cefamandole (Mandol)

Introduction

Tradename: Mandol. 2nd generation cephalosporin.

Indications

• bacterial infections due to susceptible organisms
  • lower respiratory tract infection
    • pneumonia
  • intra-abdominal infection
    • bacterial peritonitis
  • skin or soft tissue infection
  • infectious arthritis
  • osteomyelitis
• prophylaxis for perioperative infection

Dosage

0.5-1 g IV/IM every 4-8 hours

Children: 50-100 mg/kg/day divided every 4-8 hours.

Serious infections 150 mg/kg/day.

Antimicrobial activity

Gram positive

• Streptococcus
  • Streptococcus group A
  • Streptococcus group B
  • Streptococcus group C
  • Streptococcus group G
  • Streptococcus pneumonia
  • Streptococcus viridans, milleri
• Staphylococcus aureus (MSSA)
• Staphylococcus epidermidis (+/-)

Gram negative

• Neisseria gonorrhoeae
• Neisseria meningitidis
• Moraxella catarrhalis
• Haemophilus influenzae
• Escherichia coli
• Klebsiella species
• Salmonella species
• Proteus mirabilis
• Proteus vulgaris (+/-)
• Providencia species
• Morganella species
• Citrobacter species (+/-)
• Aeromonas species (+/-)
• Pasteurella multocida
• Enterobacter

Anaerobes

• Bacteroides melaninogenicus
• Clostridium species
• Peptostreptococcus species

Adverse effects

• bleeding secondary to coagulopathy (in elderly)
  • decreases vitamin K synthesis
• disulfiram-like reaction
  • nausea/vomiting
  • headaches
  • flushing
• allergic urticarial rash
• eosinophilia
• positive direct Coomb's test
• fever
• increased AST
• increased creatine kinase
• diarrhea
• thrombophlebitis
• thrombocytopenia
• granulocytopenia

• drug adverse effects of cephalosporins

Drug interactions

• coadministration with alcohol may produce a disulfiram-like reaction
• cefamandole may enhance the effect of warfarin

• drug interaction(s) anticonvulsants with anti-bacterial agents
• drug interaction(s) of antibiotics with warfarin

Laboratory

• specimen:
  • serum
  • keep specimen on ice-water
  • centrifuge at 4 degrees C
  • remove cells as soon as possible
  • freeze at -70 degrees C until assayed
• methods: HPLC, MB

More general terms

• cephalosporin, 2nd generation

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=456255
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=36831
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2613
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2615
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=441389
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=441384