cefmenoxime and Skin-Diseases--Infectious

We studied the clinical efficacy and prophylactic effect of Tomiron (cefteram pivoxil; CFTM-PI), a new oral cephalosporin, in the surgical patients. CFTM-PI was administered at a daily dose of 300 or 600 mg after meals. Infectious diseases in 151 patients consisted of infected atheroma, wound infection, subcutaneous abscess, furuncle, phlegmon, mastitis, lymphangitis, periproctal abscess and biliary tract infection. Fifty patients were administered CFTM-PI to prevent secondary wound infection. The clinical efficacy rate was 75.5% in the treatment of infection and 86.0% in the prophylactic use. The clinical efficacy for skin and soft tissue infection was regarded as excellent in 25, good in 74, fair in 17 and poor in 8 out of 124 cases, with a clinical efficacy rate of 79.8%. The eradication rate in 40 cases of monomicro-bial infection was 97.4%, and in 12 cases of polymicrobial infection it was 72.7%. For biliary tract infection, the clinical efficacy was excellent in 1, good in 5, fair in 1 and poor in 1, with a clinical efficacy rate of 75.0%. Adverse effects were observed in 4 (2.0%) of 201 cases: allergic reaction in 3, and sleepiness in 1. Abnormal laboratory findings were observed in 2 cases, but it is not clear if these were due to this drug. These results indicate that Tomiron is a useful oral antimicrobial agent in the treatment and prophylaxis of surgical infection, mainly skin and soft tissue infection.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefmenoxime; Connective Tissue Diseases; Female; Humans; Male; Middle Aged; Skin Diseases, Infectious; Surgical Wound Infection

Fifty-nine patients with serious infections were assigned at random in a two-to-one ratio to receive either cefmenoxime or cefoxitin given intravenously in a dosage of 0.5 to 2.0 g every six hours. Of 44 patients evaluable for efficacy, eight had concomitant bacteremia and all but 10 had serious underlying disease. The average duration of therapy was seven days. All patients with skin and soft tissue infections were cured after treatment with either antibiotic. Cefmenoxime achieved clinical and bacteriologic cures in 92 and 83 percent, respectively, of 12 patients with pneumonia and in 100 and 82 percent of 11 patients with urinary tract infections. Cefoxitin therapy resulted in clinical and bacteriologic cures in all four patients with pneumonia. Among 10 patients with urinary tract infection, respective cure rates were 90 and 50 percent. Both antibiotics were well tolerated. One cefmenoxime-treated patient discontinued treatment because of a rash.

Topics: Adult; Bacterial Infections; Cefmenoxime; Cefotaxime; Cefoxitin; Drug Administration Schedule; Drug Evaluation; Female; Humans; Infusions, Parenteral; Male; Random Allocation; Respiratory Tract Infections; Skin Diseases, Infectious; Urinary Tract Infections

Antimicrobacterial activities of cefteram (CFTM) against clinical isolates collected in 1988 were compared with those of new beta-lactams. 1. Antibacterial activities of CFTM against Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Branhamella catarrhalis isolated from acute respiratory tract infections were 8- to 16-fold higher than those of cefaclor (CCL). 2. Activities of cefixime (CFIX) were superior to those of CFTM against B. catarrhalis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, but were inferior to CFTM against S. pneumoniae, S. pyogenes, Staphylococcus saprophyticus and Staphylococcus aureus. 3. Activities of cefuroxime were superior to those of CCL against each of the 4 tested bacterial species from acute respiratory tract infection and S. aureus by 4-fold, but were inferior to CFTM and CFIX against most of Gram-negative rods. 4. Sultamicillin (SBTPC) is considered to have an activity to inhibit beta-lactamase, but its MICs did not exceed the MICs of ampicillin by itself. SBTPC showed poor antibacterial activities against methicillin-resistant S. aureus (MRSA). Considering these observations, it is apparent that we are faced with a variety of factors in selecting antibiotics for best results.

Topics: Ampicillin; Bacteria; Cefmenoxime; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Methicillin; Penicillin Resistance; Respiratory Tract Infections; Skin Diseases, Infectious; Staphylococcus aureus; Sulbactam; Urinary Tract Infections

Cefmenoxime, a new semisynthetic third-generation cephalosporin, was evaluated in 105 patients (45 men and 60 women) with the following infections: skin or skin structure (33), pulmonary (22), urinary tract (30), and septicemia (20). Forty-two infections were hospital-acquired, 85 patients had underlying diseases, 29 patients required concomitant surgery, and 32 patients had positive results of blood culture. Cefmenoxime dosages ranged from 4 to 12 g per day intravenously for one and a half to 51 days. Cultures revealed 183 organisms in the 105 patients. Minimal inhibitory concentrations were obtained for cefmenoxime, cefoperazone, cefotaxime, cefamandole, cefoxitin, and moxalactam. Cefmenoxime and cefotaxime exhibited nearly equivalent activities against all organisms tested and were the most active agents tested against all aerobic and facultative organisms except Staphylococcus aureus. Mean serum peak and trough levels obtained after 2 g every six hours were 84.1 micrograms/ml (peak), 8.3 micrograms/ml (trough); and after 2 g every four hours, 106 micrograms/ml (peak) and 10.9 micrograms/ml (trough). Of 105 infections, 86 were clinically cured, three were not cured, and 16 were not evaluable. Safety studies revealed 24 transient reactions in 23 patients including eosinophilia, diarrhea, leukopenia, rash, elevated liver enzyme levels, Antabuse effect, and phlebitis. On the basis of these clinical and in vitro results, cefmenoxime is a safe drug for the treatment of infections caused by gram-negative and gram-positive aerobic organisms.

Topics: Adult; Aged; Bacterial Infections; Cefmenoxime; Cefotaxime; Female; Humans; Kinetics; Lung Diseases; Male; Middle Aged; Sepsis; Skin Diseases, Infectious; Urinary Tract Infections