cefotaxime and Pyoderma

Forty-seven adults with infected cutaneous lesions including decubitus ulcers, leg ulcers, cellulitis, pyoderma, and infected dermatitis were treated in a randomized single-blind study with ceftizoxime (2 gm/day, administered intravenously) or cefamandole (4 gm/day, administered intravenously). The duration of treatment ranged from five to 17 days with ceftizoxime and from six to 14 days with cefamandole. Both gram-positive cocci (mostly Staphylococcus sp) and gram-negative bacilli were cultured from the infected areas before treatment. Clinical and bacteriological responses to both drugs were excellent. Ceftizoxime at a dosage of 1 gm twice daily proved to be at least as effective as 1 gm of cefamandole given four times daily. Both drugs were well tolerated, effective, and safe in the treatment of skin and skin-structure infections. Neither drug therapy had to be discontinued because of adverse effects.

Topics: Adult; Aged; Cefamandole; Cefotaxime; Ceftizoxime; Cellulitis; Clinical Trials as Topic; Dermatitis; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pressure Ulcer; Proteus Infections; Proteus mirabilis; Psoriasis; Pyoderma; Random Allocation; Skin Diseases, Infectious; Staphylococcal Infections; Time Factors

A 64-year-old woman fell ill with generalized pyoderma and fever up to 40 degrees C. White cell count was 600/microliters, with 96% lymphocytes. Granulopoiesis in the bone marrow was markedly diminished. After treatment with cefotaxime, 2 g twice daily for one week, the blood count returned to normal. 8 months later generalized pyoderma, fever and agranulocytosis (white cell count 700/microliters) recurred. Once again the findings improved on ofloxacin 200 mg twice daily for 9 days. On repeat questioning about previous drug intake the patient stated that each time before the onset of the agranulocytosis she had taken calcium dobesilate, 500 mg twice daily for the preceding 15 and 3 weeks, respectively. Thereupon a lymphocyte transformation test was performed which revealed significant stimulation by calcium dobesilate 4, 8 and 14 weeks after the second episode of agranulocytosis. -Allergic side effects of calcium dobesilate have repeatedly been reported, but there has been no previously published report of agranulocytosis induced by this drug.

Topics: Agranulocytosis; Calcium Dobesilate; Cefotaxime; Drug Hypersensitivity; Female; Humans; Lymphocyte Activation; Middle Aged; Ofloxacin; Pyoderma; Recurrence

Using cefotiam (CTM) against infections in neonates and premature infants, we obtained the following results: With intravenous administration of the drug to 2 cases each of pyoderma, pneumonia, and fetal infection, the drug was effective in all the cases except in 1 premature infant with pneumonia. Dose levels at individual injections were between 18.6 and 27.8 mg/kg, per dose, with an exception in 1 case of pyoderma (36.4-54.5 mg/kg), and 2 to 4 doses per day were given to each patient. For prophylactic purposes, the drug was administered to 1 case of turbid amniotic fluid and 3 cases of massive aspiration syndrome, and no infection was observed in any case. In a total of 11 cases consisting of the above mentioned 10 cases and an additional case which had been excluded from the evaluation because of the detection of P. aeruginosa, neither side effects nor abnormal laboratory values were recognized. In 5 cases of 4 to 31-day old infants, CTM concentrations in blood were measured after one-time intravenous injection of the drug at a dose level of about 20 mg/kg. Blood concentrations of CTM were low in 1 case with levels of 14.4 and 4.5 micrograms/ml at 30 minutes and 2 hours after the intravenous injection, respectively, whereas they were high in another case with readings of 82 and 65 micrograms/ml. In the remaining 3 cases, however, 30-minute and 2-hour values were between 41 to 52, and 13.5 to 22.8 micrograms/ml, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Bacterial Infections; Cefotaxime; Cefotiam; Drug Evaluation; Female; Humans; Infant, Newborn; Infant, Premature; Male; Pneumonia; Pyoderma