carumonam and Sepsis

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

The in vitro and in vivo activity of carumonam was tested in comparison with that of aztreonam and other beta-lactam antibiotics. With the exception of a few isolates that were overproducers of cephalosporinase, Enterobacteriaceae were highly susceptible to carumonam, 90% of the isolates being inhibited at 0.5 micrograms/ml. Aztreonam, ceftriaxone and ceftazidime were overall slightly less active than carumonam against Enterobacteriaceae. Carumonam was intermediate between ceftazidime and aztreonam as to the activity against Pseudomonas aeruginosa. Staphylococci were resistant to the monocyclic beta-lactams. In accordance with the in vitro data, carumonam was effective against experimental septicemias and infections of the thigh and the kidney that were caused by gram-negative pathogens.

Topics: Animals; Anti-Bacterial Agents; Aztreonam; Bacteria; Enterobacteriaceae; Escherichia coli Infections; Female; Hydrogen-Ion Concentration; Leukopenia; Mice; Mice, Inbred Strains; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pyelonephritis; Rats; Rats, Inbred Strains; Sepsis