Antibiotic concentration in the serum of dogs and cats following a single oral dose of cephalexin

Six dogs and six cats were given a single oral tableted dose containing approximately 15 mg/kg bodyweight of the semisynthetic cephalosporin antibiotic, cephalexin. Three dogs and four cats were similarly dosed using a liquid preparation of the same antibiotic. At intervals after dosing, blood samples were taken and the level of antibiotic in the serum was determined by bioassay. After fitting the results to a mathematical model the calculated peak serum level of antibiotic was found to be about 15 micrograms/ml and to occur between one and two hours after dosing. Results agree with the performance of the antibiotic in human medicine.

Comparison between cephalexin two- and four-time per day regimens in group A streptococcal pharyngitis

In previous studies, twice daily (bid) and four times daily (qid) administration of most antibiotics approved for group A streptococcus (GAS) pharyngitis therapy have been demonstrated to be equally effective. In this study, four investigators collaborated in a double-blind, randomized multicenter study assessing the efficacy of cephalexin given in doses of 1.0 g or 0.5 g daily on a bid or qid regimen for 10 to 14 days to 157 patients with GAS pharyngitis. The mean daily doses for patients on the bid and qid regimens were 30 mg/kg and 29 mg/kg, respectively. Pretreatment and two follow-up cultures, usually 2 to 6 and 12 to 16 days after the end of treatment, were taken on all patients. Failure, defined as recurrence of the original GAS M-precipitin and T-agglutination types on follow-up culture, occurred in 7.3 percent of 82 patients on the bid and 5.3 percent of 75 patients on the qid regimen. We conclude that cephalexin bid and qid regimens are equally effective, and that the bid regimen can be recommended for all antibiotics approved for GAS pharyngitis therapy.

The extended microbiology of group A streptococcal pharyngitis. Observations during a double-blind controlled study of cephalexin twice versus four-times daily

In a double-blind controlled study we compared the effectiveness of cephalexin b.i.d. versus q.i.d. in the treatment of group A streptococcal pharyngitis in 65 children. Clinical improvement was noted in 64 patients (98%) and bacteriologic cure in 60 (92%). Despite good compliance, three bacteriologic failures were noted in the q.i.d., and two in the b.i.d. treatment groups. Two of these five were carriers. Significant antibody responses were observed in 61% of the patients by at least one of three tests (ASO, anti-DNase B, Streptozyme). We also investigated the extended microbiology of streptococcal pharyngitis by looking for the presence of viruses, chlamydia and beta-lactamase producing organisms in the pharynx. Respiratory viruses were isolated concomitantly with Streptococcus pyogenes in six patients. Beta-lactamase producing bacteria were present in the pharynx of 98% of the patients at the initiation of treatment and comprised 1-98% of the total bacterial flora. The beta-lactamase producing flora did not significantly change with cephalexin therapy.

[Clinical studies on recurrence of acute uncomplicated cystitis]

Recurrence rate and symptoms after chemotherapy against acute uncomplicated cystitis (AUC) were studied. Upon completion of a 7-day treatment with two regimens, one of CEX alone (Group C) and the other of a combination of CEX with Lysozyme (Neuzym) (Group L), at a dose of 1 g CEX daily, efficacy of the drugs was assessed according to the criteria established by the UTI Study Group. The forty one cases in Group C and 38 cases in Group L showing an excellent response were evaluated for recurrence. The rates of recurrence were 12.2% in Group C and 21.1% in Group L during the first 7 days after treatment. In recurrent cases, bacteriuria was seen in 84.6% (11/13), pyuria in 53.8% (7/13) and miction pain in 30.8% (4/13). Thus, bacteriuria and pyuria should be the items of the criteria for AUC recurrence.

[A double-blind comparison between cefaclor and cephalexin in the treatment of dental infections]

A comparative clinical study of cefaclor (CCL) with cephalexin (CEX) was carried out by randomized double-blind techniques in order to contemplate the clinical efficacy, side effects and usefulness in treatment of 243 patients with dental infections. In the CEX group, CEX was orally administered 4 times a day at a daily dosage of 1,000 mg for 3 to 5 days. In the CCL group, CCL was orally administered 3 times a day at a daily dosage of 750 mg for 3 to 5 days and 1 capsule of placebo was also given every evening in order to keep the blindness of the administration. Evaluable cases for efficacy of athe drugs were 213 consisting of 108 for CCL and 105 for CEX. There were no significant differences in background of the patients and severity of the disease between 2 treatment groups. Clinical effectiveness on the 3rd day was 89.7% in CCL group and 78.6% in CEX group, showing significant difference between 2 treatment groups. Clinical effectiveness on the final day of administration was 94.4% in CCL group and 92.4% in CEX group, showing no significant difference between 2 treatment groups. Side effects were found in 10.5% of 114 patients receiving CCL and in 4.5% of 112 patients with CEX, and there was no significant difference between 2 treatment groups. The side effects were mostly gastrointestinal origin. According to the judgement by physicians in charge, no significant difference was seen in clinical usefulness between the 2 drugs.

Bacteriuria in pregnancy treated with a single dose of cephalexin

Of 87 women in whom bacteriuria was diagnosed on dip slides at between 9 and 22 weeks gestation only 51 (59%) had true bacteriuria in urine obtained by suprapubic aspiration. A single oral dose of cephalexin (3 g) was given to 37 of these patients, 10 were Indian and none of them had recurrence of infection after treatment, whereas 11 of the 27 (41%) 'indigenous' women again had bacteriuria within 2 weeks of treatment. None of the other 26 patients had recurrent bacteriuria in the pregnancy studied. Success of treatment was not related to renal concentrating ability nor, apart from ethnic group, were there other significant differences between successes and failures. Although single-dose treatment seems to be less effective in pregnancy than in the non-pregnant patients, it is an acceptable method of treatment provided that all treated patients are followed closely to detect those who do not respond and require further therapy.

Comparison of pharmacokinetics of sodium and lysine cephalexin in calves

The pharmacokinetics of sodium and lysine cephalexins were investigated after intravenous and intramuscular administration of a single dose rate of 30 mg.kg-1 body weight in calves. The data for the two salts administered intravenously were pooled, the resulting pharmacokinetic disposition of cephalexin indicating a distribution half-time (t1/2 alpha) and an elimination half-time (t1/2 beta) of 9.78 and 62.0 min, respectively. Following intramuscular administration some pharmacokinetic differences were recorded between the cephalexin preparations: lysine cephalexin was more rapidly eliminated (t1/2kel = 55.2 min) than sodium cephalexin (t1/2kel = 89.8 min), although the peak blood level was higher and attained after a longer time with lysine cephalexin.

Antibiotic prophylaxis for coronary bypass grafting. Comparison of a five-day and a two-day course

A trial was conducted to compare the effectiveness of a 2 day and a 5 day course of antibiotic prophylaxis after coronary bypass grafting. One hundred sixty patients were randomized to one of the two courses. The 2 day course comprised 48 hours of intramuscular kanamycin and intravenous cephalothin. The 5 day course comprised 48 hours of intramuscular kanamycin and intravenous cephalothin followed by 3 days of oral cephalexin. After the 2 day course, there were two wound infections and two respiratory tract infections in 79 patients (5.1%), and after the 5 day course, one wound infection and two respiratory tract infections in 81 patients (3.7%). Subsequently, in 171 patients undergoing coronary bypass grafting and given the 2 day course, the infection rate was 3.5%. There was no significant difference in infection rates among the three groups (p greater than 0.05). We conclude that no more than 2 days of antibiotic prophylaxis are necessary for patients undergoing coronary bypass grafting.

Cephalexin for oral treatment of canine urinary tract infection caused by Klebsiella pneumoniae

Oral treatment with cephalexin resulted in bacteriologic cure in 24 of 25 (96%) dogs with urinary tract infection caused by Klebsiella pneumoniae. All 25 of the isolates of K pneumoniae were susceptible in vitro to cephalexin at a concentration of less than or equal to 64 micrograms/ml, well below the mean concentration of cephalexin attained in the urine of clinically normal dogs given similar doses of this drug.

[Double-blind comparison of cefadroxil and cephalexin granules in the treatment of impetigo]

A double-blind clinical comparison of cefadroxil granules (CDX) and a long-acting preparation of cephalexin granules (L-CEX) was conducted in the treatment of impetigo in children. The long-acting cephalexin preparation was composed of 3 parts of granules soluble in the stomach and 7 parts of those soluble in the intestine. Drugs were administered at 3 different doses depending on the body weight of patients (Group I: less than 10 kg, Group II: between 10 kg and 20 kg, Group III: over 20 kg). Overall clinical evaluation by attending doctors: CDX group scored slightly better but not statistically significant results. Evaluation of usefulness: CDX group scored slightly better but not statistically significant results. Partially standardized evaluation: CDX scored statistically significantly higher points in the evaluation of total cases and Group II on Day 5, and Group II on Day 7. Cumulative points through Day 5 and Day 7 were not statistically significant. Follow-up evaluation by attending doctors: CDX group got a better result in total cases and Group II on day 3, and in total cases on days 5 and 7. Otherwise there was no statistically significant difference. Incidence of side effects was not significantly different between the 2 drug groups. As shown in Fig. 1, CDX was administered on rising in the morning, after lunch, and at bed time whereas L-CEX was given on rising and at bed time when the patients were relatively in fasting condition. This may have reduced the expected merit of L-CEX and some reserve is required in the interpretations of the results shown herein.

Treatment of chronic prostatitis by consecutive per os administration of doxycycline, sulfamethoxazole/trimethoprim, and cephalexin

Fifty men with cytologically confirmed chronic prostatitis were treated for 3 months by consecutive p.o. administration of doxycycline, sulfamethoxazole/trimethoprim, and cephalexin. The subjective symptoms, palpatory findings, secretory capacity of the accessory genital glands (values of acid phosphatase and fructose in the seminal plasma) were evaluated. The cytologic findings from the expressed prostatic fluid and semen analysis before and after the treatment were also studied. Approximately 60% of the patients were cured of the subjective symptoms. The palpatory findings disappeared in 50% of the cases. The cytologic findings became normal in 70% of the patients (inflammatory cells less than 25/HPF). The secretory function of the prostate and the seminal vesicles was improved in 50% and 25%, respectively, of the patients, and the quantitative and qualitative motility and viability of the spermatozoa after treatment were significantly enhanced.

Comparison of two dosage schedules in the treatment of streptococcal pharyngitis

The results of this comparative study in 210 patients offer substantial evidence of the safety and efficacy of cephalexin as therapy for acute bacterial pharyngitis and tonsillitis due to group A streptococci. In addition, administration twice a day appears to be as effective as four times a day, provided the total daily dosages are equivalent and are taken for 10 days.

Therapy for intercurrent respiratory infections in COLD patients: report on 200 patients

Over the last 2 years we have applied a therapeutic regimen with simultaneous use of cephalexin and bromhexine in therapy for infective exacerbations of COLD patients. The results obtained are positive. Bacteriologic features, the modification of sputum and, where possible, behavior of hematologic parameters and blood gases were checked. This pharmacologic combination appears to be useful in pneumology, as it yields very good results in obstructive chronic bronchitis in a bacterial relapsing phase and with alveolar hypoventilation linked to massive presence of endoluminal mucus. With the exception of two patients, in whom nausea and gastric pyrosis were observed, we observed no toxic or side effects of any kind, not even in subjects treated for a long time.

Therapeutic and prophylactic effects of cephalexin and bromhexine in respiratory tract complications of abdominal surgery

We report the results of a study carried out with cephalexin and bromhexine in a group of 100 patients at risk for bronchopulmonary complications following abdominal surgery. The treatment achieved very good activity and excellent tolerance. We consider this therapy very useful for prophylaxis and treatment of bronchopulmonary complications in patients who have undergone surgery.

The value of prophylactic antibiotics for simple lacerations

A prospective study was undertaken to review the efficacy of antibiotics in the treatment of patients with minor lacerations. Four hundred and ninety-nine patients were randomized into two groups. Two hundred and twenty-seven patients in group 1 received cephalexin, 250 milligrams, every six hours for 72 hours. Two hundred and seventy-two patients in group 2 received no antibiotics. The over-all infection rate was 6.6 per cent, 33 of 499 patients. Sixteen of the 227 patients in group 1, 7.0 per cent, had infections develop compared with 17 of the 272 patients in group 2, 6.25 per cent. Seven of 51 patients, 13.7 per cent, in group 1 and three of 53, 5.7 per cent, in group 2 with mildly contaminated wounds had infections develop. No significant difference was noted between the groups according to the age of the patient, interval since injury, anatomic location or suture technique. Prophylactic, orally administered antibiotics do not decrease the incidence of infection in patients with suture closure of simple lacerations.

[Clinical studies on cefadroxil in the field of pediatrics]

The newly developed cefadroxil (CDX) dry syrup in a mean daily dose of 32.9 mg/kg t.i.d. or q.i.d. was administered to children for a period of 8 days on the average; viz. a total of 64 cases consisting of 39 cases of tonsillitis, 2 of tonsillitis complicated with otitis media, 1 of bronchitis, 1 of pneumonia, 14 of scarlet fever, and 7 of urinary tract infections; and its clinical and bacteriological effects, and adverse reactions were examined, leading to the following results. 1. The clinical effects were "good" or "excellent" in any of 39 cases of tonsillitis, 2 of tonsillitis complicated with otitis media, 1 of pneumonia, 14 of scarlet fever, and 7 of urinary tract infections, and "fair" only in a case of bronchitis, showing the high efficacy of 98.4%. 2. The clinical effects by daily dose were compared only in the great cases of tonsillitis between the 2 daily dose groups of 30 mg/kg or below and 31 to 40 mg/kg, and both groups showed "good" or "excellent" results, but the latter group revealed that the excellent rate was greater by 20.8% than that of the former group. 3. The frequency of daily administration was 3 times or 4 times and the cases of 4 times administration were few in any disease. In comparison of clinical effects between the 3 times group and the 4 times group in the whole cases, no significant difference was observed between both groups but it is desirable to make the 4 times administration in view of the pharmacokinetics. 4. The bacteriological effects could be judged in 15 cases, namely bacteria were eradicated in 14 cases and unchanged in 1 case, showing a good result of the eradication rate as 93.3%. 5. No adverse reaction was observed and the laboratory test values showed eosinophilia in 7 cases (15.9%) and abnormal elevations of GPT in 1 case (4.5%), of GOT and GPT in 2 case (9.1%), of LDH in 1 case (4.8%) and of BUN in 1 case (4.8%), but 4 of the 7 cases with eosinophilia seemed attributable to underlying diseases or objective diseases. From the above it can be said that this preparation is a useful drug in mild bacterial diseases.

Cefazolin and cephalexin kinetics in continuous ambulatory peritoneal dialysis

We studied single-dose cefazolin (CFZ) and cephalexin (CPX) kinetics in continuous ambulatory peritoneal dialysis (CAPD) patients to establish therapeutic guidelines for two cephalosporins commonly used to treat peritonitis in these patients. CFZ, 10 mg/kg, was given intravenously and intraperitoneally, while CPX, 500 mg, was given orally. CFZ led to serum concentrations of 25 microgram/ml at 24 hr, with a half-life (t 1/2) of 33 hr. CAPD accounted for only 20% of total body clearance. When CFZ was given intraperitoneally, 74% of the dose was absorbed and similar serum concentrations had much the same t 1/2. CPX, on the other hand, had a serum t 1/2 of 8.6 hr and resulted in much lower peritoneal concentrations than CFZ. The kinetic principal of superposition provided a model for the prediction of plasma concentrations after repeated intraperitoneal doses of CFZ. The model predicts that a 10-mg/kg intraperitoneal loading dose, followed by 5-mg/kg doses in each exchange the first day and 2.5-mg/kg doses thereafter, will lead to steady-state plasma concentrations of 50 to 65 microgram/ml. The data suggest that CFZ needs be given only intraperitoneally at doses lower than those in current use. CPX probably adds little to the treatment of peritonitis.