minocycline and cefodizime

We evaluated clinical effects and toxicities of a combination in treatment with cefodizime (CDZM) and minocycline (MINO) for infections complicated with hematological disorders in 67 patients. Fifty-nine patients were evaluable, including 32 with acute leukemia, 15 with malignant lymphoma, and 12 with other hematological disorders. Clinical efficacies were excellent in 17 cases, good in 24 cases, fair in 2 cases, and poor in 16 cases. The efficacy rate was 69.5% (41 cases/59 cases). This treatment was also effective in 8 of 12 cases in which granulocyte counts were less than 500/microliter through the course of administration. No subjective side effects were observed. Abnormal values in laboratory tests were noted in 5 cases. Mild elevations of GOT, GPT, Al-P and bilirubin were observed, but none was serious. Thus, the combination of CDZM and MINO is an effective and safe regimen for the treatment of infections in patients complicated with hematological disorders.

Topics: Adult; Aged; Aged, 80 and over; Alanine Transaminase; Aspartate Aminotransferases; Bacterial Infections; Cefotaxime; Drug Evaluation; Drug Therapy, Combination; Female; Hematologic Diseases; Humans; Immunocompromised Host; Male; Middle Aged; Minocycline

The in vivo synergistic effect of cefodizime (CDZM) in combination with minocycline (MINO) against methicillin-resistant Staphylococcus aureus (MRSA) was investigated. A study of fractional effective dose (FED) index showed that either synergistic or additive effect was observed between CDZM and MINO. The postantibiotic effect (PAE) of MINO was not altered by the addition of CDZM. However, a strong synergistic bactericidal effect of CDZM and MINO against MRSA CT-18 was observed for more than 14 hours in the presence of immunocompromised tumour bearing murine polymorphonuclear leukocytes (PMN). These results suggest that the strong therapeutic efficacy of CDZM in combination with MINO was caused by synergistic bactericidal effect of the 2 drugs in the presence of PMN.

Topics: Animals; Carcinoma, Ehrlich Tumor; Cefotaxime; Disease Models, Animal; Drug Therapy, Combination; In Vitro Techniques; Male; Methicillin Resistance; Mice; Mice, Inbred Strains; Microbial Sensitivity Tests; Minocycline; Neutrophils; Serotyping; Staphylococcus aureus

Since cefodizime (CDZM) shows a broad antimicrobial spectrum and relatively long half life in blood, we examined its synergistic action with minocycline (MINO) in vitro against Staphylococcus aureus. 1. CDZM in the presence of MINO, most of cases 1 MIC showed FIC index greater than 0.5-less than or equal to 2 against methicillin-susceptible S. aureus (MSSA), thus the results suggested a synergistic action against S. aureus. 2. CDZM in combination with MINO at 1 MIC or sub MIC where therapeutically a favorable efficacy is expected on MINO-susceptible strains exhibited FIC index less than or equal to 0.5-less than or equal to 1, Methicillin-resistant S. aureus (MRSA), thus suggesting a synergistic action against MINO-susceptible MRSA strains. Synergism was hardly recognized against MINO-resistant MRSA strains, however. 3. Synergism by both drugs was produced in MINO-susceptible strains of S. aureus including MRSA where MIC by CDZM was high or moderate, but no synergism was demonstrated against MINO-resistant strains. That is, synergistic action by both drugs was thought to depend on antimicrobial activity of MINO.

Topics: Cefotaxime; Drug Synergism; Humans; Methicillin Resistance; Microbial Sensitivity Tests; Minocycline; Staphylococcus aureus