cefotaxime and Pharyngitis

Topics: Anti-Bacterial Agents; Cefotaxime; Ceftriaxone; Female; Gonorrhea; Humans; Japan; Male; Neisseria gonorrhoeae; Pharyngitis; Sexual Behavior; Sexually Transmitted Diseases

Topics: 4-Quinolones; Anti-Infective Agents; Cefotaxime; Diagnosis, Differential; Female; Gonorrhea; Humans; Male; Molecular Diagnostic Techniques; Neisseria gonorrhoeae; Pharyngitis; Prognosis; Urethritis; Uterine Cervicitis

The microbiological, kinetic and clinical profile of cefixime, a IIIrd generation cephalosporin, administered orally, is presented. Cefixime is highly active versus Gram-negative aerobic bacteria while, with respect to Gram-positive bacteria, it is only active against Str. pneumoniae, Str. pyogenes, Str. agalactiae, and Str. bovis. It has no action against anaerobics. Endowed with good kinetics, cefixime possesses a favourable tissue distribution. Cefixime is highly indicated in infections of the upper and lower airways where the aethiology is prevalently due to Str. pneumoniae, H. influenzae and B. catarrhalis, that are extremely sensitive to the antibiotic. It is concluded that the therapeutic armamentarium has been enriched by a new, highly active antibiotic that, administered in a monodese/die, ca satisfy patient compliance.

Topics: Animals; Bacteria; Cefixime; Cefotaxime; Gonorrhea; Humans; Microbial Sensitivity Tests; Otitis Media; Pharyngitis; Respiratory Tract Infections; Tonsillitis; Urinary Tract Infections

Sore throat is a common symptom presented to general practitioners (GPs), and there remains controversy about the appropriate use of antibiotics.. To compare, in a randomized controlled trial, the effectiveness of penicillin, cefixime and placebo on symptom resolution in patients presenting with a sore throat in general practice.. Twenty-two GPs in Avon recruited 154 patients, aged 16-60 years, presenting to their GP with a sore throat, and for whom the GP would normally prescribe an antibiotic. Patients were randomized to one of three groups: penicillin V 250 mg four times a day; cefixime 200 mg daily; and placebo. Each was prescribed for five days. The main outcome measures were a diary of symptom resolution over seven days and eradication of group A beta-haemolytic streptococcus (GABHS).. Of the 103 (67%) patients who completed symptom diaries, 40 were allocated to receive penicillin, 29 cefixime and 34 placebo. In the analysis including all patients, symptom resolution was greater by day 3 in the cefixime group than in the placebo group. Penicillin did not improve symptom resolution by day 3 compared with placebo, and cefixime was not statistically significantly different from penicillin. There were significant differences in the proportion of patients using analgesia at day 3, with the proportion being lowest in the cefixime group. The results for the subgroup of patients without GABHS were similar to those for all patients; in particular, the only statistically significant difference was between cefixime and placebo. Although numbers were too small for statistical significance, among patients with GABHS the effects of penicillin and cefixime were similarly raised in relation to placebo.. Compared with placebo, cefixime can improve the rate of resolution of symptoms in patients with a sore throat who are selected for antibiotic treatment by their GP. The unexpected finding that cefixime was of benefit compared with placebo for patients without GABHS suggests that bacteria other than GABHS may be important in the pathogenesis of sore throat.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cefixime; Cefotaxime; Family Practice; Female; Humans; Male; Middle Aged; Penicillin V; Pharyngitis; Treatment Outcome

In an open, controlled, randomized multicenter study, 160 children suffering from pharyngitis and/or tonsillitis were treated with either 8 mg cefixime/kg body weight once daily for 5 days or 20,000 I.U. penicillin V/kg body weight t.i.d. for 10 days. One hundred fifty-one children were evaluable for clinical efficacy. In the cefixime group, 65 (86.7%) children were cured, seven (9.3%) were significantly improved, one (1.3%) relapsed and in two (2.7%) therapy failed. Of the patients treated with penicillin V, 69 (90.8%) were cured, five (6.6%) improved, one (1.3%) relapsed and in one (1.3%) therapy failed. Elimination of initial pathogens occurred in 57 (82.6%) patients treated with cefixime and in 60 (88.2%) treated with penicillin V. At 3 to 4 weeks after the end of treatment, six relapses were seen in the cefixime group and eight in the penicillin V group. Mild-to-moderate adverse events that were possible related to the medication were seen in four children treated with cefixime and in five treated with penicillin V.

Topics: Cefixime; Cefotaxime; Cephalosporins; Child; Child, Preschool; Female; Humans; Infant; Male; Penicillin V; Penicillins; Pharyngitis; Streptococcal Infections; Tonsillitis

Therapy to eradicate pharyngeally carried group A streptococci (GAS) has increasingly been used in the management of institutional outbreaks and is now recommended for household contacts of patients with streptococcal toxic shock syndrome. In this randomized, controlled trial, contacts of patients with GAS infections were screened for pharyngeal GAS colonization. Those whose cultures were positive were randomized to receive either cefixime (8 mg/[kg.d]; maximum 400 mg) or rifampin (20 mg/kg; maximum, 600 mg) once a day for 4 days. Two to five days following completion of therapy, repeated cultures were negative for 13 (38%) of 34 rifampin recipients and 71 (77%; 95% CI, 69%-85%) of 97 cefixime recipients. At 10-14 days after treatment, only 53% of cefixime recipients remained culture-negative. Rates of successful clearance improved with increasing age (P < .01); among 17 adults who received cefixime, the success rate was 94%. Four days of therapy with rifampin is not effective for eradication of pharyngeally carried GAS. Four days of therapy with cefixime may be effective for adults, but further studies are needed.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Cefixime; Cefotaxime; Child; Drug Administration Schedule; Humans; Pharyngitis; Rifampin; Streptococcal Infections; Streptococcus pyogenes

An open label randomized trial conducted in rural Kentucky compared the efficacy and safety of cefixime (CFX), 8 mg/kg once daily, with those of penicillin V (PEN), 250 mg 3 times daily, in 110 pediatric patients with Group A beta-hemolytic streptococcal pharyngitis. Forty-eight CFX and 47 PEN patients were evaluable for efficacy. At the end of therapy bacteriologic eradication was 45 of 48 (94%) and 36 of 47 (77%) in the CFX and PEN V groups, respectively (P < 0.05). Up to 6 weeks posttherapy 10 (21%) CFX patients and 21 (45%) PEN patients had positive Group A beta-hemolytic Streptococcus cultures (P < 0.05). Concordant serotypes were identified from 4 of 7 CFX and 15 of 17 PEN patients with positive repeat cultures. All discordant serotypes (5 of 31) were identified at greater than 19 days posttherapy. Symptomatic treatment failures (concordant serotypes) occurred in 1 (2%) CFX and 8 (17%) PEN patients (P < 0.05). Drug-related adverse experiences consisted of 2 cases of mild diarrhea and loose stools in the CFX group and none in the PEN group. No clinically significant laboratory test abnormalities occurred in either group. CFX, once daily, was as safe as and significantly more effective than PEN given 3 times daily for the treatment of Group A beta-hemolytic streptococcal pharyngitis.

Topics: Adolescent; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Humans; Male; Penicillin V; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes

Cefixime, a new third generation oral cephalosporin antibiotic, was evaluated for safety and efficacy in the treatment of 206 children with acute bacterial pharyngitis, cystitis or pneumonia. Each patient had a throat, urine or sputum culture before therapy and was treated with a 10- to 14-day course of cefixime, 8 mg/kg once daily. Bacterial pathogens were isolated in 167 of 206 (81.1%). Streptococcus pyogenes (73.7% of isolates) and Escherichia coli (9.6%) were the most common Gram-positive and Gram-negative organisms, respectively. All patients were evaluable for safety, and 109 (52.9%) with pharyngitis (96) or cystitis (13) were evaluable for efficacy. Clinical failure occurred in 2 of 109 (1.8%) patients, both with pharyngitis; bacteriologic failure occurred in 1 patient with pharyngitis and 1 with cystitis. Five patients with pneumonia caused by possible pathogens also improved while taking cefixime. Drug-related adverse side effects occurred in 50 of 206 patients (24.3%); these were generally mild and led to discontinuing the antibiotic in only 4 patients (1.9%). The most common were diarrhea or loose stools (33 of 206, or 16%). Results of this study suggest that cefixime given once daily to children is safe and effective in the treatment of streptococcal pharyngitis and bacterial cystitis.

Topics: Adolescent; Cefixime; Cefotaxime; Child; Child, Preschool; Clinical Trials as Topic; Cystitis; Diarrhea; Female; Humans; Infant; Male; Pharyngitis; Pneumonia

Of the currently recommended regimens for treatment of uncomplicated gonorrhea, only aqueous penicillin G procaine is effective against infections at all sites. However, procaine penicillin is not effective against penicillinase-producing Neisseria gonorrhoeae and suffers from poor patient acceptability owing to the 10-mL volume of injection and allergic and toxic procaine reactions. Ceftriaxone is a new extended-spectrum cephalosporin with a long serum half-life and is many times more active than penicillin G against both beta-lactamase-positive or -negative strains of N gonorrhoeae. Ceftriaxone was compared as a single, 125-mg, 0.5-mL injection with a single 2-g injection of spectinomycin in difficult to treat pharyngeal gonorrhea in men and women and anorectal gonorrhea of men. Ceftriaxone cured 30/32 (94%) pharyngeal and 52/52 anorectal infections, compared with 6/14 (43%) and 9/9, respectively, for spectinomycin. Both regimens were well tolerated. Ceftriaxone may prove to be a drug of choice for uncomplicated gonorrhea, particularly where homosexual men are treated and/or penicillinase-producing N gonorrhoeae is prevalent.

Topics: Adult; Cefotaxime; Ceftriaxone; Clinical Trials as Topic; Drug Eruptions; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Penicillin G; Pharyngitis; Proctitis; Spectinomycin; Tetracycline

Group A streptococcus (GAS) is a major bacterial pathogen affecting children globally. Approximately 15% of school-age children experience a symptomatic episode of GAS culture-positive pharyngitis each year. Although the incidence of invasive GAS disease under these circumstances is low (0.5%-2%), an increasing number of invasive GAS cases have been reported over the last 2 decades. This report describes a 7-year-old boy who, after being treated for GAS pharyngitis, developed a fatal streptococcal toxic shock syndrome.

Topics: Acute Kidney Injury; Anti-Bacterial Agents; Cefotaxime; Child; Clindamycin; Drug Therapy, Combination; Emergencies; Fatal Outcome; Fluid Therapy; Hemorrhage; Humans; Hypotension; Intubation, Intratracheal; Male; Pharyngitis; Respiration, Artificial; Respiratory Distress Syndrome; Shock, Septic; Streptococcal Infections; Streptococcus pyogenes

We report a case of Lemierre syndrome in a healthy infant, initially presenting with otitis media and angina. Lemierre syndrome is a disease that every pediatrician must know. Early diagnosis and treatment with antibiotics are necessary to decrease mortality. A review of the history and the complications of Lemierre syndrome is presented.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents; Cefotaxime; Child; Drug Therapy, Combination; Female; Follow-Up Studies; Fusobacterium Infections; Fusobacterium necrophorum; Gentamicins; Hospitalization; Humans; Jugular Veins; Length of Stay; Metronidazole; Otitis Media; Pharyngitis; Syndrome; Time Factors; Tomography, X-Ray Computed; Venous Thrombosis

Topics: Anti-Bacterial Agents; Cefotaxime; Child; Female; Humans; Injections, Intravenous; Orbital Pseudotumor; Pharyngitis; Streptococcal Infections; Streptococcus agalactiae

Influences of cefixime and cefaclor, oral antibiotics, were studied in 50 children (age range, 11 months to 13 years) with pharyngitis. Daily doses of cefixime were 6 to 10 mg/kg in 25 children and those of cefaclor were 40 to 50 mg/kg in 25 children. Pharyngeal swabs were taken before and after 3 to 7 days of the antibiotic treatment. Pathogenic organisms, such as Streptococcus pyogenes, Haemophilus influenzae and Streptococcus pneumoniae, were isolated in 14 children before and in 1 child after cefixime use. But these bacteria were isolated in 15 children before and in 9 children, and 3 strains of H. influenzae and 3 strains of S. pneumoniae were newly isolated after cefaclor use. An isolation rate of Gram-negative bacilli, such as Acinetobacter spp., were increased after use of cefixime. In both antibiotics, isolation rates of yeasts were slightly increased. An isolation rate of alpha-hemolytic streptococci was increased from 16% to 48% by cefixime treatment and from 24% to 52% by cefaclor treatment. The MIC50 of cefixime and cefaclor against alpha-hemolytic streptococci isolated after treatment was higher than that isolated before. Effects of cefixime and cefaclor was less extensive than that of ampicillin in previous reports.

Topics: Adolescent; Bacteria; Cefaclor; Cefixime; Cefotaxime; Child; Child, Preschool; Humans; Infant; Pharyngitis; Pharynx

Fundamental and clinical studies on cefixime (CFIX), a new oral cephem antibiotic, were carried out in the pediatric field. The results were as follows: Serum concentrations and urinary recovery rates were determined after oral administration of CFIX at doses of 3 mg/kg and 6 mg/kg in 2 cases each (4 cases in total). The mean serum concentrations of CFIX were 0.52 and 0.58 micrograms/ml at 2 hours, 0.80 and 1.42 micrograms/ml at 4 hours, 0.73 and 1.36 micrograms/ml at 6 hours, 0.54 and 1.12 micrograms/ml at 8 hours, respectively. The mean peak serum concentration of CFIX was obtained at 4 hours after administration, with serum half-lives (T1/2) of 3.77 and 5.30 hours, respectively. The mean cumulative urinary recovery rates within 12 hours after administration of CFIX at doses of 3 mg/kg and 6 mg/kg were 8.4% and 6.8%, respectively. Antibacterial activities of CFIX against clinically isolated strains of S. pyogenes, S. pneumoniae. E. faecalis, S. aureus, E. coli, H. influenzae, H. parainfluenzae were compared with those of amoxicillin (AMPC), cefaclor (CCL), and cephalexin (CEX). It was observed that CFIX was a little less active than AMPC against S. pyogenes and S. pneumoniae, but CFIX was more active than CCL and CEX. CFIX was the most active against E. coli, H. influenzae and H. parainfluenzae. Twenty-one pediatric patients with bacterial infections (10, tonsillitis; 4, pharyngitis; and 7, urinary tract infections) were treated with CFIX at doses of 1.5-6.0 mg/kg in 2 or 3 times daily for 4-10 days. The efficacy rate was 95.2% clinically and 91.3% bacteriologically. No adverse reactions were observed. An abnormal laboratory finding (slight elevation of S-GOT and S-GPT) was observed in 1 case.

Topics: Acute Disease; Bacteria; Bacterial Infections; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Kinetics; Male; Pharyngitis; Species Specificity; Tonsillitis; Urinary Tract Infections

Cefixime (CFIX) was evaluated for pharmacokinetics, therapeutic effectiveness on infection, safety, and bacteriological effectiveness in pediatrics. The following is a summary of the results. Pharmacokinetics in 4 children, 2 each receiving a single dose of 1.5 mg or 6.0 mg per kg body weight, were examined. Peak serum CFIX concentrations after the dose of 1.5 mg/kg were 1.12 and 1.34 micrograms/ml, and the serum half-lives were 1.83 and 3.53 hours. For the children administered with 6.0 mg/kg of CFIX, the respective figures were 2.50 and 7.46 micrograms/ml, and 6.77 and 6.64 hours. The 12-hour urinary recoveries were 4.9 and 34.1% and 9.4 and 25.4% for the small and the large doses, respectively. Therapeutic effectiveness in 19 children with infections was "excellent" in 14 and "good" in 5, with an effectiveness rate of 100%. Bacteriological effectiveness was evaluated in 10 children. Classified by causative organisms, 5 cases had H. influenzae, 2 each H. parainfluenzae and S. pyogenes, and 1 mixed infection by H. influenzae and S. pneumoniae. Only the H. influenzae in the child with mixed infection resisted the therapy, and all the other pathogens were successfully eradicated. No side effects were recorded. The only abnormal laboratory test finding attributed to CFIX was eosinophilia in 2 children.

Topics: Acute Disease; Bacterial Infections; Cefixime; Cefotaxime; Child; Child, Preschool; Enteritis; Female; Humans; Infant; Kinetics; Male; Pharyngitis; Respiratory Tract Infections; Tonsillitis; Urinary Tract Infections

Cefixime (CFIX), a new oral cephalosporin, was administered clinically at a daily dose of 3.4 mg/kg to 10.4 mg/kg to each of 12 children, aged from 2 months to 14 years old. An additional separate study was done to compare the serum and urinary levels of CFIX in 3 children when each was administered with 100 mg of the drug in capsule with the serum and urinary levels of the drug in the same children when each was given the same amount of drug in the form of 5% granules. The results of these trials are summarized below. Peak serum levels of CFIX administered in capsules and 5% granules averaged 1.4 micrograms/ml and 1.9 micrograms/ml, respectively. The half-life of the former was 5.13 hours, while that of the latter was 4.17 hours. The difference in the peak levels was statistically insignificant. The urinary excretion of CFIX in either form of the drug (capsules and granules) was about 14-18% in 12 hours. In 9 cases of respiratory infections, therapeutic results were excellent in 3 cases, good in 6 cases, and the effective rate was 100%. In 2 cases of urinary tract infection, results were excellent in 1 case and good in 1 case. The drug efficacy was poor in 1 case of purulent cervical lymphadenitis, probably caused by Staphylococcus aureus. No adverse reactions attributable to the drug were observed. CFIX may be expected to be a highly effective and safe agent in moderate respiratory and urinary tract infections of children.

Topics: Administration, Oral; Adolescent; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Kinetics; Lymphadenitis; Male; Pharyngitis; Pneumonia; Respiratory Tract Infections; Urinary Tract Infections

The therapeutic effect of ceftizoxime suppositories (CZX-S) was studied in 8 physically handicapped patients, comprising 6 with pharyngitis, 1 with pneumonia, and 1 with urinary tract infection. The clinical effect was "excellent" in 7 and "good" in 1. Neither adverse reactions nor abnormal laboratory test findings attributable to CZX-S were detected. CZX-S proved to be useful in physically handicapped children, especially in those not suited to treatment with oral or intravenous preparations.

Topics: Adolescent; Adult; Bacterial Infections; Cefotaxime; Ceftizoxime; Child; Child, Preschool; Disabled Persons; Drug Evaluation; Drug Resistance, Microbial; Enterobacter; Female; Humans; Male; Pharyngitis; Pneumonia; Suppositories; Urinary Tract Infections

Topics: Abscess; Adult; Aged; Arthritis, Infectious; Bacterial Infections; Cefotaxime; Cephalosporins; Cholangitis; Female; Humans; Male; Middle Aged; Otitis Media; Pelvic Inflammatory Disease; Pharyngitis; Urinary Tract Infections