trimethoprim--sulfamethoxazole-drug-combination and cefodizime

Twenty-three stabilized chronic uremic patients with no active or recent infection were treated for 10 days with either cefodizime (5 x 2 g intravenously, n = 10) or cotrimoxazole (960 mg orally b.i.d., n = 8) in order to evaluate the effects on the depressed polymorphonuclear metabolic response to phagocytic challenge; a separate group of 5 patients received placebo. Ex vivo evaluation in whole blood of energy delivery to the phagocytosis-associated respiratory burst activity in response to latex and zymosan challenge was determined by measuring hexose-monophosphate shunt NAD(P)H-oxidase-related glycolytic activity. Cefodizime induced a statistically significant increase in the baseline-depressed glycolytic response for both latex and zymosan challenge, in contrast to cotrimoxazole and placebo. Depressed phagocytosis-related metabolic function in hemodialyzed patients was stimulated by cefodizime in recommended therapeutic doses but not by cotrimoxazole, the effect persisting for at least 2 weeks after the end of treatment.

Topics: Adult; Aged; Cefotaxime; Chronic Disease; Dose-Response Relationship, Drug; Energy Metabolism; Female; Glycolysis; Humans; Injections, Intravenous; Latex; Male; Middle Aged; NADH, NADPH Oxidoreductases; NADPH Oxidases; Neutrophils; Phagocytes; Phagocytosis; Renal Dialysis; Respiratory Burst; Time Factors; Trimethoprim, Sulfamethoxazole Drug Combination; Uremia; Zymosan