cefoxitin and trovafloxacin

Trovafloxacin is a new fourth-generation fluoroquinolone whose pharmacokinetics and in vitro activity suggest that it is well suited for antibiotic prophylaxis in elective hysterectomy.. In a randomized, double-blind, multicenter study, parallel groups of women 18 years of age or older received either 200 mg trovafloxacin by mouth and intravenous (i.v.) placebo or 2 g cefoxitin by i.v. infusion and placebo by mouth before elective vaginal or abdominal hysterectomy for nonmalignant disease.. In the 103 and 97 patients in the trovafloxacin and cefoxitin groups, respectively, who were evaluable for efficacy, the prophylactic success rates at hospital discharge (96% in both groups) and 30 +/- 6 days after hysterectomy (88% and 91% in the trovafloxacin and cefoxitin groups, respectively) were statistically equivalent. Both antibiotics were well tolerated.. A single oral 200 mg dose of trovafloxacin is as effective and safe as a standard cefoxitin parenteral regimen in the prevention of primary bacterial infection after elective vaginal or abdominal hysterectomy for nonmalignant disease.

Topics: Administration, Oral; Adult; Aged; Anti-Infective Agents; Antibiotic Prophylaxis; Bacterial Infections; Cefoxitin; Cephamycins; Double-Blind Method; Elective Surgical Procedures; Female; Fluoroquinolones; Humans; Hysterectomy; Hysterectomy, Vaginal; Infusions, Intravenous; Middle Aged; Naphthyridines; Surgical Wound Infection

Trovafloxacin, a broad-spectrum fourth-generation quinolone with gram-positive and gram-negative aerobic and anaerobic bacterial activity, is available in oral and intravenous formulations. The objective of this prospective, multicenter, double-blind, randomized study was to compare the efficacy of trovafloxacin with that of cefoxitin, an approved drug for treatment of acute gynecologic infections, together with amoxicillin/clavulanic acid as oral follow-on treatment.. Patients with a clinical diagnosis of acute pelvic infection received either intravenous alatrofloxacin with oral trovafloxacin follow-on (trovafloxacin) or a combined regimen of cefoxitin followed by amoxicillin/clavulanic acid for a maximum of 14 days. The primary endpoint was clinical response to therapy on follow-up at day 30.. Clinical success rates were comparable between the trovafloxacin (n = 107) and comparative (n = 119) groups at study end (90% vs. 86%, respectively; 95% confidence interval, -4.5, 12.5). Among clinically evaluable patients, clinical success rates for infections involving Enterococcus species were higher with trovafloxacin than with the comparative regimen at the end of treatment (96% and 85%) and at study end (96% and 86%).. Intravenous alatrofloxacin followed by oral trovafloxacin for a maximum of 14 days of total therapy was efficacious in the treatment of acute pelvic infections.

Topics: Acute Disease; Adolescent; Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents; Cefoxitin; Cephamycins; Clavulanic Acid; Double-Blind Method; Enterococcus; Female; Fluoroquinolones; Humans; Middle Aged; Naphthyridines; Pelvic Inflammatory Disease; Penicillins; Prospective Studies; Treatment Outcome

A time-kill method was developed to examine the killing kinetics of trovafloxacin, ciprofloxacin, sparfloxacin, metronidazole, cefoxitin, piperacillin and piperacillin/tazobactam against one strain each of Bacteroides fragilis, Bacteroides thetaiotaomicron, Prevotella melaninogenica, Fusobacterium mortiferum, Peptostreptococcus magnus and Clostridium perfringens. Solutions and suspensions were prepared inside an anaerobic glove box, using syringes and prereduced broth. Bottles were then incubated outside the chamber and viability counts determined after incubation for 0, 6, 24 and 48 h in a shaking water bath, avoiding introduction of air. Bacteriostatic/bactericidal concentrations (mg/L) after 48 h for the six strains were: trovafloxacin, 0.03-1/0.03-1; ciprofloxacin, 0.25-16/0.25-32; sparfloxacin, 0.06-2/0.06-8; metronidazole 1-64/1-64; cefoxitin, 0.125-16/0.125-32; piperacillin, 0.125-64/0.125-64; piperacillin/tazobactam, 0.06-2/0.125-8. Bacteriostatic levels were within two dilutions of broth MICs. By this time-kill method, trovafloxacin had the lowest bacteriostatic concentrations of all compounds tested.

Topics: Anti-Infective Agents; Bacteroides; Bacteroides fragilis; Cefoxitin; Ciprofloxacin; Clostridium perfringens; Fluoroquinolones; Fusobacterium; Gram-Negative Anaerobic Bacteria; Metronidazole; Microbial Sensitivity Tests; Naphthyridines; Penicillanic Acid; Peptostreptococcus; Piperacillin; Prevotella melaninogenica; Quinolones; Tazobactam

Agar dilution was used to compare the in vitro activity of CP 99,219 with those of ciprofloxacin, grepafloxacin, metronidazole, cefoxitin, piperacillin, and piperacillin-tazobactam against 489 anaerobes. CP 99,219 yielded a MIC for 50% of the strains tested (MIC50) of 0.25 micrograms/ml and a MIC90 of 1.0 microgram/ml, with 99.6% of the strains susceptible at a breakpoint of 2.0 micrograms/ml. Ciprofloxacin and grepafloxacin were less active (MIC50, 4.0 micrograms/ml; MIC90, 32.0 micrograms/ml and 2.0 and 16.0 micrograms/ml, respectively). Metronidazole was active against all gram-negative rods (MIC90, 4.0 micrograms/ml), but 31% of the gram-positive anaerobes were resistant at > 8.0 micrograms/ml. Cefoxitin was active against 84% of all strains at < or = 16.0 micrograms/ml, with a MIC50 of 4.0 micrograms/ml and a MIC90 of 32.0 micrograms/ml. Tazobactam enhanced the activity of piperacillin against > 95% of the beta-lactamase-producing gram-negative anaerobic rods (MIC90, 16.0 micrograms/ml).

Topics: Anti-Infective Agents; Bacteria, Anaerobic; Cefoxitin; Ciprofloxacin; Fluoroquinolones; Metronidazole; Microbial Sensitivity Tests; Naphthyridines; Penicillanic Acid; Piperacillin; Piperazines; Quinolones; Tazobactam