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Cefazolin in the treatment of acute enteric fever
Abstract:
Cefazolin was used in the treatment of nine patients with acute enteric fever proven by positive blood cultures. In seven patients the causative organism was Salmonella typhi and in two it was Salmonella paratyphi B. Minimal inhibitory and minimal bactericidal concentrations of cefazolin against the nine isolates ranged between 1.95 and 3.90 mug/ml. Cefazolin was administered either intramuscularly or intravenously in a daily dose of 3 to 6 g for 11 to 16 days. The mean peak serum antibiotic concentration after a 0.5-g intravenous injection was 64.4 mug/ml, and the mean trough concentration, 3 h later, was 12.7 mug/ml. The highest serum inhibitory dilution at peak level was frequently 1/64, and at trough level it was 1/16 to 1/32. The acute infection was satisfactorily controlled in all patients. Phlebitis, complicating intravenous therapy, in five out of eight patients, was the only side effect observed. Relapse of typhoid fever, as documented by positive blood culture, occurred in one patient 11 days after treatment course was completed. More extensive clinical studies are required before drawing any conclusions regarding the efficacy of cefazolin in acute enteric fever.
Insights
Cefazolin effectively treated acute enteric fever in nine patients, showing good serum concentrations. Further studies are needed to confirm cefazolin
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- Enteric fever, caused by Salmonella species, remains a significant global health concern.
- Antibiotic resistance necessitates exploring alternative treatment options for Salmonella infections.
Purpose of the Study:
- To evaluate the efficacy and safety of cefazolin in treating acute enteric fever.
- To determine the pharmacokinetic profile of cefazolin in patients with enteric fever.
Main Methods:
- Nine patients with culture-proven enteric fever (Salmonella typhi or Salmonella paratyphi B) were treated with cefazolin.
- Cefazolin was administered intramuscularly or intravenously at daily doses of 3-6 g for 11-16 days.
- Minimal inhibitory concentrations (MIC) and minimal bactericidal concentrations (MBC) were determined for cefazolin against bacterial isolates.
Main Results:
- Cefazolin demonstrated effective control of acute infection in all nine patients.
- Serum concentrations of cefazolin achieved therapeutic levels, with peak levels frequently reaching a 1/64 inhibitory dilution.
- Phlebitis was the only observed side effect, occurring in five of eight patients receiving intravenous therapy.
Conclusions:
- Cefazolin shows promise as a treatment for acute enteric fever, with satisfactory clinical response and achievable serum concentrations.
- While generally well-tolerated, intravenous administration was associated with phlebitis.
- One case of relapse occurred, highlighting the need for further extensive clinical studies to establish definitive efficacy.