cefotaxime and Bronchitis

Although there have been a number of studies in adults, to date there has been little research into sequential antimicrobial therapy (SAT) in paediatric populations. The present study evaluates the impact of a SAT protocol for the treatment of severe lower respiratory tract infection in paediatric patients. The study involved 89 paediatric patients (44 control and 45 SAT). The SAT patients had a shorter length of hospital stay (4.0 versus 8.3 days), shorter duration of inpatient antimicrobial therapy (4.0 versus 7.9 days) with the period of iv therapy being reduced from a mean of 5.6 to 1.7 days. The total healthcare costs were reduced by 52%. The resolution of severe lower respiratory tract infection with a short course of iv antimicrobials, followed by conversion to oral therapy yielded clinical outcomes comparable to those achieved using longer term iv therapy. SAT proved to be an important cost-minimizing tool for realizing substantial healthcare costs savings.

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bronchitis; Cefixime; Cefotaxime; Child; Child, Preschool; Clinical Protocols; Drug Administration Schedule; Female; Health Care Costs; Humans; Infant; Injections, Intravenous; Length of Stay; Male; Pneumonia; Treatment Outcome

The focus of a multicenter trial conducted in Germany was to investigate whether a 5-day short course of cefixime 400 mg was equivalent to a 10-day standard therapy of cefixime 400 mg in the treatment of acute exacerbation of chronic bronchitis (AECB). In the 167 patients who were evaluated, on day 11 following treatment with once-daily oral cefixime resulted in clinical success in 91 and 89% of cases in the 5-day and 10-day treatment groups, respectively. At days 6, 11 and 30 after treatment there was no statistically significant difference between the 2 dose groups (p < 0.01). Bacteriological equivalence was also demonstrated. Gastrointestinal adverse events showed a tendency to occur less frequently in the 5-day group, but the difference was not significant. The results indicate that a short course therapy is equivalent in efficacy to the standard 10-day therapy in patients with AECB, and may thus offer cost advantages.

Topics: Administration, Oral; Bronchitis; Cefixime; Cefotaxime; Cephalosporins; Chronic Disease; Cost-Benefit Analysis; Drug Administration Schedule; Drug Costs; Humans

The objective of this multicentre, randomized, prospective and comparative study was to evaluate and compare the efficacy and safety of 1 g intravenous ceftriaxone (active ingredient of Rocephin), 3 g intravenous cefoiaxime (active ingredient of clafron), and 2.25 g intavenous cefuroxime (active ingredient of Zinacef).. In this multicentre, randomized, prospective and comparative study, patients received 1 g of ceftriaxone intravenously once a day (group A), or 1 g of cefotaxime intravenously three times a day (group B), or 0.75 g of cefuroxime intravenously three time a day (group C). 197 patients were enrolled in the study, and in 142 (48 in group A, 46 in group B and 48 in group C) we were able to make an evaluation.. The overall efficacy (bacteriological eradication plus clinical cure or clear improvement) of ceftriaxone, cefotaxime and cefuroxime were 81%, 83%, 79% respectively (P > 0.05). The eradication rate for three groups were 80%, 78%, 75% (P > 0.05). No adverse events occured.. Data obtained in our study indicate that for the majority of patients with lower respiratory tract infections, 1 g ceftriaxone, 3 g cefotaxime and 2.25 g cefuroxime are effective and safe, and 7 days therapy is enough, but the use of 1 g ceftriaxone is more convenient.

Topics: Adolescent; Adult; Aged; Bronchitis; Cefotaxime; Ceftriaxone; Cefuroxime; Cephalosporins; Female; Gram-Negative Bacterial Infections; Humans; Injections, Intravenous; Male; Middle Aged; Pneumonia; Prospective Studies

Cefodizime (CAS 69739-16-8, HR 221) is a new third-generation cephalosporin with pharmacokinetic properties that make it suitable for once-daily administration in the treatment of lower respiratory tract infections (LRTI). Ninety-nine adult hospitalized patients (66 males, 33 females, median age 57.5 years) received a once-daily injection of 2 g cefodizime for LRTI. Median treatment duration was 8 days. Forty-two patients received cefodizime intravenously and 57 intramuscularly. Indications for treatment were as follows; primary lobar pneumonia (n = 36), bronchopneumonia (n = 14), secondary pneumonia (n = 3), aspiration pneumonia (n = 5), acute exacerbation of chronic bronchitis (n = 21), and of bronchiectasis (n = 9) and acute purulent bronchitis (n = 11). General condition was good in 29 patients and poor in 58; 12 patients were critically ill. The following pathogens were isolated at baseline (source: bronchial secretions, sputum or blood): S. pneumoniae (n = 47), Haemophilus spp. (n = 17), M. catarrhalis (n = 6), Streptococcus spp. (n = 9), Staphylococcus spp. (n = 5), Klebsiella spp. (n = 4), Pseudomonas spp. (n = 1), A. calcoaceticus (n = 1) and anaerobic organisms (n = 7). Fifty-nine patients were evaluable for bacteriological response and 82 for clinical response. Bacteriological outcome was satisfactory in 29/30 patients having LRTI with parenchymal involvement (97%) and in 29/29 patients without parenchymal involvement (100%). Clinical cure was achieved in 41/43 evaluable patients with parenchymal involvement (95%) and in 37/39 patients without parenchymal involvement (95%) in the per-protocol analysis and in 54/58 patients (93%) and 37/41 patients (93%), respectively, in the clinical intention-to-treat analysis. Three of the patients with an unsatisfactory clinical response died of infection during the study. Cefodizime was well tolerated. Adverse reactions--all of mild intensity--were tachycardia, lumbalgia and dizziness, each occurring in one patient. Cefodizime 2 g once daily either i.m. or i.v. was effective in the treatment of lower respiratory tract infections in hospitalized patients.

Topics: Adult; Aged; Bronchitis; Cefotaxime; Cephalosporins; Female; Humans; Male; Middle Aged; Pneumonia, Bacterial; Respiratory Tract Infections

Step-by-step therapy of patients with pneumonia and exacerbated chronic bronchitis with amoxyclav (amoxycillin/potassium clavulanate) in a dose of 1.2 g administered intravenously dropwise every 8 hours for the first 2 days of the treatment with subsequent oral use of the drug in a dose of 625 mg thrice a day for 5 days proved to be highly efficient. The recovery and improvement were stated in 19 (95 per cent) out of 20 patients. The adverse reaction (urticaria) was observed in 1 patient. Identical results were recorded in a comparative randomized trial with the use of cefotaxime in a dose of 1.0 g intramuscularly every 8 hours for 7 days. The pharmacoeconomic estimate showed the expediency of the step-by-step therapy with the use of amoxycillin/potassium clavulanate.

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Bronchitis; Cefotaxime; Cephalosporins; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Humans; Injections, Intravenous; Length of Stay; Male; Middle Aged; Pneumonia, Bacterial; Treatment Outcome

Topics: Aged; Anti-Infective Agents; Bronchitis; Cefixime; Cefotaxime; Chronic Disease; Ciprofloxacin; Drug Resistance, Microbial; Female; Follow-Up Studies; Humans; Male

In an open randomized study 218 outpatients (159 males and 59 females) ranging between 18 and 85 years of age (mean 61.9) suffering from bacterial exacerbation of chronic bronchitis have been randomly treated: 79 with co-amoxiclav (amoxicillin 875 mg+clavulanic acid 125 mg) twice daily, 69 with cefixime (400 mg) once daily, and 70 with ciprofloxacin (500 mg) twice daily for an average period of 10 days. Before treatment start, 234 bacterial strains (105 Gram-positive and 129 Gram-negative) were isolated as the cause of exacerbation; the leading pathogens were Streptococcus pneumoniae and Haemophilus spp. Eradication rates at the end of treatment were 82.2% for the co-amoxiclav group, 77.6% for the cefixime group, and 81.2% for ciprofloxacin group. Clinical success (cure+improvement) was obtained in 90.8% of the cases treated with co-amoxiclav, in 80.9% for the cefixime group and in 85.7% of patients treated with ciprofloxacin. Seven adverse events (8.9%) of which 4 cases of diarrhea and 3 of itching, were recorded in the co-amoxiclav group. Eleven adverse events (14.7%) were recorded in the cefixime group including gastrointestinal disturbances in 6 patients and mild to moderate increase of liver function in 2. Nine adverse events (12.9%) occurred in the ciprofloxacin group, including insomnia in 3 patients, gastrointestinal disturbances in 2, and serious increase of liver function tests in one patient. It can be concluded that there were no statistically significant differences among the three treatment groups. However, co-amoxiclav demonstrated a higher efficacy rate than cefixime and ciprofloxacin and was better tolerated. Therefore, it can be used as a first-choice drug in the treatment of exacerbation of chronic bronchitis.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bronchitis; Cefixime; Cefotaxime; Chronic Disease; Ciprofloxacin; Clavulanic Acids; Drug Therapy, Combination; Evaluation Studies as Topic; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Treatment Outcome

Betalactams, mainly when orally administered, may lead to intestinal flora modifications related to their spectrum of activity, rate of absorption and degradation. therefore it is important to investigate the possible influence of recently developed oral cephem derivatives on normal human microflora. We have investigated the impact on normal human intestinal flora in a 10-day course with cefetamet-pivoxil (CET, 500 mg BID) in comparison to cefixime (CFX, 400 mg qD) or cefuroxime axetil (CA, 250 mg BID) in 24 patients suffering from acute exacerbation of chronic bronchitis. Stool specimens were taken before (day 0), at the end (day 10) and 14 days after treatment (day 24) and quali-quantitative microflora composition was determined with a detection limit of 10 CFU/g dry weight. Treatment with CET caused slight and non-significant modifications of normal intestinal flora. On the contrary CFX and CA significantly affect Enterobacteriaceae and clostridia with a concomitant increase in enterococci for CFX. With both CFX and CA there was a new appearance of Salmonella spp. as well as Clostridium difficile in 4 and 2 cases, respectively. Therefore CET seems to affect normal bowel flora minimally in comparison to other oral cephalosporins. This aspect might contribute to the low incidence of GI related side effects in patients treated with CEt for longer than 1 week.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteria, Anaerobic; Bronchitis; Cefixime; Cefotaxime; Ceftizoxime; Cefuroxime; Cephalosporins; Chronic Disease; Clostridium; Enterobacteriaceae; Enterococcus; Feces; HeLa Cells; Humans; Intestines; Microbial Sensitivity Tests; Middle Aged

Two hundred and thirty-eight in-patients with signs and symptoms of acute purulent bronchitis or purulent exacerbation of chronic bronchitis at stage 1 and 2 of Anthonisen's classification were enrolled in 11 Centers and randomly assigned to one of the following 3 treatment groups: group A, cefodizime 1 g i.m. qD; group B, cefodizime 1 g i.m. BID; group C, ceftriaxone 1 g i.m. qD. Bacteriological results after treatment were satisfactory in 64 patients (91.4%) of group A, 64 (92.8%) of group B and 74 (94.9%) of group C. Global clinical results after treatment showed satisfactory efficacy in 57 patients (79.2%) of group A, 59 (85.5%) of group B and 63 (80.8%) of group C. There was no statistically significant difference in improvement in single symptoms, global bacteriological or clinical results between the 3 groups. Mild adverse events occurred in only 3 patients (one per group).

Topics: Acute Disease; Bronchitis; Cefotaxime; Ceftriaxone; Cephalosporins; Chronic Disease; Drug Administration Schedule; Female; Humans; Injections, Intramuscular; Male

In a prospective, open clinical trial 21 patients suffering from lower respiratory tract infections were treated with the new oral cephalosporin cefixime. The antibiotic was given at a dosage of 200 mg b. i. d. for seven to eleven days. Seventeen of 18 evaluable patients were cured or distinctly improved at the end of therapy as well as two days after the end of treatment. Clinical results correlated well with the results of the lung function tests, especially with the significant decrease of resistance. At the end of therapy all initially isolated pathogens were eradicated. The tolerability of cefixime was good, only in two patients treated mild and transient side effects were noticed (1 x diarrhea, 1 x epigastric pain).

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Infections; Bronchitis; Bronchopneumonia; Cefixime; Cefotaxime; Citrobacter; Drug Resistance, Microbial; Drug Tolerance; Enterobacteriaceae Infections; Escherichia coli Infections; Female; Haemophilus Infections; Humans; Male; Middle Aged; Pneumonia; Pneumonia, Pneumococcal; Prospective Studies; Proteus Infections

Patients with purulent exacerbation of chronic bronchitis were randomized to receive either a single 400-mg daily dose of cefixime or 250 mg of cephalexin, orally, four times a day. Patients were males with a mean age of 63 years. Of the 86 patients, 71 (82%) had bronchitis caused by a single organism (29 by Haemophilus influenzae, 27 by Branhamella catarrhalis, 9 by gram-negative enteric organisms, 6 by Streptococcus pneumoniae), while more than one pathogen was implicated in 15 patients (18%). A total of 70.8% of the cefixime group and 50% of the cephalexin group were clinically cured (chi 2 = 3.89, P less than 0.05); however, when the categories of cured and improved were combined, no significant difference was noted between treatment groups (chi 2 = 3.39, P = 0.06). Analysis of side effects included all 130 evaluable and nonevaluable patients: diarrhea was noted in six patients in the cefixime group and none of the patients in the cephalexin group (P = 0.013 by the Fisher exact test). The diarrhea was mild and self-limited in all cases. B. catarrhalis has emerged as a major cause of exacerbation of bronchitis in our experience; there is an increased need to emphasize the examination of sputum samples by Gram staining if cost-effective antibiotic choices are to be made; any empirically chosen antibiotic should have activity against beta-lactamase-producing strains of B. catarrhalis as well as S. pneumoniae and H. influenzae.

Topics: Acute Disease; Bronchitis; Cefixime; Cefotaxime; Cephalexin; Chronic Disease; Gram-Negative Bacteria; Haemophilus Infections; Haemophilus influenzae; Humans; Moraxella catarrhalis; Pneumococcal Infections; Randomized Controlled Trials as Topic; Respiratory Tract Infections

In a double-blind prospective study, 180 patients admitted to hospital with acute purulent exacerbations of chronic bronchitis were treated for seven days with twice daily 1 g intramuscular injections of either cefodizime or cefotaxime. Sputum cultures performed before, during and immediately after treatment showed complete eradication of the infection in 89/90 given cefodizime and 86/90 receiving cefotaxime. Some symptomatic Pseudomonas aeruginosa superinfections occurred with each agent. During the follow-up week, recurrences or reinfections after apparent clearance occurred in 15 patients given cefodizime and in 21 receiving cefotaxime. Pharmacokinetic studies in blood showed mean Cmax values of 50.8 mg/l for cefodizime and 36.5 mg/l for cefotaxime, corresponding values in the sputum being 1.61 and 0.62 mg/l. Mean AUC values in both blood and sputum were 2 1/2- to 3-fold higher for cefodizime. Some features suggested better performance by cefodizime than by cefotaxime, but the clinical results were not statistically significantly different.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Bronchitis; Cefotaxime; Chronic Disease; Double-Blind Method; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Prospective Studies; Randomized Controlled Trials as Topic; Sputum

Clinical usefulness of cefixime (CFIX), a new oral cephalosporin antibiotic, in pediatric field was investigated. The results obtained were summarized as follows. 1. The clinical efficacy of CFIX was investigated in a total of 138 children including 49 with upper respiratory tract infections (RTI), 22 with acute bronchitis, 18 with pneumonia, 19 with scarlet fever and 21 with urinary tract infections (UTI). 2. Clinical effectiveness was excellent in 58, good in 60, fair in 14 and poor in 3, with an overall efficacy rate of 87.4%. The efficacy rate classified according to types of infection were 85.7% in upper RTI, 89.5% in acute bronchitis, 94.4% in pneumonia, 78.9% in scarlet fever, and 90.5% in UTI. 3. Out of the suspected causative organisms, 43 strains of a total of 50 strains isolated were eradicated. The bacteriological eradication rate was 86.0%. (Haemophilus influenzae 100%, Haemophilus parainfluenzae 100%, Streptococcus pyogenes 88.5%, Escherichia coli 85.7%). 4. One hundred forty four children were analyzed for side effect. Side effects were observed in 2 children (1.4%) with diarrhea in 1 and anorexia in another. Abnormal laboratory test results were recorded in 4 children (3.3%). The above results suggest that CFIX is a very useful new oral cephalosporin for the treatment of bacterial infections in children.

Topics: Adolescent; Bacterial Infections; Bronchitis; Cefixime; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male; Multicenter Studies as Topic; Pneumonia; Respiratory Tract Infections; Urinary Tract Infections

Topics: Adult; Aged; Bronchitis; Cefamandole; Cefotaxime; Ceftizoxime; Cephalosporins; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pneumonia

Topics: Bronchitis; Cefotaxime; Cephalosporins; Chronic Disease; Haemophilus influenzae; Humans; Microbial Sensitivity Tests; Streptococcus pneumoniae

The aim of the current investigation was to evaluate practical impact of modern NCCLS recommendations for the selection of 2nd and 3rd generation cephalosporins in Moscow teaching multi profile hospital. The sensitivity of clinically significant 96 strains from patients with pyelonephritis and 180 strains from patients with lower respiratory tract infections (pneumonia, COPD) was compared for cefuroxime and cefotaxime or ceftriaxone according NCCLS recommendations during 2000-2001 years. At the lower respiratory tract infection total sensitivity of all pathogens was 70.6% and 72.8%, at the pyelonephritis 71.9% and 76.0% for 2nd and 3rd generations respectively. The differences between cephalosporins were not statistically significant. Based on the application of modern NCCLS recommendations in the routine microbiological practice similar clinical efficacy of 2nd and 3rd generations cephalosporin in lower respiratory tract infections and pyelonephritis could be predicted.

Topics: Anti-Bacterial Agents; Bronchitis; Cefotaxime; Ceftriaxone; Cefuroxime; Gram-Negative Bacteria; Hospitals, General; Hospitals, Teaching; Humans; Microbial Sensitivity Tests; Moscow; Pneumonia, Bacterial; Practice Guidelines as Topic; Pyelonephritis; Staphylococcus aureus

Topics: Aged; Anti-Infective Agents; Bronchitis; Cefixime; Cefotaxime; Chronic Disease; Drug Tolerance; Humans; Male; Middle Aged; Respiratory Tract Infections; Time Factors

1 or 2 g doses of cefodizime i.m. were studied in 287 patients admitted to hospital with acute purulent exacerbations of chronic bronchitis, mostly associated with Haemophilus influenzae, Streptococcus pneumoniae or Moraxella catarrhalis. Pharmacokinetic studies in serum and sputum on the first treatment day yielded mean peak serum concentrations of 50 to 100 mg/l, with corresponding sputum concentrations of 1.4 and 2.7 mg/l, after the two respective doses. No great differences were found between the clinical and microbiological results in the various dosage groups, and no corresponding improvement was noted with the highest dosages studied. In general, infection was eliminated in 90 to 95% of patients at the end of treatment, and in approximately 70 to 80% after a follow-up week. Some infections associated with beta-lactamase producing M. catarrhalis persisted or relapsed after treatment. Unwanted drug effects were recorded in five patients, leading to discontinuation in two. It is concluded that a single daily intramuscular dose of 1 g cefodizime for seven days produces satisfactory results in most patients.

Topics: Aged; Bacteria; Bronchitis; Cefotaxime; Chronic Disease; Female; Humans; Male; Middle Aged; Sputum; Suppuration

Concentrations of cefotaxime and its major active metabolite, desacetylcefotaxime, were determined in the serum and bronchial secretion of patients with chronic bronchitis aggravated after intramuscular injection of cefotaxime in a dose of 4 g once a day. Characteristic patterns of cefotaxime metabolism and high peak concentrations of desacetylcefotaxime in the serum (67.6 +/- 17.2 micrograms/ml) defined the prolonged retention of the metabolite both in the blood and bronchial secretion. The metabolite concentrations in more than half of the patients maintained within 2 micrograms/ml in the bronchial secretion by the 12th hour after the injection and in the blood serum by the 24th hour. Therefore, 4 g cefotaxime administered intramuscularly once a day provided the blood concentrations of the metabolite comparable with the MIC for the majority of the pathogens causing nosocomial infections of the respiratory tract practically within the whole period of the daily dosage. In the bronchial secretion such concentrations were attained within half of the period of the daily dosage.

Topics: Adult; Biological Availability; Bronchi; Bronchitis; Cefotaxime; Chronic Disease; Circadian Rhythm; Humans; Injections, Intramuscular; Middle Aged; Sputum; Time Factors

In a pilot study with a limited number of patients the efficacy and tolerance of cefixime, a new oral cephalosporin antibiotic, were investigated in 15 children with the clinical diagnosis of bacterial respiratory tract infection, otitis media or urinary tract infection. The dosage was 2 x 4 mg/kg body weight daily for a period of seven to 11 days. Clinical efficacy was good in 13 cases, and subjective tolerance was good in all cases. The results support the assumption that cefixime is suited for the treatment of children with bacterial infections of the airways and urinary tract with sensitive pathogens.

Topics: Anti-Infective Agents; Bronchitis; Cefixime; Cefotaxime; Child; Child, Preschool; Humans; Lymphadenitis; Otitis Media; Pneumonia; Respiratory Tract Infections; Sinusitis; Urinary Tract Infections

A study was conducted of the effects of cefotaxime, a third generation cephalosporin antibiotic, on the function of the kidney, using several indices of renal function including urinary concentrations of the renal enzyme N-acetyl-beta-D-glucosaminidase (NAG). In 6 patients with respiratory infections and normal renal function (group I), the urinary concentrations of NAG before and after the administration of cefotaxime 2 to 4g daily were 5.7 +/- 0.6 U/L and 5.5 +/- 0.9 U/L, respectively (NS). Similarly, 9 patients with chronic renal failure who were not undergoing haemodialysis showed pre- and post-treatment urinary NAG concentrations of 8.7 +/- 4.0 U/L and 6.6 +/- 1.7 U/L, respectively (NS), while the corresponding values in 12 renally impaired patients undergoing haemodialysis (group III) were 8.1 +/- 3.5 U/L and 8.9 +/- 3.8 U/L, respectively (NS). With regard to other parameters of renal function (serum creatinine, BUN, beta 2M, and creatinine clearance), no statistically significant differences were found between the values obtained before and after therapy with cefotaxime. Therefore, it was concluded that the influence of cefotaxime on renal function is slight, and that this antibiotic can be safely used to treat patients with infections in the presence of renal dysfunction.

Topics: Acetylglucosaminidase; Bacterial Infections; Bronchitis; Cefotaxime; Humans; Kidney; Kidney Failure, Chronic; Pneumonia; Radioimmunoassay; Renal Dialysis

Topics: Adjuvants, Immunologic; Anti-Bacterial Agents; Bacterial Proteins; Bronchitis; Cefotaxime; Humans; Monocytes; Neutrophils; Phagocytosis

Topics: Bronchitis; Bronchopneumonia; Cefixime; Cefotaxime; Child; Child, Preschool; Drug Resistance, Microbial; Enterobacteriaceae; Feces; Female; Heart Septal Defects, Ventricular; Humans; Infant; Intestines; Male

Topics: Adolescent; Adult; Aged; Bacterial Infections; Bronchitis; Cefotaxime; Cefotiam; Female; Humans; Male; Middle Aged; Pneumonia

20 patients suffering from severe lower respiratory tract infections were included in the study. 10 patients were given ceftriaxone (1-2 g/day) and the other 10 cefotaxime (2-4 g/day) for a week. The results of microbiological findings and both local and systemic tolerance were found to be similar for both drugs. This indicates that 7-14 g of ceftriaxone and 14-28 g of cefotaxime are equivalent quantities in the treatment of severe respiratory tract infections.

Topics: Acute Disease; Adult; Aged; Bronchitis; Cefotaxime; Ceftriaxone; Drug Resistance, Microbial; Drug Tolerance; Haemophilus influenzae; Humans; Middle Aged; Pneumonia; Respiratory Tract Infections; Staphylococcus aureus; Streptococcus; Streptococcus pneumoniae

We used cefixime (CFIX), a newly developed oral cephalosporin antibiotic, to treat 21 children with various infections. The results are summarized as follows. The serum half-lives of CFIX after an administration of 6 mg/kg to each of 2 children were 2.56 and 2.79 hours. The serum concentrations were high enough to ensure the therapeutic response. The clinical response was "excellent" in 16 children and "good" in 5, with a 100% efficacy rate. No side effects were recorded. The only abnormal finding was slight eosinophilia in 1 child.

Topics: Acute Disease; Adolescent; Bronchitis; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Half-Life; Humans; Infant; Kinetics; Male; Pneumonia; Respiratory Tract Infections; Tonsillitis; Urinary Tract Infections

Pharmacokinetics and clinical effects of cefixime (CFIX), a new oral cephalosporin antibiotic, in pediatric field were investigated. The result obtained were summarized as follows. CFIX (5% granules) was given to each of 5 children twice in a single dose of 1.5 or 3.0 mg/kg in a cross-over trial. The mean peak serum concentration of CFIX was 0.64 micrograms/ml at 4 hours after given the dose of 1.5 mg/kg and 1.15 micrograms/ml at 4 hours after the dose of 3.0 mg/kg. The mean half-life and the mean AUC values were 2.72 hours and 4.10 micrograms X hr/ml, respectively after the dose of 1.5 mg/kg, and 2.77 hours and 8.26 micrograms X hr/ml after the dose of 3.0 mg/kg. The urinary recovery was investigated in 5 children after the dose of CFIX of 1.5 mg/kg and in 4 children after the dose of 3.0 mg/kg. The mean peak urinary concentrations of CFIX and the mean 12-hour urinary recovery rates were 10.6-67.9 micrograms/ml at 2-10 hours and 15.7% after the dose of 1.5 mg/kg, and were and were 6.16-230 micrograms/ml at 2-8 hours and 18.9% after the dose of 3.0 mg/kg, respectively. CFIX was given to 6 children twice in a single dose of 50 mg either in the form of 5% granules or in capsules in a cross-over trial. The mean peak serum concentrations, half-life and AUC values were 1.26 micrograms/ml at 4 hours, 3.09 hours and 9.63 micrograms X hr/ml, respectively after the dose of 50 mg CFIX in 5% granules, and were 1.16 micrograms/ml at 4 hours, 2.87 hours, and 7.82 micrograms X hr/ml, respectively after the dose of 50 mg in capsules. The urinary recovery was investigated in 5 children. The mean peak urinary concentrations and the mean 12-hour urinary recovery rates were 19.1-114 micrograms/ml at 4-10 hours and 15.7%, respectively after the dose of 50 mg in 5% granules, and were 8.16-89.0 micrograms/ml at 4-10 hours and 11.3%, respectively after the dose of 50 mg in capsules. Clinical efficacy of CFIX was investigated in a total of 26 children including 2 with tonsillitis, 2 with acute bronchitis, 2 with scarlet fever and 20 with urinary tract infection. Each of children were given orally a dose of 2.6 mg/kg CFIX 2-3 times a day for 11 days in average.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Acute Disease; Adolescent; Bacterial Infections; Bronchitis; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Intestinal Absorption; Kinetics; Male; Scarlet Fever; Tonsillitis; Urinary Tract Infections

A 33-week-gestation infant with respiratory distress syndrome is reported. At five days of age, acute life-threatening tracheal obstruction occurred, which was relieved after removal of a plug during bronchoscopy. Histologic examination of the plug revealed partially necrotic tracheal mucosa, compatible with the diagnosis of necrotizing tracheobronchitis. At 31 days of age, obstruction recurred due to the development of a tracheal stricture, which resolved after tracheal reintubation (to maintain patency) and corticosteroid therapy. Tracheal stricture may be a long-term complication of necrotizing tracheobronchitis, when the initial episode does not lead to death from obstruction.

Topics: Bronchitis; Cefotaxime; Dexamethasone; Drug Therapy, Combination; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Intubation, Intratracheal; Necrosis; Respiratory Distress Syndrome, Newborn; Tracheitis

Ceftizoxime suppositories (CZX-S), containing 250 mg or 125 mg of CZX, were given to 6 children, 4 with acute bronchopneumonia and 2 with acute pharyngobronchitis, who were not suited to treatment with injectable or oral form of the drug. The clinical response was "good" in all the children and the causative organisms were eradicated in 2 children (H. influenzae or S. aureus). Adverse reactions consisted of 1 case each of diarrhea and transiently increased GPT. In conclusion, CZX-S proved to be highly effective in the treatment of bacterial infections in children.

Topics: Bacteria; Bronchitis; Bronchopneumonia; Cefotaxime; Ceftizoxime; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Kinetics; Male; Suppositories

Ceftizoxime suppositories (CZX-S) were given to 5 children comprising 3 with acute bronchitis, 1 with acute bronchitis complicated by enteritis, and 1 with acute urinary tract infection, in doses of 12.5 12.5-17.4 mg/kg with 1 suppository containing 125 mg or 250 mg (potency) given 3 times a day. The clinical response was "markedly effective" in 2 and "effective" in 3. Microbiologically CZX-S caused a eradication of 1 strain each of S. aureus and E. coli and caused a decrease of organisms in 1 strain of S. aureus. There were no adverse reactions or abnormal laboratory test findings attributable to CZX-S. In conclusion, CZX-S proved to be a clinically useful antibiotic preparation for the treatment of infection in children not suited to treatment with oral or intravenous preparations.

Topics: Bacteria; Bacterial Infections; Bronchitis; Cefotaxime; Ceftizoxime; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male; Suppositories; Urinary Tract Infections

With the recent development of new potential antibiotics, it has become easier to treat patients with common bacterial infections. However, we find it difficult to handle severe infections due to opportunistic pathogens, developed in the so-called immunocompromised patients. SM-4300 is a newly developed intravenous human gamma-globulin, which is said to be intact without conventional enzyme-treatment and sulfonization. SM-4300 is also free from large molecules of aggregated gamma-globulin. SM-4300 was administered in combination with antibiotics to 2 patients of severe respiratory infections, having refractory underlying diseases. Case No. 1 was a 65-year-old female with bronchopneumonia, who had been suffering from pulmonary fibrosis, chronic bronchitis, chronic congestive heart failure and tricuspid insufficiency for several years. During her hospitalization because of these diseases, she developed cough with slight sputum and exertional dyspnea accompanied by high body temperature of 38 degrees C on January 1983. Chest X-ray revealed infiltration in the right lung field which was compatible with bronchopneumonia. SM-4300 of 5 g was added intravenously on 5th day after 4 day-cefotiam treatment with no improvement. High body temperature subsided and laboratory data became normal around 3 days after single SM-4300 injection. Case No. 2 was a 68-year-old male patient of chronic bronchitis with chronic pulmonary emphysema and bronchial asthma. Around the end of May 1983, he complained of dyspnea on exertion and had mucopurulent sputum, more than 100 ml daily, from which Pseudomonas aeruginosa was cultured in large number. He was afebrile.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Bronchitis; Bronchopneumonia; Cefotaxime; Cefotiam; Cefsulodin; Chronic Disease; Drug Evaluation; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Humans; Immunization, Passive; Immunoglobulins; Infusions, Parenteral; Pseudomonas aeruginosa

Based on a study of the clinical efficacy of endolymphatic administration of antibiotics in 160 patients with different pulmonary diseases the methods of the use of endolymphatic therapy (ET) as part of a complex of therapeutic measures for lung abscess, pneumonia, chronic purulent bronchitis have been devised. The pharmacodynamics of gentamicin, brulamicin, pentrexyl, ketocef and claforan administered endolymphatically has been explored. Positive shifts have been demonstrated in cyclic nucleotides and immune responsiveness during ET, a constituent part of multiple modality treatment.

Topics: Adolescent; Adult; Aged; Ampicillin; Anti-Bacterial Agents; Bronchitis; Cefotaxime; Cefuroxime; Evaluation Studies as Topic; Female; Humans; Injections, Intralymphatic; Lung Abscess; Male; Middle Aged; Pneumonia; Respiratory Tract Diseases; Tobramycin

A group of 36 patients, admitted to hospital because of acute purulent exacerbations of chronic bronchitis, were treated with once daily injections of ceftriaxone for 10 days, 17 receiving 1 g injections and 19 patients 2 g doses. At the end of treatment (day 11) six patients remained infected (three with Branhamella catarrhalis and three with Pseudomonas aeruginosa) but during the 7 follow-up days 12 patients developed infections with beta-lactamase producing strains of Bran. catarrhalis, Ps. aeruginosa was cultured from 2 patients and Streptococcus pneumoniae from 3 more. Kinetic studies confirmed the long half-life of ceftriaxone (13 to 14 h in this patient group) and showed average peak serum concentrations of 31 mg/l after 1 g and 43 mg/l after the 2 g dose. The comparable sputum concentrations were 3.5 and 4.8 mg/l, respectively. However, four patients failed to show any ceftriaxone in the sputum despite simultaneous blood concentrations of between 32 and 50 mg/l and in two patients ceftriaxone only appeared in the sputum 12 h after the injection. All except one harboured beta-lactamase-producing Bran. catarrhalis in the sputum, and the possibility of breakdown of ceftriaxone by branhamella beta-lactamases is suggested.

Topics: Acute Disease; Bronchitis; Cefotaxime; Ceftriaxone; Chronic Disease; Haemophilus influenzae; Humans; Kinetics; Microbial Sensitivity Tests; Micrococcus; Pseudomonas Infections; Respiratory Tract Infections; Sputum

Topics: Adolescent; Adult; Aged; Bacterial Infections; Bronchitis; Bronchopneumonia; Cefotaxime; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Pulmonary Emphysema

Topics: Acute Disease; Adolescent; Adult; Ampicillin; Anti-Bacterial Agents; Bronchiectasis; Bronchitis; Cefazolin; Cefotaxime; Chronic Disease; Doxycycline; Female; Humans; Lung Abscess; Lung Diseases; Male; Middle Aged; Pneumonia; Premedication; Preoperative Care

A new cephalosporin antibiotic, cefmenoxime (CMX) was administered to 22 patients aged 5 days to 8 years, and who had moderate or severe pediatric infections, to examine its clinical effect. The infections were 3 of acute bronchitis, 2 cases of asthmatic bronchitis, 6 of acute pneumonia, 1 of Mycoplasma pneumonia, 2 of sepsis (1 accompanied with pneumonia), 3 of vacterial meningitis, 2 of urinary tract infection, 1 of acute appendicitis, 1 of aseptic meningitis and 1 of fever of undetermined origin. The drug was administered by one shot intravenous injection 4 times daily at the dose of 40 approximately 200 mg/kg/day. The drug was administered for 3 approximately 15 days, the total dosage administered being 0.7 approximately 43.5 g. Clinically, excellent, good and fair response was obtained in 2, 11 and 4 cases, respectively, the drug being effective in all cases excluding the 5 cases in which judgement was unknown. The 6 strains of bacteria isolated from the lesion as the assumed causative bacteria (1 strain of S. pneumoniae, 2 of H. influenzae, 2 of E. coli, 1 of K. pneumoniae) were all eradicated after drug administration. No notable side effects were produced.

Topics: Bronchitis; Cefmenoxime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Injections, Intravenous; Male; Meningitis, Aseptic; Pneumonia; Pneumonia, Mycoplasma; Respiratory Tract Infections

Thirty-nine patients, 17 to 80 years old, were admitted to a pneumology department. The diagnosis was acute serious or severe respiratory tract infection in 25 patients, exacerbation of chronic bronchopulmonary infection in 6, purulent pneumonia in 4, purulent bronchitis in 4. 28 infecting organisms were identified: Gram-positive cocci (Pneumococcus: 6, Streptococcus: 8. Staphylococcus: 1) and 6 Haemophilus influenzae (3 of which were associated with 1 Pneumococcus) 7 Enterobacteria (isolated or associated). Local, biological and systemic tolerance was generally very good in the majority of patients. Cefotaxime at a daily dose of 2 g intramuscularly for 12 days, showed very good efficacy in the treatment of various bacterial infections of the lower respiratory tract. The activity was evident against a variety of organisms in respiratory infections. The in vitro results of the antibiogram which indicated a superiority of cefotaxime in some cases on other antibiotics currently used in these indications were confirmed by the clinical results.

Topics: Adolescent; Adult; Aged; Bronchitis; Cefotaxime; Cephalosporins; Enterobacteriaceae Infections; Female; Haemophilus Infections; Humans; Male; Middle Aged; Pneumonia; Staphylococcal Infections; Streptococcal Infections

Topics: Bile; Bone and Bones; Bronchitis; Cefotaxime; Cephalosporins; Humans; Sputum