Paul Actor

SK&F 75073, New Parenteral Broad-Spectrum Cephalosporin with High and Prolonged Serum Levels

SK&F 75073, a new parenteral cephalosporin, was found to have broad in vitro and in vivo antibacterial activity including isolates usually resistant to cephalothin and cefazolin. This activity included indole-positive Proteus and Enterobacter species and some Serratia isolates. Proteus mirabilis strains were particularly susceptible, as were Haemophilus influenzae and Neisseria species. The activity of SK&F 75073 against gram-positive bacteria was poorer than that of the control cephalosporins. This cephalosporin is highly bound to serum proteins, and a loss in in vitro activity was observed in the presence of serum. Parenteral administration of SK&F 75073 to experimental animals (mice, dogs, squirrel monkeys) resulted in high and prolonged serum levels when compared with cefazolin and other injectable cephalosporins. This favorable serum profile was reflected in the excellent protection observed in mice infected with pathogenic bacteria.

Kinetics and renal handling of cefonicid

Cefonicid kinetics were determined after intravenous and intramuscular injection and the renal handling of the drug was examined, including the effect of probenecid on its excretion. Peak serum levels after 1000 and 500 mg intravenously were 221 and 91 μg/ml. The half‐life (t½) was the same for both regimens (3.5 hr). Intramuscular injection of the 1000‐ and 500‐mg doses resulted in peak serum levels of 112 and 40 μg/ml. When probenecid was given with the 500‐mg dose, the peak serum level was 61 μg/ml and the time to peak level rose from 13 to 2.5 hr. The t½ after 1000 and 500 mg alone was much the same at 4.8 and 4.9 hr. The addition of probenecid to the 500‐mg dose extended the t½ to 7.5 hr. Renal clearance, excretion, and secretion rates for cefonicid were reduced by the addition of probenecid. Cefonicids long t½ and high blood levels max provide clinical efficacy with a single daily dose.

Semiautomated Turbidimetric Microbiological Assay for Determination of Cefazolin

The Autoturb System, a semiautomated system for photometric bioassay, was used to determine cefazolin content. Suitable conditions for the assay using Streptococcus faecalis ATCC 10541 as the indicator organism included a medium pH of 6.0 to 7.0 and an incubation time of 3 to 3.5 h at 36 C. Multiple independent assays of samples from a common batch showed the test to be highly reproducible. Accuracy of the turbidimetric assay was evaluated by comparing data obtained from a chemical (hydroxylamine) and a biological (disk diffusion) assay. The available data show the turbidimetric assay to be a rapid, accurate, and reproducible method for determining the biological activity of cefazolin samples.

Comparative Serum Levels and Protective Activity of Parenterally Administered Cephalosporins in Experimental Animals

Six cephalosporin antibiotics were administered subcutaneously to mice at a level of 20 mg/kg. The serum levels of each were determined at five time intervals ranging from 5 to 120 min after dosing. Urinary recovery and the presence of active metabolites in mouse urine were determined. The peak serum levels and serum half-lives in mice were found to be positively correlated with the mean effective dose values obtained after lethal challenge with Escherichia coli. The administration of cefazolin and cephanone resulted in the highest serum level and the best protection. Good protection was obtained with cephaloridine despite somewhat lower serum levels. The cephalosporins with the acetoxy side chain (cephalothin, cephapirin, and cephacetrile) showed lower serum levels and the poorest protection. Cefazolin, cephaloridine, and cephalothin serum levels were also determined in dogs, squirrel monkeys, and rabbits. A mixed response was obtained in these species, with cefazolin peak serum levels being highest in rabbits and cephaloridine peak highest in dogs.

Distribution of Sodium Cefazolin in Serum, Muscle, Bone Marrow, and Bone of Normal Rabbits

Cefazolin levels were detected in bone and bone marrow of normal rabbits dosed intramuscularly, even in the absence of detectable levels in serum.

Cefatrizine (SK&F 60771), a New Oral Cephalosporin: Serum Levels and Urinary Recovery in Humans After Oral or Intramuscular Administration – Comparative Study with Cephalexin and Cefazolin

Cefatrizine (SK&F 60771), a new broad-spectrum cephalosporin, was administered in a 0.5-g dose either orally or intramuscularly to volunteers in a crossover study. After oral administration, the average peak serum levels were 5.6 and 22.1 μg/ml for cefatrizine and cephalexin, respectively. The serum half-life of cefatrizine appeared to be more extended than that of cephalexin. Urinary recovery of cefatrizine (35%) was approximately half that of cephalexin (68%) after oral administration. After intramuscular injection of 0.5 g, the average peak serum level of cefatrizine (12.0 μg/ml) was approximately one-fourth that of cefazolin (44.0 μg/ml). The serum half-life after intramuscular injection was 86 min for cefatrizine and 118 min for cefazolin. Urinary recovery was 45% of the intramuscularly administered dose, as compared with cefazolin, which was 74%.

Disk Susceptibility Studies with Cefazolin and Cephalothin

Cefazolin and cephalothin disk susceptibility and minimal inhibitory concentration determinations were conducted on 591 clinical isolates. Cefazolin demonstrated superior activity, as shown by lower minimal inhibitory concentrations, and a greater percentage of isolates inhibited in the disk susceptibility test. The cephalothin antibiotic class disk by the standard Bauer-Kirby method failed to detect susceptibility to cefazolin in a significant percentage of Escherchia coli, Enterobacter species, and Enterococcus isolates. A separate cefazolin disk with a susceptibility cut-off point of 18 mm is recommended. An alternative to a separate cefazolin disk would be a reinterpretation of the cephalothin susceptibility disk zone diameters so that it would more adequately predict cefazolin activity.

Presumptive identification of aminoglycoside antibiotics by the pH susceptibility disc agar-diffusion method.

Using the pH (buffered) sensitivity discs for the agar-diffusion bioassay of aminoglycoside antibiotics, characteristic response curves were obtained. Since the nature of the activities observed are structure-related, this method can serve as a useful aid for primary identification of members of this class of antibiotics.

Comparative Stability of Cephalothin and Cefazolin in Buffer or Human Serum

A marked loss in potency was observed when cephalothin was incubated for 5 h in human serum at 37°C. Cefazolin was stable under these conditions.

Relationships between in vitro susceptibility and efficacy in experimental mouse infection-protection assay of cefazolin and cephalothin using Escherichia coli strains.

The disc sensitivity and minimal inhibitory concentrations (MIC) of cefazolin and cephalothin were compared against a series of Escherichia coli isolates. These data were correlated with the mouse protective doses of the 2 cephalosporins in animals infected with E. coli strains selected according to their various degrees of in vitro sensitivity to the 2 cephalosporins. The overwhelming majority of E. coli strains showed a significantly higher degree of susceptibility and lower MIC values for cefazolin than for cephalothin. There has been found a good correlation between the inhibition zones and especially the MIC values and the ED50 results for both cephalosporins. Using E. coli clinical isolates, cefazolin was found to be superior to cephalothin not only in vitro experiments but also more potent in protecting the experimentally infected mice.