The minimal inhibitory concentration(MIC) of cephalosporin derivatives, (cephaloridine, cefazolin sodium, cephradine, cephapirin aodium, cephacetrile sodium, and cephalexin from various Korean drug companies) for Staphykcoccus aureus ATCC 25923 and Escherichia coli ATCC 25922 was measured by the tube dilution method, using Mueller-Hinton broth. The results obtained were as follows: 1) The MIC of each individual cephalosporin derivative, although produced by different manufacturers, was similiar or equal. 2) Against Staphyloeoccus aureus, cephaloridine and cephapirin had the lowest MIC while cephradine and, cephalexin the highest. Against E. coli, cephaloridine and cefazolin had the lowest MIC while cephradine and cephalexin the highest. 3) The MIC against Staphylococcus aureus was l5.6 to 250 times lower than that against E. coli in all cephalosporin derivatives. 4) The MIC against Staphylococcus aureus ranges from 0.0125 to l.0ug/ml and against E. coli from 1. 56 to 25ug/ml in all cephalasporin derivatives.
Cefazolin ; Cephacetrile ; Cephalexin ; Cephaloridine ; Cephapirin ; Cephradine ; Escherichia coli ; Staphylococcus aureus

Several of the newer broad-spectrum, potent antibiotics are currently being used for the treatment of meningitis, ventriculitis and shunt-tract infection. The risk of complications following intrathecal administration of some of this newer antibiotics varies considerably. Possible complications of immediate or delayed seizure, cortical electric depression, radiculopathy, transverse myelopathy, and arachnoiditis after intrathecal or intraventricular administration must be weighed against the potential value of this route. These risks may influence the therapeutic management of a specific clinical situation. The author studied the effect of the first generation of cephalosporins(cepalothin, cefazolin, cepharadine, cephapirin), the second generation of cephalosporins(cefamandole, cefmetazole), and the third generation of cephalosporins(cefotaxime, cetriaxone, cefotetan), on electrocortical activity of cerebral cortex. The results are as follows : 1) The topical application of cephalothin, cefazolin, cephapirin 8mg/ml shows electrocortical spike activity. In higher concentration, each cases show intense electrocortical spike activity. The topical application of cephradine 100mg/ml shows electrocortical spike activity and in higher concentration, electrocortical spike activity continued. 2) The topical application of cefamandole 64mg/ml shows electrocortical spike activity first and that of cefmetazole 100mg/ml shows electrocortical spike activity and in higher concentration of each cases, intense electrocortical spike activity continued. 3) The topical application of cefotaxime 16mg/ml shows electrocortical spike activity and that of ceftriaxon 200mg/ml and cefatetan 100mg/ml shows mild electrocortical spike activity. In higher concentration of each cases, electrocortical spike activity continued. In conclusion, the degrees of epileptogenic effect was most severe in the first generation of cephalosporins and the second generation of cephalosporins and the third generation of cephalosporins on the decreasing order.
Anti-Bacterial Agents ; Arachnoid ; Arachnoiditis ; Cefamandole ; Cefazolin ; Cefmetazole ; Cefotaxime ; Ceftriaxone ; Cephalosporins* ; Cephalothin ; Cephapirin ; Cephradine ; Cerebral Cortex* ; Depression ; Meningitis ; Radiculopathy ; Seizures ; Spinal Cord Diseases

This experiment was performed to determine the stability of antiblotics in cured bone cement and the antibacterial effect with various the amount of antibiotics mixed in bone cement. Experimental animals were divided into control and antibioticimpregnated groups; 3 each for control, cloxacillin, celospor, kanamycln and panimycln groups. Antibiotic activities were measured by disk diffusion method using Staphylococcus aureus and Escherichla coli as standard organisms. The results were as follows: 1. Bone cement itself does not have antibacterial effect on the growth of Staphylococcus aureus and Escherlchia coli. Antlbiotlc impregnated acrylic bone cement showed antibacterial effects which was stable for 4 weeks. 2. In vitro test, the amount to antibiotics released In 24 hours perlod was proportional to the amount of antibiotlcs mixed in bone cement. 3. The duration of antibacterial effect was also roughly proportional to the amount of antiblotics mixed In bone cement. 4. No antibacterial effect could be measured in control groups. 4. In vivo test, the result was revealed similar patterns compared with the result of “In vitro test”, but the amounts of antibiotics released and durations of antibaterial effect was decreased. No antibacterial effect could be measured in control groups. As a result of this sutdy of this study, It is proved that the amount of antiblotics and the duratlon of antibacterial effect are proportional to the amount of antibiotics mixed in bone cemcnt. The impregnation of antiblotics in acrylic bone cement may be used to prevent and treat Infection in the orthopedic fleld.
Animals ; Anti-Bacterial Agents ; Cephacetrile ; Cloxacillin ; Diffusion ; In Vitro Techniques ; Methods ; Orthopedics ; Polymethyl Methacrylate ; Staphylococcus aureus

PURPOSE: Recently, Staphylococcus aureus has been reported as the principal microorganism isolated from impetigo, showing variable degrees of antimicrobial resistance. The aim of this work was to study the causative organism of impetigo the their antimicrobial susceptibility developed in impetigo in the past four years. METHODS: We performed bacterial cultures and antimicrobial susceptibility tests in 73 patients with impetigo who visited the Department of Dermatology and Pediatrics at St. Paul's Hospital of the Catholic University of Korea in Seoul. RESULTS: Of 73 patients, microorganisms were identified in 70 patients between May 1995 and August 1999. Staphylococcus aureus was isolated from 63 (90%) patients. Antimicrobial susceptibility test for Staphylococcus aureus revealed low resistance to bactrim (0.0%), rifampicin (0.0%), van- comycin (3.2%), ceftriaxone (4.0%), imipenem (5.4%), ampicillin-clavulanic acid (6.1%), oxacillin (8.1%), cephazolin(9.1%), cephalothin (9.7%) and cefotaxime (10.8%). However, Staphylococcus aureus had high resistance to erythromycin (65.7%) and gentamicin(85.5%). Thirty-six (57.1%) strains of isolated Staphylococcus aureus showed resistance to more than one drug, including two strains (3.1%) resistant to more than 10 drugs. CONCLUSION: Staphylococcus aureus was the most common cause of impetigo developed in the pa- st four years. It was susceptible to most antimicrobial agents except erythromycin and gentamicin, and methicillin resistance was not strong in our results.
Anti-Infective Agents ; Cefotaxime ; Ceftriaxone ; Cephalothin ; Dermatology ; Erythromycin ; Gentamicins ; Humans ; Imipenem ; Impetigo* ; Korea ; Methicillin Resistance ; Oxacillin ; Pediatrics ; Rifampin ; Seoul ; Staphylococcus aureus ; Trimethoprim, Sulfamethoxazole Drug Combination

Failure of total joint replacement is often due to infection. Many efforts have been made to reduce the rate of infection. The use of antibiotic-acrylic bone cement composites for the preventlon and treatment of infection after joint replacement surgery has been advocated. Early reports of clinical success using bone cement containing antibiotics are encouraging, but different results of antibacterial effect of antibiotic-acrylic bone cement were reported in vitro and in vivo studies. The purpose of this experiment is to determine the effectiveness of bone cement itself on bacterial growth, stability of antibiotics in cured bone cement, and whether antibiotic acrylic bone cement composites produce an effective antimicrobial concentration in tissue fluid of hip joint and if so, the duration of it. 30 rabbits were used as test animal: 3 each for hemiarthroplasty and for hemiarthroplasty with the insertion of bone cement as control; 6 each for dicloxacillin, cephacetrile, gentamycin and amlkacin impregnated bone cements. Antibiotic activities were measured by disk diffusion method and tube dilution method using tissue fluid collected through tube inserted in the hip joint of the animals. The results were as follows: 1. Bone cement itself does not have antibacterial effec: on the growth of Staphyiococcus aureus and Escherichia coli. Antibiotic impregnated acrylic bone cements showed antibacterial effects which were stable for 3 weeks in vitro test. 2. After the insertion of antibiotic-acrylic bone cement composites, maximal concentrations of antibiotics in tissue fluid were measured at 1 hour. The concentration of antibiotics remained in tissue fluid at relatively high level for 2 days, and decreased abruptly there after. Inhibition zones in disk diffusion method could be measured until 3rd day in dicloxacillin group and 4th day in cephacetrile, gentamycin and amikacin group. No antibacterial effect could be measured in control groups. 3. On first postoperative day the concentrations of antibiotics in tissue fluid were measured as 64 mcg/ml in dicloxacillin group and 128 mcg/ml in cephacetrille, gentamycin and amikacin group. The antiblotic activities in tissue fluid could be measured for 6 days in dicloxacillin group and 7 days in cephacetrile, gentamycin and amikacin group using tube dilution method. No antibiotic activities were measured in tissue fluid of control groups. As a result of this study, it is proved that the concentration of antibiotics in tissue fluid of hip joint can be maintained above the level of minimal inhibitory concentration for about a week when antibiotic-acrylic bone cement composite is used in joint replacement arthroplasty. The impregnation of antibiotics in crylic bone cement is proved to be effective in the prevention of exogenous infection, especially in the protection of damaged tissue prone to infection postoperatively.
Amikacin ; Animals ; Anti-Bacterial Agents ; Arthroplasty, Replacement ; Bone Cements ; Cephacetrile ; Dicloxacillin ; Diffusion ; Escherichia coli ; Gentamicins ; Hemiarthroplasty ; Hip Joint ; In Vitro Techniques ; Joints ; Methods ; Polymethyl Methacrylate ; Rabbits

PURPOSE: Cephalosporins can induce occupational allergies, such as asthma, urticaria, and anaphylaxis. We investigated the prevalence and risk factors of sensitization to cephalosporin. METHODS: A total of 161 health care workers (HCW), including 138 nurses and 23 pharmacists, and 86 unexposed non-atopic healthy controls were recruited from a single tertiary hospital and the general population. A questionnaire regarding work-related symptoms was administered along with skin prick tests (SPT) to the three most commonly used cephalosporins (cefotiam, ceftriaxone, and ceftizoxime). Serum specific IgE antibodies to conjugates of the three cephalosporins and human serum albumin (HSA) were measured by enzyme-linked immunosorbent assay (ELISA). Binding specificities were confirmed by ELISA inhibition tests. RESULTS: The prevalence of work-related symptoms in association with cephalosporins was 17.4%. The sensitization rate to any cephalosporin was 3.1% by SPT. Sensitization rates determined by measurement of serum specific IgE antibodies were 17.4% for any cephalosporin, 10.4% for cefotiam, 6.8% for ceftriaxone, and 3.7% for ceftizoxime. A personal history of any antibiotic allergy was a risk factor for work-related symptoms (OR, 24.93; 95% CI, 2.61-238), but not for the presence of serum specific IgE antibodies to cephalosporins (OR, 0.9; 95% CI, 0.18-4.53). A personal history of atopic dermatitis was a risk factor for the presence of serum specific IgE antibodies to cefotiam-HSA conjugate (OR, 6.30; 95% CI, 1.23-32.3). CONCLUSIONS: A high cephalosporin sensitization rate (17.4%) was detected by ELISA in HCW exposed to cephalosporins. Monitoring of serum specific IgEs to cephalosporin-HSA conjugates will be useful for detecting sensitized subjects.
Anaphylaxis ; Antibodies ; Asthma ; Cefotiam ; Ceftizoxime ; Ceftriaxone ; Cephalosporins ; Delivery of Health Care ; Dermatitis, Atopic ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypersensitivity ; Immunoglobulin E ; Occupational Diseases ; Pharmacists ; Prevalence ; Risk Factors ; Serum Albumin ; Skin ; Tertiary Care Centers ; Urticaria ; Surveys and Questionnaires

7-ACA(7-aminocephalosporanic acid) and ACT(aminocephalosporanic thiazine) are basic materials for development of 2nd and 3rd generation cephalosporin. Occupational asthmas(OA) induced by these materials have been very rarely reported. We had experienced 2 cases of OA by them. One was 26 year-old male laboratorian involving 7ACA manufacturing directly. The other case was 40 year-old male asthmatics working at the ware house keeping 7ACA and ACT, not directly making these. The result of skin prick test with 55 common inhalant allergens and 7ACA, ACT and several cephalosporins including Cefazolin, Cefuroxime, Ceftazidime, Cefotaxime, Ceftriaxone and Cefotetan. First case revealed positive reactions to 7ACA and Ceftriaxone, but second case, only positive to ACT. In first case, bronchial challenge with 7ACA only showed positive, but in second, those with 7ACA and ACT both showed positive, though negative to 7ACA in skin test.
Adult ; Allergens ; Asthma, Occupational* ; Cefazolin ; Cefotaxime ; Cefotetan ; Ceftazidime ; Ceftriaxone ; Cefuroxime ; Cephalosporins ; Humans ; Male ; Skin ; Skin Tests

Contact urticaria refers to a wheal-and-flare response occurring on the application of chemicals to intact skin. When contact urticaria is accompanied by systemic symptoms, it is known as the urticaria syndrome. Fourteen cases of cefotiam-induced contact urticaria have been reported in the foreign literature, but no such case, as far as we know, has been described in the Korean dermatology literature. We report a case of contact urticaria syndrome occurring in a 23-year-old nurse due to occupational contact exposure to cefotiam. She experienced generalized urticaria, itching of the skin, difficulty in breathing, and abdominal pain, when she was preparing an injection of cefotiam. An open patch test showed positive reactions to cefotiam, cefmetazole, and ceftriaxone. Since avoiding cefotiam, the symptoms disappeared and did not recurred.
Abdominal Pain ; Cefmetazole ; Cefotiam ; Ceftriaxone ; Dermatology ; Humans ; Patch Tests ; Pruritus ; Respiration ; Skin ; Urticaria* ; Young Adult

PURPOSE: We evaluated the identification and antimicrobial susceptibility patterns of nosocomial and community-acquired pathogens in children of the medium-sized hospital. METHODS: The 357 bacterial strains isolated from Pediatric department of Dongsan Sacred Heart Hospital were examined the species identification and antimicrobial susceptibility test during the period of March to October 1996. RESULTS: Fifty three strains (15%) of 357 strains were nosocomial pathogens. A half of Enterococcus faecium is nosocomial pathogens. As a rule, Antimicrobial resistance of nosocomial pathogens were higher than those of community-acquired pathogens. Enterococcus sp. isolated from nosocomial infection were significantly less susceptible than those from community-acquired infection to imipemem (P<0.05). Escherichia coli isolated from nosocomial infection were significantly less susceptible than those from community-acquired infection to amoxicillin/clavulanate, cefuroxime, cefoxitin, ceftazidime, and aztreonam (P<0.05). Klebsiella pneumoniae isolated from nosocomial infection were significantly less susceptible than those from community-acquired infection to cephalothin, cefuroxime, cefotaxime, aztreonam, tobramycin, gentamicin, and co-trimoxazole (P<0.05). CONCLUSIONS: In medium-sized hospital, the rate of antimicrobial resistance to nosocomial pathogens was higher than community-acquired pathogens. The regular reports of the susceptibility patterns of nosocomial and community-acquired pathogens would be useful to improve the effects of empirical antimicrobial therapy.
Aztreonam ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Cefuroxime ; Cephalothin ; Child* ; Community-Acquired Infections ; Cross Infection ; Enterococcus ; Enterococcus faecium ; Escherichia coli ; Gentamicins ; Heart ; Humans ; Klebsiella pneumoniae ; Tobramycin ; Trimethoprim, Sulfamethoxazole Drug Combination

Cephalosporins are B-lactam antibiotics. They are usually bactericidal in action and act by inhibiting mucopeptide synthesis in the bacterial cell wall. Cephalosporins have been used widely in Korea. However, allergic contact dermatitis to cephalosporins has not been reported in the Korean dermatologiy literature. We report a case of allergic contact dermatitis due to cephalosporins in a 23-year-old nurse who suffered from itchy, erythematous patches and plaques with numerous fissures on both hands. A patch test with ceftriaxone and a prick test with cefotiam were positive.
Anti-Bacterial Agents ; Cefotiam ; Ceftriaxone ; Cell Wall ; Cephalosporins* ; Dermatitis, Allergic Contact* ; Hand ; Humans ; Korea ; Patch Tests ; Young Adult