VOL.27 S-5 CHEMOTHERAPY Table 1 Clinical evaluations of cefamandole on UTI (1) Benign prostatic hypertrophy (2) Transurethral resection of bladder tum

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CHEMOTHERAPY JUNE 1972 Fig. 1 Chemical structure of cefamandole E. coil, Klebsiella Proteus vulgaris indole positive Proteus sp., Enterobacter, Citrobacter, Serratia marcescens Chemical name: 7-D-mandelamido-3- k k(1-methyl -1H-tetrazol-5-y1)-tlai,o)methyl) -3-cephem-4-carboxylic acid, sodium salt Molecular formula (M. W.): Ci8Hi7N6O5S2Na(484.5) E. coli Enterobacter Proteus morganii, Proteus tnirabilis, Proteus vulgaris, Pseudomonas aeruginosa Pseudomonas aeruginosa Proteus morganii Pseudomonas aerugmosa Klebsiella Citrgbacler

VOL.27 S-5 CHEMOTHERAPY Table 1 Clinical evaluations of cefamandole on UTI (1) Benign prostatic hypertrophy (2) Transurethral resection of bladder tumor (3) Suprapubic prostatectomy (4) Transurethral resection of prostate (5) Bladder neck contracture Not done ** CEZ disc was used. *

CHEMOTHERAPY JUNE 1079

VOL.27 S-5 CHEMOTHERAPY Table 2 Overall clinical efficacy on complicated UTI Table 3 Overall clinical efficacy classified by type of infection Table 4 Bacteriological response

CHEMOTHERAPY JUNE 1179 Table 5 Normal values of laboratory tests Pseudomonas aeruginosa Pseudomonas aeruginosa P seudomona saerugino sa (expressed prostatic secretion, EPS) Pseudomonas aeruginosa Pseudomona s a erugitma

CHEMOTHERAPY JUNE MO Table 7 Abnormal values on blood examinations and follow up * Treated at internal medicine

CHEMOTHERAPY 1) SHEMONSKY, N. K.; J. CARRIZOSA & M. E. LEVISON: In vitro activity and pharmacokinetics in patients of cefamandole, a new cephalosporin antibiotic. Antimicr. Agents & Chemoth. 8(6): 679~683, 1975 2) BODEY G. P. & S. WEAVER: In vitro studies of cefamandole. Antimicr. Agents & Chemoth. 9(3): 452~457, 1976 3) VERSIST. L.: Comparison of the antibacterial activity of nine cephalsoporinp against EntproOactoriacetu and nonfermentative gram-negative bacilli. Antmicr. Agents & Chemother. 10(4): 657 `663, 1976 4) MEYERS, B. R. & S. Z. HIRSCHMAN: Antibacterial activity of cefamandole in vitro. J. Infect. Dis. 137 (Suppl.): S 25 `S 81, 1978 6) HOYME, U. & P.O. MADSEN: Cefamandole and cefazolin in the therapy of complicated urinary tract infections. J. Infect. Dis. 137 (Supp I.): S 100 `S 102 1978 7) LEVINE, L. R. & E. McCAtri: Cefamandole in the treatment of infections due to Enterobacter and indolepositive Proteus. J. Infect. Dis. 137 (Suppl.): S 125 `S 132, 1978 8) WALLACE, H. & D. HENDLIN: Cefoxitin, a semisynthetic cephamycin antibiotic: Susceptibility studies. Antimicr. Agents & Chemoth. 5(1): 25 `32, 1974 10) SUZUKI, K.; L NAGAKUBO, K. NIIMURA & Y. NAIDE: Diffusion of antibacterial drugs into human prostatic fluids. Current Chemotherapy. Proceedings of the 10th International Congress of Chemotherapy. p.412 `415, 1978 11) NEU, H. C.: Comparison of the pharmacokinetics of cefamandole and other cephalosporin compounds. J. Infect. Dis. 137 (Suppl.): S 80 `S 87, 1978

CHEMOTHERAPY JUNE 1979 THE CLINICAL EVALUATIONS OF CEFAMANDOLE ON CHRONIC COMPLICATED URINARY TRACT INFECTIONS KEIZO SUZUKI Department of Urology, Hiratsuka Municipal Hospital KENJI NIIMURA, TAMIO FUJITA, HARUYOSHI ASANO, HIDEKI TAMAI and YORIO NAIDE Department of Urology, Fujita Gakuen University, School of Medicine (1) Clinical evaluations: Twenty patients with gram-negative bacterial infections in the field of urology were treated with a new cephalosporin derivative, cefamandole sodium. Of 17 patients with chronic complicated urinary tract infections, 10 (58.8%) responded excellent or good clinically and bacteriologically with a daily dose of 3 to 4 g. Excluding 2 infections due to Pseudomonasaeruginosa from above cases, the rate of effectiveness achieved 66.7%. Against one case with chronic urethritis, the treatment resulted in failure, however, in a case with chronic bacterial prostatitis caused by E. coli, bacteriological cure was gained. One patient with uncomplicated acute cystitis cured by only a single intravenous administration of 2 g. (2) Side effects: In the laboratory investigations of the blood chemistry, abnormal values were shown in 5 cases in the tests of liver function and in one case in the test of kidney function after receiving cefamandole. It can not be considered that these results were wholly attributed to the drug, however, intensive care would be necessary in the treatment of patients with an episode of hepatitis or abnormal values of liver functions. Peripheral hematology yielded 3 cases of eosinophilia, but no any clinical abnormal manifestations were observed in the patients. (3) Conclusion: From the results of this study, it would be appear that cefamandole is a superior effective antibiotic for use in treatment of urinary tract infections caused byindolepositive Proteus species except Proteus vulgaris to other known cephalosporins.

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