Use of cephalosporins with enhanced anti-anaerobic activity for treatment and prevention of anaerobic and mixed XXXX .

@entity1 @entity9853 @entity2868 @entity8 @entity868 @entity130 @entity2886 @entity693 @entity281 @entity5860 @entity12092 @entity8933 @entity1320 @entity3398 @entity3402 @entity3399
The microbiology, adverse-effect profiles, pharmacokinetics, published results of comparative clinical trials, and costs of @entity2886 with enhanced antianaerobic activity are reviewed. @entity3398 , @entity8933 , @entity12092 , and @entity3399 have been used as single agents in the treatment or prophylaxis of anaerobic or mixed aerobic and anaerobic @entity281 , including intra-abdominal, female genital tract, and soft-tissue @entity281 . None of these agents is as active against @entity2868 species as is @entity3402 or @entity868 , but differences among the four cephalosporins do not appear to be clinically important. These agents differ somewhat in their activity against gram-positive and gram-negative bacteria. The majority of adverse reactions to these agents are immunological; @entity9853 -like reactions and alterations in normal hemostasis have also been observed with @entity12092 and @entity3399 . All of these agents are well absorbed after intramuscular injection and produce serum concentrations adequate to treat most @entity281 . Only @entity8933 and @entity3399 produce cerebrospinal fluid concentrations adequate for treatment of gram-negative @entity693 . The primary route of elimination is renal, and each agent requires dosage adjustments in @entity1 with @entity8 . Major differences exist among the elimination half-lives of the agents in @entity1 with normal renal function. The decision to use a cephalosporin for treatment of anaerobic @entity281 should be based on the results of clinical trials that have demonstrated the efficacy of the agent. Data are available to support the use of @entity3398 , @entity8933 , and @entity3399 in the treatment of @entity1320 ; @entity3398 and @entity3399 to prevent @entity130 to the abdomen; all four agents in the treatment of female @entity5860 ; and all four agents for prophylactic use in surgical procedures that may involve enteric anaerobes, especially @entity2868 . Cephalosporins with enhanced antianaerobic activity appear to have similar in vitro microbiological activity and have efficacy similar to that of combination regimens for the treatment and prophylaxis of @entity1320 , @entity1320 , and soft-tissue @entity281 .
