carumonam and Bacterial-Infections

Carumonam is a new monobactam antibiotic with potent activity against gram-negative aerobes. To study the efficacy and safety of carumonam for treatment of complicated and uncomplicated urinary tract infections, 54 patients were randomized to therapy with either carumonam or ceftazidime. Of 42 patients who could be evaluated, 82% of the carumonam-treated patients and 80% of the ceftazidime-treated patients were cured clinically. At 5 to 9 days posttherapy, microbiologic criteria indicated that 13 carumonam-treated patients (48%) and 8 ceftazidime-treated patients (53%) were cured. Patients with indwelling bladder catheters at the end of therapy had a markedly worse microbiologic outcome than those without catheters. Enterococcus sp. reinfection was common in both groups. Possible adverse clinical and laboratory reactions occurred in six carumonam-treated patients (21%) and four ceftazidime-treated patients (27%). Most reactions occurred at the end of therapy and resolved with discontinuation of the study drug. In this small study, carumonam appeared as safe and as effective as ceftazidime for the treatment of complicated and uncomplicated urinary tract infections.

Topics: Adult; Anti-Bacterial Agents; Aztreonam; Bacterial Infections; Ceftazidime; Drug Tolerance; Female; Humans; Male; Urinary Tract Infections

We evaluated the efficacy of a combination therapy with carumonam (CRMN) and clindamycin (CLDM) on severe infections in patients with hematologic malignancies. Fifty three patients were included in this study. The efficacy of the combination therapy was evaluated according to the criteria by TAKAKU et al. Fourteen cases were evaluated as excellent, and 24 cases were as good, with a total rate of effectiveness of 71.7% (38/53). It should be noted that the rate of effectiveness in patients having less than 100/microliters neutrophils was 77.3% (17/22). Adverse effects were observed in 2 patients (3.7%). One case was hepatotoxicity and the other was nephrotoxicity. Both were mild and transient, however. These observations suggested that the combination therapy with CRMN and CLDM was effective and safe for the treatment of severe infections in patients with hematologic malignancies.

Topics: Adult; Aged; Anti-Bacterial Agents; Aztreonam; Bacterial Infections; Clindamycin; Drug Evaluation; Drug Therapy, Combination; Female; Hematologic Diseases; Humans; Infusions, Intravenous; Male; Middle Aged

Topics: Adult; Anti-Bacterial Agents; Aztreonam; Bacteria; Bacterial Infections; Clinical Trials as Topic; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Treatment Outcome

Antibacterial activities of monobactam antibiotics (carumonam (CRMN) and aztreonam (AZT] against Gram-negative bacilli isolated from inpatients in the latter half of 1987 were investigated using penicillin (PC: piperacillin (PIPC], cephems (CEPs: ceftazidime (CAZ), cefotaxime (CTX), latamoxef (LMOX), cefsulodin (CFS], carbapenem (imipenem (IPM] and pyridonecarboxylic acids (norfloxacin (NFLX) and ofloxacin (OFLX] as reference antibiotics. A total of 400 strains of 13 species, i.e. Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis, Proteus vulgaris, Morganella morganii, Providencia rettgeri, Citrobacter freundii, Enterobacter cloacae, Enterobacter aerogenes, Serratia marcescens, Pseudomonas aeruginosa and Haemophilus influenzae, were used as test strains. 1. CRMN and AZT, both monobactam antibiotics, were roughly comparable in their activities and no resistant strain to these antibiotics were found among isolates of E. coli, Klebsiella spp., Proteus spp., M. morganii, P. rettgeri or H. influenzae and few resistant strains were observed among isolates of S. marcescens. On the other hand, isolates of C. freundii, Enterobacter spp. and P. aeruginosa included rather numerous strains resistant to the monobactam antibiotics. Among these cases, whereas R strains, i.e. resistant strains showing MICs greater than or equal to 50 micrograms/ml, accounted for a large proportion of strains resistant to PC and CEPs, I strains, i.e. intermediately resistant strains showing MICs between 12.5 and 25 micrograms/ml, accounted for a large proportion of strains resistant to the monobactam antibiotics. 2. Strains resistant to PIPC, a PC, were detected with high and more or less uniform frequencies over the entire spectrum of the isolates examined. 3. Antibacterial activities of CEPs varied against different bacterial species. While strains resistant to CTX, CAZ and LMOX were commonly detected with high frequencies among isolates of C. freundii, Enterobacter spp. and S. marcescens, large percentages of LMOX-resistant strains of C. freundii and Enterobacter spp. were of the I type. CTX-resistant strains were also found among isolates of P. vulgaris and M. morganii. Proportions of CEP-resistant strains of P. aeruginosa were 28% for CFS and 12% for CAZ. 4. No or few strains among the isolates of 13 species investigated were resistant to IPM, a carbapenem antibiotic, which showed the most stable antibacterial activity, but it was less active than monobac

Topics: 4-Quinolones; Anti-Bacterial Agents; Anti-Infective Agents; Aztreonam; Bacteria; Bacterial Infections; Drug Resistance, Microbial; Humans; Monobactams

Carumonam is a new N-sulfo-beta-lactam antibiotic active against aerobic Gram-negative bacteria. An open study was carried out to evaluate the efficacy, safety and tolerance of carumonam with either 1 g t.i.d. (group A) or 2 g t.i.d. (group B) in bacterial septicaemia or severe sepsis. A total of 24 patients (14 men and 10 women) were included in the study, their ages ranged from 48-87 years (mean age 59). Eighteen patients were treated for bacteraemia, three for bronchopneumonia, two for urinary tract infection and one for a subphrenic abscess; seven were in group A and fourteen in group B; three were treated with a variable regimen. The pathogens isolated included E. coli [10], Klebsiella aerogenes [9], Enterobacter cloacae [3], Citrobacter freundii [2], Pseudomonas spp. [4], Providence stuartii [2], Serratia marcescens [1] and Haemophilus influenzae [1]. Clinical improvement occurred in all patients in both groups. One patient in group A and four patients in group B required further antibiotic therapy. The overall clinical cure rate was 84% and the bacteriological cure rate was 72%. Supra-infection occurred in three patients and adverse reactions attributable to carumonam were seen in two patients: diarrhoea (in one), and aggravation of renal failure in the other. Carumonam is well tolerated at both the dosage regimens; it is effective in the treatment of aerobic Gram-negative sepsis.

Topics: Aged; Aged, 80 and over; Aztreonam; Bacterial Infections; Female; Gram-Negative Aerobic Bacteria; Humans; Male; Middle Aged; Sepsis

To evaluate the clinical efficacy of carumonam (CRMN, AMA-1080), the drug was used in the treatment of 10 patients including 4 with pneumonia and each with acute tonsillitis, chronic bronchitis, Mycoplasma pneumonia, primary atypical pneumonia (PAP), chronic pyelitis, and acute cystitis. Since beta-lactam antibiotics were not active against Mycoplasma pneumonia and PAP, these diseases were excluded from the clinical efficacy evaluation of CRMN. Responses were excellent in 1 patient and good in 7. Side effects were not observed. The laboratory test recognized slight elevations of GOT, GPT and eosinophilia in 1 patient and a slight leucopenia in another upon the administration of CRMN.

Topics: Adult; Aged; Anti-Bacterial Agents; Aztreonam; Bacterial Infections; Female; Humans; Infusions, Intravenous; Lactams; Male; Middle Aged; Respiratory Tract Infections

The in vitro and in vivo antibacterial activities of carumonam (AMA-1080), a synthetic sulfazecin derivative, were compared with those of aztreonam, cefoperazone, ceftazidime, and cefsulodin. Carumonam was highly active in vitro against members of the family Enterobacteriaceae, Pseudomonas aeruginosa, and Haemophilus influenzae and weakly active against Streptococcus pneumoniae, but it was not active against Staphylococcus aureus. The MICs of carumonam for 90% of 1,156 clinical Enterobacteriaceae isolates were between 0.013 and 25 micrograms/ml, which were the lowest MICs of the antibiotics tested. The MIC of carumonam for 90% of Klebsiella oxytoca was 0.2 micrograms/ml, whereas that of aztreonam was 50 micrograms/ml. The superiority of carumonam to aztreonam and the reference cephalosporins was also demonstrated by their activities against Klebsiella pneumoniae and Enterobacter cloacae. The MIC of carumonam for 90% of P. aeruginosa was 12.5 micrograms/ml, which was comparable to the MICs of aztreonam and ceftazidime. Carumonam showed a high affinity for the penicillin-binding protein 3 of gram-negative bacteria, but not for the penicillin-binding proteins of S. aureus and Bacteroides fragilis. Carumonam was resistant to hydrolysis by 12 plasmid-mediated beta-lactamases and 7 chromosomal beta-lactamases. It was more stable than aztreonam to hydrolysis by the beta-lactamase of K. oxytoca; this stability is related to the superiority of the in vitro and in vivo activities of carumonam to those of aztreonam against this species. In general, the protective activities (50% effective dose) of carumonam and reference antibiotics in mice with experimental intraperitoneal infections correlated with the in vitro activities (MIC); carumonam showed excellent protective activity against most aerobic gram-negative bacteria.

Topics: Animals; Anti-Bacterial Agents; Aztreonam; Bacteria; Bacterial Infections; beta-Lactamases; beta-Lactams; Drug Stability; Female; Hydrolysis; Mice; Mice, Inbred ICR; Microbial Sensitivity Tests; Protein Binding