cefmenoxime and Sinusitis

The guidance deals with the recommended applications, procedures, and safety management of nebulizer therapy for acute rhinosinusitis. In Japan, nebulizer therapy for sinusitis has been covered by public health insurance since 1958 and has been commonly carried out nationwide. The Japan Society for Infection and Aerosol in Otorhinolaryngology and the Oto-Rhino-Laryngological Society of Japan set up a working group to draw up a consensus guidance on nebulizer therapy for acute rhinosinusitis. The device for nebulizer therapy are classified into jet, ultrasound, and mesh types. In Japan, cefmenoxime hydrochloride (CMX) was approved for use in nebulizer therapy since 1996. The widening of the obstructed lesions such as large polyps prior to nebulizer therapy were recommended. The numbers of times of nebulizer therapy is recommended for three times in a week for at least for 2 weeks (cure rate: 68%, eradication ratio: 48%). Concerns should be pay for the changes of activity of medicine due to the mixing and bacterial contamination. Pseudomonas cepacia growing in a short even in both saline and distilled water leads to contamination at high concentrations by 2 days. Nebulizer therapy is an effective treatment based on a drug delivery system (DDS) to the nasal and paranasal cavities. The therapy effectively increases the local drug concentration by promptly and uniformly delivering drugs to a targeted local site. The therapy is safe with less systemic absorption and with few adverse reactions.

Topics: Acute Disease; Administration, Inhalation; Adrenal Cortex Hormones; Anti-Bacterial Agents; Cefmenoxime; Disinfection; Drug Delivery Systems; Equipment Contamination; Equipment Design; Humans; Japan; Nebulizers and Vaporizers; Rhinitis; Sinusitis

In order to evaluate antimicrobial activity of cefmenoxime (CMX), minimum inhibitory concentrations (MICs) of CMX and control drugs were determined against clinical isolates from patients of sinusitis that were obtained in our laboratory from October of 1993 to March of 1994. The results are summarized as follows; 1. CMX showed strong antimicrobial activities against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella subgenus Branhamella catarrhalis that were 3 major aerobic bacteria from sinusitis. Antimicrobial activities of CMX against benzylpenicillin (PCG)-insensitive S. pneumoniae (PISP) and PCG-resistant S. pneumoniae (PRSP) were stronger than those of ampicillin (ABPC), and these strong activities suggested that CMX might have strong antimicrobial activities against beta-lactamase producing H. influenzae and M. (B.) catarrhalis. 2. Antimicrobial activities of CMX against microaerophiles, Streptococcus constellatus, Streptococcus intermedius and Gemella morbillorum and against Peptostreptococcus spp., from chronic sinusitis and odontogenic maxillary sinusitis, were stronger than those of most of the control drugs. 3. The MIC90's of CMX against isolates from patients of sinusitis were < or = 0.025-0.39 micrograms/ml. These values were lower than transitional concentrations in mucous membrane of maxillary sinus obtained when "1% CMX nasal solution" was used with nebulizer. It appears likely that sufficient concentrations exceeding MICs against main organisms would be obtained by nebulizer treatment using CMX nasal solution.

Topics: Cefmenoxime; Drug Resistance, Microbial; Haemophilus influenzae; Humans; Moraxella catarrhalis; Sinusitis; Streptococcus pneumoniae

Topics: Administration, Inhalation; Aminoglycosides; Anti-Bacterial Agents; Cefmenoxime; Fosfomycin; Humans; Nebulizers and Vaporizers; Sinusitis; Staphylococcal Infections

From clinical studies on T-2588, an oral ester type cephem, the following results were obtained. Ten patients with acute tonsillitis, 3 with acute pharyngolaryngitis, 2 with acute sinusitis, 1 with acute exacerbation of chronic sinusitis and 2 with acute exacerbation of chronic otitis media were treated with T-2588 at a daily dose of 300 or 600 mg. Clinical responses were excellent in 12, good in 4, fair in 1 and poor in 1. Clinical efficacy was 88.9%. Bacteriologically, all isolates except one strain of S. aureus were eliminated. Clinical efficacies classified by clinical isolates correlated well with bacteriological efficacies. The MICs of T-2525 against clinical isolates were determined and compared with those of cephalexin, cefaclor and amoxicillin. The T-2525 showed potent antibacterial activity against Gram-positive and Gram-negative bacteria including S. pneumoniae, H. influenzae and beta-Streptococcus, but the activity of T-2525 against S. aureus was similar to that of the other antibiotics examined. Neither side effect nor abnormal laboratory finding was observed.

Topics: Administration, Oral; Adult; Cefmenoxime; Cephalosporins; Female; Humans; Laryngitis; Male; Middle Aged; Pharyngitis; Sinusitis; Tonsillitis