Clinical and laboratory evaluation of cefamandole in infants and children
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Cefamandole effectively treated soft tissue infections and pneumonia in children, with a 98% success rate. This cephalosporin demonstrated excellent activity against ampicillin-resistant Haemophilus influenzae, a key pediatric pathogen.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Bacteriology
Background:
- Bacterial infections pose significant risks to infants and children.
- Effective antibiotic treatment is crucial for pediatric patients, especially those with resistant pathogens.
- Cephalosporins are a common class of antibiotics used in pediatric care.
Purpose of the Study:
- To evaluate the efficacy and safety of cefamandole in treating bacterial infections in pediatric patients.
- To assess cefamandole's activity against common pediatric pathogens, including ampicillin-resistant strains.
- To determine cefamandole's clinical and bacteriologic response rates in infants and children.
Main Methods:
- Intravenous administration of cefamandole (100 mg/kg/day) to 53 pediatric patients (3 months to 15 years).
- Patients presented with soft tissue cellulitis (47) or pneumonia (6).
- Identification of primary pathogens and assessment of clinical and bacteriologic outcomes.
Main Results:
- Cefamandole achieved a 98% satisfactory clinical and bacteriologic response rate.
- Effective against Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae.
- Demonstrated excellent in vitro activity against 87 ampicillin-resistant H. influenzae strains.
Conclusions:
- Cefamandole is highly effective and safe for treating common pediatric bacterial infections.
- Its potent activity against ampicillin-resistant H. influenzae makes it particularly valuable for pediatric use.
- Cefamandole shows promise for treating infections in infants and young children, especially those caused by resistant pathogens.
Abstract:
Fifty-three infants and children, aged three months to 15 years, were treated with an average daily dose of 100 mg of cefamandole/kg intravenously. Of these patients, 47 had soft tissue cellulitis and six had pneumonia. Primary pathogens, including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae, were isolated from 43 of the 53 patients. Bacteremia was documented in six of the 53 patients. A satisfactory clinical and bacteriologic response to cefamandole was achieved in all cases except on (98%). The only treatment failure occurred in an infant with both periorbital cellulitis and bacteremia due to H. influenzae who developed meningitis while receiving cefamandole; no extravasation of the drug across the blood-brain barrier could be detected in spite of inflamed meninges. In general, the only aberrant effects of cefamandole were the appearance of eosinophilia in 28% of patients and a positive indirect Cooms' test without hemolysis in one patient. Cefamandole showed excellent in vitro activity against 87 ampicillin-resistant strains of H. influenzae. Because it has greater activity than any of the other cephalosporins against this important pediatric pathogen, cefamandole may have particular pertinence in the treatment of infections in infants and young children.