cefmenoxime and Enterobacteriaceae-Infections

Topics: Anti-Bacterial Agents; beta-Lactams; Cefmenoxime; Cefmetazole; Cefoperazone; Cefotaxime; Cefotiam; Cefsulodin; Ceftazidime; Ceftizoxime; Ceftriaxone; Cephalosporins; Cephamycins; Drug Interactions; Drug Resistance, Microbial; Enterobacteriaceae; Enterobacteriaceae Infections; Humans; Imipenem; Moxalactam

The clinical efficacy of the combination therapy with cefmenoxime plus cefsulodin was studied in patients with complicated urinary tract infections caused by Pseudomonas aeruginosa. Patients received 1 g of CMX and 1 g of CFS concomitantly twice a day by 1-hour intravenous drip infusion. Of a total of 127 patients who received medication, 82 patients were evaluated on the 5th day. The overall clinical efficacy of treatment was evaluated by the criteria proposed by the UTI Committee, Japan, as excellent, moderate or poor. It was excellent in 15%, moderate in 55% and poor in 30%. Of the 143 strains isolated from 82 patients, 115 strains (80%) were eradicated. The eradication rate of P. aeruginosa was 83%. Subjective side effects were observed in 3 (2.4%) of the patients. Drug-related aggravations in laboratory test results were observed in 8 (7.5%), but most of them were minimal and reversible. The results of this study suggest that a combination of cefmenoxime and cefsulodin might be useful in the treatment of complicated urinary tract infections caused by P. aeruginosa.

Topics: Candidiasis; Cefmenoxime; Cefotaxime; Cefsulodin; Drug Therapy, Combination; Enterobacteriaceae Infections; Humans; Pseudomonas Infections; Urinary Tract Infections

One hundred sequential Gram-negative rod isolates from patients with hospital-acquired bloodstream infections were tested against seven new cephalosporins. Duplicate broth microdilution tests indicated superior activity for ceftazidime with 97% of strains susceptible to 16 mg/l. Less in-vitro activity was demonstrated cefotaxime (91% susceptible to 16 mg/l, P = 0.07), latamoxef (moxalactam) (90%, P = 0.04), cefoperazone (90%, P = 0.04), ceftriaxone (87%, P = 0.008), cefmenoxime (80%, P = 0.0001), and ceftizoxime (79%, P less than 0.0001). With the exception of cefoperazone, the newer drugs had mean MICs of less than or equal to 0.6 mg/l against Enterobacteriaceae. Ceftazidime and cefoperazone had highest activities against Pseudomonas aeruginosa with MIC90S of 4 and 16 mg/l, respectively. A comparison of recently published data shows important geographic differences in MIC90 data for the new cephalosporins against specific species.

Topics: Cefmenoxime; Cefoperazone; Cefotaxime; Ceftazidime; Ceftizoxime; Ceftriaxone; Cephalosporins; Cross Infection; Enterobacteriaceae; Enterobacteriaceae Infections; Gram-Negative Bacteria; Humans; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections; Sepsis

The inhibitory combination effect of cefmenoxime with gentamicin, tobramycin, netilmicin and amikacin against 148 Enterobacteriaceae was compared using the checkerboard agar dilution technique. On average 41% of cefmenoxime-moderately susceptible (MIC between 2 and 32 micrograms/ml) or cefmenoxime-resistant (MIC greater than 32 micrograms/ml) strains were inhibited by synergistic, and 23,5% by partial synergistic cefmenoxime-aminoglycosides combinations. Against cefmenoxime-susceptible strains, these rates of synergy or partial synergy were twofold lower, but only one isolate was not susceptible to these combinations. The amikacin-cefmenoxime interaction was the most performant.

Topics: Amikacin; Aminoglycosides; Anti-Bacterial Agents; Cefmenoxime; Cefotaxime; Drug Resistance, Microbial; Drug Synergism; Enterobacteriaceae; Enterobacteriaceae Infections; Gentamicins; Humans; Netilmicin; Species Specificity; Tobramycin

Cefmenoxime was evaluated in an open trial consisting of 41 patients. Forty infections in 36 patients could be evaluated. Thirteen patients had pyelonephritis due to Escherichia coli (two bacteremic), Pseudomonas aeruginosa, Klebsiella pneumoniae, or Streptococcus faecalis; all improved and 12 of 13 were clinically cured, but one relapse (S. faecalis) occurred at two weeks. Six patients with cystitis due to E. coli, Citrobacter freundii, Serratia marcescens, P. aeruginosa, or S. faecalis all improved, but relapse or reinfection, or both, occurred in five due to P. aeruginosa, S. faecalis, C. fruendii, or E. coli. Neurogenic bladder or other complications were present in five of 13 patients with pyelonephritis and five of six with cystitis. Ten patients with pneumonia and one with tracheobronchitis due to Hemophilus influenzae, S. pneumoniae, S. agalactiae, or Neisseria meningitidis all improved and seven had resolution without relapse, but P. aeruginosa emerged in two patients, one of whom died. Eight soft tissue infections due to Staphylococcus aureus, Peptococcus prevotti, Streptococcus species, or infections of mixed origin resolved in six. Sterility of blood cultures was obtained in one patient with endocarditis due to S. anginosus, but other therapy was substituted. Clinical resolution of the toxic shock syndrome and subsequent negative endocervical cultures for S. aureus occurred in one. Granulocytopenia of unverified cause in four (with less than 1,500 mm3) and two (with less than 2,000 mm3) was reversible. Headache during treatment occurred in six patients and a possible disulfiram-like effect in three. Elevations of serum glutamic oxalacetic transaminase and alkaline phosphatase occurred in five, Coombs' positivity in two, and diarrhea in three. Clinical efficacy of cefmenoxime was significant. Possible side effects require further study.

Topics: Abscess; Adolescent; Adult; Aged; Bacterial Infections; Cefmenoxime; Cefotaxime; Cellulitis; Cystitis; Drug Resistance, Microbial; Enterobacteriaceae Infections; Female; Humans; Leukopenia; Male; Microbial Sensitivity Tests; Middle Aged; Pneumonia; Urinary Tract Infections

Sixty patients (23 men and 37 women) with a median age of 56.7 years (range 20 to 80) and a median weight of 69 kg were treated with cefmenoxime as short-term perioperative prophylaxis. Patients were undergoing surgery for an infected gallbladder, bile duct, or colon or were being treated for local or diffuse peritonitis and soft tissue infections. Overall clinical efficacy including very good and good results could be achieved in 88.3 percent. Moderate clinical efficacy was achieved in six cases, two of which were due to Pseudomonas aeruginosa. In 38 of 60 patients an antibiogram could be performed before and after therapy. Of the isolated 46 strains, 40 pathogens (86.95 percent) were eradicated during cefmenoxime treatment and in two cases a replacement was observed. After one hour, peak concentrations in serum could be reached with over 70 micrograms/ml.

Topics: Adult; Aged; Ascitic Fluid; Body Fluids; Cefmenoxime; Cefotaxime; Enterobacteriaceae Infections; Female; Humans; Kinetics; Male; Middle Aged; Premedication; Surgical Wound Infection