Castleton B, Goodwin C S, Stirling J, Pitcher-Wilmott R, Elton A
Age Ageing. 1976 Aug;5(3):181-7. doi: 10.1093/ageing/5.3.181.
Cephazolin, a semi-synthetic cephalosporin for parenteral use, was evaluated in 39 elderly hospital patients. Thirty-three of these patients were seriously ill at the start of treatment, suffering from pulmonary infections. In the other six patients, the drug was used post-operatively as a prophylactic, and it was effective in all cases in preventing any subsequent infection. Cephazolin was very effective in the treatment of 27 of the severely ill patients; the primary pathogen was eradicated and there was good clinical improvement. In two patients the primary pathogens were resistant to cephazolin, and the antibiotic therapy was changed after sensitivities were known. Of four patients with Haemophilus influenzae infection, clinical cure was obtained in two. Cephazolin therapy was discontinued in one woman because she developed a rash. However, there were no major toxic effects of therapy in terms of hepatic, renal or haematological function. No patient complained of pain when the intramuscular therapy was given. A dose of 1 g IM twice daily was shown to produce consistently high serum concentrations. Thus, in the elderly, the advantages of cephazolin are its lack of nephrotoxicity even when diuretic therapy is being administered concurrently, its lack of pain on intramuscular injection, and its sustained concentrations in the blood and urine so that it only requires to be given twice daily. In vitro studies showed that cephazolin is more active than cephaloridine against hospital pathogens.
头孢唑林是一种供注射用的半合成头孢菌素，对39例老年住院患者进行了评估。其中33例患者在治疗开始时病情严重，患有肺部感染。另外6例患者在术后用作预防用药，在预防随后发生的任何感染方面均有效。头孢唑林对27例重症患者治疗非常有效；主要病原体被根除，临床症状有明显改善。2例患者的主要病原体对头孢唑林耐药，在得知药敏结果后更换了抗生素治疗。4例流感嗜血杆菌感染患者中，2例获得临床治愈。1名女性患者因出现皮疹而停用头孢唑林治疗。然而，在肝、肾或血液学功能方面，治疗没有出现重大毒性作用。肌内注射治疗时没有患者主诉疼痛。每日两次肌内注射1g剂量显示能持续产生高血清浓度。因此，对于老年人来说，头孢唑林的优点是即使同时给予利尿治疗也没有肾毒性，肌内注射时不痛，并且在血液和尿液中浓度持续，所以每天只需给药两次。体外研究表明，头孢唑林对医院病原体的活性比头孢噻啶更强。
