Cefamandole is a second-generation broad-spectrum cephalosporin antibiotic used to treat bacterial infections of the skin, urinary tract, lower respiratory tract and bones/joints.
The mechanism by which cefamandole works is by the inhibition of cell-wall synthesis. As a beta-lactam antibiotic, cefamandole binds to penicillin-binding proteins inside the bacterial cell wall, inhibiting the last stage of bacterial cell wall synthesis. Autolysins mediate cell lysis, and so it is possible that cefamandole interferes with an autolysin inhibitor.
The antibiotic releases free N-methylthiotetrazole (NMTT) while being broken down in the body, and so this can cause hypoprothrombinemia(vitamin K supplements are recommended during therapy) and a reaction with ethanol (similar to the reaction produced by disulfiram) as a result of the inhibition of alcohol dehydrogenase.