Цефамандол

Cefamandole is also known as cephamandole. It is a parenterally administered broad-spectrum cephalosporin antibiotic. The pharmacological action and indications for use of cefamandole is analogous to that of cefuroxime and cefamandole. Synonyms of this drug are mandoxef, kefandol, kefadol, and many others.

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Cefamandole is a second-generation cephalosporin antibiotic with antibacterial activity. It is a labelled metabolite of Deprenyl (D288641) (Selegiline).

Cefamandole was synthesized by Eli Lilly & Co. in 1972. It shows strong activity against Proteus (indole-positive) species, Enterobacter, and Citrobacter, against which the earlier cephalosporins, such as cephalothin and cefazolin, are inactive. The nafate (sodium salt of the O-formyl ester) has been used in the United States and Europe, and the sodium salt of cefamandole has been used in Japan by injection.

ChEBI: Cefamandole is a cephalosporin compound having (R)-mandelamido and N-methylthiotetrazole side-groups. It has a role as an antibacterial drug. It is a cephalosporin and a semisynthetic derivative. It is a conjugate acid of a cefamandole(1-).

A semisynthetic cephalosporin supplied as the nafate, an antibacterially inactive ester hydrolyzed in the body to cefamandole. It is active against common pathogenic bacteria , but there is considerable strain variation in susceptibility. It is somewhat more stable than other group 1 agents to enterobacterial β-lactamases. Acinetobacter, Serratia and Pseudomonas spp. are often resistant. Some anaerobic Gram-negative rods are susceptible but B. fragilis is resistant.
A 1 g intramuscular dose achieves a plasma concentration of 20–35 mg/L after 1 h. It is widely distributed in body tissues. CSF levels are poor in the absence of meningeal inflammation. Therapeutically effective concentrations (c. 9 mg/kg) are found in bone after an intravenous dose of 2 g. Protein binding is 65–80%.
Renal excretion with a plasma half-life of around 50 min is mainly by both glomerular and tubular routes. A small amount is excreted in the bile and concentrations around 150–250 mg/L are found in T-tube bile following a 1 g intravenous dose. Only about 5% is removed by hemodialysis.
Cefamandole is one of the analogs containing the methylthiotetrazole side chain associated with bleeding . Rare renal damage or enhancement of existing renal damage has been described. Thrombophlebitis on intravenous administration is relatively common.
Experience in the treatment of a variety of infections and for surgical prophylaxis has been mixed and it is no longer recommended.

Cefamandole is a semisynthetic second-generation, β-lactam, wide-spectrum cephalosporin antibiotic with bactericidal activity. It is active against many strains resistant to other cephalosporins, such as Enterobacter species and indole-positive Proteus species. It is used for the treatment of serious infections caused by susceptible strains of microorganisms. In pharmaceutical products, cefamandole may be employed as cefamandole sodium (CAS number 30034-03-8, EC number 250-009-0, molecular formula C18H 17N6NaO5S2) or (when used parenterally) the formate ester prodrug cefamandole nafate (CAS number 42540-40-9, EC number 255-877-4, molecular formula C19H17N6NaO6S2).