Cefonicid concentrations in serum and atrial tissue during open-heart surgery

Sterling, Rosalyn P.; Connor, D; Norman, John C.; Cooley, Denton A.

doi:10.1128/aac.23.5.790

Cited by 8 publications

(2 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cefonicid concentrations in the atrial appendage and penetration ratios were markedly higher in our study than those recently reported by Sterling et al after a comparable 2-g dose (15). However, there are a few differences in study design that account for these differences.…”

Section: Resultscontrasting

confidence: 56%

Comparative penetration of cefonicid and cefazolin into the atrial appendage and pericardial fluid of patients undergoing open-heart surgery

Dudley¹,

Nightingale²,

Drezner³

et al. 1984

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The penetration of cefonicid and cefazolin into cardiac tissue was compared after a single 30-mg/kg dose in 30 patients undergoing aortocoronary artery bypass graft surgery. Samples of the right atrial appendage, pericardial fluid, and serum were obtained at various times and assayed for drug content. The concentrations of cefonicid in serum and the atrial appendage were at least twice those observed for cefazolin at a given time after a dose. The mean (± standard deviation) atrial appendage-serum ratio was 0.47 ± 0.14 for cefonicid and 0.34 ± 0.06 for cefazolin (P < 0.005). Pericardial Cefonicid is a new cephalosporin with an antimicrobial spectrum similar to that of cefamandole except that it is less active against S. aureus and S. epidermidis. Cefonicid is excreted slowly by the kidneys, with a serum elimination half-life of ca. 4 h. High binding to serum proteins (96 to 98%) results in high concentrations in serum but also reduced the in vitro activity of this agent (6, 7). The high and prolonged concentrations in serum achieved after a single dose may allow for single-dose prophylaxis of infection during certain surgical procedures. In view of the pharmacokinetic properties of cefonicid and the potential usefulness of this agent in surgical prophylaxis, we compared the concentrations of cefonicid and cefazolin in serum, the right atrial appendage, and pericardial fluid of patients undergoing coronary artery bypass graft surgery.( the following were excluded from entry: total body weight (TBW) greater than lean body weight, +/-40%; renal dysfunction (serum creatinine greater than 1.5 mg/dl); history of a significant hypersensitivity reaction to a betalactam antibiotic; requirement for circulatory support (i.e., use of an intro-aortic balloon pump); or inability or refusal to give informed consent. There were two women in the cefonicid group and three women in the cefazolin group. The mean (+ standard deviation) total and ideal weights in the cefonicid group were 70 ± 11 and 66 ± 9 kg, respectively; in the cefazolin group, these weights were 75 ± 10 and 85 ± 10 kg, respectively. The mean preoperative serum creatinine was 1.0 ± 0.2 in the cefonicid group and 1.1 ± 0.2 in the cefazolin group. Each patient underwent a prestudy physical examination, gave a complete medical history, and had the following laboratory tests performed: complete blood count, blood urea nitrogen, serum creatinine, serum bilirubin, serum glutamic-oxaloacetic transaminase, and urinalysis. All of these tests were within the normal range in all patients.Dosing and sample collection. Patients were randomly distributed so as to receive a single 30-mg/kg TBW dose of either cefonicid or cefazolin intravenously over 5 min before surgery. Additional antimicrobial agents were withheld until after the collection of serum and tissue samples. One to three serum samples were collected from each patient during surgery before cardiopulmonary bypass. Blood samples were centrifuged at 3,250 x g for 10 min, and the serum was harvested. Pericardial fluid ...

show abstract

Section: Resultscontrasting

confidence: 56%

Comparative penetration of cefonicid and cefazolin into the atrial appendage and pericardial fluid of patients undergoing open-heart surgery

Dudley¹,

Nightingale²,

Drezner³

et al. 1984

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…[28][29][30][31][32] Cefonicid depends on renal mechanisms for its elimination, with -90 percent of the drug excreted unchanged over 24 hours. Cefonicid's half-life increases to 50 hours in patients with severe renal impairment.…”

Section: Pharmacokineticsmentioning

confidence: 99%

Inappropriate Use of High-Dose Glyburide to Treat Uncontrolled Type 2 Diabetes Mellitus

1993

View full text Add to dashboard Cite

The new second-generation cephalosporins, cefonicid, ceforanide, and cefuroxime, have recently become available. These agents are generally less active against gram-positive cocci than first-generation cephalosporins and, at best, equal to cefoxitin and cefamandole against many gram-negative bacteria. Cefuroxime, however, is the most active cephalosporin for {3lactamase-producing Haemophilus influenzae. These newer agents have superior pharmacokinetic characteristics over cefoxitin and cefamandole. Smaller doses, longer dosing intervals and, potentially, a reduction in total drug cost may be the real advantage of these agents. Open trials and a limited number of comparative studies have documented the effectiveness of cefonicid, ceforanide, and cefuroxime in the treatment of most mild-to-serious infectious diseases, although failures with cefonicid in the treatment of staphylococcal infections have been reported. Notably, cefuroxime has received approval for the treatment of common pediatric bacterial meningitis infections. Replacement of cefamandole or cefoxitin with one of these "longer-acting" agents may be cost-beneficial; however, clinicians must be on alert for the development of bacterial resistance or decreased efficacy.

show abstract

Cefonicid: A Long‐acting, Second‐generation Cephalosporin; Antimicrobial Activity, Pharmacokinetics, Clinical Efficacy and Adverse Effects

Pontzer

Kaye

1984

Pharmacotherapy

View full text Add to dashboard Cite

Cefonicid is a new second-generation cephalosporin with a broad antimicrobial spectrum of activity and a prolonged serum elimination half-life. It has good in vitro activity against methicillin-sensitive Staphylococcus aureus, nonenterococcal streptococci, Hemophilus influenzae, Neisseria gonorrhoeae, Neisseria meningitidis and many of the commonly isolated Enterobacteriaceae. Organisms usually resistant to cefonicid include species of Pseudomonas, Serratia, Acinetobacter and Providencia, and Bacteroides fragilis. The drug is 98% protein bound in human serum, which probably contributes to its significant reduction of antimicrobial activity measured in serum. Limited clinical trials have demonstrated it to be effective for surgical prophylaxis and for treating infections of the urinary tract, lower respiratory tract and bone. Failures have been reported in treatment of soft tissue infections and endocarditis caused by S. aureus. A potential cost reduction may be achieved by administering a single daily dose of cefonicid for established infections or a single preoperative dose for effective surgical prophylaxis instead of multiple-dose regimens of other, similar agents.

show abstract

Cefonicid concentrations in serum and atrial tissue during open-heart surgery

Cited by 8 publications

References 9 publications

Comparative penetration of cefonicid and cefazolin into the atrial appendage and pericardial fluid of patients undergoing open-heart surgery

Comparative penetration of cefonicid and cefazolin into the atrial appendage and pericardial fluid of patients undergoing open-heart surgery

Inappropriate Use of High-Dose Glyburide to Treat Uncontrolled Type 2 Diabetes Mellitus

Cefonicid: A Long‐acting, Second‐generation Cephalosporin; Antimicrobial Activity, Pharmacokinetics, Clinical Efficacy and Adverse Effects

Contact Info

Product

Resources

About