RESUMO
Two hundred patients undergoing prostatic surgery at 2 hospitals were randomly allocated into 4 equal groups. The groups were a control, cephalexin, co-trimoxazole and carfecillin treated groups. The incidence of urinary tract infections and other complications of prostatic surgery were studied in each group after a short-term prophylactic regime of 3 doses of the antibiotic. The incidence of urinary infection was significantly improved from 28% in the control group to 8% and 16% in the co-trimoxazole and cephalexin groups respectively. Carfecillin was not effective in reducing urinary infection. However, all 3 antibiotics reduced the incidence of other infective sequelae.
Assuntos
Antibacterianos/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Pré-Medicação , Prostatectomia , Infecções Urinárias/prevenção & controle , Carfecilina/uso terapêutico , Cefalexina/uso terapêutico , Ensaios Clínicos como Assunto , Combinação de Medicamentos/uso terapêutico , Humanos , Masculino , Sulfametoxazol/uso terapêutico , Trimetoprima/uso terapêutico , Combinação Trimetoprima e SulfametoxazolRESUMO
The pharmacokinetics of carfecillin (Carbenicillin-phenyl-ester) were studied in 10 healthy subjects, in 5 patients with hepatic cirrhosis and in 5 cases of renal insufficiency. In healthy subjects maximal carbenicillin serum levels attained by therapeutic doses were about 20 microgram/ml; concentrations in the urine surpassed 1000 mu/ml. The phenol moiety was detectable as free phenol in sera (less than 1 microgram/ml) and urine (less than 3 microgram/ml), but its major part was transformed to glucuronide and sulphate conjugates. Pharmacokinetics were not altered significantly by hepatic lesion. In renal insufficiency, serum levels of both carbenicillin and conjugated phenol were higher and their decrease delayed, while urine concentration was low. Carfecillin treatment was successful in 20 out of 30 patients with UTI.
Assuntos
Carbenicilina/análogos & derivados , Carfecilina/metabolismo , Infecções Bacterianas/tratamento farmacológico , Carbenicilina/metabolismo , Carfecilina/uso terapêutico , Meia-Vida , Humanos , Nefropatias/metabolismo , Cinética , Cirrose Hepática/metabolismo , Fenóis/metabolismoRESUMO
1. Ten patients with chronic urinary tract infection by Pseudomonas aeruginosa or Proteus species were treated with carfecillin. Excellent response was seen in one case, fairly good in 5 cases and clinical effective rate was 60%. 2. The recurrence suppression effect of carfecillin was examined in two patients suffering from complicated urinary tract infection. In both cases, recurrence was not found when carfecillin was administered for a week after the effective pretreatment of carbenicillin, but found when administered for two weeks. 3. Side effects were observed in 3 cases (itching, tinnitus, diarrhea).
Assuntos
Carbenicilina/análogos & derivados , Carfecilina/uso terapêutico , Cistite/tratamento farmacológico , Pielonefrite/tratamento farmacológico , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Proteus/tratamento farmacológico , Infecções por Pseudomonas/tratamento farmacológicoRESUMO
Carfecillin, the alpha-phenyl ester of carbenicillin, hydrolyses rapidly in the presence of serum or body tissues to liberate carbenicillin but hydrolysis is less rapid in aqueous solution. The activity of carfecillin in antibacterial tests in vitro depends upon the extent of hydrolysis to carbenicillin, and in conventional serial dilution tests carfecillin shows an antibacterial spectrum generally similar to that of carbenicillin due to extensive hydrolysis. However, in tests in which the extent of hydrolysis is reduced, carfecillin displays lesser activity than carbenicillin against gram-negative bacilli and greater activity against gram-positive cocci. In the presence of serum carfecillin is hydrolysed rapidly to carbenicillin and the activity shown is solely that of carbenicillin. Unlike carbenicillin, carfecillin is well absorbed in mice after oral administration, producing significant carbenicillin blood concentrations and the compound is as effective by the oral route in the treatment of various experimental mouse infections as is parenteral carbenicillin.
