Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1978 Jul;14(1):13–18. doi: 10.1128/aac.14.1.13

Double-Blind Comparison of Cefamandole and Penicillin in Pneumococcal Pneumonia

Brent G Petty 1, Craig R Smith 1,2, James C Wade 1, Gary L Conrad 1, James J Lipsky 2, Jerrold J Ellner 2, Paul S Lietman 1
PMCID: PMC352398  PMID: 356724

Abstract

We conducted a prospective, randomized, double-blind comparison of intravenous penicillin and cefamandole in the therapy of pneumococcal pneumonia. Patients received either 1 g of cefamandole or 600,000 U of aqueous penicillin G every 6 h. Of the 100 patients entered into the study, 96 had clinical and radiographic evidence of pneumonia. Microbial etiology was determined from the results of sputum and blood cultures and/or sputum Gram stains. Streptococcus pneumoniae was pathogenic in 49 patients, of whom 24 received cefamandole and 25 received penicillin. There was no statistically significant difference in the response or cure rate. Of the 100 patients, 93 were treated for 3 days or more and were evaluated for adverse effects and toxicity. There was no significant difference between cefamandole-treated and pencillin-treated patients in the incidence of colonization, superinfection, phlebitis, thrombocytosis, decrease in hematocrit, or elevated liver function tests. Eosinophilia occurred more frequently in patients treated with penicillin (20 of 42) than in those treated with cefamandole (11 of 42 (chi square, P < 0.05). Only one patient receiving cefamandole developed a positive direct Coombs test. No patient in either group developed meningitis. We conclude that, with the doses and route of administration employed in this study, cefamandole is as effective as penicillin in the therapy of pneumococcal pneumonia without an increased incidence of colonization, superinfection, or adverse effects.

Full text

PDF
13

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barrett-Connor E. The nonvalue of sputum culture in the diagnosis of pneumococcal pneumonia. Am Rev Respir Dis. 1971 Jun;103(6):845–848. doi: 10.1164/arrd.1971.103.6.845. [DOI] [PubMed] [Google Scholar]
  2. Benner E. J., Munzinger J. P., Chan R. Superinfections of the lung. An evaluation by serial transtracheal aspirations. West J Med. 1974 Sep;121(3):173–178. [PMC free article] [PubMed] [Google Scholar]
  3. Cherubin C. E., Anagnastopoulos C., Berger S., Matarese R., Padmanabhan C. S., Perilli J., Pulini M., Scannapiego S., Taddonio R., Tan J. Presumed pneumococcal pneumonia. Treatment with parenteral penicillin, cephaloridine, and lincomycin with continuation on oral therapy. N Y State J Med. 1974 Oct;74(11):1954–1958. [PubMed] [Google Scholar]
  4. LOURIA D. B., BRAYTON R. G. THE EFFICACY OF PENICILLIN REGIMENS, WITH OBSERVATIONS ON THE FREQUENCY OF SUPERINFECTION. JAMA. 1963 Dec 14;186:987–990. [PubMed] [Google Scholar]
  5. Mangi R. J., Kundargi R. S., Quintiliani R., Andriole V. T. Development of meningitis during cephalothin therapy. Ann Intern Med. 1973 Mar;78(3):347–351. doi: 10.7326/0003-4819-78-3-347. [DOI] [PubMed] [Google Scholar]
  6. Meyers B. R., Leng B., Hirschman S. Z. Cefamandole: antimicrobial activity in vitro of a new cephalosporin. Antimicrob Agents Chemother. 1975 Dec;8(6):737–741. doi: 10.1128/aac.8.6.737. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Murray P. R., Washington J. A. Microscopic and baceriologic analysis of expectorated sputum. Mayo Clin Proc. 1975 Jun;50(6):339–344. [PubMed] [Google Scholar]
  8. Neu H. C. Cefamandole, a cephalosporin antibiotic with an unusually wide spectrum of activity. Antimicrob Agents Chemother. 1974 Aug;6(2):177–182. doi: 10.1128/aac.6.2.177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. SHULMAN J. A., PHILLIPS L. A., PETERSDORF R. G. ERRORS AND HAZARDS IN THE DIAGNOSIS AND TREATMENT OF BACTERIAL PNEUMONIAS. Ann Intern Med. 1965 Jan;62:41–58. doi: 10.7326/0003-4819-62-1-41. [DOI] [PubMed] [Google Scholar]
  10. Spencer R. C., Philp J. R. Effect of previous antimicrobial therapy on bacteriological findings in patients with primary pneumonia. Lancet. 1973 Aug 18;2(7825):349–350. doi: 10.1016/s0140-6736(73)93192-9. [DOI] [PubMed] [Google Scholar]
  11. Tempest B., Austrian R. Cephaloridine and penicillin G in the treatment of pneumococcal pneumonia. A comparative study. Ann Intern Med. 1967 Jun;66(6):1109–1115. doi: 10.7326/0003-4819-66-6-1109. [DOI] [PubMed] [Google Scholar]
  12. Thorsteinsson S. B., Musher D. M., Fagan T. The diagnostic value of sputum culture in acute pneumonia. JAMA. 1975 Aug 25;233(8):894–895. [PubMed] [Google Scholar]
  13. Tillotson J. R., Finland M. Bacterial colonization and clinical superinfection of the respiratory tract complicating antibiotic treatment of pneumonia. J Infect Dis. 1969 Jun;119(6):597–624. doi: 10.1093/infdis/119.6.597. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES