Withdrawn in 1986 by U.S.FDA, Cefamandole was voluntarily withdrawn from the market due to reports of hemolytic anemia associated with its use. Hemolytic anemia is a condition in which red blood cells are destroyed at a faster rate than they can be produced, leading to a shortage of red blood cells in the body. This can cause symptoms such as fatigue, weakness, and shortness of breath, and also in severe cases can be life-threatening. The risk of hemolytic anemia was found to be higher in patients with renal impairment, and it was determined that the benefits of the drug did not outweigh this risk. As a result, the manufacturer decided to discontinue its production and marketing
Allopathy
Prescription Required
Cefamandole belongs to the pharmacological class of Second-generation cephalosporin antibiotics.
Cefamandole has been approved to relieve symptoms and also for the treatment and maintenance of Respiratory tract infections, Urinary tract infections, Skin as well as soft tissue infections, Bone and joint infections, and Septicemia.
Cefamandole is a second-generation cephalosporin antibiotic used to treat various bacterial infections. After intravenous administration, cefamandole is rapidly absorbed with a bioavailability of 80-100%. The drug is distributed widely throughout the body and reaches therapeutic concentrations in many tissues and fluids, including bone, bile, and cerebrospinal fluid. The protein binding of cefamandole ranges from 30-40%. The drug is primarily eliminated through the kidneys via glomerular filtration and tubular secretion with a half-life of approximately 1.5 hours in healthy adults.
The common side effects which involve the use of Cefamandole are nausea, vomiting, gas, weakness, tiredness, itching, diarrhea, headache, upset stomach, etc.
Cefamandole is available in the form of Powder injection and solution for injection.
Cefamandole belongs to the pharmacological class of Second-generation cephalosporin antibiotics.
Cefamandole is a bactericidal antibiotic that works by inhibiting bacterial cell wall synthesis. Specifically, it binds to and inhibits the activity of the enzymes responsible for cross-linking peptidoglycan strands in bacterial cell walls, known as penicillin-binding proteins (PBPs). This leads to the weakening and eventual lysis of bacterial cell walls, resulting in the death of the bacteria. Cefamandole is effective against a wide range of gram-positive and gram-negative bacteria, including Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, and Klebsiella pneumoniae, among others.
Cefamandole has been approved to relieve symptoms and also for the treatment and maintenance of Respiratory tract infections, Urinary tract infections, Skin and soft tissue The peak serum concentration (Cmax) of cefamandole is achieved 30 minutes to 2 hours after intravenous administration and 1 to 2 hours after intramuscular injection. The onset of action is rapid, with antibacterial activity occurring within 30 minutes to 1 hour after administration. The duration of action is approximately 6 hours.
Cefamandole is found to be available in the form of Powder for injection, Solution for injection.
Cefamandole can be used in the following treatment:
● Respiratory tract infections
● Urinary tract infections
● Skin and soft tissue infections
● Bone and joint infections
● Septicemia
Cefamandole can help to relieve symptoms and also for the treatment and maintenance of Respiratory tract infections, Urinary tract infections, Skin and soft tissue infections, Bone and joint infections, Septicemia.
Cefamandole is approved for use in the following clinical indications:
● Respiratory tract infections
● Urinary tract infections
● Skin and soft tissue infections
● Bone and joint infections
● Septicemia
● Respiratory tract infections: 500mg to 1g every 6 to 8 hours
● Urinary tract infections: 500mg to 1g every 12 hours
● Skin and soft tissue infections: 500mg to 1g every 6 to 8 hours
● Bone and joint infections: 1g every 6 to 8 hours
● Septicemia: 1g every 6 to 8 hours
Powder for injection: 1 g and 2 g vials
Powder for reconstitution: 250 mg/5 mL and 500 mg/5 mL
Solution for injection: 1 g and 2 g vials
Dosage Adjustments in Kidney Patients:
CrCl greater than 30 mL/minute: No adjustment necessary
CrCl 10 to 30 mL/minute: Administer every 12 hours
CrCl less than 10 mL/minute: Administer every 24 hours
Dosage Adjustments in Hepatic Impairment Patients:
No dosage adjustments are needed for hepatic Impairment.
Available as Powder for injection, Solution for injection.
Avoid high acid foods like citrus fruits as well as juices like orange and grapefruit, soda and chocolates.
Alcohol intake might lead to nausea,vomiting and headache
Multivitamins and antacids contain minerals primarily magnesium calcium aluminum iron or zinc which binds to the antibiotic and refrain it from working. Spacing them at least for 2 hours after Cefamandole administration is recommended.
Cefamandole may be contraindicated under the following conditions:
● Cefamandole is contraindicated in patients who have demonstrated hypersensitivity to Cefamandole, other cephalosporins, penicillins or any component of the formulation. It should also not be used in patients who have a history of anaphylaxis to beta-lactam antibiotics.
● Additionally, it is contraindicated in neonates with hyperbilirubinemia or a history of jaundice, as Cefamandole may displace bilirubin from albumin and increase the risk of kernicterus.
● Finally, Cefamandole is contraindicated in patients with a history of colitis, inflammatory bowel disease or pseudomembranous colitis associated with the use of antibiotics.
The physician should closely monitor the patients and keep pharmacovigilance as follows:
Allergic reactions: Cefamandole can cause severe allergic reactions, including anaphylaxis, which can be life-threatening. Patients who have a history of hypersensitivity to cephalosporins or penicillins should not use cefamandole.
Clostridium difficile-associated diarrhea: Cefamandole can lead to the development of Clostridium difficile-associated diarrhea (CDAD) due to the disruption of the normal bacterial flora in the intestine. This may range from mild to severe and potentially fatal. Patients who develop diarrhea during or after treatment with cefamandole should be monitored for CDAD.
Superinfection: The use of cefamandole can lead to the development of superinfection due to the overgrowth of nonsusceptible organisms. Patients should be monitored for signs and symptoms of superinfection, and appropriate therapy should be initiated if necessary.
Alcohol Warning
There is a moderate interaction between alcohol and Cefamandole. It is generally recommended to avoid drinking alcohol while taking Cefamandole because it may increase the risk of side effects such as dizziness, drowsiness, and gastrointestinal upset. Additionally, alcohol may also impair the body's ability to fight infections, which may reduce the effectiveness of Cefamandole in treating bacterial infections.
Breast Feeding Warning
Cefamandole is excreted in human milk, and its use during lactation is not recommended unless the benefits outweigh the potential risks.
Pregnancy Warning
Pregnancy Category B
Cefamandole is classified as pregnancy category B, which means that it is generally considered safe for use during pregnancy. However, it should be used with caution and only if clearly needed, as there have been limited studies on its use in pregnant women.
Food Warning
No sufficient scientific evidence is traceable regarding the use and safety of Cefamandole in concurrent use with any particular food.
The adverse reactions related to Cefamandole can be categorized as follows:
Common
● Nausea,
● Vomiting
● Diarrhea
● Headache
● Skin rash.
Less common
● Fever
● Itching
● Abdominal pain
Rare
● Anemia
● Blood clotting disorders
● Kidney problems
● Seizures.
The clinically relevant drug interactions of Cefamandole is briefly summarized here:
● Cefamandole may interact with drugs that cause nephrotoxicity, such as aminoglycosides and vancomycin. Concurrent use of cefamandole with these drugs may increase the risk of kidney damage.
● Cefamandole may also interact with other antibiotics, such as chloramphenicol, which may decrease the effectiveness of cefamandole.
● The use of cefamandole with drugs that affect blood clotting, such as warfarin, may increase the risk of bleeding.
● Additionally, cefamandole may interfere with some laboratory tests, such as the Coombs test, leading to false-positive results. It is important to inform healthcare providers about all medications, supplements, and herbs being taken before starting cefamandole.
The following are the side effects involving Cefamandole :
● Diarrhea
● Nausea
● Vomiting
● Stomach pain
● Headache
● Dizziness
● Rash or itching
● Yeast infection
Pregnancy
Pregnancy Category B
Cefamandole is classified as pregnancy category B, which means that it is generally considered safe for use during pregnancy. However, it should be used with caution and only if clearly needed, as there have been limited studies on its use in pregnant women.
Lactation:
Cefamandole is excreted in human milk, and its use during lactation is not recommended unless the benefits outweigh the potential risks.
Pediatric:
The safety and efficacy of cefamandole in pediatric patients have not been established. However, it may be used in children under the direction of a healthcare provider.
Geriatric:
The pharmacokinetics of cefamandole may be altered in elderly patients, and caution should be exercised when using this medication in this population. Dose adjustment may be necessary based on renal function.
Physicians should be knowledgeable and vigilant about the treatment and identification of overdosage of Cefamandole.
There is limited information available on the specific management of an overdose of cefamandole. However, in the case of an overdose, supportive measures such as monitoring of vital signs, fluid and electrolyte balance, and renal function should be initiated. Hemodialysis may be considered to remove cefamandole from the body.
It is important to note that cefamandole overdose is rare, and the dosages used in clinical practice are well-tolerated. Therefore, it is important to follow the prescribed dosage and duration of therapy to prevent any adverse effects. In case of suspected overdose, medical attention should be sought immediately.
Pharmacodynamics
Cefamandole is a broad-spectrum cephalosporin antibiotic that works by inhibiting bacterial cell wall synthesis. It achieves this by binding to and inhibiting the activity of penicillin-binding proteins (PBPs), which are enzymes responsible for cross-linking peptidoglycan chains that make up the bacterial cell wall. This results in the weakening of the bacterial cell wall, leading to cell lysis and death. Cefamandole has activity against both Gram-positive and Gram-negative bacteria, including some strains that are resistant to other beta-lactam antibiotics. The pharmacodynamic parameters of cefamandole, such as the minimum inhibitory concentration (MIC), time above MIC, and area under the concentration-time curve (AUC), are important determinants of its antimicrobial activity and efficacy.
Pharmacokinetics
Cefamandole is a second-generation cephalosporin antibiotic used to treat various bacterial infections. After intravenous administration, cefamandole is rapidly absorbed with a bioavailability of 80-100%. The drug is distributed widely throughout the body and reaches therapeutic concentrations in many tissues and fluids, including bone, bile, and cerebrospinal fluid. The protein binding of cefamandole ranges from 30-40%. The drug is primarily eliminated through the kidneys via glomerular filtration and tubular secretion with a half-life of approximately 1.5 hours in healthy adults.
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2. https://pubchem.ncbi.nlm.nih.gov/compound/Cefamandole
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5. https://www.drugs.com/sfx/cefamandole-side-effects.html
6. https://www.mims.com/philippines/drug/info/cefamandole?mtype=generic
