cefotaxime and Edema

Topics: Acute Disease; Anti-Bacterial Agents; Cefotaxime; Child; Clindamycin; Drug Therapy, Combination; Edema; Female; Humans; Magnetic Resonance Imaging; Mastoiditis; Myringoplasty; Osteomyelitis; Temporal Bone

Topics: Abdominal Cavity; Aged, 80 and over; Anti-Infective Agents; Ascites; Cefotaxime; Diagnosis, Differential; Diet, Sodium-Restricted; Diuretics; Edema; Humans; Inflammation; Liver Cirrhosis; Lower Extremity; Male; Norfloxacin; Paracentesis; Peritonitis; Spironolactone; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography

We report two cases, one of a 52-year-old man and one of a 32-year-old man, who were treated with cefotaxime. On day 23 and day 28 of the treatment, respectively, the patients manifested clinically with fever, pruriginous skin rash, and facial edema. Blood tests showed marked eosinophilia and atypical lymphocytosis for both patients, and hepatic cytolysis only in the second patient. Cefotaxime was discontinued in both patients; the clinico-biological picture improved gradually and completely disappeared approximately 4 weeks later. Six weeks after complete recovery, both patients underwent intradermal testing which was positive to cefotaxime (2 mg/ml) at the 48-hour reading and negative to benzylpenicillin, amoxicillin, and cefazolin at the 20-minute and 48-hour readings. These clinical pictures suggest drug rash with eosinophilia and systemic symptoms (DRESS) induced by cefotaxime. To the best of our knowledge, only one case of cefotaxime-induced DRESS has been reported in the medical literature. Thus, we add two new cases of cefotaxime-induced DRESS and emphasize the usefulness and safety of intradermal testing in establishing the diagnosis.

Topics: Adult; Anti-Bacterial Agents; Cefotaxime; Edema; Eosinophilia; Humans; Lymphocytosis; Male; Middle Aged; Skin Diseases

Four local irritation studies of cefodizime sodium (THR-221), a new developed cephem-type antibiotics, were carried out with NZW rabbits. 1. In eye irritation test, 25% THR-221 water solution had no irritancy on eye mucosa in rabbits. 2. In single injective intramuscular irritation study, regardless of solvents (water or 0.5% lidocaine), 25% THR-221 solution had irritancy equal to 0.75% acetic acid. But recovery process of the muscle injured with THR-221 was faster and better than with 0.75% acetic acid. 3. In five days injective muscular irritation study, the irritancy of 25% THR-221 water solution on the muscle was milder than that of CTT or CET. Histopathological damage with THR-221, necrosis/degeneration of muscle fibers and edema/hemorrhage in interstitium etc., were well recovered. 4. In vessel irritation study, 10% or more THR-221 water solution had irritancy on ear vessel. THR-221, as same as CTT, caused organized thrombi and inflammation at the surrounding area. The degree of irritation of 20% THR-221 solution was slightly stronger than that of 20% CET, but weaker than that of 20% CTT. 5. In a clinical phase, it is to be desired that THR-221 like as CTT or CET shall be avoided repeated intramuscular or intravenous injections at the same site.

Topics: Animals; Cefotaxime; Cefotetan; Cephalothin; Edema; Eye; Hemorrhage; Injections, Intramuscular; Injections, Intravenous; Irritants; Male; Mucous Membrane; Muscles; Muscular Diseases; Necrosis; Rabbits; Thrombophlebitis; Veins