cefotaxime and Rectal-Diseases

Cefotaxime is a third-generation cephalosporin with excellent in vitro antimicrobial activity against Neisseria gonorrhoeae, including beta-lactamase-producing strains. A single 1-g intramuscular dose is suitable for the treatment of uncomplicated gonorrhea. We conducted an open, randomized study to evaluate the efficacy, safety, and cost impact of a lower dose (500 mg) of cefotaxime versus 250 mg ceftriaxone, an often recommended treatment for uncomplicated gonorrhea. Of the 222 patients enrolled, the cases of 151 were fully assessable. Bacteriologic elimination rates were 99% in the cefotaxime group and 100% in the ceftriaxone group. Clinical response rates were 78% and 83% in the two groups, respectively. Adverse clinical events occurred in 4% and 9% of patients in the two groups, respectively. The average wholesale price of 500 mg cefotaxime is 31% lower than that of 250 mg ceftriaxone. A 500-mg dose of cefotaxime appears to be a safe and cost-effective alternative to 250 mg ceftriaxone for the treatment of uncomplicated gonorrhea.

Topics: Adolescent; Adult; Cefotaxime; Ceftriaxone; Costs and Cost Analysis; Drug Resistance, Microbial; Female; Gonorrhea; Humans; Injections, Intramuscular; Male; Neisseria gonorrhoeae; Rectal Diseases; Urethral Diseases; Uterine Cervicitis

Systemic antibiotic prophylaxis in surgery of the colon and rectum is principally useful. It should be administered only on the day of surgery. Stapling makes it possible to enlarge the indication for deeper rectal resection. In cases of deep rectal anastomoses in men bladder dysfunction has to be expected in a considerable percentage. Anal continence does not depend on the anastomotic technique but on the anastomotic level in relation to its distance from the ano-cutaneous line and in consequence on the loss of reservoir capacity.

Topics: Cefotaxime; Clinical Trials as Topic; Colonic Diseases; Fecal Incontinence; Humans; Intestinal Fistula; Mezlocillin; Premedication; Rectal Diseases; Surgical Staplers; Surgical Wound Dehiscence; Surgical Wound Infection; Suture Techniques; Urination Disorders; Wound Healing

In an open randomized study in a large Rotterdam male and female population (n = 1500), suffering from uncomplicated urogenital, rectal and oropharyngeal gonorrhoea treatment with cefotaxime 1.0 g proved to be more effective than with cefuroxime 1.5 g in all patients studied. However, statistically significant differences between the failure rates of the cefotaxime and the cefuroxime treatment were found only for all male and female patients, in urethral or urogenital and rectal infections in this group, for all male patients, and in urethral infections in men. Failure rates were low (1.7 and 5.6%, respectively for cefotaxime and cefuroxime). Oropharygeal gonorrhoea responded less well than urethral or urogenital and rectal gonorrhoea. Both drugs were very effective in the eradication of uncomplicated gonococcal infections caused by both non-beta-lactamase producing and beta-lactamase producing gonococci. High (greater than 30%) post-gonococcal urethritis rates were observed. Side-effects were minor.

Topics: beta-Lactamases; Cefotaxime; Cefuroxime; Cephalosporins; Female; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Pharyngeal Diseases; Random Allocation; Rectal Diseases; Urethral Diseases; Uterine Cervical Diseases

Topics: Cefotaxime; Colonic Diseases; Erythromycin; Escherichia coli; Humans; Injections, Intravenous; Neomycin; Pseudomonas aeruginosa; Rectal Diseases; Surgical Wound Infection