estudio se realizó en 52 pacientes con lesión de cadera que ameritaba corrección quirúrgica. Desde el postoperatorio inmediato y durante tres días se administró 1 g de cefradina por vía endovenosa cada 12 horas, y en los siete días posteriores se continuó con 500 mg por vía oral cada 12 horas. No se administraron dosis pre o intraoperatorias. Sólo en tres casos se presentó eritema persistente en la periferia de la herida quirúrgica, que cedió al séptimo día postoperatorio, por lo que no fue necesario alterar el protocolo de estudio. Los resultados de esta investigación mostraron que la cefradina es una excelente opción terapéutica para cirugías de gran calibre debido a que no requiere combinaciones o modificaciones bruscas en la antibioticoterapia y ofrece un bajo índice de complicaciones

Antibiotic prophylaxis in surgery

During a period of one year i.e from March 1997 to February 1998, 182 patients undergoing clean surgical procedures were studied in Surgical unit II and IV of Civil Hospital, Karachi. Patients were divided randomly into Group A which received prophylactic antibiotics and Group B which received none. Group A patients received one gram of cephradine and 80 mg of gentamicin intravenously at the time of induction of anaesthesia and two more doses at 8 hours interval. Postoperative wound infection rate in Group A was 2.2% and in Group B-7.6%. In majority of cases wound infection became obvious on 8th postoperative day. Culture and sensitivity of pus from infected wounds revealed Staphylococcus in 61%, E. coli in 19%, Pseudomonas in 12%, and Klebsiella, Streptococcus and Proteus in 8% each. In 2.2% cases of Group A, which developed infection, the causative organisms were hospital acquired strains of Staphylococcus and Pseudomonas resistant to cephradine and gentamicin. The incidence of postoperative drain site infection, respiratory tract infection and urinary tract infection was also less in Group A

A Case of Pyogenic Vertebral Osteomyelitis in Childhood

Pyogenic vertebral osteomyelitis, which is not uncommon in adults, is rare in children. Furthermore, the clinical presentation is often subtle and nonspecific. As a result, vertebral osteomyelitis is often not considered in the initial evaluation in children, resulting in a delay in diagnosis and treatment. We report a 3-year-old boy who was eventually diagnosed with pyogenic vertebral osteomyelitis and treated successfully with antibiotics. The patient initially presented himself with mild fever and abdominal pain for one week. Urinary tract infection, initially considered due to dysuria with suprapubic tenderness, was ruled out. Further investgation revealed that he had right sided suprapubic tenderness and low abdominal pain. He refused to sit or walk, and preferred a recumbent position with his knees bent. The magnetic resonance imaging study showed findings of L2-L3 vertebral osteomyelitis. With 4 weeks of intravenous cephradine treatment, the patient improved clinically and radiologically.

Uso de cefradina como tratamiento secuencial en cirugía ortopédica / Use of cefradine how sequential treatment in orthopedic surgery

La cefradina es una cefalosporina de primera generación que se utiliza en pacientes que requieren cirugía ortopédica. El presente estudio comprendió 20 pacientes con diversas enfermedades osteoarticulares agudas y crónicas, que requirieron intervención quirúrgica; en todos se utilizó tratamiento secuencial con cefradina, 1g por vía intravenosa, inmediatamente antes de la operación; durante las primeras 24 horas del postoperatorio, se administraron 500 mg por vía intravenosa cada 12 horas y después, 500 mg por vía oral los siguientes siete días. La complicación más frecuente de la intervención quirúrgica fue edema las primeras 24 horas en 16 pacientes (80 por ciento). Sólo en cuatro enfermos el edema persistió los siete días siguientes y el resto de los parámetros clínicos permanecieron normales. La cefradina empleada como tratamiento secuencial en operaciones ortopédicas, reúne características que la hacen una excelente alternativa terapéutica