cefotaxime and Respiratory-Tract-Infections

Topics: Aged; Anti-Bacterial Agents; Asthma; Bacteremia; Cefotaxime; Clostridium; Clostridium Infections; Diagnostic Errors; Drug Therapy, Combination; Female; Humans; Immunocompetence; Levofloxacin; Respiratory Tract Infections

These studies were designed to assess the efficacy and safety of cefepime, a fourth generation cephalosporin, for the treatment of serious infections, including lower respiratory tract infections (LRTI) in children.. Four clinical trials of cefepime for the treatment of serious bacterial infections enrolled 259 children with LRTI. In 3 trials cefepime was compared with ceftazidime (n = 166), cefotaxime (n = 16) or cefuroxime (n = 12). One trial was noncomparative (n = 65).. Treatment with cefepime 50 mg/kg/ dose administered every 8 to 12 h produced a satisfactory clinical response (clinical signs of infection resolved or improved with no evidence of recurrent infection at posttreatment follow-up) in 88 to 100% of patients, comparable with comparator therapy. In children from whom a causative pathogen was identified, bacteriologic eradication was comparable between cefepime and comparator therapy. Cefepime was as safe and well-tolerated as comparator therapy. Few treatment-related clinical or laboratory adverse events were noted and were equivalent to comparator in all studies.. Cefepime is as effective, safe and well-tolerated for the empiric treatment of children with LRTI as comparator agents but offers the advantage of an enhanced spectrum of activity for Gram-positive and Gram-negative pathogens compared with second or third generation cephalosporins.

Topics: Adolescent; Cefepime; Cefotaxime; Ceftazidime; Cefuroxime; Cephalosporins; Child; Child, Preschool; Clinical Trials as Topic; Humans; Infant; Recurrence; Respiratory Tract Infections; Safety; Treatment Outcome

Topics: Amoxicillin; Anti-Bacterial Agents; Cefazolin; Cefotaxime; Cephalosporins; Child, Preschool; Clavulanic Acid; Drug Resistance, Microbial; Epidural Abscess; Humans; Male; Penicillins; Pneumococcal Infections; Respiratory Tract Infections; Streptococcus pneumoniae; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cefotaxime; Ceftriaxone; Cephalosporins; Female; Gram-Negative Bacterial Infections; Humans; Male; Middle Aged; Randomized Controlled Trials as Topic; Respiratory Tract Infections

Topics: Anti-Bacterial Agents; Blood-Brain Barrier; Cefotaxime; Cephalosporins; Gram-Negative Bacterial Infections; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Respiratory Tract Infections

Cefixime is an orally active third generation cephalosporin with in vitro antibacterial activity against most important lower respiratory pathogens. The drug is active against Haemophilus influenzae, Moraxella catarrhalis and penicillin-susceptible Streptococcus pneumoniae but not Staphylococcus aureus. Cefixime has a long elimination half-life (3 hours compared with 0.5 hours for cefaclor and 1.5 hours for cefalexin), which allows once daily administration. Several trials have established the clinical efficacy of the drug in patients with lower respiratory tract infection (LRTI). In comparative studies cefixime had similar efficacy to amoxicillin +/- clavulanic acid, cefaclor, cefalexin, cefuroxime axetil and clarithromycin. Trials evaluating the efficacy of cefixime as the oral component of intravenous to oral switch therapy have produced promising preliminary results although further carefully designed trials are needed in this area. As with certain other drugs of its class, gastrointestinal disturbances are the most frequently reported adverse events in patients taking cefixime and cases of pseudomembranous colitis have been reported. Thus, cefixime is an effective treatment for mild to moderate LRTI and may have a role as the oral component of intravenous to oral switch therapy although further well designed studies are needed to confirm initial favourable results in this important emerging area of antibacterial therapy.

Topics: Anti-Bacterial Agents; Bacteria; Cefixime; Cefotaxime; Clinical Trials as Topic; Humans; Microbial Sensitivity Tests; Respiratory Tract Infections

Cefodizime is a third generation cephalosporin with a broad spectrum of antibacterial activity. Administered intravenously or intramuscularly, cefodizime 1 to 4 g daily for an average of 7 to 10 days produced clinical cure in 80 to 100% of patients (adults, elderly or children) with upper or lower respiratory tract infections or urinary tract infections, and in comparative trials cefodizime was as effective as other third generation cephalosporins. A single dose of cefodizime 1 or 2 g is also useful in treating lower urinary tract infections, particularly uncomplicated infections, with a rate of clinical success of 72 to 88%. Urogenital gonorrhoea, whether caused by beta-lactamase producing or non-beta-lactamase producing Neisseria gonorrhoeae, is very effectively treated by single dose therapy with intramuscular cefodizime 0.25 to 1 g (virtually 100% cured). Preliminary data from a small number of patients indicate that cefodizime may also be useful in the treatment of otitis media, sinusitis and gynaecological infections, and for the prophylaxis or treatment of surgical infections. The clinical efficacy of cefodizime in comparison with other third generation cephalosporins is superior to that predicted from in vitro results. This superior activity of cefodizime may be related to the relatively long elimination half-life of the drug or its ability to modify some functions of the immune system--a potentially important finding awaiting further investigation. Cefodizime is well tolerated and has a tolerability profile similar to other members of its class with systemic adverse events being primarily gastrointestinal or dermatological. Thus, limited comparative studies indicate cefodizime has the potential to become a useful alternative to current antimicrobial therapy for the treatment of a variety of infections. Cefodizime may be more convenient to administer than some other agents of its class as it may be given once or twice daily. While there are no trials comparing cefodizime to other third generation cephalosporins in immunosuppressed populations, preliminary information indicates cefodizime may be useful in this group.

Topics: Animals; Biological Availability; Cefotaxime; Female Urogenital Diseases; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Immunosuppression Therapy; Male Urogenital Diseases; Microbial Sensitivity Tests; Respiratory Tract Infections; Surgical Wound Infection; Tissue Distribution

The efficacy of cefodizime (CDZ) in lower respiratory tract infections (LRTI) with parenchymal involvement was assessed by the analysis of data from 919 patients who participated in four controlled, randomized studies and three open studies. Sputum bacteriology and a chest x-ray were performed at baseline and after therapy. A total of 778 patients were evaluable for clinical efficacy and 451 for bacteriological efficacy. The most frequent pathogen was Streptococcus pneumoniae, followed by Staphylococcus aureus, Klebsiella pneumoniae and Haemophilus influenzae. CDZ 1 g b.i.d., 2 g b.i.d. and 2 g once daily achieved clinical and bacteriological cure rates above 90%, which matched those observed with the comparators (cefuroxime 1.5 g t.i.d. and cefotaxime 2 g b.i.d.). No significant differences in clinical and bacteriological outcome were detected when the various CDZ dosage regimens were compared. 1 g CDZ b.i.d. is therefore recommended as the regimen of choice for the treatment of LRTI with parenchymal involvement, with CDZ 2 g once daily as an alternative.

Topics: Age Factors; Aged; Bacteria; Cefotaxime; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

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

A total of 560 patients were treated in two double-blind, randomized multicenter studies to compare the safety and efficacy of cefixime (400 mg administered once daily) and amoxicillin (250 or 500 mg administered three times daily) for the treatment of bacterial respiratory tract infections. Eighty percent of the 244 patients treated in the lower respiratory tract infections (LRTI) study had acute bronchitis. Streptococcus pneumoniae (13 percent), Haemophilus influenzae (28 percent), and Escherichia coli (10 percent) were the pathogens most frequently isolated from sputum in these patients. Among evaluable patients with positive bacterial culture results at baseline, a favorable clinical response (cured or improved) was obtained in 100 percent of the cefixime-treated patients (22 of 22) and in 96 percent of the amoxicillin-treated patients (23 of 24). Bacteriologic eradication rates were 100 percent and 83 percent for cefixime and amoxicillin, respectively. In the upper respiratory tract infections (URTI) study, 316 patients with pharyngitis (80 percent) or tonsillitis (14 percent) were treated. Group A, beta-hemolytic Streptococcus (69 percent) and H. influenzae (8 percent) were the pathogens most frequently isolated from the throat culture specimens of these patients. Favorable clinical results were obtained in 99 percent of the evaluable cefixime-treated group (n = 73) and in 98 percent of the amoxicillin-treated group (n = 66). The bacteriologic eradication rates were 93 percent and 100 percent, respectively. The adverse experiences reported during both studies were similar in nature and frequency to those reported for other beta-lactam antibiotics with the exception of a higher incidence of altered bowel movement (diarrhea and stool changes) with both drugs. These episodes usually resolved without remedial medication when the treatment was withdrawn. No significant adverse laboratory findings were observed. Results of these trials demonstrate that cefixime at a dosage of 400 mg once daily is an effective and safe oral antibiotic for the treatment of acute respiratory tract infections.

Topics: Amoxicillin; Cefixime; Cefotaxime; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Random Allocation; Respiratory Tract Infections

A review of clinical studies of piperacillin shows that it is valuable for the treatment of respiratory infections due to Enterobacteriaceae, Pseudomonas sp, anaerobes, and mixed flora including anaerobes. Various studies of a total of 420 patients treated with piperacillin for lower respiratory tract infections found that 97% of the patients were cured or markedly improved. Piperacillin has also been found as effective as combination therapy (gentamicin or tobramycin plus carbenicillin or ticarcillin) in the treatment of serious infections, including pneumonia and several caused by gram-negative organisms and anaerobic organisms. A review of the literature on bacteriological responses to piperacillin shows that 126 of 153 (82%) of the susceptible strains could be eradicated. Streptococcus pneumoniae, beta-hemolytic streptococci, Haemophilus influenzae, Peptostreptococcus sp, Bacteroides sp, and Fusobacterium sp have been completely eradicated by treatment with piperacillin. Most of the published studies indicate that therapy with the drug is usually well tolerated.

Topics: Amikacin; Carbenicillin; Cefotaxime; Cystic Fibrosis; Drug Therapy, Combination; Enterobacteriaceae; Haemophilus influenzae; Humans; Piperacillin; Pseudomonas Infections; Respiratory Tract Infections; Streptococcus; Streptococcus pneumoniae; Tobramycin

Topics: Anti-Bacterial Agents; Biliary Tract Diseases; Biliary Tract Surgical Procedures; Cefotaxime; Ceftriaxone; Cephalosporins; Humans; Injections, Intravenous; Postoperative Complications; Premedication; Prospective Studies; Respiratory Tract Infections; Risk; Surgical Wound Infection

Topics: Bacteria; Bacterial Infections; beta-Lactamases; Cefotaxime; Ceftizoxime; Drug Evaluation; Drug Stability; Endocarditis, Bacterial; Female; Genital Diseases, Female; Humans; Respiratory Tract Infections; Urinary Tract Infections

Selective digestive tract decontamination aims to eradicate gram-negative bacteria in both the intestinal tract and respiratory tract and is combined with a 4-day course of intravenous cefotaxime. Selective oropharyngeal decontamination only aims to eradicate respiratory tract colonization. In a recent study, selective digestive tract decontamination and selective oropharyngeal decontamination were associated with lower day-28 mortality, when compared to standard care. Furthermore, selective digestive tract decontamination was associated with a lower incidence of intensive care unit-acquired bacteremia caused by gram-negative bacteria. We quantified the role of intestinal tract carriage with gram-negative bacteria and intensive care unit-acquired gram-negative bacteremia.. Data from a cluster-randomized and a single-center observational study.. Intensive care unit in The Netherlands.. Patients with intensive care unit stay of >48 hrs that received selective digestive tract decontamination (n = 2,667), selective oropharyngeal decontamination (n = 2,166) or standard care (n = 1,945).. Selective digestive tract decontamination or selective oropharyngeal decontamination.. Incidence densities (episodes/1000 days) of intensive care unit-acquired gram-negative bacteremia were 4.5, 3.0, and 1.4 during standard care, selective oropharyngeal decontamination, and selective digestive tract decontamination, respectively, and the daily risk for developing intensive care unit-acquired gram-negative bacteria bacteremia increased until days 36, 33, and 31 for selective digestive tract decontamination, standard care, and selective oropharyngeal decontamination and was always lowest during selective digestive tract decontamination. Rectal colonization with gram-negative bacteria was present in 26% and 71% of patient days during selective digestive tract decontamination and selective oropharyngeal decontamination, respectively (p < .01). Irrespective of interventions, incidence densities of intensive care unit-acquired gram-negative bacteremia was 4.5 during patient days with both intestinal and respiratory tract gram-negative bacteria carriage. These incidence densities reduced with 33% (to 3.1) during days with intestinal gram-negative bacteria carriage only and with another 45% (to 1.0) during days without gram-negative bacteria carriage at both sites.. Respiratory tract decolonization was associated with a 33% and intestinal tract decolonization was associated with a 45% reduction in the occurrence of intensive care unit-acquired gram-negative bacteremia.

Topics: Bacteremia; Cefotaxime; Cluster Analysis; Colony Count, Microbial; Cross Infection; Decontamination; Drug Administration Schedule; Female; Follow-Up Studies; Gastroenteritis; Gastrointestinal Tract; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Incidence; Infusions, Intravenous; Intensive Care Units; Intestines; Male; Netherlands; Oropharynx; Proportional Hazards Models; Prospective Studies; Respiratory Tract Infections; Risk Assessment; Standard of Care; Treatment Outcome

Beta-lactamase producing bacteria present a major problem in treating lower respiratory tract infections. The objective of this study was to evaluate efficacy and safety of cefotaxime-sulbactam combination versus amoxicillin-clavulanic acid injection as an alternative therapeutic option for treatment of lower respiratory tract infections in pediatric patients.. This randomized, multicentric, comparative study enrolled 102 inpatients with lower respiratory tract infections, in the age range of 3 months - 12 years. Patients received cefotaxime-sulbactam or amoxicillin-clavulanic acid injection intravenously for up to 7 days.. There was no difference between the two groups in demography or disease characteristics (p > 0.05) at baseline. Efficacy was evaluated in a total of 96 patients. Both the treatment groups were comparable in response rate at the end of the therapy (p > 0.05). Clinical success rate was 93.6% and 89.8%, respectively for cefotaxime-sulbactam and co-amoxiclav. One patient from the cefotaxime-sulbactam group reported convulsions, which were probably not related to the study medication in the opinion of the investigator. Except for this serious adverse event, both the study medications were safe and well tolerated in the study population.. In conclusion, cefotaxime-sulbactam administered 3 times a day for up to 7 days was found to be as effective as co-amoxiclav therapy. However, further studies with a large number of patients are required to confirm these findings with more robust microbiological evaluation.

Topics: Amoxicillin-Potassium Clavulanate Combination; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Male; Respiratory Tract Infections; Sulbactam

To compare the pharmacokinetics/pharmacodynamics, antibiotic resistance and clinical efficacy of continuous (CA) vs. intermittent administration (IA) of cefotaxime in patients with obstructive pulmonary disease and respiratory infections.. A randomized controlled prospective nonblinded study was performed in 93 consecutive hospitalized patients requiring antibiotics for acute exacerbations of chronic obstructive pulmonary disease. Forty-seven patients received 2 g of cefotaxime intravenously over 24 h plus a loading dose of 1 g, and 46 patients were given the drug intermittently (1 g three times daily).. Similar pathogens were identified in both groups, being mostly Haemophilus influenzae (51%), Streptococcus pneumoniae (21%) and Moraxella catharralis (18%). Mean minimal inhibitory concentration (MIC) values were also similar before and after treatment in both groups. Clinical cure was achieved in 37/40 (93%) (CA) vs. 40/43 (93%) (IA) of patients (P = 0.93). In microbiologically evaluable patients, criteria such as 70% of treatment time with antibiotic concentrations > or = MIC (CA 100%vs. IA 60% of patients) and/or > or = 5 x MIC (CA 100%vs. IA 55% of patients) were significantly better following continuous administration (P < 0.01). Samples with suboptimal antibiotic concentrations were found in 0% of CA vs. 65% of IA patients (P < 0.01).. Although clinical cure rates were comparable, continuous cefotaxime administration led to significantly greater proportions of concentrations > MIC and > 5 x MIC compared with intermittent dosing. Continuous administration of cefotaxime at a lower dose [2 g (CA) vs. 3 g (CI)] is equally effective pharmacodynamically and microbiologically, may be more cost-effective and offers at least the same clinical efficacy. Based on these observations, we recommend continuous administration of cefotaxime as the preferred mode of administration.

Topics: Adult; Aged; Anti-Bacterial Agents; Cefotaxime; Disease Susceptibility; Female; Humans; Male; Middle Aged; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Respiratory Tract Infections

Cefixime is quickly establishing in Western countries as a potent broad-spectrum antibiotic with a variety of indications. A multinational, nonrandomized study in Central and Eastern Europe has confirmed the excellent efficacy of cefixime in both children and adults. In 45 children with acute sinusitis and 50 with acute otitis media, once-daily cefixime in oral suspension resulted in clinical cure or improvement in 45 (100%) and 48 (96%) patients, respectively. In 60 adult patients with acute exacerbations of chronic bronchitis and 12 with pneumonia, cefixime 400 mg resulted in cure or improvement in 59 (98%) and 12 (100%) patients, respectively. Similarly, excellent efficacy was found in adults with urinary tract infections (UTI), with cure in 80 (94%) patients, improvement in 4 (5%), and failure in 1 (1%). Very good efficacy of cefixime was also demonstrated microbiologically, with eradication in 35 of 36 isolates from children, including all Streptococcus pneumoniae isolates, 40 of 45 isolates from patients with respiratory tract infections, and 64 of 71 isolates from patients with UTI.

Topics: Adult; Cefixime; Cefotaxime; Cephalosporins; Child; Humans; Otitis Media; Pneumococcal Infections; Respiratory Tract Infections; Treatment Outcome; Urinary Tract Infections

It is generally accepted that the treatment of community-acquired pneumonia, either in adults or in pediatric patients, is mainly empirical. Thus, the treatment selection must fulfill both the epidemiological requirements, according to the most frequently described pathogens, and the pharmacological criteria to ensure adequate and prolonged drug concentrations at the infection site, to reach clinical efficacy. Cefotaxime has proven to be effective in this indication when traditionally administered three times daily and, more recently, twice daily, as a result of a re-evaluation of its pharmacokinetic/pharmacodynamic features. To gain further evidence using this updated dosing schedule, 258 pediatric patients with lower respiratory tract infections were treated with cefotaxime 100 mg/kg/day, administered as a twice daily or three times daily regimen. In the cefotaxime 50 mg/kg twice-daily group (n = 130), a complete resolution of clinical signs and symptoms were observed in 88.5% of patients. Similarly, in the cefotaxime 33.3 mg/kg group (n = 128), 93.6% of patients had a complete resolution of clinical signs and symptoms. Both drug schedules were well tolerated. Pharmacokinetic parameters determined for the two cefotaxime dosing schedules showed comparability. The serum half-life of desacetylcefotaxime was marginally longer than for cefotaxime in both dosage groups (1.64 and 1.36 h for desacetylcefotaxime versus 1.2 and 0.85 h for cefotaxime after 50 mg/kg or 33.3 mg/kg doses, respectively). Results from this study support the use of twice-daily cefotaxime administration for the treatment of lower respiratory tract infections in pediatric patients.

Topics: Cefotaxime; Cephalosporins; Child; Child, Preschool; Drug Administration Schedule; Drug Evaluation; Female; Follow-Up Studies; Humans; Infant; Male; Prospective Studies; Respiratory Tract Infections

The safety and efficacy of two dose regimens of cefodizime (CAS 69739-16-8, HR 221) in hospitalized patients with lower respiratory tract infections were assessed in two consecutive studies. Sputum bacteriology, chest X-ray and a safety laboratory check were performed at baseline and after therapy. In order to compensate for the lack of a double-blind design the evaluation was conducted as a clinical intention-to-treat analysis. 32 patients (16 males, 16 females, mean age: 64 years) were admitted to study A and 42 subjects (30 males, 12 females, mean age: 66 years) to study B. The dosage regimens of cefodizime were 1 g b.i.d. (median 7 days) in study A and 2 g once daily (median 6 days) in study B. Parenchymal involvement was confirmed by chest X-ray in 56% of the patients in study A and 64% in study B, the remainder patients had acute exacerbations of chronic bronchitis with reasonable evidence of bacterial infection. The most frequent pathogens were Streptococcus pneumoniae and Haemophilus spp. The clinical cure rate was 97% in study A and 88% in study B. Eradication rates were 100% and 94%, respectively. No superinfection occurred. No adverse reactions were observed. In conclusion, a single daily injection of cefodizime 2 g achieved similar clinical and bacteriological cure rates to the standard dose regimen of 1 g b.i.d.

Topics: Adult; Aged; Aged, 80 and over; Cefotaxime; Cephalosporins; Cough; Double-Blind Method; Female; Humans; Male; Middle Aged; Radiography; Respiratory Tract Infections; Sputum

We conducted a randomized, open-label, controlled, multicenter study to compare sulbactam/cefoperazone with cefotaxime in terms of efficacy and safety for the treatment of hospitalized patients with moderate-to-severe bacterial infections. More than two-thirds of the pathogens recovered from these patients produced beta-lactamase. Two hundred-seven (88.1%) of the 235 patients enrolled completed the study and were included in the efficacy and safety evaluations. One hundred-three patients received sulbactam/cefoperazone (2-4 g/d) administered in evenly divided doses every 12 hours by a 30-minute intravenous drip; 104 patients received cefotaxime (6-12 g/d) administered in evenly divided doses every 6 or 8 hours by a 30-minute intravenous drip. The overall efficacy rates (i.e., cure or markedly improved) were 95% for the sulbactam/cefoperazone group and 90% for the cefotaxime group (P = .186), whereas the bacterial eradication rates were 85% for the sulbactam/cefoperazone group and 81% for the cefotaxime group (P = .467). Both drug regimens were well tolerated. Sulbactam/cefoperazone is effective and safe for the treatment of moderate-to-severe bacterial infections caused mainly by beta-lactamase-producing organisms.

Topics: Adolescent; Adult; Aged; Bacteria; Bacterial Infections; beta-Lactamase Inhibitors; Cefoperazone; Cefotaxime; Cephalosporins; Drug Therapy, Combination; Enzyme Inhibitors; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections; Skin Diseases, Bacterial; Sulbactam; Urinary Tract Infections

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

A randomized controlled clinical study of cefetamet pivoxil (CAT) compared with cefixime (CFX) was conducted to evaluate its safety and efficacy in treating bacterial infections. 99 patients suffering from respiratory and urinary tract infections were enrolled in the study. 10 patients were excluded within the first 72 hrs after initiation of the study. 55 and 54 were evaluated for the safety of CAT and CFX respectively. 51 patients in the CAT group and 48 patients in the CFX group were evaluated for the efficacy. The doage of CAT was 250-500 mg and CFX was 200 mg, twice daily orally for 7-10 days. The results showed that the clinical efficacy rates of CAT and CFX were 94.1% (48/51) and 91.7% (44/48), the bacterial clearance rates were 95.3% and 95.1%, respectively. Adverse drug reactions occurred in 9.1% and 7.4% in the two groups respectively. The study demonstrated that there were no satistical differences between the two groups with respect to clinical efficacy, bacterial clearance and adverse reactions.

Topics: Adolescent; Adult; Bacterial Infections; Cefixime; Cefotaxime; Ceftizoxime; Cephalosporins; Escherichia coli; Female; Humans; Klebsiella; Male; Respiratory Tract Infections; Streptococcus pyogenes; Urinary Tract Infections

To investigate the efficacy, safety and immunomodulating activities of cefodizime in immunocompromised patients with infections, we carried out a randomized controlled prospective study of cefodizime vs ceftizoxime in 107 patients. The total effective cure rate and bacterial eradication rate were 87.3%, 61.8% and 89.3% in cefodizime group and 82.7%, 59.6% and 90.6% in ceftizoxime group. Drug tolerance was similar in the two groups, and side effect was mild and transient, mainly gastrointestinal reactions. Cefodizime had effect on both phagocyte and lymphocyte functions: enhancing the phagocytie rate, phagocytic index and bacterial killing activity, increasing the number of CD4+ lymphacyte and the ratio of CD4+/CD8+, stimulating NK cell activity and enhancing expression of IL-2R of active lymphocyte. Meanwhile ceftizoxime had no effect on any of the parameter mentioned above. The result showed that cefodizime is effective and safe in the treatment of LRTI, upper and complicated UTI in immunocompromised patients, as well as possessed immunomodulating activities.

Topics: Adult; Aged; CD4-CD8 Ratio; Cefotaxime; Ceftizoxime; Cephalosporins; Escherichia coli; Female; Humans; Killer Cells, Natural; Male; Middle Aged; Phagocytes; Phagocytosis; Prospective Studies; Respiratory Tract Infections; Urinary Tract Infections

Fifty-three hospitalized patients suffering from lower respiratory tract infections were evaluated in a randomized, comparative trial studying the safety and efficacy of ampicillin/sulbactam (2 g ampicillin plus 1 g sulbactam intravenously every 6 h) versus cefotaxime (2 g intravenously every 6 h). Thirty-four of the 36 and 16 of the 17 patients treated with ampicillin/sulbactam and cefotaxime, respectively, were evaluable. Clinical and bacteriologic efficacy did not differ significantly between the two treatment groups (p = 0.828 and p = 0.648, respectively). Twenty-one (61.8%) of the ampicillin/sulbactam-treated patients were cured, eight (23.5%) improved and four (11.8%) were treatment failures. Nine (56.3%) of the cefotaxime treated patients were cured, four (25.0%) improved and two (12.5%) failed therapy. All primary pathogens were eradicated in 19 (55.9%) of the ampicillin/sulbactam group and were partially eradicated in seven (20.6%) patients. In the cefotaxime treatment group bacteriologic eradication occurred in 10 (62.5%) and partial eradication in two (12.5%) patients. Both study drugs were well tolerated, as the number of adverse reactions in each treatment group was small and similar between the two groups. Ampicillin/sulbactam appears to be as safe and effective as cefotaxime in the therapy of hospitalized patients with lower respiratory tract infections caused by beta-lactamase positive and beta-lactamase negative pathogens.

Topics: Adult; Aged; Ampicillin; Bacterial Infections; Cefotaxime; Drug Therapy, Combination; Female; Hospitalization; Humans; Male; Middle Aged; Respiratory Tract Infections; Sulbactam

Topics: Adjuvants, Immunologic; Cefotaxime; Cefuroxime; Humans; Injections, Intramuscular; Injections, Intravenous; Respiratory Tract Infections; Time Factors

In this open, randomized and controlled multicenter study involving a total of 100 hospitalized patients with infections of the lower respiratory tract, including pneumonia, the efficacy and tolerability of sequential treatment with cefotaxime i.v./cefixime oral were compared with those of exclusively parenteral treatment with cefotaxime. The patients received either 2 x 2 g cefotaxime i.v. over a period of 7 to 10 days, or 2 x 2 g cefotaxime over a period of 48 to 72 hours followed by oral cefixime treatment (1 x 400 mg/day) for a further 5 to 8 days.. A total of 94 patients were evaluated for efficacy; in 93.6% of the evaluable patients in each treatment group, either a cure or improvement was obtained. In four patients in the cefotaxime group and five patients treated first with cefotaxime and then with cefixime, adverse reactions were observed. For three of these adverse reactions (diarrhea, nausea, aggravation of an pre-existing genital mycosis) an association with the respective test substance was considered to be at least possible.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Anti-Infective Agents; Cefixime; Cefotaxime; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Pneumonia, Bacterial; Respiratory Tract Infections

Patients with lower respiratory tract infection (LRTI) were randomized 2:1 to receive either cefepime 2 g i.v. bd or cefotaxime 2 g i.v. tds. Bronchopneumonia alone or associated with another LRTI was diagnosed in 30 of 37 cefepime recipients and in 11 of 18 cefotaxime recipients; other diagnoses included bronchitis, lobar pneumonia and aspiration pneumonia. The mean duration of treatment was 5.9 days in the cefepime group and 5.4 days in the cefotaxime group. There were no significant differences between the two groups with regard to clinical or bacteriological outcome. Treatment was associated with a satisfactory clinical response in 27 (73%) of 37 evaluable cefepime patients and in 10 (56%) of 18 evaluable cefotaxime patients. Treatment resulted in eradication of 33 (89%) of 37 pathogens in the cefepime group, including 13 of 15 strains of Staphylococcus aureus, and of 16 (73%) of 22 pathogens in the cefotaxime group, including eight of ten strains of S. aureus. Two Pseudomonas aeruginosa strains persisted in the cefotaxime group. The sole clinical adverse event reported was a rash in one cefepime patient which did not require discontinuation of treatment. No clinically relevant changes in laboratory test results were attributed to either agent. Cefepime twice daily and cefotaxime three times daily were of comparable safety and efficacy in the treatment of bronchopneumonia and other LRTIs.

Topics: Adult; Aged; Aged, 80 and over; Bronchopneumonia; Cefepime; Cefotaxime; Cephalosporins; Female; Humans; Injections, Intravenous; Male; Middle Aged; Respiratory Tract Infections; Treatment Outcome

Multicentre trials of cefixime (Cefspan, Fujisawa Pharmaceutical Co., Ltd., Japan) were performed in 1992. The trials involved 137 children and 269 adult patients with inflammatory infections of the respiratory organs and urinary tracts and otorhinolaryngologic affections. Positive clinical and bacteriological results of the trials were stated in 76-90 per cent of the cases. The adverse reactions such as skin eruption and dyspepsia were rare and did not require the specific treatment.

Topics: Adolescent; Adult; Anti-Infective Agents; Cefixime; Cefotaxime; Child; Child, Preschool; Humans; Infant; Inflammation; Otorhinolaryngologic Diseases; Respiratory Tract Infections; Urinary Tract Infections

Clarithromycin is a new acid-stable, 14-membered macrolide active against many of the organisms responsible for lower respiratory tract infections. It has been administered to over 5,000 patients worldwide and has been shown to be a safe and effective treatment for acute bacterial exacerbations of chronic bronchitis and bacterial pneumonia when given twice daily (250 to 500 mg). Cefixime is an amino-thiazolyl cephalosporin with an extended spectrum of antibacterial activity inhibiting beta-lactamase-producing respiratory pathogens. It has a long half-life, allowing once-daily administration.. This randomized, double-blind multicenter study compared clarithromycin and cefixime as treatment for patients with community-acquired lower respiratory tract infections (n = 213). Patients had bacterial pneumonia (clarithromycin, 19 percent; cefixime, 21 percent) or acute bacterial exacerbation of chronic bronchitis or asthmatic bronchitis (clarithromycin, 81 percent; cefixime, 79 percent). Patients received 500 mg of clarithromycin twice daily (n = 103) or 400 mg of cefixime once daily (n = 110) for 7 to 14 days.. Clinical cure or improvement occurred in 86 percent of the clarithromycin-treated patients and 88 percent of the cefixime-treated patients. When only patients with identified infections with Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae were considered, clinical success rates were 97 percent for clarithromycin and 96 percent for cefixime; the rate of bacteriologic eradication was 91 percent for clarithromycin and 90 percent for cefixime. Adverse events occurred in 29 percent of the clarithromycin-treated patients and 23 percent of the cefixime-treated patients.. This study demonstrates that clarithromycin and cefixime are effective treatments for pneumonia and acute bacterial exacerbations of bronchitis of mild to moderate severity caused by the most common infecting organisms.

Topics: Adult; Aged; Ambulatory Care; Analysis of Variance; Anti-Bacterial Agents; Bacteria; Cefixime; Cefotaxime; Clarithromycin; Community-Acquired Infections; Double-Blind Method; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections; United States

The optimal antibiotic dosage in serious chest infections is not established and commonly used regimens may well be excessive. We have compared the efficacy of a low dose of cefotaxime (2 g every 12 h) with a more usual dose (2 g every 8 h) in a prospective, randomized study of the treatment of chest infections in the seriously ill. Fifty intensive care unit patients received either regimen for five days. The two groups appeared demographically comparable. Clinical resolution occurred in 86 percent, no change occurred in 4 percent, and deterioration occurred in 10 percent. Microbiologic clearance occurred in 52 percent of those in whom a pathogen was isolated (46 percent of patients). There was no significant difference in clinical or microbiologic response between the two regimens. It is concluded that cefotaxime in a dose of 2 g twice daily is effective in the treatment of serious chest infections.

Topics: Adult; Aged; Bacteria; Cefotaxime; Drug Administration Schedule; Female; Humans; Intensive Care Units; Male; Middle Aged; Prospective Studies; Respiratory Tract Infections; Single-Blind Method

The objective of this study was to assess the effect of a novel regimen of antibiotic prophylaxis on the incidence of lower respiratory tract infection in patients requiring prolonged (at least five days) mechanical ventilation. The design was a controlled, prospective, randomized trial, with blinded comparison of the groups regarding the incidence of respiratory tract infection in an intensive care unit of a university hospital. After determination of the APACHE II score for severity of disease, 88 patients were randomly divided in three groups. Twenty-four of these patients did not complete five days of mechanical ventilation, and eight were withdrawn for other reasons. Fifty-six patients (18 in group 1, 21 in group 2, 17 in group 3) completed the study. Patients in both control groups 1 and 2 did not receive antibiotic prophylaxis, but the two groups differed in the antibiotic policy in case of infection. Patients in group 3 received antibiotic prophylaxis consisting of norfloxacin, polymyxin E, and amphotericin B, applied topically in oropharynx and stomach from time of ICU admission until extubation, and intravenous cefotaxime 500 mg three times a day during the first five days of admission. In both control groups, about 90 percent of the patients acquired microbial colonization of oropharynx or stomach. In group 3, only 12 percent and 24 percent of the patients acquired colonization of oropharynx and stomach, respectively (p less than 0.001). This resulted in a reduction of the incidence of lower respiratory tract infection (78 percent in group 1, 62 percent in group 2, 6 percent in group 3 [p = 0.0001]). The regimen of antibiotic prophylaxis studied prevented respiratory tract infection in mechanically ventilated patients. Antibiotic prophylaxis should be considered in all patients expected to require prolonged mechanical ventilation.

Topics: Administration, Topical; Amphotericin B; Bacteria; Cefotaxime; Colistin; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Intensive Care Units; Male; Middle Aged; Norfloxacin; Oropharynx; Prospective Studies; Respiration, Artificial; Respiratory Tract Infections; Severity of Illness Index; Stomach

181 patients undergoing resection of the oesophagus for carcinoma were randomised to receive selective decontamination (test group) or conventional perioperative antibiotic prophylaxis (controls). 114 patients were finally included in the study: 12 of 56 test patients had 18 infections, whereas 32 of 58 controls acquired 51 infections. Colonisation with aerobic gram-negative microorganisms, and the number of postoperative respiratory tract infections were significantly lower in the test patients. The postoperative therapeutic use of antibiotics was significantly lower in the test group. No endogenous infections were caused by gram-negative bacilli in the test group. Selective decontamination reduces colonisation with gram-negative bacilli and postoperative infections after resection of the oesophagus.

Topics: Adult; Aged; Cefotaxime; Chi-Square Distribution; Cross Infection; Drug Administration Schedule; Drug Evaluation; Esophageal Neoplasms; Female; Follow-Up Studies; Gram-Negative Aerobic Bacteria; Humans; Length of Stay; Male; Metronidazole; Middle Aged; Premedication; Prospective Studies; Randomized Controlled Trials as Topic; Respiratory Tract Infections; Surgical Wound Infection

The efficacy and tolerance of cefodizime in lower respiratory tract infections in hospitalized adults was evaluated in an open, non-comparative multicentre trial. Cefodizime (HR 221), was administered as a dose of 1 g by slow iv or im injection every 12 h (2 g daily) to 301 hospitalized patients aged 18-91 years. The mean duration of treatment was 10 +/- 3 days (median 9, range 1.23). All 301 patients were evaluable for tolerance, 270 were evaluable for clinical efficacy, and 204 were evaluable for bacteriological efficacy. A satisfactory clinical response was achieved in 87.8% (237/270) of patients and a satisfactory bacteriological response in 90.2% (184/204). Of the patients given the drug iv, 3.9% (6/153) had pain at the site of the injection compared with 7.4% (11/148) of those given the drug im. Tolerance was good; only five patients experienced an adverse reaction, and a relationship with cefodizime was considered probable in four of these cases. Haematological, hepatic and renal function tests revealed 27 abnormalities, all considered to have a doubtful relationship with treatment.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cefotaxime; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Male; Middle Aged; Respiratory Tract Infections

In a prospective open clinical trial 20 patients with the diagnosis bacterial respiratory tract infection and underlying chronic obstructive lung disease were treated for 13 to 17 days with 200 mg cefixime b. i. d. 14 of 16 evaluable patients were treated successfully. In one patient the clinical symptoms remained unchanged and in another patient cefixime treatment failed. Ten of the 16 evaluable patients showed a positive baseline culture. In nine of these patients the initially isolated pathogens could be eliminated. In one patient, in whom cefixime therapy failed, change of pathogens was noticed after the end of treatment. Four of the 20 patients treated with cefixime reported side effects (gastritis, three; fungal dermatitis, one). In the patient with fungal dermatitis cefixime therapy was stopped.

Topics: Adult; Aged; Anti-Infective Agents; Bacterial Infections; Cefixime; Cefotaxime; Female; Humans; Male; Middle Aged; Prospective Studies; Respiratory Tract Infections

Clinical efficacy and tolerance of cefixime were investigated in an open, uncontrolled trial. 200 mg of cefixime were applied twice daily, duration of therapy was between eight and 14 days (mean value 10.1 days, standard deviation +/- 1.4 days). Ten male patients (mean age 42.7 years) and 19 female patients (mean age 34.4 years) were enrolled. Cure or improvement was observed in all 27 patients evaluable for efficacy of treatment. Bacteriological results based on 15 bacteriologically evaluable patients were: elimination of the initial pathogen 60%, persistence 40%. Unwanted side effects and their incidence among the 29 patients evaluable for tolerance were: diarrhoea eight patients (mild to moderate, limited to three to four days on average), nausea and vomiting one patient, discharge and pruritus one patient.

Topics: Adult; Anti-Infective Agents; Bacterial Infections; Cefixime; Cefotaxime; Drug Tolerance; Female; Humans; Male; Otitis Media; Respiratory Tract 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 multicentre, prospective, controlled trial 211 patients with suspected septicaemia or pneumonia were allocated at random to either imipenem-cilastatin 500 mg 8-hourly or cefotaxime 1 g 6-hourly combined with amikacin 5 mg/kg 8-hourly. The treatments were administered for at least 5 days. Seventy patients on imipenem and 70 patients on cefotaxime-amikacin were assessable for comparison. There were no statistically significant differences between the two groups in underlying pathology and in the clinical results obtained: septicaemia 20/26 patients of the imipenem group and 20/25 patients of the cefotaxime-amikacin group were cured; pneumonia 38/44 patients of the imipenem group and 34/45 patients of the cefotaxime-amikacin group were cured. There were also no differences in the initial organisms and in the bacteriological cure rate, except for Pseudomonas aeruginosa. At the moment, imipenem administered alone is as effective as the cefotaxime-amikacin combination in the treatment of septicaemia or pneumonia in intensive care patients, with the exception of P. aeruginosa pneumonia in patients under assisted ventilation.

Topics: Adult; Aged; Aged, 80 and over; Amikacin; Anti-Bacterial Agents; Cefotaxime; Cilastatin; Drug Therapy, Combination; Female; Humans; Imipenem; Intensive Care Units; Male; Middle Aged; Prospective Studies; Randomized Controlled Trials as Topic; Respiratory Tract Infections; Sepsis

A novel regimen of selective decontamination (SDD) with initial systemic cefotaxime prevented bacterial colonization of the oropharynx and stomach in mechanically ventilated patients. In a three-group study of all patients receiving prolonged mechanical ventilation, patients in control groups A and B received antibiotics only when infection was present. In group A, antibiotics that disturb colonization resistance (CR) were used. In group B, antibiotics use was restricted to antibiotics not affecting CR. Patients in group C received SDD, consisting of norfloxacin, polymyxin E and amphotericin B, administered via a gastric tube and applied to the oropharynx. Group C patients further received an initial five day course of cefotaxime, 500 mg tid. The lower respiratory tract was colonized with microorganisms on admission in about half of the patients, and this persisted in both control groups. In group C, lower respiratory tract colonization was eliminated in all patients after five days. In both control groups about 90% of the patients acquired microbial colonization of the oropharynx and stomach, mostly with Gram-negative bacilli. In group C, only 12% and 24% of the patients acquired colonization of the oropharynx and stomach respectively (P less than 0.001). The oropharynx and stomach were the major sources of microorganisms causing lower respiratory tract infection in both control groups. In group C, elimination of oropharyngeal and gastric colonization completely prevented lower respiratory tract infection from these sources.

Topics: Adult; Aged; Bacteria; Cefotaxime; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Humans; Intensive Care Units; Male; Middle Aged; Norfloxacin; Oropharynx; Rectum; Respiration, Artificial; Respiratory Tract Infections; Stomach

This multicentre, randomized, double-blind study evaluated the effectiveness and safety of cefixime versus amoxicillin. Patients were admitted if they had lower respiratory tract infection with a bacterial pathogen susceptible to both study drugs. Diagnoses included acute respiratory tract infections with no underlying pulmonary pathology (cefixime 21, amoxicillin 27), acute exacerbation of chronic obstructive lung disease (cefixime 32, amoxicillin 42), superinfection of viral bronchitis or lung cancer, and pleuritis (cefixime 10, amoxicillin 6). Patients were treated for at least 10 days with either cefixime 200 mg b.d. or amoxicillin 1 g b.d. A clinical success rate of 80.7 per cent (50/62) in the cefixime group and 82.2 per cent (60/73) in the amoxicillin group was achieved in infections due to susceptible organisms. In acute infections with no underlying pathology, the clinical success rate was 90.5 per cent with cefixime and 81.5 per cent with amoxicillin. Twenty-three cefixime patients and 20 amoxicillin patients were seen 2 to 6 weeks after treatment: there were 2 and 1 clinical recurrences, respectively. All 3 patients were suffering from chronic obstructive lung disease. The bacteriological eradication rate at the end of treatment in assessable patients was 94.7 per cent (17/18) with cefixime and 80 per cent (16/20) with amoxicillin. Six and 11 new organisms appeared, responsible for 2 superinfections under cefixime and 7 under amoxicillin. Treatment was well tolerated by 96.4 per cent of cefixime patients and 90 per cent of amoxicillin patients. This study confirms the value of cefixime as a new oral antibiotic in the treatment of lower respiratory tract infections in adults.

Topics: Adolescent; Adult; Aged; Amoxicillin; Cefixime; Cefotaxime; Clinical Trials as Topic; Double-Blind Method; Female; Follow-Up Studies; Humans; Male; Middle Aged; Multicenter Studies as Topic; Random Allocation; Respiratory Tract Infections

Cefixime is a new oral cephalosporin with the same activity as that of third generation cephalosporins, particularly against organisms responsible for lower respiratory tract infections. The effectiveness and safety of cefixime were evaluated in the multicentre study reported here. Cure was obtained in 54 of 61 assessable patients suffering from bronchopneumonia (40/44), acute bronchitis (3/5) or acute exacerbations of chronic bronchitis (11/12). The causative agents were eradicated in 35 of 41 assessable cases. No clinical side-effect was observed. Thrombocytosis without clinical manifestations was reported in 14 cases. Administered in doses of 200 mg twice daily, cefixime proved effective and safe in the treatment of lower respiratory tract infections.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Cefixime; Cefotaxime; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Multicenter Studies as Topic; Respiratory Tract Infections

Cefixime, the first oral third generation cephalosporin, was administered to 2,832 patients in the USA, UK, FRG and France. 478/1063 patients were treated for urinary tract infections (upper or lower UTI) with 200 mg cefixime bid; clinical cure was obtained in 92 and 96 per cent of upper and lower UTI respectively, and bacteriological cure in 97.5 and 89 per cent of the cases; among 142 patients with a 1 month follow-up, no relapse or reinfection was observed in 78 per cent of cases. Of 521 patients treated for lower respiratory tract infection, 355 received 200 mg cefixime bid and 166 received a single daily dose of 400 mg. Clinical cure was obtained in 88 per cent and 93 per cent patients with pneumonia or bronchitis respectively, with bacteriological cure in 93.2 and 93.8 per cent. Among ENT infections, the most interesting study was in the treatment of sinusitis and otitis. Good clinical results were shown in nearly 95 per cent of cases, with bacteriological cure in more than 90 per cent. The safety studies demonstrated a global 6.6 per cent incidence of undesirable effect. These manifestations were mild and reversible, consisting of abdominal discomfort and minor diarrhea in most cases. The overall effectiveness of cefixime appears to be similar to that of established compounds as far as susceptible pathogens are concerned. However, in clinical trials, cefixime seemed to be effective on isolated bacteria unresponsive to conventional antibiotics.

Topics: Cefixime; Cefotaxime; Clinical Trials as Topic; Gastrointestinal Diseases; Humans; Multicenter Studies as Topic; Otorhinolaryngologic Diseases; Respiratory Tract Infections; Urinary Tract Infections

The objectives of this open, prospective, randomized and comparative study were to evaluate and compare the efficacy and safety of intravenous ceftriaxone (active ingredient of Rocephin) and cefotaxime in treatment of bacterial pneumoniae. Forty-three patients were enrolled in the study and in 40 (21 in the ceftriaxone group and 19 in the cefotaxime group) we were able to make an evaluation. Bacteriological results were essentially based on a positive culture obtained with transtracheal aspirate (TTA) - 34 out of 40 cases; in the remaining patients, at least an initial positive sputum culture was obtained. Most of the lower respiratory tract infections were secondary to previous chronic respiratory diseases or were nosocomial infections; 25 out of 40 cases were considered to be severe or critical situations. The overall efficacy (bacteriological eradication plus clinical cure or clear improvement) of ceftriaxone and cefotaxime were 90.5% (19/21) and 73.7% (14/19), respectively (p less than 0.05). The tolerability of both drugs was good: 16 (76.2%) patients in the ceftriaxone group and 12 (63.2%) in the cefotaxime group had no adverse events, while in 5 and 7 patients, respectively, tolerability was considered satisfactory (minor side effects, none of which required discontinuation or even reduction of dosage).

Topics: Adult; Aged; Bacterial Infections; Cefotaxime; Ceftriaxone; Female; Humans; Male; Middle Aged; Prospective Studies; Random Allocation; Respiratory Tract Infections

Sixty patients with lower respiratory tract infections, mainly acute bronchitis were treated for 14 days with either cefixime 200 mg twice daily (plus placebo once daily) or amoxicillin/clavulanic acid 500 mg/125 mg thrice daily in a double-blind manner. The sputum cultures indicated that all isolated pathogens (notably Hemophilus species, S. pneumoniae and B. catarrhalis, including the beta-lactamase producing species) were sensitive to cefixime, with the exception of Pseudomonas species. The bacteriological eradication rates were 54% and 52% for cefixime and amoxicillin/clavulanic acid, respectively. The positive clinical response (cured or improved) was 71% for the cefixime treated group and 74% in the amoxicillin/clavulanic acid group. There were no side effects and no significant adverse laboratory changes in both groups. The results indicate that cefixime twice daily is comparable in safety and efficacy with amoxicillin/clavulanic acid, thrice daily in acute bronchitis.

Topics: Adult; Amoxicillin; Bacterial Infections; Cefixime; Cefotaxime; Clavulanic Acid; Clavulanic Acids; Clinical Trials as Topic; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections

A multi-center open study was conducted to investigate cefodizime (CDZM), a newly developed cephem antibiotic, from pharmacokinetic, bacteriological and clinical aspects, in the pediatric field with the participation of 17 institutions and their related facilities. The results are summarized as follows: 1. Serum concentrations and urinary excretion: The pharmacokinetics in pediatric patients was investigated with a dose of 20 mg/kg, via a bolus intravenous injection or intravenous drip infusion over 30 or 60 minutes. The results were nearly the same as those in adult patients. Mean serum concentrations 5 minutes after a bolus intravenous injections were: 105.5, 264.0 and 461.7 micrograms/ml with 10, 20 and 40 mg/kg, respectively, and T 1/2 (beta)'s for the 3 dosages were 1.75, 1.92 and 1.88 hours, respectively. With 30-minute intravenous drip infusion, mean serum concentrations at the end of infusion were: 90.5 micrograms/ml with a dose level of 10 mg/kg, 178.3 micrograms/ml with 20 mg/kg, and 322.8 micrograms/ml with 40 mg/kg, and T 1/2 (beta)'s for these dosages were 1.90, 2.15 and 1.93 hours, respectively. With 60-minute intravenous drip infusion, mean serum concentrations at the end of infusion were: 66.3 micrograms/ml with a dose level of 10 mg/kg, 136.0 micrograms/ml with 20 mg/kg and 259.2 micrograms/ml with 40 mg/kg, and T 1/2 (beta)'s for these dosages were 1.43, 2.05 and 1.46 hours, respectively. In 8 hours after administration of CDZM, urinary excretion rates were 82.1, 77.7 and 76.5% for bolus intravenous injections of 10 mg/kg, 20 mg/kg and 40 mg/kg, respectively, and 83.3, 71.3 and 68.1% for 30-minute intravenous drip infusions of 10 mg/kg, 20 mg/kg and 40 mg/kg, and 84.4 and 84.3% for 60-minute intravenous drip infusions of 20 mg/kg and 40 mg/kg, respectively. 2. Concentrations in cerebrospinal fluid: Penetrations into cerebrospinal fluid in patients with purulent meningitis reached levels of 1.96-9.48 micrograms/ml with administration of CDZM at 50 mg/kg in acute cases within 6 days after onset. The penetration rates of CDZM were about a median range among injectable beta-lactam agents. 3.. Of 457 cases treated with CDZM, 53 cases were excluded from the clinical evaluation. Clinical efficacies were evaluated as "excellent" in 126 and "good" in 78 out of 221 case from which causative agents were isolated, with an efficacy rate of 92.3%. Efficacies were "excellent" in 97 and "good" in 69 out of 183 cases from which pathogens were not isolated giving an efficacy rate of 90.7%.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Adolescent; Age Factors; Bacteria; Bacterial Infections; Cefotaxime; Child; Child, Preschool; Clinical Trials as Topic; Female; Humans; Infant; Male; Multicenter Studies as Topic; Respiratory Tract Infections; Urinary Tract Infections

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

A randomized controlled study design was used to compare the efficacy of cefixime versus cefaclor in 30 patients suffering from lower respiratory tract infections. Patients were treated with a 10 to 11 day course of cefixime 200 mg b.i.d. or cefaclor 500 mg t.i.d. The overall clinical response (cured and improved) in the 13 evaluable patients of the cefixime group was 100%. 12 of the 14 patients of the cefaclor group were cured or improved. In the two other patients the symptoms remained unchanged. The bacteriological efficacy in both groups was comparable. Adverse effects were not reported during the study.

Topics: Adult; Aged; Aged, 80 and over; Cefaclor; Cefixime; Cefotaxime; Cephalexin; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

A total of 560 patients were treated in two double-blind, randomized multicenter studies to compare the safety and efficacy of cefixime (400 mg administered once daily) and amoxicillin (250 or 500 mg administered three times daily) for the treatment of bacterial respiratory tract infections. Eighty percent of the 244 patients treated in the lower respiratory tract infections (LRTI) study had acute bronchitis. Streptococcus pneumoniae (13 percent), Haemophilus influenzae (28 percent), and Escherichia coli (10 percent) were the pathogens most frequently isolated from sputum in these patients. Among evaluable patients with positive bacterial culture results at baseline, a favorable clinical response (cured or improved) was obtained in 100 percent of the cefixime-treated patients (22 of 22) and in 96 percent of the amoxicillin-treated patients (23 of 24). Bacteriologic eradication rates were 100 percent and 83 percent for cefixime and amoxicillin, respectively. In the upper respiratory tract infections (URTI) study, 316 patients with pharyngitis (80 percent) or tonsillitis (14 percent) were treated. Group A, beta-hemolytic Streptococcus (69 percent) and H. influenzae (8 percent) were the pathogens most frequently isolated from the throat culture specimens of these patients. Favorable clinical results were obtained in 99 percent of the evaluable cefixime-treated group (n = 73) and in 98 percent of the amoxicillin-treated group (n = 66). The bacteriologic eradication rates were 93 percent and 100 percent, respectively. The adverse experiences reported during both studies were similar in nature and frequency to those reported for other beta-lactam antibiotics with the exception of a higher incidence of altered bowel movement (diarrhea and stool changes) with both drugs. These episodes usually resolved without remedial medication when the treatment was withdrawn. No significant adverse laboratory findings were observed. Results of these trials demonstrate that cefixime at a dosage of 400 mg once daily is an effective and safe oral antibiotic for the treatment of acute respiratory tract infections.

Topics: Amoxicillin; Cefixime; Cefotaxime; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Random Allocation; Respiratory Tract Infections

Subjects in a cefotaxime (CTX) single administration group and in a CTX + fosfomycin (FOM) administration group were randomly selected for a comparative study on the utility of each product against respiratory tract infections. Overall improvement rates were 81.3% in 32 cases of the CTX single administration group, and 75.6% in 41 cases of the CTX + FOM concomitant administration group. No statistical difference was observed. As for adverse reactions and abnormal laboratory test results, pyrexia, thrombocytopenia, increases in GOT and GPT, and increase in GPT were observed in 4 cases of the CTX single administration group, while angialgia, increases in GOT and GPT (3 cases), and increases in BUN, (totalling 5), were observed in the CTX + FOM group. However, all the symptoms were transient, and none was serious in nature.

Topics: Adult; Aged; Aged, 80 and over; Cefotaxime; Clinical Trials as Topic; Drug Synergism; Drug Therapy, Combination; Female; Fosfomycin; Humans; Male; Middle Aged; Multicenter Studies as Topic; Respiratory Tract Infections

The clinical and laboratory safety of cefixime based on analysis of data from 1575 adults (1118 treated daily and 457 treated twice a day) and 615 children (299 treated daily and 316 treated twice a day) in studies of urinary tract and lower and upper respiratory tract infections (including otitis media) is reviewed. The incidence of adverse clinical experiences and occurrence of laboratory abnormalities were similar to those seen with other beta-lactam antimicrobial agents. Gastrointestinal side effects were the predominant adverse experiences seen in both daily and twice daily programs in adults and children. The incidence of gastrointestinal intolerance was not dependent upon the frequency of the dosage. Symptoms of drug hypersensitivity were infrequently reported. No serious chemical, hematologic or urologic abnormalities were noted. The data confirm the safety of cefiximine in both adults and children, whether it is administered once or twice a day.

Topics: Adult; Cefixime; Cefotaxime; Child; Child, Preschool; Clinical Trials as Topic; Diarrhea; Drug Administration Schedule; Drug Hypersensitivity; Feces; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

Topics: Adult; Aged; Cefmenoxime; Cefotaxime; Ceftizoxime; Cephalosporins; Chronic Disease; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

Eighty-two adult hospitalized patients suffering from respiratory tract infections were treated with cefotiam or cefamandole in an open comparative study. The patients were allocated randomly to one of the two treatments. The recommended dosage regimens (i.m. or i.v.) were used for both groups (cefotiam 1 g b.i.d., cefamandole 1 g t.i.d.). The duration of treatment was 7 to 14 days according to the response of the disease condition. 80 patients were analyzed. The tolerability of both drugs was good and comparable. The clinical and bacteriological efficacy of both drugs was equivalent. The radiological examinations showed a better improvement of the patients treated with cefotiam.

Topics: Adolescent; Adult; Aged; Cefamandole; Cefotaxime; Cefotiam; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Random Allocation; Respiratory Tract Infections

Topics: Cefotaxime; Cephamycins; Chronic Disease; Clinical Trials as Topic; Humans; Lung Abscess; Pneumonia; Respiratory Tract Infections

Seventy-seven patients with acute bacterial infections were treated with ceftriaxone (1 gm administered intravenously every 12 hours). The 58 patients evaluable for efficacy had 60 infections, including 39 of the respiratory tract, 14 of the urinary tract, and seven of soft tissue. Five patients were bacteremic. The mean duration of ceftriaxone treatment was eight days for patients with respiratory and urinary tract infections and 13 days for patients with other types of infections. A satisfactory clinical response occurred in 56 (93%) of the infections. Eighty-four (94%) of the 89 pretherapy pathogens were bacteriologically eradicated. Included were all 19 isolates of Haemophilus influenzae, all 15 of Streptococcus pneumoniae, all 12 of Escherichia coli, 22 of the 23 isolates of other Enterobacteriaceae species, three of five isolates of Pseudomonas aeruginosa, and three of four isolates of Staphylococcus aureus. Two cases of superinfection (one with bacteremia) occurred with P aeruginosa. There were two cases each of reinfection and colonization with Streptococcus faecalis. One patient developed manifestations of culture-documented S pneumoniae meningitis eight hours after the first dose was administered. Peak and trough plasma levels of ceftriaxone were 142 and 64 micrograms/ml. Ceftriaxone achieved therapeutic levels in infected cerebrospinal fluid and in the abscess fluid of selected patients. Adverse effects, which were mild, included diarrhea in 4% of the patients and elevated transaminase levels in 10%.

Topics: Adult; Aged; Alanine Transaminase; Bacterial Infections; Cefotaxime; Ceftriaxone; Clinical Trials as Topic; Connective Tissue Diseases; Diarrhea; Escherichia coli Infections; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Middle Aged; Pneumococcal Infections; Respiratory Tract Infections; Sepsis; Streptococcus pneumoniae; Time Factors; Urinary Tract Infections

Topics: Adult; Aged; Cefotaxime; Cefotiam; Ceftazidime; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

Fifty-nine patients with serious infections were assigned at random in a two-to-one ratio to receive either cefmenoxime or cefoxitin given intravenously in a dosage of 0.5 to 2.0 g every six hours. Of 44 patients evaluable for efficacy, eight had concomitant bacteremia and all but 10 had serious underlying disease. The average duration of therapy was seven days. All patients with skin and soft tissue infections were cured after treatment with either antibiotic. Cefmenoxime achieved clinical and bacteriologic cures in 92 and 83 percent, respectively, of 12 patients with pneumonia and in 100 and 82 percent of 11 patients with urinary tract infections. Cefoxitin therapy resulted in clinical and bacteriologic cures in all four patients with pneumonia. Among 10 patients with urinary tract infection, respective cure rates were 90 and 50 percent. Both antibiotics were well tolerated. One cefmenoxime-treated patient discontinued treatment because of a rash.

Topics: Adult; Bacterial Infections; Cefmenoxime; Cefotaxime; Cefoxitin; Drug Administration Schedule; Drug Evaluation; Female; Humans; Infusions, Parenteral; Male; Random Allocation; Respiratory Tract Infections; Skin Diseases, Infectious; Urinary Tract Infections

A comparative study was conducted using cefmenoxime, a new extended spectrum cephalosporin, versus cefoxitin. Entry into the study was based on a computer-generated randomization (two cefmenoxime to one cefoxitin). An intravenous dose of cefmenoxime (0.5 to 1 g every six hours) or cefoxitin (1 to 2 g every six hours) was administered to patients suspected of having serious bacterial infections. Six patients had urinary tract infections. Four who received cefmenoxime, including two with positive blood cultures, had eradication of bacteremia. One of the two who received cefoxitin had significant bacteriuria, and the urine was clear after treatment. Twenty-four patients were treated for lower respiratory tract infections. All 15 patients who received cefmenoxime had clinical and bacteriologic cures. Two of the nine patients who received cefoxitin continued to have the pathogens at the end of the treatment period. Both patients had a neoplasm of the lung. All 11 patients who had soft tissue infections (nine of whom received cefmenoxime) responded well. Both antibiotics were well tolerated.

Topics: Bacterial Infections; Cefmenoxime; Cefotaxime; Cefoxitin; Clinical Trials as Topic; Humans; Random Allocation; Respiratory Tract Infections; Urinary Tract Infections

We have investigated the effectiveness of seven new beta-lactam antibiotics, azlocillin, piperacillin, ceftazidime, cefsulodin, cefoperazone, latamoxef (moxalactam), and cefotaxime, against acute pulmonary exacerbations caused by Pseudomonas aeruginosa in cystic fibrosis. Three hundred and fifty-five strains of Ps aeruginosa isolated from 310 sputum cultures (190 cystic fibrosis patients) were tested for susceptibility to the drugs by determination of minimal inhibitory concentrations (MIC). The highest activity was shown by ceftazidime (6% resistant strains) followed by cefsulodin and piperacillin (15 and 16% resistant strains); very low activity was found for cefotaxime and latamoxef (moxalactam). Ceftazidime was the most active drug against 32 pseudomonas isolates that were resistant to both carbenicillin and aminoglycosides (78% susceptible). A randomized, double-blind trial of azlocillin, piperacillin, ceftazidime, cefsulodin or cefoperazone was performed in 111 cystic fibrosis patients with predominant and susceptible pseudomonas in their sputum. Results were evaluated by a clinical, radiological and bacteriological scoring system: the best results were obtained with ceftazidime, followed by cefsulodin and piperacillin. However, pseudomonas was eradicated in only 22 (23%) of the cases with the most active drugs and persisted or reappeared in all the cases 1 to 3 months later. Ceftazidime always eradicated Staph. aureus and Haemophilus influenzae associated with pseudomonas. Similar eradication occurred nearly always with cefsulodin but rarely with the other drugs. No serious drug reaction occurred but a later fever and rash with piperacillin, transient diarrhoea with cefoperazone, vomiting with cefsulodin, and very frequent eosinophilia with ceftazidime should be mentioned. These five drugs offer, in varying degree, alternatives to traditional anti pseudomonas antibiotics in cystic fibrosis pulmonary infections, but they should be used only against well-proven resistant strains. Ceftazidime is best and cefotaxime and latamoxef (moxalactam) least useful.

Topics: Adolescent; Alcohol Deterrents; Anti-Bacterial Agents; Azlocillin; Cefoperazone; Cefotaxime; Cefsulodin; Ceftazidime; Cephalosporins; Child; Clinical Trials as Topic; Cystic Fibrosis; Double-Blind Method; Eosinophilia; Humans; Moxalactam; Penicillins; Piperacillin; Pseudomonas Infections; Random Allocation; Respiratory Tract Infections

Ceftriaxone effectively inhibited 332 out of 452 (73.45%) bacterial strains in vitro tests. 291 out of 365 (79.69%) gram negative and 41 out of 87 (47.12%) gram positive strains were inhibited. The tests showed ceftriaxone to be more effective than cephalothin, cephotaxime, cephuroxime, cephamandol and cephoxitin. Kinetic tests showed that cephtriaxone has a plasmatic half life of 7.25 hrs. 24 hours after administration of a 1000 mg venous bolus the drug was still present in the blood. Urinary elimination over a 24 hr. period amounted to means 486.8 mg (48.68%). The drug has liquor transfer capacity. 37 of the 38 patients treated showed complete clinical or clinicobacteriological cure. Improvement was noted in the 38th.

Topics: Adolescent; Adult; Aged; Cefotaxime; Ceftriaxone; Child; Child, Preschool; Clinical Trials as Topic; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Half-Life; Humans; Kinetics; Klebsiella Infections; Male; Meningitis; Middle Aged; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections

Topics: Adult; Aged; Cefamandole; Cefotaxime; Ceftizoxime; Cephalosporins; Clinical Trials as Topic; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Random Allocation; Respiratory Tract Infections

Topics: Bacterial Infections; Biliary Tract Diseases; Cefotaxime; Ceftizoxime; Clinical Trials as Topic; Endocarditis, Bacterial; Female; Genital Diseases, Female; Humans; Japan; Kinetics; Meningitis; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Topics: Abdomen; Arthritis, Infectious; Bacterial Infections; Cefotaxime; Ceftizoxime; Clinical Trials as Topic; Gonorrhea; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meningitis; Osteitis; Respiratory Tract Infections; Sepsis; Skin Diseases, Infectious; United States; Urinary Tract Infections

A second-generation cephalosporin (cephotaxime) with a marked resistance to beta-lactamase, a very broad spectrum, and remarkably low renal toxicity was used to treat 47 patients with respiratory, urinary and other infections. The results were excellent in 89.2% and good in 8.5%. The antibiotic proved effective even against germs that are usually resistant to cephalosporins (Pseudomonas, Proteus, Serratia and Enterobacteriaceae). Bacteriuria disappeared in all cases of urinary infection. Local and general tolerance was excellent in all cases but one. Renal tolerance was also excellent in patients with chronic renal failure, for whom the daily dose can be usefully reduced and a check on renal function should be kept.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefotaxime; Cephalosporins; Child; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

Topics: Bacteria; Cefazolin; Cefotaxime; Cephalosporins; Humans; Pneumonia; Respiratory Tract Infections

Topics: Aged; Anti-Bacterial Agents; beta-Lactamases; Cefotaxime; China; Ciprofloxacin; Citrobacter freundii; Drug Resistance, Multiple, Bacterial; Humans; Imipenem; Male; Meropenem; Microbial Sensitivity Tests; Respiratory Tract Infections; Thienamycins

We report a case of a 5-year-old boy with acute disseminated encephalomyelitis as the initial presentation of neuroborreliosis. Parents report an upper-airway infection a few days before the development of acute encephalopathy, mild facial palsy, and seizures. The patient needed mechanical ventilation for 10 days, and after extubation, he presented hypotonia, ataxia, dysarthria, as well as weak gag and cough reflexes. Brain magnetic resonance imaging showed hyperintense lesions on T2- and fluid-attenuated inversion recovery sequences on the right subcortical occipital and parietal region, left posterior arm of the internal capsule, and in the medulla oblongata. Borrelia burgdorferi was identified in the plasma and cerebrospinal fluid by polymerase chain reaction and in the plasma by Western blotting. He was treated with ceftriaxone, methylprednisolone, and human immunoglobulin. Recovery was partial.

Topics: Brain Damage, Chronic; Cefotaxime; Ceftriaxone; Child, Preschool; Coma; Diazepam; Encephalomyelitis, Acute Disseminated; Facial Paralysis; Humans; Immunoglobulins, Intravenous; Lyme Neuroborreliosis; Magnetic Resonance Imaging; Male; Mastoiditis; Methylprednisolone; Portugal; Respiration, Artificial; Respiratory Insufficiency; Respiratory Tract Infections; Seizures; Sinusitis; Vancomycin

Antimicrobial susceptibility patterns and beta-lactam resistance mechanisms of 544 Haemophilus influenzae isolates through the nationwide Acute Respiratory Infections Surveillance (ARIS) network in Korea during 2005 and 2006 were determined. Resistance to ampicillin was 58.5%, followed by resistance to cefuroxime (23.3%), clarithromycin (18.7%), cefaclor (17.0%), amoxicillin-clavulanate (10.4%), and chloramphenicol (8.1%). Levofloxacin and cefotaxime were the most active agents tested in this study. beta-Lactamase production (52.4%) was the main mechanism of ampicillin resistance, affecting 96.1% of TEM-1-type beta-lactamase. According to their beta-lactam resistance mechanisms, all isolates were classified into the following groups: beta-lactamase-negative, ampicillin-sensitive (BLNAS) strains (n = 224; 41.5%); beta-lactamase-positive, ampicillin-resistant (BLPAR) strains (n = 255; 47.2%); beta-lactamase-negative, ampicillin-resistant (BLNAR) strains (n = 33; 6.1%); and beta-lactamase-positive, amoxicillin-clavulanate-resistant (BLPACR) strains (n = 28; 5.2%). Among the BLNAR and BLPACR strains, there were various patterns of multiple-amino-acid substitutions in penicillin-binding protein 3. Particularly, among BLNAR, group III isolates, which had three simultaneous substitutions (Met377Ile, Ser385Thr, and Leu389Phe), were identified for the first time in Korea. Three group III strains displayed the highest MIC of cefotaxime (1 to 2 mug/ml). The results indicate the importance of monitoring a changing situation pertaining to the increase and spread of BLNAR and BLPACR strains of H. influenzae for appropriate antibiotic therapy for patients with respiratory tract infections in Korea.

Topics: Adolescent; Adult; Aged; Amino Acid Sequence; Amino Acid Substitution; Ampicillin; Ampicillin Resistance; beta-Lactamases; Child; Child, Preschool; DNA, Bacterial; Drug Resistance, Bacterial; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Korea; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Sequence Data; Penicillin-Binding Proteins; Population Surveillance; Respiratory Tract Infections; Reverse Transcriptase Polymerase Chain Reaction; Serotyping; Young Adult

A nationwide multicenter susceptibility surveillance study (Susceptibility to the Antimicrobials Used in the Community in España [SAUCE] project), SAUCE-4, including 2,559 Streptococcus pneumoniae, 2,287 Streptococcus pyogenes, and 2,736 Haemophilus influenzae isolates was carried out from May 2006 to June 2007 in 34 Spanish hospitals. Then, the results from SAUCE-4 were compared to those from all three previous SAUCE studies carried out in 1996-1997, 1998-1999, and 2001-2002 to assess the temporal trends in resistance and the phenotypes of resistance over the 11-year period. In SAUCE-4, on the basis of the CLSI breakpoints, penicillin (parenteral, nonmeningitis breakpoint) and cefotaxime were the antimicrobials that were the most active against S. pneumoniae (99.8% and 99.6%, respectively). Only 0.9% of isolates had a penicillin MIC of > or = 2 microg/ml. In S. pyogenes, nonsusceptibility to erythromycin was observed in 19.4% of isolates. Among the H. influenzae isolates, a beta-lactamase-positive prevalence of 15.7% was found. A statistically significant temporal decreasing trend over the 11-year period was observed for nonsusceptibility (from 60.0% to 22.9%) and resistance (from 36.5% to 0.9%) to penicillin and for the proportion of erythromycin-resistant isolates of S. pneumoniae of the macrolide-lincosamide-streptogramin B (MLS(B)) phenotype (from 98.4% to 81.3%). A similar trend was observed for the prevalence of ampicillin resistance (from 37.6% to 16.1%), beta-lactamase production (from 25.7% to 15.7%), and beta-lactamase-negative ampicillin resistance (BLNAR) in H. influenzae (from 13.5% to 0.7%). Among erythromycin-resistant isolates of S. pyogenes, a significant increasing trend in the prevalence of MLS(B) was observed (from 7.0% to 35.5%). SAUCE-4 confirms a generalized decline in the resistance of the main respiratory pathogens to the antimicrobials as well as a shift in their resistance phenotypes.

Topics: Ampicillin; Anti-Bacterial Agents; Cefotaxime; Erythromycin; Haemophilus influenzae; Lincosamides; Macrolides; Microbial Sensitivity Tests; Penicillins; Respiratory Tract Infections; Spain; Streptococcus pneumoniae; Streptococcus pyogenes; Streptogramin B

Topics: Adult; Amoxicillin; Anti-Bacterial Agents; Cefotaxime; Ceftazidime; Cesarean Section; Clavulanic Acid; Female; Fever; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infectious Disease Transmission, Vertical; Male; Maternal Exposure; Meningitis, Meningococcal; Neisseria meningitidis, Serogroup B; Penicillin G; Pregnancy; Pregnancy Complications, Infectious; Respiratory Tract Infections; Seizures; Treatment Outcome

The genes erm(B), mef(A), and both erm(B) and mef(A) were identified in 42.6, 10.1, and 47.3%, respectively, of the erythromycin-resistant Streptococcus pneumoniae isolates. Of the strains, 3.8% were nonsusceptible to levofloxacin and had 1 to 6 amino acid changes in the quinolone resistance-determining region, including a new mutation, Asn94Ser, in the product of parC. Levofloxacin with reserpine was highly specific for efflux screening.

Topics: Anti-Bacterial Agents; Community-Acquired Infections; DNA, Bacterial; Drug Resistance, Bacterial; Erythromycin; Fluoroquinolones; Genes, Bacterial; Hospitals; Humans; Korea; Levofloxacin; Macrolides; Microbial Sensitivity Tests; Molecular Epidemiology; Mutation; Ofloxacin; Pneumococcal Infections; Polymerase Chain Reaction; Prevalence; Reserpine; Respiratory Tract Infections; Retrospective Studies; Streptococcus pneumoniae

To evaluate retrospectively the response of preseptal and orbital cellulitis in children to empiric antibiotic treatment.. We included nine patients (five male and four female) admitted to our hospital between October 2002 and October 2003 because of preseptal or orbital cellulitis.. Four patients (44.4%) responded to empiric antibiotic treatment (R); five (55.5%) did not respond (NR) and required a second antibiotic to resolve the infection. The presence of an upper respiratory infection was the most common associated disease in both groups, R and NR. However we also found two cases of acute dacryocystitis in the NR. Four patients (44.4%) were treated with cefotaxime intravenously with the infection resolving in three of these. Five patients (55.6%) were treated with cefuroxime intravenously as first empiric option, however only one patient responded.. We found a high prevalence of acute dacryocystitis as a potential cause of the cellulitis. Children with preseptal and orbital cellulitis responded better to cefotaxime than to cefuroxime. The presence of acute dacryocystitis was associated with a lack of response to cefuroxime.

Topics: Acute Disease; Anti-Bacterial Agents; Cefotaxime; Cefuroxime; Cellulitis; Child; Child, Preschool; Dacryocystitis; Female; Humans; Infant; Injections, Intravenous; Male; Orbital Diseases; Respiratory Tract Infections; Retrospective Studies; Treatment Outcome

To investigate the antibiotics-resistance type and molecular epidemiology of Streptococcus pneumoniae isolated from children in Hangzhou.. The sensitivities of 323 strains of Streptococcus pneumoniae to 9 antibiotics were determined in vitro by Kirby-Bauer diffuse methods, and MICs of penicillin and cefotaxime were determined by E-test methods.. Among all 323 strains isolated from children during the period from August 2001 to July 2002, 136 strains (42.1%) were sensitive to penicillin, while 57 strains (17.7%) were penicillin-resistant. Penicillin MICs ranged from 0.012 microg/ml to 4.0 microg/ml. All the strains were sensitive to cefotaxime and its MICs ranged from 0.012 microg/ml to 4.0 microg/ml. The most resistant antibiotic was erythromycin and it's resistant-rate was as high as 90.7%, followed by tetracycline (87.6%), trimethoprim-sulfamethoxazole (48.6%) and chloromycetin (14.9%). Totally 197 strains (61.0%) were multi-drug-resistant pneumococci and most of them were resistant to trimethoprim-sulfamethoxazole, erythromycin and tetracycline at the same time. Two strains (0.6%) were resistant to rifampin and none was resistant to vancomycin and ofloxacin. BOX PCR typing was carried out and no overwhelming fingerprinting pattern was found among penicillin resistant Streptococcus pneumoniae strains which were isolated from patients, while the banding patterns were always similar or identical among the strains isolated from the same specimen or from the same patient at different time, respectively.. The antibiotics-resistant rate of pneumococci was high in Hangzhou, but the third-generation cephalosporins were still the best antibiotics against Streptococcus pneumoniae. One child could be infected or colonized by more than one pneumococci clone at the same or different time.

Topics: Anti-Bacterial Agents; Cefotaxime; Child, Preschool; China; Chloramphenicol; Drug Resistance, Bacterial; Erythromycin; Female; Humans; Infant; Male; Microbial Sensitivity Tests; Ofloxacin; Penicillins; Pneumococcal Infections; Respiratory Tract Infections; Rifampin; Streptococcus pneumoniae; Tetracycline; Trimethoprim

Haemophilus influenzae (H. influenzae) is the most frequent bacterial pathogen of respiratory tract infections in children. Detection of antimicrobial susceptibility of H. influenzae is necessary for institution of appropriate antibiotic treatments.. A total of 281 strains of H. influenzae isolated from sputum samples of 281 pediatric patients with respiratory tract infections were recruited for study. Antibiotic susceptibility was determined by assessing minimum inhibitory concentrations (MIC) of antimicrobial agents. MIC were measured by utility of Agar dilution susceptibility test.. Of the total, 38 (13.5%) strains produced beta-lactamase (BLP), 56 (19.9%) strains were beta-lactamase non-producing, ampicillin resistant (BLNAR). The overall resistant proportion to ampicillin was 33.4%. The data indicated that sulbactam/ampicillin, cefotaxime, ceftriaxone and cefditoren are effective against BLP strains. In addition, a high prevalence of BLNAR H. influenzae strains was identified, with an overall isolation rate of 19.9%. Those strains mainly demonstrated intermediate level to ampicillin (ampicillin-MIC

Topics: Amoxicillin; Ampicillin; Anti-Bacterial Agents; beta-Lactamases; Cefotaxime; Ceftriaxone; Cephalosporins; Child; Child, Preschool; Dose-Response Relationship, Drug; Drug Resistance, Bacterial; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Microbial Sensitivity Tests; Respiratory Tract Infections

To study the enhancing effect of cefodizime on cellular immunity of patients with lung cancer.. The parameters of cellular immunity in blood and pulmonary alveoli were investigated in 45 patients with lung cancer complicated with lower respiratory tract infection (LRTI) and 10 non-cancer patients with LRTI. Nitroblue tetrazolium (NBT) reaction of polymorphonuclear neutrophils (PMN), the percentage of natural killer (NK) cells, and that of CD4+ cells, ratio of CD4+/CD8+ in peripheral blood, OD value of alveolar macrophages phagocyting neutral red, and IL-1 beta (ng/L) in broncho-alveolar lavage flind (BALF) were determined.. The parameters examined in cancer patients with LRTI were significantly improved after cefodizime treatment, approaching to those seen in non-cancer patients with LRTI. The therapeutic results were better in patients treated with cifodizime than in patients treated with ceftriaxonum.. Cefodizime is a better choice of antibiotic for the treatment of lung cancer complicated with lower respiratory tract infection. Its enhancing effect on systemic and local immune functions plays a role.

Topics: Adult; Aged; Cefotaxime; Cephalosporins; Female; Humans; Immunity, Cellular; Lung Neoplasms; Male; Middle Aged; Respiratory Tract Infections

The rising incidence of antibiotic resistance, including penicillin-resistant Streptococcus pneumoniae (PRSP), has become a great clinical problem in many countries. Cefixime, an orally active third-generation cephalosporin has broad and potent activity against various pathogens, especially gram-negative organisms including beta-lactamase producing strains. However, as with all other oral agents, cefixime is inactive against PRSP. As a possible solution to this problem, the effectiveness of a combination of cefixime and amoxicillin which retains stronger activity against PRSP was evaluated. This combination worked synergistically against S. pneumoniae including PRSP by the checkerboard method with a mean FIC index value of 0.60 and the time-kill kinetic method. Similarly, a synergistic effect was shown in the mouse respiratory tract infection model, with an FED index of 0.29 (cefixime:amoxicillin = 2:1). Additionally, this combination showed excellent activity against mixed organisms including PRSP, in the human serum level simulating kinetic method and mouse respiratory mixed infection models. We review here briefly preclinical studies carried out in our laboratory which demonstrate the synergistic effect of this cefixime plus amoxicillin combination, and suggest the empirical therapeutic potency of this combination for treating community-acquired respiratory tract infections, including PRSP, in the clinical setting.

Topics: Amoxicillin; Animals; Cefixime; Cefotaxime; Cephalosporins; Drug Synergism; Drug Therapy, Combination; Humans; Mice; Penicillin Resistance; Penicillins; Pneumococcal Infections; Respiratory Tract Infections; Streptococcus pneumoniae

An increasing number of clinical failures has been noted after treatment of upper respiratory tract infection and acute otitis media with conventional antibiotics. At present, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and group A beta-hemolytic streptococcus (GABHS) are the bacterial pathogens most frequently responsible for these infections. Although GABHS has so far not developed penicillin resistance, the frequency of bacteriological failures with either benzathine penicillin or penicillin V has increased. Firstly, a number of hypotheses have been put forward to explain this, including poor patient compliance and inactivation by beta-lactamase-producing oropharyngeal flora. Secondly, this has added to the demand for new agents to treat resistant streptococci. Cefixime, an orally active third-generation cephalosporin, has attracted considerable attention following the results of numerous clinical studies. Comparative studies between cefixime and conventional antibiotics for the treatment of upper respiratory tract infections and otitis media are summarized.

Topics: Cefixime; Cefotaxime; Cephalosporins; Humans; Otitis Media; Patient Compliance; Penicillin Resistance; Respiratory Tract Infections; Streptococcal Infections; Treatment Outcome

To investigate the distribution and drug-resistance of gram-negative bacilli in respiratory ward.. (1) Drug-resistance was tested by Kirby-Bauer disk sensitivity method and MIC by agar doubling dilution. (2) beta-lactanase was tested by nitrocephin. (3) ESBLs was tested by E test.. (1) Among 345 strains gram-negative bacillus, klebsiella pneumoniae and pseudomonas aeruginoea was about 39.7%, 17.4%, respectively. (2) Drug-resistance rate of cefotaxime dropped from 42.9% (6 years ago) to 8.2%. (3) beta-lactamase positive rate of 345 strains bacilli was 54.5%. (4) ESBLs was negative.. (1) Klebsiella pneumoniae and pseudomonas aerugries were the main pathogens in lower respiratory tract infection in hospital. (2) Although we didn't find the evidence of ESBLs, we should pay more attention to it in the future.

Topics: Bronchiectasis; Cefotaxime; Cephalosporins; Drug Resistance, Microbial; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Klebsiella pneumoniae; Lung Diseases, Obstructive; Pseudomonas aeruginosa; Respiratory Tract Infections

As part of the Alexander Project during 1992 and 1993, 690 Staphylococcus aureus strains isolated from community-acquired lower respiratory tract infections by clinical microbiology centres located in Europe and the USA were analysed by a co-ordinating laboratory that determined minimal inhibitory concentrations of 15 antimicrobial agents using a standardised microdilution technique. The prevalence of penicillin-susceptible microorganisms in this collection of pathogens was significantly higher in Europe (21.2%) than it was in the USA (12.1%). Most isolates (72.5%), however, were strains that had acquired the ability to synthesise a beta-lactamase but which were sensitive to methicillin. The incidence of methicillin-resistance (9.1% overall) was highly variable depending on geographic location and year of isolation. Analysis of MIC50, MIC90, MIC range and modal MIC of the 15 antibiotics assayed disclosed no major differences between the data sets obtained during the 2-year survey. Except for methicillin-resistant S. aureus, the activity of all the beta-lactams tested, with the exclusion of penicillin, amoxycillin and cefixime (that were completely inactive), was satisfactory. The effect of beta-lactamase synthesis was inhibited by the combination of amoxycillin with clavulanate, and by cefuroxime and ceftriaxone. Cefaclor was slightly less effective. Erythromycin, clarithromycin and azithromycin showed identical cross-resistance rates (around 10%). Resistance to the macrolides was more frequent in the USA than in Europe and was the sole trait found to increase during the survey. Doxycycline, chloramphenicol, co-trimoxazole and the two fluoroquinolones tested (ofloxacin and ciprofloxacin) were remarkably effective (resistance lower than 1%). Only doxycycline and, to a lesser extent, co-trimoxazole were partially active against methicillin-resistant strains.

Topics: Anti-Bacterial Agents; Cefixime; Cefotaxime; Drug Resistance, Microbial; Europe; Humans; Lactams; Macrolides; Methicillin Resistance; Microbial Sensitivity Tests; Penicillin Resistance; Respiratory Tract Infections; Staphylococcus aureus; United States

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacteria; Cefixime; Cefotaxime; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Lung Diseases, Obstructive; Male; Middle Aged; Respiratory Tract Infections; Sputum

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

From October, 1993 to August, 1994, a post-marketing surveillance study enrolled 9,568 adults and children treated for respiratory tract infections with cefixime in a daily dose of 400 mg or 8 mg/kg body weight, respectively. Twice daily dosage was preferred with adults (60.4%) and children (54.4%). Bronchitis (45.5%) and otitis media (48.0%) were the most frequent indications given for cefixime use in adults and children, respectively. Bacterial analysis was done in 5.4% of adults and in 6.5% of children. With a median therapy of 6 days, cure or improvement was reported in 98.7% of adult patients and in 98.0% of children. Symptoms rapidly improved in a majority of patients. Adverse events occurred in 1.12% of adult patients and 1.92% of children. In 96.7% of all cases the dry syrup was very well or well accepted by children. In conclusion, high efficacy and low incidence of side effects make cefixime a drug of choice for treatment of respiratory tract infections.

Topics: Adult; Cefixime; Cefotaxime; Cephalosporins; Child, Preschool; Female; Humans; Male; Respiratory Tract Infections

During 1991-1995 a Spain collaborative study group surveyed the resistance to cefotaxime both in community as well as in hospital isolates of bacteria. The isolates tested during the study period of 5 years were 813, 875, 3631, 3184, and 3050 strains, respectively. Antimicrobial activity of cefotaxime was assayed by broth or agar microdilution, in accordance with criteria of the National Committee of Clinical Laboratory Standards (NCCLS). Cefotaxime resistance included 2.5% of all isolates: 2.6% Enterobacteriaceae, 1.7% Streptococcus pneumoniae, 0.5% Haemophilus influenzae, 0.0% Haemophilus spp., and 0.0% Moraxella catarrhalis. The overall incidence of resistance to cefotaxime decreased fro member of Enterobacteriaceae from 3.6% in 1991 to 2.5% in 1995. The incidence of resistance varied with the species and was highest in Enterobacter and in Citrobacter freundii.

Topics: Bacterial Infections; Cefotaxime; Cephalosporin Resistance; Cephalosporins; Enterobacteriaceae; Humans; Respiratory Tract Infections; Spain

Topics: Amoxicillin; Ampicillin Resistance; Anti-Bacterial Agents; beta-Lactam Resistance; Cefotaxime; Cephalosporin Resistance; Cephalosporins; Drug Resistance, Microbial; Erythromycin; Humans; Imipenem; Patient Care Planning; Penicillin G; Penicillin Resistance; Penicillins; Pleural Effusion; Pneumococcal Infections; Respiratory Tract Infections; Streptococcus pneumoniae; Tetracycline Resistance; Thienamycins; Tracheal Diseases

Topics: Administration, Oral; Bacteria; Cefixime; Cefotaxime; Drug Resistance, Microbial; Humans; Respiratory Tract Infections

The in vitro activity of cefodizime and two comparative cephalosporins, cefuroxime and ceftriaxone were studied against respiratory pathogens. MIC90s of cefodizime were 0.06-0.512 microgram/ml for Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae. MIC50s of cefodizime for Klebsiella pneumoniae and Staphylococcus aureus isolates were 2 micrograms/ml and 8 micrograms/ml respectively. Cefuroxime and ceftriaxone at a concentration of 2 micrograms/ml and 1 microgram/ml inhibited 50% of Klebsiella pneumoniae and 50% of Staphylococcus aureus strains studied respectively. Cefodizime inhibited many of the important respiratory pathogens and can be suggested as an active antimicrobial agent for respiratory tract infections.

Topics: Cefotaxime; Ceftriaxone; Cefuroxime; Haemophilus Infections; Haemophilus influenzae; Humans; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Moraxella catarrhalis; Neisseriaceae Infections; Pneumococcal Infections; Respiratory Tract Infections; Staphylococcal Infections; Staphylococcus aureus; Streptococcus pneumoniae

The in vitro activity of cefixime and 9 other orally used antimicrobial agents against 545 selected clinical respiratory tract pathogens was tested using the plate-dilution method. Of the strains tested, 144 were Haemophilus influenzae strains, 151 group A streptococci, 105 pneumococci and 145 Moraxella catarrhalis isolates. Ciprofloxacin was the most active drug, with a minimal inhibitory concentration (MIC) of < 0.06 mg/l for more than 87% of the isolates. With cefixime, a MIC of 0.06 mg/l inhibited 55% of the strains tested and a MIC of 1.0 mg/l inhibited all except one of the 545 strains. One pneumococcal strain was resistant to cefixime. Beta-lactamase producing H. influenzae and M. catarrhalis strains were clearly more susceptible to cefixime than to other oral cephalosporins (cephalexin, cefaclor, cefuroxime). However, penicillin, ampicillin and cefuroxime were more effective against beta-hemolytic streptococci and pneumococci than was cefixime. The new third generation cephalosporin, cefixime, showed markedly better in vitro activity against certain major respiratory tract pathogens than the other peroral antimicrobials commonly used against respiratory tract infections.

Topics: Anti-Bacterial Agents; Cefixime; Cefotaxime; Finland; Haemophilus influenzae; Humans; Microbial Sensitivity Tests; Moraxella catarrhalis; Respiratory Tract Infections; Streptococcus pneumoniae; Streptococcus pyogenes

Topics: Anti-Bacterial Agents; Cefixime; Cefotaxime; Cephalosporins; Child; Dexamethasone; Humans; Meningitis; Otitis Media; Respiratory Tract Infections

Topics: Amoxicillin; Cefotaxime; Erythromycin; Haemophilus influenzae; Humans; Microbial Sensitivity Tests; Moraxella catarrhalis; Respiratory Tract Infections; Streptococcus pneumoniae

A 6 year old boy receiving chemotherapy for acute lymphocytic leukaemia developed pneumonia due to Corynebacterium pseudodiphtheriticum. He responded to antibiotics.

Topics: Cefotaxime; Child; Corynebacterium Infections; Drug Resistance, Microbial; Humans; Male; Opportunistic Infections; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Respiratory Tract Infections

The ecological effect of cefixime on aerobic fecal flora was evaluated in 6 children aged 2 to 5 years given oral cefixime (8 mg/kg/day in two divided doses) for five days. Serial dilutions of stools recovered at baseline (D0), 2 and 5 days after initiation of therapy (D2 and D5) and two days after completion of therapy (DC + 2) were cultured on selective media. Colonies of Enterobacteriaceae, group D streptococci, staphylococci, and Candida were counted. A moderate but significant (p less than 0.01) decrease in the Enterobacteriaceae count was seen, with a fall from 8 log 10 (4.8 to 9.4) on D0 to 6.4 (3.6-9) on D2, 6 (4.6-7.2) on D5 and 4.7 (2-8.2) on DC + 2. No cefixime-resistant Entrobacteriaceae or Pseudomonas strains were evidenced. A slight, non significant decrease in group D streptococci counts was found, with values of 7.1, 7.1, 5.8, and 8.3 log 10 at the successive time points. All children exhibited fecal staphylococcal strains which were all coagulase-negative and which did not undergo noticeable quantitative changes (mean successive values were 2.5, 1.8, 3.5, and 3.8 log 10). Candida were found in four children and also changed little over time (mean successive values: 2, 1.7, 2, and 2.6 log 10). In sum, oral administration of cefixime was associated with a modest decrease in the number of Enterobacteriaceae, with no development of resistance to cefixime.

Topics: Administration, Oral; Anti-Infective Agents, Urinary; Cefixime; Cefotaxime; Child, Preschool; Drug Resistance, Microbial; Enterobacteriaceae; Feces; Humans; Respiratory Tract Infections; Staphylococcus; Streptococcus

The wide and potent in vitro activity of cefixime, a new oral broad spectrum cephalosporin, has been confirmed on a collection of respiratory and urinary pathogens recently isolated in Italy. The new cephem emerged as the most bactericidal of all the comparators tested against several fast as well as slowly-growing gram-negative species including Enterobacteria, Haemophilus and Moraxella, irrespective of their ability to synthetize beta-lactamases. Among the gram-positive species Streptococcus pyogenes and S. pneumoniae were effectively covered. Cefixime activity was not adversely influenced by several important variables such as pH (over the range from 5 to 8), inoculum size (from 10(5) to 10(8) CFU per ml) and the presence of 50% human serum or urine. Time-kill tests confirmed a pronounced bactericidal potency of the drug especially towards common respiratory pathogens (H. influenzae, M. catarrhalis, S. pneumoniae and S. pyogenes). Killing of urinary strains was optimal at cefixime concentrations reached in urine since eradication, except for Proteus mirabilis, was enhanced with increasing levels of the drug. The absence of an untoward paradoxic effect on the rate of cefixime bactericidal action was confirmed by employing a dynamic bladder model simulating the pharmacokinetic parameters of the drug after a single 200 mg daily dosage. Interactions of cefixime with several other drugs that may be employed in combination therapy were generally prone to provide indifference and synergism while antagonism was never observed. Favorable interactions were also registered when cefixime acted with other antibiotics on partially resistant species such as Staphylococci and Pseudomonas. The new cephem seems to provide excellent opportunities for expanding oral cephalosporin therapy to a wide range of infections produced by susceptible pathogens in the adult and pediatric populations.

Topics: Anti-Infective Agents, Urinary; Cefixime; Cefotaxime; Drug Interactions; Enterobacteriaceae; Gram-Negative Bacteria; Humans; Microbial Sensitivity Tests; Models, Biological; Respiratory Tract Infections; Urinary Bladder; Urinary Tract Infections

Against strains of Branhamella catarrhalis which were separated from various RTIs (respiratory tract infections) in 1991 antimicrobial activities (MICs) of cefetamet (CFMT) were determined, and the following conclusions were obtained. 1. The MIC80 of CFMT against B. catarrhalis was 0.39 microgram/ml, which was higher than that of cefixime (CFIX) by one dilution or twofold, but was lower than that of cefpodoxime (CPDX) by two dilutions or fourfold and that of cefotiam (CTM) by three dilutions or eightfold. 2. The fact that all of the 50 strains tested were beta-lactamase producers appeared to indicate that CFMT was stable against BRO-1 and BRO-2 beta-lactamases produced by B. catarrhalis. 3. Blood concentrations of the test drug, CFMT, and control drugs upon normal single doses were calculated using pharmacokinetic parameters. Lengths of time periods during which drug concentrations stayed above their MICs against B. catarrhalis obtained in this study were determined for CFMT, CFIX, CPDX and CTM. They were, respectively, 12 hours, 12 hours, 6 hours, and 2 hours, thus CFMT appeared to remain above MIC for sufficiently long time for the treatment of RTIs which are affected by B. catarrhalis directly or indirectly.

Topics: beta-Lactamases; Cefixime; Cefotaxime; Cefotiam; Cefpodoxime; Ceftizoxime; Drug Resistance, Microbial; Drug Stability; Humans; Moraxella catarrhalis; Respiratory Tract Infections

The influence of cefodizime (CDZ) on CD4 and CD8 lymphocytes was investigated in patients with lower respiratory tract infection and underlying respiratory diseases. Ten men and one woman were treated with CDZ 1 g i.m. b.i.d. for ten days. The infecting organisms were Haemophilus influenzae (5), Streptococcus pneumoniae (2) and Escherichia coli (1). No adverse events were reported. Nine patients were clinically cured; two required further antibiotic therapy. Leucocyte counts decreased significantly during treatment. Lymphocyte counts and CD4 cells both increased significantly in absolute and relative numbers, while there was a much smaller increase in CD8 cells. This resulted in a significant increase in the CD4/CD8 ratio. These effects of CDZ might be of benefit for immunocompromised patients with bacterial infections.

Topics: Acute Disease; CD4-CD8 Ratio; Cefotaxime; Female; Humans; Immunologic Factors; Male; Respiratory Tract Infections; T-Lymphocyte Subsets

Bacteriological and clinical studies on cefodizime (CDZM, THR-221), a new cephem developed by Hoechst AG and Roussel Uclaf, were carried out and the results are summarized below: 1. Against Gram-positive bacteria, Staphylococcus aureus, Streptococcus pyogenes and Streptococcus pneumoniae, antibacterial activities of CDZM were similar to those of cefotaxime (CTX), cefazolin, cefotiam and piperacillin. Against Escherichia coli, Klebsiella pneumoniae and Serratia sp., antibacterial activities of CDZM were similar to that of CTX, and superior to those of other tested antibiotics. Especially against Haemophilus influenzae and Branhamella catarrhalis, it showed an excellent antibacterial activity. 2. Although the clinical efficacy was poor in 1 patient with sepsis caused by Salmonella marcescens and in another with cervical lymphadenitis, in 5 patients with upper respiratory tract infection, 4 patients with bronchitis, 6 patients with bronchopneumonia, 18 patients with pneumonia, 5 patients with urinary tract infection and 1 patient with enteritis, the clinical efficacy was excellent or good and the efficacy rate was 95.1% (39/41) including excellent efficacies in 25 cases. 3. Bacteriologically, all identified causative bacteria were eradicated except for 1 case of Salmonella sp., thus the eradication rate was 97.4% (38/39). Especially S. pneumoniae in 10 cases, H. influenzae in 12 cases and B. catarrhalis in 3 cases were eradicated totally. 4. Adverse reactions were studied in 46 cases, and digestive symptoms were observed in 9 cases (diarrhea 5 cases, loose stools 4 cases). Eruption and vascular pain were observed in 1 case each. As digestive symptoms in 9 cases were mild, the treatment were not suspended. In laboratory test values, elevation of GOT, elevation of GPT, elevation of bilirubin, and eosinophilia were observed in 1 case each. Influences on blood coagulation parameters were studied. No change was observed between the beginning and the end of the treatment. From above results, we have concluded that CDZM is a useful and safe antibiotic in pediatrics, administered at a daily dose of 20 mg/kg divided into 3 or 4 doses and administered intravenously.

Topics: Adolescent; Age Factors; Bacteria; Bacterial Infections; Cefotaxime; Child; Child, Preschool; Drug Resistance, Microbial; Female; Humans; Infant; Male; Respiratory Tract Infections

Cefixime (CFIX) was evaluated clinically in pediatric respiratory tract infections, particularly those caused by Haemophilus influenzae: 1. The total number of children in this study treated with CFIX was 232, out of which 215 cases were evaluated for clinical efficacy and 224 cases were investigated for safety. A daily dosage of 3-6 mg/kg/day was given divided into 2 to 3 times daily for 3-15 days. 2. Causative organisms were identified in 146 cases, out of which 128 cases were found to be single microbial infections and 18 cases were mixed infections. In single microbial infections, clinical efficacy was 100% for those caused by H. influenzae/Haemophilus parainfluenzae, and was 95% for Streptococcus pyogenes with an overall efficacy of 96.9%. In mixed infections, the clinical efficacy was 100% for those caused by a combination of H. influenzae and Streptococcus pneumoniae, and the overall rate was 94.4%. An involvement of H. influenzae was observed in 108 cases with a clinical efficacy rate of 99.1%, and definite involvement of beta-lactamase secreting strains of H. influenzae was found in 32 cases with a clinical efficacy of 96.9%. 3. Bacteriological effect was studied for 164 strains identified in 146 cases, and eradication rates were 89.5% for H. influenzae, 100% for H. parainfluenzae and S. pyogenes, and 71.4% for S. pneumoniae. The overall eradication rate was 91.4%. Superinfection was observed in 21 cases. MICs against 78 strains of H. influenzae were in a range of less than or equal to 0.10 microgram/ml regardless of beta-lactamase production, and far superior to cefaclor and amoxicillin. MICs against S. pyogenes and S. pneumoniae were in ranges of less than or equal to 0.10 microgram/ml and 0.39 micrograms/ml, respectively. 4. Clinical efficacy was 93.0% in 215 cases (excellent: 136, good: 64, fairly good: 10, poor: 5). CFIX attained a high efficacy in the range of 89.4-95.7% in acute pharyngitis, acute tonsillitis, acute bronchitis and acute pneumonia. 5. Safety was monitored in 224 cases and there were only one case of loose stool and another of diarrhea as side effects. There were no abnormal findings in 31 cases of the laboratory test. In conclusion, it was confirmed that CFIX is excellent and safe in the treatment of the respiratory tract infections.

Topics: Age Factors; Cefixime; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Haemophilus influenzae; Humans; Infant; Male; Respiratory Tract Infections; Streptococcus pneumoniae

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

The in-vitro activity of cefodizime was studied against respiratory pathogens and was compared with the activity of other beta-lactams, ciprofloxacin and erythromycin. Cefodizime displayed high activity against Haemophilus influenzae (MIC90 0.008 mg/l), Branhamella catarrhalis and Streptococcus pneumoniae (MIC90 0.5 mg/l). Klebsiella spp. were less susceptible (MIC90 2 mg/l). It was concluded that cefodizime should be a useful agent in the therapy of respiratory tract infections.

Topics: Anti-Bacterial Agents; Bacteria; Cefotaxime; Haemophilus influenzae; Humans; Klebsiella pneumoniae; Microbial Sensitivity Tests; Moraxella catarrhalis; Respiratory Tract Infections; Streptococcus pneumoniae

Topics: Anti-Bacterial Agents; Cefixime; Cefotaxime; Humans; Microbial Sensitivity Tests; Respiratory Tract Infections; Urinary Tract Infections

The clinical efficacy and safety of Cefodizime (CDZM), a new cephem antibiotic, was objectively compared with that of Cefotaxime (CTX) in patients with respiratory infections under a well-controlled comparative study. Patients were administered CDZM or CTX by drip infusion b.i.d. for 14 days in principle at a daily dose of two grams. The parameters assessed were clinical efficacy, safety and clinical usefulness. The following results were obtained: 1. On the basis of committee judgement the clinical efficacy rate was 78.1% (125/160) for the CDZM group, 82.7% (124/150) for the CTX group, and no significant difference was observed between the two drug groups. On the other hand, on the basis of judgement by physicians in charge, the clinical efficacy rate was 83.1% (133/160) for the CDZM group, 83.9% (125/149) for the CTX group, and no significant difference was observed between the two groups. 2. The corresponding figures for patients with pneumonia and pulmonary suppuration were 82.4% (70/85) for the CDZM group, 79.7% (59/74) for the CTX group and no significant difference was observed according to the committee judgement. The judgement by physicians in charge also revealed 83.5% (71/85) for the CDZM group and 82.2% (60/73) for the CTX group. No significant difference was noted between the two groups. While, the committee judgement for the clinical efficacy in patients with chronic respiratory tract infections showed 73.3% (55/75) for the CDZM group, 85.5% (65/76) for the CTX group, and no significant difference was observed between the two drug groups. The corresponding figures were 82.7% (62/75) for the CDZM group, 85.5% (65/76) for the CTX group, and no significant difference was observed between the two drug groups on the judgement by physicians in charge. Furthermore, the clinical efficacy of both drugs on chronic respiratory tract infections was assessed according to "Criteria for Evaluation of Clinical Efficacy of Chemotherapeutics on Chronic Respiratory Tract Infection". It was 76.8% (53/69) for the CDZM group, 76.3% (58/76) for the CTX group, and no significant difference was observed between the two groups. 3. The bacteriological eradication rate of causative pathogens was 92.4% out of 66 patients treated with CDZM and 95.5% out of 67 patients treated with CTX in whom judgement was possible. No significant difference was observed between the two drug groups. 4. The adverse reactions occurred in 4 (2.2%) patients for the CDZM group and 8 (4.5%) pa

Topics: Anti-Bacterial Agents; Cefotaxime; Drug Evaluation; Humans; Respiratory Tract Infections

Experimental and clinical study of cefodizime (CDZM, THR-221), a newly developed cephem antibiotic, was done in the field of pediatrics and the results obtained are summarized as follows: 1. Serum levels and urine excretion were examined after 60-minute drip infusion of CDZM at a dose level of 10 mg/kg to 1 patient, at 20 mg/kg to 4 and at 40 mg/kg to 1. Peak levels in serum were 66.3 micrograms/ml for the 10 mg/kg dose occurring 1 hours after the dose, 118.1 micrograms/ml (mean) for 20 mg/kg, 259.2 micrograms/ml for 40 mg/kg, thus a dose-response was observed. T 1/2's (beta phase) were between 1.17 and 1.69 hours. Urinary recovery rates of the drug were between 71.5% and 98.0% in the first 8 hours after administration. 2. The concentration in the cerebrospinal fluid was 0.76 microgram/ml and the serum level was 380.67 micrograms/ml at 15 minutes after intravenous administration of 433 mg of CDZM to a patient with purulent meningitis. 3. The clinical efficacy rate was 95.2% in a total of 21 cases, i.e., 1 purulent meningitis, 10 respiratory tract infection, 3 whooping cough, 5 urinary tract infection, 1 purulent infection of soft tissues and 1 acute thyroiditis. Diarrhea occurred in 1 case as adverse reactions. Abnormal changes in laboratory test results occurred as 1 case each of slightly elevated GOT.GPT and GOT.

Topics: Age Factors; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

1. Absorption and elimination Serum and urinary levels of cefodizime (CDZM, THR-221) were determined in 7 children with ages ranging from 3 to 12 years after a intravenous bolus injection of the drug at 20 mg/kg. The average serum level of the drug was 119.27 +/- 13.83 micrograms/ml at 30 minutes, then decreased gradually with a half-life of 2.01 +/- 0.25 hours to 10.56 +/- 2.93 micrograms/ml at 6 hours. The average urinary elimination rate was 77.34 +/- 12.60%. 2. Clinical study CDZM was given to the following 39 patients with ages ranging from 2 months to 15 years and clinical efficacy, bacteriological response and adverse reactions were evaluated. The treated cases were 2 cases of acute purulent tonsillitis, 30 cases of acute pneumonia, 1 case of acute purulent otitis media and 2 cases of acute urinary tract infections. Clinical efficacies were excellent in 29 cases, good in 5 cases and poor in 1 with an efficacy rate of 97.1%. Organisms presumed to be pathogens included 3 strains of Streptococcus pneumoniae, 1 beta-Streptococcus, 1 Staphylococcus epidermidis, 9 Haemophilus influenzae (1 beta-lactamase producing strain and 8 non-producing strains) and 1 Enterococcus faecalis. The last one was decreased and the others were eradicated with an eradication rate of 93.3% for all strains. Adverse reactions occurred in no patients. Abnormal changes in laboratory test values involved only 1 case each of elevated GOT, elevated GOT and GPT, eosinophilia and thrombocytosis. Based on the above-mentioned result and features of this drug, it was confirmed that this drug showed an excellent usefulness in the treatment of infections in childhood. It may be also effective in the management of infections under immunosuppression.

Topics: Adolescent; Age Factors; Bacterial Infections; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male; Respiratory Tract Infections

Clinical trials of cefodizime (CDZM, THR-221) were carried out in pediatric infection. Results are summarized as follows. 1. The mean half-life of CDZM in the serum following intravenous injection of CDZM (20 mg/kg) was about 2.06 hours. 2. The mean urinary excretion rate of CDZM within 8 hours after intravenous injection of CDZM was 60.1%. 3. CDZM was administrated to 19 pediatric patients with various infections; 9 cases of pneumonia, 3 bronchitis, 1 cervical lymphadenitis, 2 tonsillitis and 4 urinary tract infections. The overall efficacy rate was 94.7%. 4. No adverse reactions were observed. Abnormal laboratory test values found were thrombocytosis in 2, slight elevation of GOT and GPT in 1 and eosinophilia in 1 patient.

Topics: Age Factors; Bacteria; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

In this study, cefodizime (CDZM, THR-221) was administered to 34 children with infections and the efficacy was evaluated in 30 patients. The efficacy rate was 90.0% and CDZM was proved to be a highly effective antibiotic for infectious diseases in childhood. We also demonstrated that CDZM had strong antibacterial activities against both Gram-positive and Gram-negative bacteria. No severe toxicity related to intravenous injection of CDZM was observed in our 34 cases.

Topics: Age Factors; Bacteria; Bacterial Infections; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male; Respiratory Tract Infections

Cefodizime (CDZM, THR-221), a new cephem antibiotic, was investigated for its clinical efficacy and pharmacokinetics in children. The results obtained are summarized as follows. 1. Antimicrobial activities Antimicrobial activities of CDZM against clinically isolated organisms were determined. MICs of CDZM against 1 strain each of Streptococcus pneumoniae, Escherichia coli and Klebsiella pneumoniae were 0.05 micrograms/ml to 0.10 micrograms/ml. Especially, MIC against all 6 strains of Haemophilus influenzae was less than or equal to 0.024 micrograms/ml. This MIC value was lower than those of other antibiotics such as cefotaxime, cefotiam, cefazolin, piperacillin. 2. Pharmacokinetics CDZM was given to 1 case at a dose of 20 mg/kg by a 60-minute intravenous drip infusion. The peak value of serum concentration of CDZM was 207.80 micrograms/ml at the end of the infusion. The half-life was 2.15 hours. The mean urinary excretion rate was 68.5% in the first 4 hours, 79.2% in 6 hours and 76.5% in 8 hours after the 30-minute drip infusion. 3. Clinical efficacy CDZM was given to a total of 27 patients, 13 with pneumonia, 1 with bronchitis, 2 with acute pharyngitis, 1 with purulent tonsillitis, 5 with urinary tract infection, 1 each with retrograde cholangitis, acute enteritis, pericementitis, phlegmon and inguinal lymphadenitis. Overall clinical efficacies were excellent in 5 cases, good in 17 and the efficacy rate was 81%. Bacteriological effects were investigated in 13 cases and the eradication rate was 85%. No adverse reactions were observed in any case. As abnormal laboratory findings, elevated GOT, GPT, A1-P, LAP and gamma-GTP, were noted in 1 out of the 28 cases examined.

Topics: Adolescent; Age Factors; Bacteria; Bacterial Infections; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male; Respiratory Tract Infections

Cefodizime (CDZM, THR-221) was given intravenously to 20 children with the following acute bacterial infections: 2 cases each of tonsillitis, bronchitis, purulent cervical lymphadenitis, and urinary tract infections and 12 cases of pneumonia. Good clinical responses were obtained in 18 patients out of the 20, and bacteriologically, all of the 5 strains identified were eradicated. No side effect was obtained except one case of eosinophilia. From the above clinical results, it is apparent that CDZM is a useful antibiotic for the treatment of pediatric patients with various kinds of bacterial infections.

Topics: Age Factors; Bacteria; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

Cefodizime (CDZM, THR-221) was evaluated for its pharmacokinetics, safety and efficacy in 30 pediatric patients with bacterial infections. The following results were obtained. 1. The pharmacokinetics of CDZM in 6 children were investigated with a dose level of 20 mg/kg via intravenous injection. Mean serum half-lives (T 1/2 beta) of the drug were 120.9 minutes (HPLC) and 115.6 minutes (bioassay). In 8 hours after administration of CDZM, urinary excretion rates were 74.7% (HPLC) and 75.0% (bioassay). 2. The clinical efficacies of CDZM were studied in 29 pediatric patients, comprising 22 with respiratory tract infections, 2 with urinary tract infections, 2 with enteritis, 2 with lymphadenitis and 1 with gingivitis. The clinical efficacies were excellent in 13, good in 13 and fair in 3, with an efficacy rate of 89.7%. 3. The eradication rate for pathogens identified in 7 pediatric patients was 60% (6/10). The clinical efficacy rate in cases where pathogens were identified was 100% in terms of excellent+ good evaluations. 4. Only one case of mild diarrhea was observed as a side effect associated with CDZM. Laboratory tests revealed abnormal value of slightly elevated eosinophil in 3 cases. The data suggested that CDZM is a safe and effective injectable antibiotic for the treatment of infections in children.

Topics: Adolescent; Age Factors; Bacterial Infections; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Female; Humans; Male; Respiratory Tract Infections

Laboratory and clinical studies on cefodizime (CDZM, THR-221), a newly developed cephem antibiotic, were done. The results obtained are summarized as follows: 1. Absorption and elimination were examined in a total of 5 cases including a case of 10 mg/kg intravenous drip infusion for 30 minutes, 2 cases of 20 mg/kg rapid intravenous injection and 2 cases of 40 mg/kg drip infusion for 30 minutes. Maximum serum levels were attained immediately after drip infusion or rapid injection. Cmax's were 119.2 micrograms/ml for 10 mg/kg, 374.9 micrograms/ml or 255.7 micrograms/ml for 20 mg/kg, and 321.3 micrograms/ml or 431.8 micrograms/ml for 40 mg/kg. These values were determined using an high performance liquid chromatography (HPLC) method. In general, values using the bioassay were higher than those with the HPLC method. T 1/2 (beta)'s were between 1.74 and 1.93 hours using HPLC, and between 1.77 and 2.24 hours using bioassay. Urinary recovery rates were examined in 3 out of 5 cases. Cumulative urinary recovery rates were 57.9-90.6% with HPLC method and 50.4-88.0% with bioassay in a period of 0-8 hours after administration. 2. Clinical efficacy was evaluated in a total of 22 cases including 14 cases of respiratory tract infections, 5 cases of urinary tract infections and 3 cases of cellulitis. Clinical efficacy rate was 95.2%. Bacteriologically, pathogenic organisms were eradicated in 90.0%. As adverse reactions, 1 angular stomatitis, 1 diarrhea and 1 loose stool were noted. Abnormal laboratory test values detected were 1 case of increased GPT and 1 case of increased GOT and GPT.

Topics: Adolescent; Age Factors; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

Cefodizime, a new cephem antibiotic, was intravenously injected to mice with systemic or urinary tract infection by Escherichia coli and those with respiratory infection by Streptococcus pneumoniae, and the time courses of the plasma and tissue cefodizime levels were determined and compared with those in healthy mice (control group). In mice with systemic infection, the drug level in the plasma, liver, kidneys and lung changed on the basis of the two-compartment model. In this group, disappearance of the drug from plasma and tissues was obviously delayed and decrease in elimination constant (KE) and increase in the apparent volume of distribution (V2) were noted as compared with the control group. In the group with respiratory infection, T1/2(beta) and AUC for the hepatic drug level and T1/2(beta) for the renal drug level increased but in the other organs there was no great difference from the control group. In the urinary tract infection group, T1/2(beta) and AUC in the kidneys (infected site) and liver that mainly participate in elimination of cefodizime considerably increased differently from the control group. Changes of the distribution volume seemed to correspond with a physiological change of increase in body water content in the peripheral tissues (muscle, etc.) of the systemic infection group and in the liver, kidneys, etc. of the urinary tract infection group. Regarding the protein binding ratio, the urinary tract infection group showed a significant decrease as compared with the control group, but no distinct difference was noted in systemic and respiratory infections.

Topics: Animals; Bacterial Infections; Body Water; Cefotaxime; Injections, Intravenous; Kidney; Liver; Male; Mice; Mice, Inbred ICR; Protein Binding; Respiratory Tract Infections; Time Factors; Urinary Tract Infections

Topics: Anti-Bacterial Agents; Cefotaxime; Cross Infection; Digestive System; Disinfection; Humans; Intensive Care Units; Oropharynx; Respiratory Tract Infections; Sterilization

This study reports 45 cases of respiratory tract infection associated with Branhamella catarrhalis, diagnosed by bacteriological examination out of 980 sputum samples studied over a 6 months period. These infections were observed mainly in patients with chronic respiratory disease (68.9%). More than half of the isolates were found in pure culture, others were isolated from mixed infections most often with Haemophilus influenzae, Streptococcus pneumoniae or H. influenzae plus S. pneumoniae. 64.7% of Branhamella catarrhalis isolates produced beta-lactamase. In vitro antimicrobial susceptibility testing demonstrated that the B. catarrhalis isolates, including beta-lactamase producing strains, were very susceptible to clavulanic acid plus amoxycillin (MIC90:0.12 microgram/ml) as well as to doxycycline and erythromycin (MIC90:0.5 microgram/ml).

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin; beta-Lactamases; Cefotaxime; Clavulanic Acid; Clavulanic Acids; Doxycycline; Erythromycin; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Moraxella catarrhalis; Respiratory Tract Infections

Synergistic activities of isepamicin (ISP) and a beta-lactam antibiotic such as piperacillin (PIPC) or cefotaxime (CTX) against Pseudomonas aeruginosa were demonstrated in vitro and in vivo. In vitro synergistic activity was observed when ISP was used together PIPC or CTX. The synergy observed in vitro was reproduced in vivo against experimental mouse infections, and a ISP-PIPC or a ISP-CTX combination showed significantly greater protective effects than individual antibiotics by themselves.

Topics: Animals; Anti-Bacterial Agents; Cefotaxime; Drug Synergism; Drug Therapy, Combination; Gentamicins; Male; Mice; Mice, Inbred ICR; Peritonitis; Piperacillin; Pseudomonas aeruginosa; Pseudomonas Infections; Respiratory Tract Infections

Topics: Adolescent; Adult; Aged; Cefotaxime; Chronic Disease; Female; Humans; Lung Diseases; Male; Middle Aged; Opportunistic Infections; Respiratory Tract Infections

Topics: Adult; Aged; Cefotaxime; Female; Half-Life; Humans; Male; Middle Aged; Respiratory Tract Infections

Topics: Adolescent; Adult; Aged; Cefoperazone; Cefotaxime; Drug Evaluation; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

Cefotaxime is one of two third-generation cephalosporins (the other being ceftriaxone) that undergo significant metabolism and is the only third-generation cephalosporin for which an active metabolite has been identified. Cefotaxime was administered intravenously in doses of 6 g per day to 20 patients with serious infections of the lower respiratory tract due to organisms susceptible to cefotaxime (isolates of Enterobacteriaceae and of Pseudomonas aeruginosa). It was administered with gentamicin in some high-risk patients. Cefotaxime resulted in mean peak concentrations of 32 mu/ml (cv% = 53) and of 29.5 micrograms/ml (cv% = 65) respectively after the first and after the last dose of a regimen of 2 g every 8 hours. The half-life value averaged 1.8 h and 6.4 h for cefotaxime and its desacetyl metabolite respectively. The average value of the metabolite at the end of short infusion was 11.5 micrograms/ml (cv% = 31) after the initial dose and 15.5 micrograms/ml (cv% = 37) after the last administered dose. Overall results were 75% patients cured or improved; 83% of the patients with nosocomial pulmonary infections due to Enterobacteriaceae were cured; 50% of the patients with Pseudomonas aeruginosa infections were cured and 25% improved despite the pathogen not being eradicated. No serious toxicity was observed.

Topics: Adolescent; Adult; Cefotaxime; Critical Care; Gentamicins; Humans; Kinetics; Middle Aged; Respiratory Tract Infections

Ceftizoxime (CZX) was given in daily doses of 4 approximately 6 g by intravenous drip infusion to 30 patients with infection accompanying lung cancer to investigate the usefulness of the drug for infectious disease: The rate of effectiveness (marked and moderate) was 73.3% (22/30 patients). Of the 30 patients, 2 had drug fever; 1, arthralgia; and 1, eosinophilia. These side effects improved after the drug was withdrawn. CZX is a very useful antibiotic with high effectiveness and safety in immunocompromised patients with infection accompanying advanced lung cancer.

Topics: Adenoma; Adult; Aged; Bacterial Infections; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Cefotaxime; Ceftizoxime; Female; Fever; Humans; Lung Neoplasms; Male; Middle Aged; Pneumonia; Pyelitis; Respiratory Tract Infections

Topics: Adult; Aged; Cefotaxime; Ceftriaxone; Drug Evaluation; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

In order to investigate the frequency of the emergence of resistance during treatment, 1,403 episodes of lower respiratory infection were studied in a General Hospital with three departments of Chest Medicine in a period of four years. In 650 episodes the pathogen was isolated and in 82 of those failure of therapy was accompanied by emergence of resistance to the agent used. Factors associated with this phenomenon were: intensive care, tracheostomy, involvement of Pseudomonas aeruginosa, Enterobacter spp., Serratia marcescens, Staphylococcus aureus or Acinetobacter calcoaceticus, use of antipseudomonas penicillins, cefotaxime (especially when used in P. aeruginosa infections) and co-trimoxazole and monotherapy as opposed to appropriate combination therapy in patients with nosocomial pneumonia.

Topics: Acinetobacter; Anti-Bacterial Agents; Bacteria; Cefotaxime; Cross Infection; Drug Combinations; Drug Therapy, Combination; Drug Utilization; Enterobacteriaceae; Humans; Intensive Care Units; Penicillin Resistance; Penicillins; Pneumonia; Pseudomonas aeruginosa; Respiratory Tract Infections; Retrospective Studies; Staphylococcus aureus; Sulfamethoxazole; Tracheotomy; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

Clinical evaluation of cefmenoxime (CMX, Bestcall) was performed against infections associated with hematological, respiratory tract and other disorders. Clinical effectiveness of CMX against severe infections with hematological disorders including sepsis, pneumonia, pyelitis and so on was 74.4% for good responses and against the respiratory tract infections, 96.2% for good responses was obtained. Neither objective or subjective side effects nor extreme abnormalities in laboratory tests were observed in these patients. It can be concluded, therefore, that CMX is one of the most useful drugs against infectious diseases associated with hematological disorders, respiratory tract and other disorders.

Topics: Bacterial Infections; Biliary Tract Diseases; Cefmenoxime; Cefotaxime; Hematologic Diseases; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Neutropenia; Pneumonia; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Ceftizoxime (CZX) were administered and tested for the efficacy and safety in 80 elderly patients who were older than 65 years of age with infections. The sensitivity of bacteria found in these infections to CZX was examined before the administration of the drug. Serum concentrations and the rate of urinary output of the drug were examined in 3 cases. The clinical effect of CZX was as follows: 29 cases (36.3%) of excellent effectiveness and 31 cases (38.8%) showed moderate effectiveness. The patients were divided into 2 groups depending on the presence or the absence of other diseases in their backgrounds. Effectiveness of CZX for patients with and without other diseases were 74.0% and 85.7%, respectively. The effectiveness of CZX in patients with other diseases in their background was lower than the group without other diseases. Other antibiotics were used in 16 cases before the use of CZX. The effectiveness of CZX for these patients was 62.5%. Infecting bacteria were detected in a total of 46 cases (19 cases of respiratory infections and 27 cases of urinary tract infections). Among the respiratory cases, 8 were due to Gram-positive bacteria and 11 were due to Gram-negative bacteria. No Gram-positive organisms were detected from urinary tract infections, which were all due to Gram-negative bacteria. Sensitivities of isolates of these infecting bacteria to CZX were very sensitive 3 isolates, sensitive (++) 8 and slightly sensitive (+) 1 isolate. It was found that CZX was effective against 39 of 46 cases from which causative organisms were identified. The effectiveness ratio was 84.8%. Serum concentration of CZX was determined after a drip injection of 1 g CZX for 1 hour. The half-lives of CZX in plasma in healthy subjects and aged patients were 1.33 hours and 2.15 hours, respectively. The rate of urinary output of CZX during 6 hours after the injection was 76.4% in healthy subjects. Delayed urinary output which was 58.2% during 7 hours after injection was observed in aged patients. Fever in 1 patient and eosinophilia in 3 cases were observed after administration of CZX.

Topics: Age Factors; Aged; Aged, 80 and over; Bacteria; Bacterial Infections; Biliary Tract Diseases; Cefotaxime; Ceftizoxime; Female; Humans; Kinetics; Male; Respiratory Tract Infections; Urinary Tract Infections

Cefmenoxime (CMX, Bestcall) was administered by drip infusion to 65 patients with various respiratory infections and its effect was evaluated. The rate of effectiveness was 86.2% in all cases including 40 cases of acute pneumonia and 12 cases of chronic bronchitis. CMX was examined comparatively with other drugs for antibacterial activity on clinically isolated strains of 2 bacterial species, i.e. H. influenzae and B. catarrhalis, each of which has a high frequency of clinical isolation from infected respiratory organs. On H. influenzae CMX exerted the strongest antibacterial activity among test drugs (ampicillin, piperacillin cefoperazone, latamoxef) regardless of the production of beta-lactamase by the organism, while on B. catarrhalis it also exerted an antibacterial activity strong enough to control the proliferation of all strains at a dose level of 0.39 microgram/ml. Drip infusion of this drug (2 gram) brought about an average maximum blood concentration of 127.2 +/- 21.5 micrograms/ml and an average half-life in blood of 1.10 +/- 0.28 hours. However, different values were obtained for different individual cases because these subjects were patients of chronic respiratory infections each having some underlying disease or other. Side effects of the drug were observed as allergic symptoms such as pyrexia, eruption and the like, but only 5 cases without any serious cases. Increases in transaminase suggestive of abnormal clinical test results were also observed in 5 cases. However, numerical recoveries to the normal values were obtained in all of these 5 cases with the withdrawal of the drug.

Topics: Adolescent; Adult; Aged; Cefmenoxime; Cefotaxime; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Respiratory Tract Infections

Topics: Aged; Aged, 80 and over; Bacterial Infections; Cefotaxime; Ceftizoxime; Female; Humans; Male; Respiratory Tract Infections; Urinary Tract Infections

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

The most frequently encountered infectious disease in the field of internal medicine is respiratory tract infections. One of the most important requirements for an antibiotic in the treatment of infections is that it must be efficiently transferred to the infected site to attain a high concentration there. In the case of respiratory tract infections, it is desirable for the drug concentration in the sputum to be higher than the MIC for the causative bacterium. Cefotaxime (CTX) expresses potent antibacterial activity against Haemophilus influenzae, Klebsiella pneumoniae and Streptococcus pneumoniae, which are the major causative bacteria of respiratory tract infections. CTX also exerts antibacterial effects against a wide range of other bacteria. We administered CTX to patients with respiratory tract infections, then measured and compared the drug concentrations in the serum and sputum. The results are described below. When 2 g of CTX was drip-infused, the drug concentration in the serum was 113.0 micrograms/ml at 5 minutes after the completion of infusion, 64.9 micrograms/ml at 30 minutes, 38.7 micrograms/ml at 1 hour, 19.0 micrograms/ml at 2 hours, 8.9 micrograms/ml at 4 hours and 3.8 micrograms/ml at 6 hours. The drug concentration in the sputum was 1.29 micrograms/ml at 5 minutes after completion of infusion, 1.54 micrograms/ml at 5 to 30 minutes, 1.36 micrograms/ml at 30 minutes to 1 hour, 1.47 micrograms/ml at 1 to 2 hours, 1.12 micrograms/ml at 2 to 4 hours and 1.35 micrograms/ml at 4 to 6 hours. The drug concentration in the serum was the highest at 5 minutes after completion of the drip-infusion, and then it gradually decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Bacterial Infections; Cefotaxime; Female; Humans; Male; Middle Aged; Respiratory Tract Infections; Sputum

A new beta-lactamase-stable oral cephem antibiotic, cefixime (CFIX), was evaluated for safety, efficacy and pharmacokinetics in children. CFIX was effective in 19 of 20 cases (95%) with bacterial infections. The drug was especially effective against the cases of pneumonia due to beta-lactamase-producing H. influenzae or B. catarrhalis. Pharmacokinetic parameters of CFIX (3 mg/kg) with premeal administration were as follows: Kel 0.328 +/- 0.066 hr-1, T 1/2 2.14 +/- 0.36 hrs, AUC 10.9 +/- 8.7 micrograms X hr/ml, and Vd/F 1.64 +/- 1.42 L/kg. In most of the cases tested, the urinary excretion rate in 12 hours was 5 to 17%. A dose of 3 mg/kg twice daily seems to be adequate for a regular treatment.

Topics: Bacterial Infections; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Haemophilus Infections; Humans; Infant; Kinetics; Male; Pneumonia; Pneumonia, Mycoplasma; Respiratory Tract Infections; Urinary Tract Infections

A newly developed cephalosporin, cefixime (CFIX), was evaluated clinically in 35 pediatric patients. A pharmacokinetic study was also performed with 11 patients. CFIX was administered as granules. The pharmacokinetic study was conducted in 11 patients, each of 6 patients was given CFIX at a dose of 3 mg/kg and each of the remaining patients was given CFIX at 6 mg/kg. Serum concentrations of CFIX were measured at 2, 4, 6, 8 and 12 hours after dosing. Urinary concentrations of CFIX were measured for periods of 0-6 and 6-12 hours after dosing. CFIX was assayed by the disk method using E. coli ATCC 39188 as the test organism. The clinical evaluation was conducted in 35 children including 5 patients of acute tonsillitis, 10 of acute lacunar tonsillitis, 1 of purulent lymphadenitis, 1 of scarlet fever, 8 of acute bronchitis, 5 of pneumonia, 3 of urinary tract infections and 1 of paratyphoid B. One additional patient was included only in the evaluation of safety since he was suffering from Mycoplasma pneumonia. the patients were from 4 months to 8 years 2 months old and 11 of them were inpatients. Daily doses were from 6.0 to 13.5 mg/kg. After CFIX administration in doses of 3 mg/kg and 6 mg/kg, peak serum concentrations were 1.75 and 3.36 micrograms/ml, half-lives were 2.65 and 2.86 hours and urinary excretions rates up to 12 hours after dosing were 16.1 and 12.4%, respectively. Serum concentrations were dose dependent and the half-life was fairly long compared with other known oral cephalosporins. Clinical efficacies of CFIX in 34 patients were "excellent" in 25 children, "good" in 8 and "poor" in 1 with effectiveness rate of 97.1%. Twenty-two strains of causative organisms, including 6 strains of S. aureus, 3 of S. pyogenes, 2 of S. pneumoniae, 3 of E. coli, 5 of H. influenzae, 2 of H. parainfluenzae and 1 of S. paratyphi B, were isolated. After treatment all strains except 2 strains of S. aureus (one was unknown and the other was decreased), 1 strain of S. pneumoniae (unknown) and 1 strain of H. influenzae (unknown) were successfully eradicated but S. paratyphi B was proved again in feces 9 days after treatment. No adverse reaction was observed. Among 18 children who went through laboratory test, however, an elevation of eosinophile and elevations of GOT and GPT were observed in 2 children and 1 child, respectively.

Topics: Administration, Oral; Bacterial Infections; Capsules; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Kinetics; Male; Respiratory Tract Infections; Urinary Tract Infections

Fundamental and clinical studies of cefixime (CFIX) granules, a new oral cephalosporin, were carried out with the following results: The MICs of CFIX against 234 clinical isolates were determined. Antibacterial activities of the drug against S. aureus, S. epidermidis and E. faecalis were weaker than those of conventional oral cephalosporins but antibacterial activities against Gram-negative bacteria were almost the same as those of cephem antibiotics of the Fujii's group 5. Peak serum concentrations of CFIX after oral doses of 3 and 6 mg/kg were, respectively, 1.51-4.86 micrograms/ml at 2-6 hours and 3.22-7.76 micrograms/ml at 4-8 hours. Serum concentrations of CFIX were dose-dependent in a patient given 3 and 6 mg/kg in a cross-over study. CFIX granules were administered mainly to children suffering from respiratory tract infection, otitis media and urinary tract infection at a dose of 3 mg/kg b.i.d. or t.i.d. for 3-27 days. The clinical responses to CFIX were excellent to good in 44 of the 50 children with infections, with an effectiveness rate of 88%. Thirty-five strains of the 40 clinical isolates were eradicated by the treatment with CFIX. The bacteriological eradication rate was 87.5%. Side effects observed were diarrhea and soft stool in 2 patients each, and elevated GOT X GPT and eosinophilia in 1 patient each. These symptoms and laboratory abnormalities disappeared on the day after the completion of therapy with CFIX. From the above results it has been concluded that CFIX is a useful and safe antibiotic for treating various bacterial infections in children.

Topics: Adolescent; Bacteria; Bacterial Infections; Capsules; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Kinetics; Male; Respiratory Tract Infections; Species Specificity; Urinary Tract Infections

Fundamental and clinical studies were carried out on cefixime (CFIX) 5% granules, and the results are summarized below. Antimicrobial activity Antimicrobial activities of CFIX, cefaclor, cefroxadine, cephalexin and amoxicillin (AMPC) were studied against clinical isolates. CFIX showed greater activities than all the other antibiotics against E. coli, K. pneumoniae, H. influenzae, P. mirabilis, E. cloacae and S. marcescens, but it was slightly less active than AMPC against S. pyogenes. Absorption and excretion Serum concentrations and urinary excretions of CFIX were determined following single or repeated oral administration. In 8 patients given single dose of CFIX 1.5 or 3.0 mg/kg, mean serum concentrations were 1.27 and 1.09 micrograms/ml at 2 hours, 1.27 and 1.35 micrograms/ml at 4 hours, 0.85 and 1.10 micrograms/ml at 6 hours, 0.17 and 0.24 micrograms/ml 12 hours after administration, respectively. Mean serum half-lives were 2.54 hours for the dose of 1.5 mg/kg and 2.60 hours for 3.0 mg/kg. Urinary recovery rates in the 12-hours urine varied 6.7 to 33.6%, with an average of 13.5%. In 3 patients given a repeated dose of CFIX 3.0 or 5.6 mg/kg b.i.d., the serum concentrations were 0.23-1.01 micrograms/ml at 0 hour, 1.91-2.80 micrograms/ml at 2-4 hours and 1.13-2.07 micrograms/ml at 6-8 hours after administration. Clinical study The CFIX was given orally by mainly b.i.d. at a daily dose of 4.4-11.6 mg/kg for 4-15 days to a total of 33 patients consisting of 3 patients with pneumonia, 3 with bronchitis, 9 with tonsillitis, 15 with UTI, one each with scarlet fever, lymphadenitis and colitis. Clinical responses were excellent in 24 patients, good in 8 and fair in 1, with an effectiveness rate of 97.0%. All of the 21 bacterial isolates examined were eradicated after CFIX treatments including 3 beta-lactamase producing strains. No side effects of abnormal laboratory findings were observed in these patients.

Topics: Administration, Oral; Bacteria; Bacterial Infections; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Intestinal Absorption; Kinetics; Male; Respiratory Tract Infections; Species Specificity; Urinary Tract Infections

Bacteriological, pharmacokinetic, and clinical studies of cefixime (CFIX), a newly developed oral cephalosporin, was conducted in our pediatric department as outlined below. Bacteriology The prevalent MICs of CFIX by microbiological species, compared with those of the reference drugs, were detailed below. Against 16 strains of S. aureus, the MICs averaged 6.25 micrograms/ml, and were found to be nearly the same as the MICs of amoxicillin (AMPC) but higher than those of cephalexin (CEX) and cefaclor (CCL). For 4 strains of S. pyogenes, the MICs averaged 0.05 microgram/ml, and were higher than the MICs of AMPC but lower than those of CEX and CCL. Mean MICs of CFIX against other clinical isolates were lower than those of CEX, CCL, or AMPC; E. coli (20 strains), 3.13 micrograms/ml; K. pneumoniae (9), 0.10 microgram/ml; P. mirabilis (16), 0.025 microgram/ml; P. vulgaris (5), 0.10 microgram/ml; H. influenzae (11), 0.05 microgram/ml; and S. typhimurium (4), 0.10 microgram/ml. The MICs of CFIX against 10 strains of P. aeruginosa were distributed at and above 25 micrograms/ml, a range much lower than greater than or equal to 100 micrograms/ml for CEX, CCL, or AMPC. Pharmacokinetics The serum concentrations and urinary recovery were studied in 3 children ranging from age 7 to 13. They were given CFIX on empty stomach in 2 different single doses of 3 and 6 mg/kg in a cross-over design. Average serum CFIX concentrations were dose-dependent, as evidenced by the respective peak concentrations of 1.70 microgram/ml for a 3 mg/kg dosage and 2.72 micrograms/ml for 6 mg/kg, which were attained 4 hours after the administration of the drug. The average half-lives of CFIX in the serum were 3.09 hours and 3.11 hours, respectively, and the 12-hour serum concentrations were 0.32 microgram/ml and 0.77 microgram/ml, respectively, for the 2 different dose levels. The average 12-hour urinary recovery was 25.2% and 22.3%, respectively. Clinical study Clinical effectiveness, bacteriological effectiveness, and side effects were studied in 27 children with infection including 4 patients with acute pharyngitis, 13 with acute purulent tonsillitis, 5 with acute pneumonia, 3 with urinary tract infection, and 1 each with acute rhinitis and acute bronchitis. One child with acute pneumonia (Mycoplasma pneumonia) was excluded from the study. The therapeutic effectiveness was "excellent" in 21, "good" in 3, "fair" in 1, and "poor" in 1, with an effectiveness rate of 92.3%.(ABSTRACT TRUNCATED AT 4

Topics: Bacteria; Bacterial Infections; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Intestinal Absorption; Kinetics; Male; Respiratory Tract Infections; Species Specificity; Urinary Tract Infections

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

Cefixime (CFIX) was given orally to 25 children with acute bacterial infections including 13 with acute tonsillitis, 1 with acute tonsillitis and cervical lymphadenitis, 1 with acute bronchitis, 5 with bronchopneumonia and 5 with urinary tract infection. Good to excellent clinical response was obtained in 23, and bacteriological response was obtained in 14 of the 16 children who underwent bacteriological tests. Side effects with soft stool or eosinophilia were observed in 1 child each. The flavor and odor of CFIX appeared to be well accepted by children. Our clinical experience has suggested the usefulness of this antibiotic for the treatment of various bacterial pediatric infections.

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

A clinical study of cefixime (CFIX), a new oral cephalosporin, was carried out to evaluate its therapeutic effectiveness on bacterial infections in children. CFIX was orally administered to 13 patients including 6 with upper respiratory tract infection (RTI), 3 with pneumonia, and 1 each with bronchitis, otitis media, skin abscess, and urinary tract infection (UTI). The daily dosage per kg bodyweight ranged from 5.1 to 17.4 mg (average: 8.7 mg), and was given in 2 or 3 divided doses per day for 3 to 10 days (average: 5.8 days). The clinical response was excellent in 4 (30.8%), good in 7 (53.8%) and poor in 2 (15.4%), with an overall efficacy rate of 84.6%. Bacteriological efficacy was good, and 6 of the 8 identified causative organisms were eradicated. Side effects were observed in 3 children, i.e., loose stool in 1 and transient elevations of GOT and GPT in 2. The above results suggest that CFIX is a useful new oral cephalosporin for the treatment of bacterial infections in children.

Topics: Bacteria; Bacterial Infections; Cefixime; Cefotaxime; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Diarrhea; Female; Humans; Infant; Male; Otitis Media; Respiratory Tract Infections; Skin Diseases; Urinary Tract Infections

We have evaluated cefixime (CFIX) fine granules for pharmacokinetics and therapeutic effectiveness in children with infections. The results were summarized as follows. Pharmacokinetic parameters after the oral administration of single doses of 1.5 mg and 6.0 mg per kg body weight in a cross-over design in 1 child were as follows: The peak serum CFIX concentrations were 0.65 microgram/ml at 2 to 3 hours and 3.33 micrograms/ml at 4 hours for the low and the high doses, respectively; the respective biological half-lives were 2.4 hours and 2.5 hours, and urinary recovery was 10.3% at 8 hours and 5.2% at 12 hours, respectively. A clinical study was performed on 19 children with infections, including 7 with bronchitis; 3 each with tonsillitis, UTI, and cervical lymphadenitis; and 1 each with pharyngitis, retroauricular lymphadenitis, and enteritis. Doses ranging from 1.8 to 7.8 mg/kg body weight were given b.i.d. or t.i.d. The period of treatment ranged from 3 to 13 days. The therapeutic response was considered "excellent" in 15 and "good" in 4, with an effectiveness rate of 100%. No side effects were observed. The only abnormal laboratory findings was a slight elevation of GOT and GTP recorded in 1 child. It was concluded that CFIX was a promising drug for the treatment of bacterial infections in children.

Topics: Administration, Oral; Bacterial Infections; Cefixime; Cefotaxime; Child; Child, Preschool; Female; Half-Life; Humans; Infant; Intestinal Absorption; Kidney; Kinetics; Male; Respiratory Tract Infections; 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

Following a brief review of the main bacteriological and pharmacokinetic properties of ceftriaxone, the authors present a therapeutic evaluation of this new cephalosporin antibiotic. The effects of ceftriaxone in severe infections, such as septicaemia, bacterial meningitis, urinary tract infections, typhoid, bone infections and sexually transmitted diseases, are described on the basis of recent publications. Mention is also made of the adverse reactions to, and benign side-effects of the drug. Finally, the advantages of ceftriaxone in the treatment of some infections are envisaged: the single daily dose and short therapeutic courses may modify therapeutic habits and exert a beneficial effect on costs in some cases.

Topics: Bacterial Infections; Cefotaxime; Ceftriaxone; Humans; Meningitis; Respiratory Tract Infections; Sepsis; Sexually Transmitted Diseases; Typhoid Fever; Urinary Tract Infections

Ceftizoxime (CZX) was used for 33 patients with respiratory tract infections; 22 patients with pneumonia, 3 patients with pulmonary abscess, 4 patients with diffuse panbronchiolitis and 4 patients with acute exacerbation of bronchiectasia. Clinical effects of CZX were evaluated in 33 patients; excellent in 16 and good in 14 patients. The efficacy rate was 91%. Bacteriological effects of CZX were prominent in 7 patients infected with S. pneumoniae, H. influenzae, K. pneumoniae and Citrobacter, but not in a patient infected with P. aeruginosa. The elimination rate was 92% (12/13). As the side effects, exanthema in 1 patient and gastrointestinal symptoms (nausea and vomiting) in 1 patient were observed. However, they improved without any treatment by cessation of CZX use. Abnormal laboratory findings were observed in 2 patients with elevated GOT and/or GPT. They normalized after cessation of drug. The usefulness of CZX was 82% (27/33). Therefore, CZX is a very useful drug and its effects are promising in clinical management of respiratory tract infections.

Topics: Adult; Aged; Cefotaxime; Ceftizoxime; Drug Evaluation; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Respiratory Tract Infections

In 11 patients with respiratory tract infections, the concentrations of cefmenoxime (CMX) in serum and sputum after 1 hour intravenous administration of 2 g of CMX were investigated. The peak serum level of CMX was 102.2 +/- 11.4 micrograms/ml after 1 hour drip infusion, then declined and was 3.51 +/- 0.55 micrograms/ml after 5 hours. Sputum level of CMX was lower than serum level but it was able to cover enough for MIC of Haemophilus influenzae, Klebsiella pneumoniae, Escherichia coli, Streptococcus pneumoniae and the peak sputum level of CMX was 0.77 +/- 0.17 micrograms/g after from 2 hours to 4 hours. Among the 11 patients with respiratory tract infections, 2 patients showed excellent, 6 patients good, 3 patients poor results (isolated organisms of sputum were normal flora) and no side effects observed.

Topics: Adult; Aged; Cefmenoxime; Cefotaxime; Drug Evaluation; Female; Humans; Male; Middle Aged; Respiratory Tract Infections; Sputum

Cefotiam, a new cephalosporin, was evaluated in the treatment of lower respiratory tract infections in 29 patients. The bacteria isolated from the sputum of these patients included Streptococcus pneumoniae (31%), Klebsiella pneumoniae (31%), and Haemophilus influenzae (28%). Satisfactory response was observed in 90% of the patients. There were three treatment failures, two superinfections, and four colonizations with gram-negative organisms resistant to the drug. Superficial phlebitis was noted in two patients. The results of this study suggest that cefotiam is an effective and well-tolerated antibiotic for the treatment of lower respiratory tract infections due to susceptible organisms.

Topics: Adult; Aged; Cefotaxime; Cefotiam; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

This paper deals with fundamental and clinical results, in the field of pediatrics, of the newly developed rectal suppository (CZX-S) of a cephem antibiotic ceftizoxime (CZX). CZX-S was well absorbed in children. The mean peak serum concentrations of CZX in the 125 mg-administered group (average: 9.9 mg/kg) and the 250 mg-administered group (average: 13.4 mg/kg) were 5.10-7.71 micrograms/ml at 15-30 minutes after dosing. Serum concentrations of CZX were measurable level in almost all the children at 6 hours after administration with the half-lives were 1.34-1.55 hours. The 6-hour urinary excretion rate accounted for 16.5-22.0%. CZX-S was administered to 30 children with acute upper or lower respiratory tract infections about 20-60 mg/kg/day in 3-4 divided portions. CZX-S provided favorable therapeutic-effect in most of the children 3-5 days after administration. The effectiveness rate was 93%. The causative organisms of H. influenzae (3 cases) and S. aureus (4 cases) isolated clinically from pharyngeal mucous and sputum were eradicated after administration of CZX-S. Anal pain and diarrhea experienced in 5 of the 30 children and CZX-S was withdrawn in 4 (of the 5) children, but exhibited satisfactory therapeutic-effect in 2 of the 4 cases up to withdrawal of the drug. An increase in GOT and GPT was observed in 3 cases. The values returned to the normal range in 1 case after the treatment with CZX-S. The test was not reexamined in the other 2 cases. The present clinical result suggests the usefulness of CZX-S substituted for oral and injectable forms in the treatment of various pediatric infections caused by organisms sensitive to CZX.

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

A fundamental and clinical study of ceftizoxime (CZX) suppositories was performed in pre-school and school-age children. The average time courses of CZX serum and urinary concentrations after administration of CZX suppository 250 mg (i.e. per kg body weight doses of 8.3-10.9 mg) to 4 school-age children were as follows. Serum concentrations: 6.1 micrograms/ml at 15 minutes, 6.3 micrograms/ml at 30 minutes, 3.8 micrograms/ml at 1 hour, 1.7 microgram/ml at 2 hours, 0.5 microgram/ml at 4 hours and 0.2 microgram/ml at 6 hours with a biological half-life of 1.43 hours. Urinary concentrations: 885 micrograms/ml for 0-2 hours, 209 micrograms/ml for 2-4 hours and 112 micrograms/ml for 4-6 hours with an average 6-hour urinary recovery rate of 25.6%. The clinical and biological effectiveness and adverse reactions were studied in 11 infants and school-age children afflicted with various infections (acute purulent tonsillitis, 1; acute bronchitis, 3; acute pneumonia, 4; and UTI, 3). The clinical responsiveness was "excellent" in 8, "good" in 2, and "failure" was recorded in 1, with an overall efficacy of 90.9% inclusive of "excellent" and "good". The microbiological effectiveness of CZX suppositories on presumed pathogenic organisms comprising 4 strains of H. influenzae, 1 strain of H. parainfluenzae, and 3 strains of E. coli was satisfactory, as evidenced by the substantially high eradication rate of 87.5%. The only organism that survived CZX suppository treatment was 1 strain of H. influenzae which however was greatly decreased. The only side effect was diarrhea in 1 patient, which however did not necessitate withdrawal of the drug. The only laboratory test abnormality was GOT and GPT elevation in 1 patient which was normalized within 8 days. In conclusion, CZX suppositories were found to be efficacious and safe for treatment of bacterial infections in children.

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

In experimental infections in mice, the therapeutic efficacies of rectal administration of ceftizoxime (CZX) were compared with those of subcutaneous administration. The efficacies of rectal administration were equivalent to those of subcutaneous administration against intraperitoneal infections due to Streptococcus pneumoniae and Escherichia coli. Against Staphylococcus aureus, Streptococcus pyogenes, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Morganella morganii and Serratia marcescens, the efficacies of rectal administration were inferior to those of subcutaneous administration. Against urinary tract and respiratory tract infections, the efficacies of rectal administration were slightly inferior to those of subcutaneous administration. Serum concentrations of CZX for rectal administration were less than those of subcutaneous administration.

Topics: Animals; Cefotaxime; Ceftizoxime; Drug Evaluation, Preclinical; Female; Injections, Subcutaneous; Male; Mice; Peritonitis; Respiratory Tract Infections; Suppositories; Urinary Tract Infections

A group of 104 neonates with clinical signs of infection sufficient to justify treatment with penicillin plus gentamicin received instead monotherapy with ceftriaxone (50 mg/kg once daily). Bacteriological cultures from 20 babies before treatment yielded significant isolates (9 had bacteraemia). Following treatment, infecting bacteria were eradicated from 15/20 babies. Ten of the 104 babies died; all were examined post mortem. Only one death was attributed to bacterial infection. The remaining babies responded well to treatment. No adverse alteration in biochemical or haematological values was associated with ceftriaxone therapy. The incidence of diarrhoea, blood in the stools, necrotising enterocolitis or anti-coagulation problems was the same as in the babies not receiving ceftriaxone. Pharmacokinetic values were determined on 40 babies. Elimination half life (T1/2 beta) and minimum serum concentration (Cmin.) decreased and clearance increased with increasing postnatal age. Postnatal age was the single most significant factor affecting pharmacokinetics. Ceftriaxone is a safe and effective alternative to conventional therapy for infected neonates. Prolonged therapy is associated with superficial colonisation with inherently resistant bacteria.

Topics: Bacterial Infections; Cefotaxime; Ceftriaxone; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Kinetics; Male; Respiratory Tract Infections; Sepsis

Cefotaxime is an effective antibiotic in lower respiratory tract infection caused by streptococci and staphylococci. There is a limited tendency to superinfections with Pseudomonas aeruginosa (1.5%) and there is a low incidence of side-effects. It is questionable whether there is really an urgent need for cefotaxime in gram-positive lower respiratory tract infections.

Topics: Adult; Aged; Bacterial Infections; Cefotaxime; Gram-Positive Bacteria; Humans; Middle Aged; Respiratory Tract Infections

This paper is a report on our studies on superinfections in respiratory tract infections treated during the years 1981-1984. The isolated strains of Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus faecalis, Streptococcus faecium and glucose non-fermentative gram-negative rods such as Pseudomonas aeruginosa were resistant to third-generation cephem antibiotics. These organisms proved to be widely distributed in hospitals and were frequently isolated from the sputum, excised lung and cardiac blood. The colonization of the sputum by bacteria in respiratory tract infections before, during and after treatment with third-generation cephem antibiotics revealed a tendency for these organisms to appear after treatment. Among the gram-positive cocci, S. faecium was most resistant to these antibiotics, followed by S. faecalis, S. epidermidis and S. aureus in that order. The incidence of resistant isolates in 1984 exceeded that in 1983, suggesting an annual increase in resistant bacteria.

Topics: Cefotaxime; Cephalosporins; Drug Resistance, Microbial; Gram-Positive Bacteria; Humans; Lung; Pneumonia; Respiratory Tract Infections; Sputum

The clinical efficacy and safety of cefotaxime and cefoperazone were evaluated in a comparative study. There were 18 adult males and 11 females. Their underlying disease was pneumonia (10), pleural empyema (2), bronchiectasis (6), bacterial bronchitis (9), lung abscess (2). Bacterial material included sputum, bronchial secretion gained by bronchoscopy or tracheal aspiration, and pleural punctures obtained up to 24 h before treatment. Most patients had Streptococcus pneumoniae or Haemophilus influenzae infections, although two patients in the cefoperazone group had infections caused by Pseudomonas aeruginosa, and another two anaerobic flora. Standard disc diffusion, and agar dilution susceptibilities were performed on all isolates. Patients received either cefoperazone (14) intravenously or intramuscularly in a dose range from 2 to 8 g/day or cefotaxime (15) 1 to 2 g intravenous or intramusculary at dosing intervals of 6 to 8 h (total 3 to 8 g/day), depending on the severity of the disease. Clinical improvement occurred in 14/15 (93%) of patients in the cefotaxime group, and 12/14 (86%) of patients treated with cefoperazone. Two failures in the cefoperazone group were secondary to superinfection (Acinetobacter and Ps. aeruginosa). Bacteriological and symptomatic failure, occurred in one patient with anaerobic lung abscess treated with cefotaxime. The results of this study indicate that cefotaxime is safe and effective in the therapy of acute bacterial lower respiratory tract infections.

Topics: Adult; Aged; Bacteria; Cefoperazone; Cefotaxime; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

The efficacy and safety of ceftizoxime administered twice daily were evaluated in 215 hospitalized patients with documented lower respiratory tract infections. The majority of patients received 1 to 2 gm of ceftizoxime intramuscularly or intravenously every 12 hours; the mean dosage was 2 gm/day, and the mean duration of therapy was 8.9 days. Clinical cure was achieved in 204 (95%) of the 215 patients with lower respiratory tract infection. One hundred and thirty-eight patients were both clinically and bacteriologically evaluable. The clinical response rates, by organism, were: Streptococcus pneumoniae, 100% (50/50); Haemophilus influenzae, 96% (25/26); gram-negative bacilli (Escherichia coli, Proteus mirabilis, Enterobacter sp, Serratia sp, Pseudomonas sp, Klebsiella sp, Citrobacter sp, and Morganella morganii), 86% (32/37); and Staphylococcus aureus, 92% (12/13). In the other 77 patients with clinical symptoms, no pathogen was isolated or insufficient follow-up data were collected to assess bacteriologic response. Adverse reactions, which were infrequent, were similar to those reported in other US trials of the drug. The findings indicate that ceftizoxime, 1 to 2 gm BID, is effective and safe in the treatment of lower respiratory tract infections in hospitalized patients. This low-dose regimen can significantly reduce the cost of cephalosporin therapy.

Topics: Adolescent; Adult; Aged; Cefotaxime; Ceftizoxime; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Respiratory Tract Infections

Topics: Adult; Aged; Bacterial Infections; Cefotaxime; Cefotiam; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Male; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

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

Clinical studies on ceftriaxone (Ro 13-9904, CTRX) were carried out and the results were as follows: Twelve patients (acute purulent tonsillitis 1, pneumonia 6, urinary tract infection 5) were treated with CTRX, in doses of 21-48 mg/kg divided 2 times per day for 3.5-8 days intravenously. The overall efficacy rate was 100%. No adverse reactions were observed. No abnormal laboratory data were noted.

Topics: Adolescent; Cefotaxime; Ceftriaxone; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Injections, Intravenous; Male; Respiratory Tract Infections; Urinary Tract Infections

Ceftriaxone (Ro 13-9904, CTRX) was evaluated in 20 children with a suspicion of bacterial infections, 18 were shown to be effective (efficacy rate, 90%). The diagnosis included upper respiratory tract infection (3), bronchitis (3), pneumonia (8) and urinary tract infection (6). The etiologic pathogens isolated were S. pneumoniae (1), and enteropathogenic E. coli (6). These strains were eradicated after treatment. No severe adverse reaction was encountered with the CTRX therapy. The data suggest that CTRX is an effective and safe parenteral antibiotic in the treatment of susceptible pediatric bacterial infections.

Topics: Cefotaxime; Ceftriaxone; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

Ceftriaxone CTRX was evaluated about its antibacterial activity against clinical isolates at our department and tried clinically in 10 children of 6 months to 10 years and 6 months of age. The antibacterial activity was equal to cefotaxime or higher while the clinical results were almost satisfactory. Three out of 4 strains were eradicated (75%). As to the adverse reaction, eosinophilia was observed only in 1 case.

Topics: Bacteria; Bacterial Infections; Cefotaxime; Ceftriaxone; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male; Respiratory Tract Infections; Sepsis; Skin Diseases, Infectious; Urinary Tract Infections

Fundamental and clinical evaluation of ceftriaxone (CTRX) was performed in the pediatric field and the following results were obtained. The MIC of CTRX against E. coli isolated from urinary tract infections in children ranged from less than or equal to 0.024 to 0.39 mcg/ml except for 1 strain. CTRX was superior to other 3rd generation cephalosporins such as CPZ and LMOX, showing effectiveness also against ABPC-resistant bacteria. The clinical efficacy and bacteriological efficacy in 6 children consisting of 5 with respiratory tract infections and 1 with urinary tract infection were 83% and 100%, respectively. As to the adverse reaction, diarrhea was observed in 2 cases. The determination of PIVKA-II performed during the therapy with CTRX, which is observed when vitamin K is deficient, showed positiveness in 2 cases out of 6 cases including 1 which the clinical efficacy could not be evaluated. The test of platelet function in 3 cases found no inhibition of agglutination. Twice-daily administration with 20 mg/kg CTRX was considered to be a useful and safe method for treatment of bacterial infections in children, although attention should be taken not to cause vitamin K deficiency as in other 2nd and 3rd generation cephalosporins.

Topics: Cefotaxime; Ceftriaxone; Child; Child, Preschool; Drug Evaluation; Female; Humans; Male; Platelet Aggregation; Respiratory Tract Infections; Urinary Tract Infections; Vitamin K Deficiency

Twenty-eight pediatric patients were treated with ceftriaxone (Ro 13-9904, CTRX) in the doses ranging from 8.75 to 25 mg/kg every 12 hours for 3.5 to 11.5 days, and the clinical efficacy and side effects were evaluated. Among the 21 children with bacterial infections including pneumonia, acute bronchitis, otitis media, tonsillitis and urinary tract infections, the results were excellent in 9, good in 11, and fair in 1 patient. Out of the 28 patients, 2 patients had diarrhea, 3 patients had slightly elevated serum concentrations of transaminases, and 2 patients showed eosinophilia. The serum concentrations of CTRX in 5 children ranged from 50.0 to 93.8 micrograms/ml (mean 75.0 micrograms/ml) at 15 minutes and from 10.2 to 15.6 micrograms/ml (mean 13.4 micrograms/ml at 6 hours after 10 mg/kg intravenous bolus injection of CTRX. The serum half-lives were from 2.61 to 8.30 hours (mean 6.16 hours), and urinary recovery rates were from 43.3 to 58.0% (mean 48.5%) during 0-6 hours and from 52.0 to 66.1% (mean 59.4%) during 0-12 hours. After 20 mg/kg intravenous bolus injection of CTRX in 4 children, the serum concentrations of CTRX were from 118.8 to 162.5 micrograms/ml (mean 139.1 micrograms/ml) at 15 minutes and from 18.0 to 21.1 micrograms/ml (mean 19.2 micrograms/ml) at 6 hours. The serum half-lives were 4.07 to 6.34 hours (mean 5.13 hours), and urinary recovery rates were 38.6 to 51.1% (mean 45.4%) during 0-6 hours and from 54.8 to 64.0% (mean 59.0%) during 0-12 hours. Patients with impairment of renal function were excluded from this pharmacokinetic study.

Topics: Adolescent; Cefotaxime; Ceftriaxone; Child; Child, Preschool; Drug Evaluation; Female; Half-Life; Humans; Infant; Kinetics; Male; Respiratory Tract Infections; Urinary Tract Infections

Clinical evaluation of cefmenoxime (CMX, Bestcall) was examined in the infection associated with hematological disorders, respiratory tract and other disorders. Clinical effectiveness for severe infection of hematological disorders was 47.4% in good and 84.2% in fair response, however, in the respiratory tract infections, 89.7% in good response was obtained. Opportunistic infection due to Gram-negative bacilli are often experienced in patients with hematological disorders. It was discussed that CMX would be a good therapeutic agent against infectious diseases associated with hematological disorders because it's antibacterial spectrum would be parallel to pathogens of such disorders.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefmenoxime; Cefotaxime; Female; Hematologic Diseases; Humans; Infusions, Parenteral; Injections, Intravenous; Male; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

19 patients received an intravenous 5-min bolus injection of 2 g ceftriaxone at various times before thoracic surgery. Lung tissue concentrations of 31.8 micrograms/g could be maintained for at least 5 h. Serum and lung tissue concentrations of ceftriaxone are high enough to inhibit most organisms causing nosocomial and community-acquired respiratory tract infections.

Topics: Cefotaxime; Ceftriaxone; Cross Infection; Humans; Injections, Intravenous; Lung; Middle Aged; Premedication; Respiratory Tract Infections; Thoracic Surgery

Topics: Bacteroides; Cefotaxime; Ceftriaxone; Digestive System Surgical Procedures; Escherichia coli; Female; Humans; Male; Respiratory Tract Infections; Staphylococcus aureus; Surgical Wound Infection

We evaluated the efficacy and safety of ceftriaxone in 50 adults with serious infections, usually giving 1 g every 12 h. Of the 35 patients who could be evaluated for clinical efficacy, 15 had failed on previous therapy, 15 had nosocomial infections, and all but 1 had underlying diseases. One patient had three sites of infection. Favorable responses were seen in 34 of 37 infections, including 11 of 13 respiratory tract infections, all 7 urinary tract infections, all 12 skin and soft tissue infections, 1 of 2 bone and joint infections, a catheter-related septicemia, a liver abscess, and an otitis media and externa. Favorable bacteriological responses were seen for 48 of 58 organisms. This included 6 of 7 Staphylococcus aureus strains, 14 of 16 other aerobic gram-positive cocci, 18 of 20 Enterobacteriaceae, 6 of 9 Pseudomonas aeruginosa, and 1 of 2 anaerobes. Peak plasma ceftriaxone levels on day 1 were 152 micrograms/ml by bioassay and 78 micrograms/ml by high-pressure liquid chromatography. Four of the 31 initial isolates of aerobic gram-negative rods developed resistance to ceftriaxone on disk diffusion testing. Diarrhea occurred in 3 of 50 patients. All three had received a higher than usual dose. Drug administration was stopped twice, once for a thrombocytopenia and once for a thrombocytopenia with leukopenia. Neither problem could be attributed exclusively to ceftriaxone. Other adverse reactions were eosinophilia, abdominal pain, inguinal candidiasis, and nonsuppurative phlebitis. Even among debilitated adults, ceftriaxone was safe and effective in a twice daily regimen.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Cefotaxime; Ceftriaxone; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Respiratory Tract Infections; Skin Diseases, Infectious; Urinary Tract Infections

Cefmenoxime is a new syn-methoxyimino cephalosporin antibiotic derived from cefotiam, which has been proved to be a very effective and useful antibiotic for the treatment of respiratory infections. This bacteriological and pharmacokinetic study was therefore performed in order to evaluate the potency of cefmenoxime in the treatment of respiratory infections. The minimum inhibitory concentrations of cefmenoxime against 179 isolates of respiratory pathogens (Streptococcus pneumoniae 53, Haemophilus influenzae 64, Klebsiella pneumoniae 43, Escherichia coli 9, Enterobacter spp. 10) were less than 0.20 micrograms/ml, and 43 (73%) of 60 Pseudomonas aeruginosa were inhibited by 12.5 micrograms/ml. In vitro antibacterial activity of cefmenoxime was superior to 18 other antibiotics, including cefotiam and cefotaxime tested in this study. Pharmacokinetic studies on tissue distribution in rats, serum levels and urinary excretion in 3 healthy volunteers, and penetration into bronchial secretes of 9 patients with respiratory infections, revealed that cefmenoxime has a higher penetration into the lung and bronchial secretes compared with cefotiam and cefotaxime. In 1 patient with chronic bronchiolitis, the concentration of cefmenoxime in the intra-bronchial secrete reached 12.5 micrograms/ml. From these results, it is concluded that cefmenoxime is a highly potent and useful antibiotic, and may be more effective in the treatment of respiratory infections than many other cephalosporins, including cefazolin, cefotiam and cefotaxime.

Topics: Animals; Anti-Bacterial Agents; Bacteria; Cefmenoxime; Cefotaxime; Cefotiam; Humans; Kinetics; Microbial Sensitivity Tests; Pneumonia; Rats; Respiratory Tract Infections; Sputum; Tissue Distribution

Topics: Adult; Aged; Bacterial Infections; Bronchi; Cefotaxime; Drug Evaluation; Female; Humans; Kinetics; Lung; Lung Diseases; Male; Middle Aged; Respiratory Tract Infections

Ceftriaxone, a broad spectrum cephalosporin with a markedly extended half-life, was administered to 68 patients with 71 infections in an open trial. Sixty-three infections (89%) had a satisfactory clinical response with eradication of bacteria present at the initiation of therapy in 62 infections (87%). The eight treatment failures correlated well with the development of resistance to ceftriaxone during therapy in Enterobacter and Pseudomonas species (two cases) and with superinfection with Bacteroides fragilis (three cases). Treatment was discontinued in eight patients because of unwanted effects. Serious side effects included leukopenia, rash, fever, and enterocolitis.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefotaxime; Ceftriaxone; Creatinine; Female; Humans; Male; Middle Aged; Osteitis; Respiratory Tract Infections; Skin Diseases, Infectious

Cefotiam (SCE 963), a new, broad-spectrum, third generation cephalosporin was used in the treatment of 136 patients suffering from respiratory tract infections, urinary tract infections, septicemia, meningitis, biliary tract infections and osteoarthritis infections. Cefotiam was administered in monotherapy to 98 patients at the mean posology of two grams per day (extreme doses: 1 to 6 g). The following clinical effectiveness was noted: 83 successes and 18 failures on 101 available clinical reports. The general, biological tolerance and renal tolerance was good in all patients.

Topics: Adolescent; Adult; Age Factors; Aged; Bacterial Infections; Cefotaxime; Cefotiam; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Respiratory Tract Infections; Sepsis; Skin Diseases, Infectious; Urinary Tract Infections

Topics: Anti-Bacterial Agents; Cefotaxime; Cross Infection; Digestive System; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Intensive Care Units; Polymyxins; Respiratory Tract Infections; Sepsis; Tobramycin

Cefotaxime (CTX) was used for 129 cases in respiratory tract and other infections; 57 cases of pneumonia, 20 cases of bronchopneumonia, 20 cases of acute bronchitis, 14 cases of chronic bronchitis, 7 cases of acute exacerbation of bronchiectasia or pulmonary emphysema, 4 cases of suppurative diseases of the lung, 1 case of pyothorax, 1 case of retropharyngeal abscess, 3 cases of pleurisy and 1 case of urinary tract infection. (A case was excepted on clinical evaluation.) CTX was administered by intravenous injection or drip infusion at a daily dose ranging from 0.5 to 8 g, for a term of 2 to 61 days. The total dose patients received ranged from 3 to 226 g. The results obtained were as follows. Clinical effects; excellent in 45 cases, good in 63 cases, fair in 9 cases, poor in 7 cases and unevaluable in 4 cases. The efficacy rate was 87.1% (108/124). Bacteriological effects; eliminated in 30 cases, decreased in 8 cases, unchanged in 2 cases and replaced in 1 case. The elimination rate was 75.6% (31/41). Side effects and abnormal laboratory findings; general itching, fatigue in lower extremities and albuminuria in 1 case each, and anemia in 2 cases. Increased number of eosinophiles and elevated GOT in 1 case each, elevated GOT and GPT in 3 cases and elevated GOT, GPT and A1-P in 2 cases. These symptoms or abnormal laboratory findings disappeared after the discontinuation or termination of CTX therapy. In view of the above, CTX may be considered to be a clinically useful antibiotic against respiratory tract infections.

Topics: Adult; Aged; Cefotaxime; Drug Evaluation; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

Twenty patients suffering from severe infections (9 with respiratory tract infection, 9 with urinary tract infection, 2 with pharyngitis, 1 with enteritis and 4 with fever of unknown origin (FUO] were treated by intravenous infusing CTX 2 g over 30 to 40 minutes 2 or 3 times daily for 4 to 10 days. Other antibiotics were concomitantly used in 9 cases. Response to CTX was proved good in 15 cases (75%), fair in 3 cases and poor in 2 cases. No adverse reactions were observed.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefotaxime; Drug Evaluation; Female; Humans; Infusions, Parenteral; Leukemia; Lymphoma; Male; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

The effect of cefotaxime in treatment of lower respiratory tract infections was evaluated in 23 patients. Because of its high efficacy, low potential for adverse reactions, and convenient dosage, cefotaxime was found to be an effective antibacterial choice in the treatment of this troublesome condition.

Topics: Aged; Bacteria; Bacterial Infections; Blood Chemical Analysis; Cefotaxime; Drug Evaluation; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections; Urine

33 patients with serious gram-negative bacillary infections were treated with cefotaxime. In patients with normal renal function the dose varied between 1.5 to 4 g/day. 17 patients had urinary tract infections, 5 respiratory tract infections, 1 combined urinary tract infection and respiratory tract infection, and 10 miscellaneous infections. 16 patients had septicemia. 25 infections were due to pathogens resistant in vitro to ampicillin, cephalothin, gentamicin and/or tobramycin. 15 infections had failed to respond to ampicillin, cefazolin, gentamicin or tobramycin therapy. 32/33 patients responded favourably to cefotaxime (cure or improvement) but 4 patients developed superinfection with cefotaxime-resistant bacteria. No evidence of nephrotoxicity was observed except for a transient moderate rise in creatinine in one patient.

Topics: Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Cefotaxime; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

Topics: Adult; Aged; Cefotaxime; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

Topics: Animals; Cefotaxime; Cefotiam; Dogs; Female; Humans; Injections, Intramuscular; Kinetics; Maternal-Fetal Exchange; Pregnancy; Rats; Respiratory Tract Infections; Tissue Distribution

The objective of this study was to evaluate the penetration into bronchial secretions, of cefotaxime, a new highly-active cephalosporin. The study was performed in 45 patients with respiratory infections. The doses and the route of administration of the drug were different in 3 groups of patients: 10 patients received 0.750 g and 20 received 1 g intramuscularly; 10 patients received a 30 min IV Infusion of 2 g of cefotaxime. Bronchial samples were taken by means of fiberoptic bronchoscopy, after a single dose in all patients, and, respectively, after 3 and 7 days treatment in 30 and 15 patients. Simultaneous serum samples were collected in order to determine relationship between bronchial and corresponding serum levels. Assays were performed by means of the microbiological agar diffusion technique. In 30 cases bacteriological analysis was performed in order to determine the MICs for cefotaxime of the bacteria isolated in sputum. The results of the study showed a mean bronchial peak reaching about 2 microgram/ml at the 3d h. Individual concentrations were varying according to doses, route of administration and underlying pathology; the ratios between bronchial and corresponding serum levels were about 15 to 23 p. cent as usual for other cephalosporins. This study indicates that cefotaxime realizes significant bronchial amounts superior to MICs of microorganisms responsible for respiratory infections.

Topics: Bronchi; Bronchoscopy; Cefotaxime; Fiber Optic Technology; Humans; Kinetics; Respiratory Tract Infections; Sputum

Cefotiam (CTM) was administered to 52 patients with infectious disease associated with respiratory system, hematological malignancy, urinary system and other system. Good clinical responses were obtained in 38 out of 52 cases (73.1%). Neither objective and subjective side effects nor extreme abnormalities of laboratory tests were observed in these patients. It can be, therefore, concluded that CTM is 1 of the most useful drugs for infectious diseases in respiratory system, hematological malignancy, urinary system and other system.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefotaxime; Cefotiam; Drug Evaluation; Female; Hematologic Diseases; Humans; Male; Middle Aged; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Topics: Anti-Bacterial Agents; Bacterial Infections; Cefamandole; Cefazolin; Cefotaxime; Ceftizoxime; Cephalosporins; Humans; Respiratory Tract Infections; Skin Diseases, Infectious; Tobramycin; Urinary Tract Infections

Clinical studies in the field of pediatrics have been carried out with cefmenoxime (CMX), a new cephalosporin antibiotic and the following results were obtained. 1. CMX was administered intravenously by drip infusion in 23 patients with infectious diseases. These diseases consist of 10 pneumonia, 1 bronchitis, 6 upper respiratory tract infections, 2 acute pyelitis, 3 other urinary tract infections and 1 Douglas abscess. CMX was effective in all cases except 1 case of pneumonia with pyothorax. 2. No side effects have been observed in all cases. As for abnormal laboratory findings, 2 cases of eosinophilia, slight elevations of GOT in 3 cases and GPT in 2 cases were seen.

Topics: Age Factors; Cefmenoxime; Cefotaxime; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Infusions, Parenteral; Male; Respiratory Tract Infections; Urinary Tract Infections

The present study was performed to evaluate the clinical effectiveness and safety of cefmenoxime (CMX), a new cephalosporin antibiotic for injection in the field of pediatrics. Thirty-one cases, including 2 cases with sepsis, 18 cases with respiratory tract infections and 7 cases with urinary tract infections, were given CMX at daily doses of 30 mg/kg to 125 mg/kg divided into 3 or 4 for 3 days to 13 days. Clinical responses were excellent in 16 cases, good in 9 cases and poor in 6 cases, the satisfactory response being 80.6%. No side effects and no abnormal laboratory findings relating to the drug were observed.

Topics: Cefmenoxime; Cefotaxime; Child; Child, Preschool; Female; Humans; Infant; Male; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Topics: Bronchopneumonia; Cefmenoxime; Cefotaxime; Child; Child, Preschool; Female; Half-Life; Humans; Infant; Infusions, Parenteral; Injections, Intravenous; Male; Respiratory Tract Infections; Urinary Tract Infections

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

Cefmenoxime (CMX) was evaluated in 25 children with a suspicion of bacterial infection. Of the 20 confirmed bacterial infections, 19 were cured by CMX therapy (effective rate, 95%). The diagnoses included acute pharyngotonsillitis (4), acute bronchitis (1), pneumonia (7), streptococcal dacryocystitis (1), infections accompanied with acute leukemia (4), and acute urinary tract infections (3). The etiologic pathogens were beta-hemolytic Streptococcus group A (1), and F (1), Staphylococcus aureus (4), Haemophilus influenzae (4), Escherichia coli (4), Klebsiella pneumoniae (2), etc. CMX was very effective for 2 children with respiratory infections due to ampicillin resistant H. influenzae type b. The half life of serum concentration of CMX was 0.76 +/- 0.17 hour after an intravenous bolus injection. A cerebrospinal fluid level of CMX was 5.2 mcg/ml 1 hour after intravenous injection of 1 g (23.8 mg/kg) in a child with inflamed meninges. However this level was not as high as those of cefotaxime, latamoxef, or ceftizoxime measured in the same case. No severe adverse reaction was encountered with CMX therapy. The data suggest that CMX is a safe and effective parenteral antibiotic when used in children with susceptible bacterial infections.

Topics: Adolescent; Bacterial Infections; Cefmenoxime; Cefotaxime; Child; Child, Preschool; Female; Half-Life; Humans; Infant; Leukemia, Lymphoid; Male; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Topics: Cefmenoxime; Cefotaxime; Child; Child, Preschool; Drug Resistance, Microbial; Escherichia coli; Female; Humans; Infant; Male; Pseudomonas aeruginosa; Respiratory Tract Infections; Staphylococcus aureus; Streptococcus pyogenes; Urinary Tract Infections

Basic and clinical studies were made on cefmenoxime (CMX) in pediatric field, and the following results were obtained. 1. The antibacterial activity of CMX against clinically isolated and maintained strains was examined. CMX had stronger antibacterial activity than CEZ against Escherichia coli, Salmonella, Klebsiella pneumoniae, Proteus mirabilis, Serratia marcescens and Pseudomonas aeruginosa, but CEZ had stronger antibacterial activity against Staphylococcus aureus. 2. The blood concentrations of CMX, 0.5, 1, 2, 4 and 6 hours after a one-shot intravenous injection of 20 mg/kg of CMX were 33.6, 15.1, 4.5, 2.5 and 0.6 mcg/ml, respectively, with the half-life of 1.04 hours. 3. The blood concentrations of CMX, 0.5, 1, 2, 4 and 6 hours after a 1-hour intravenous drip infusion of 20 mg/kg of CMX were 32.0, 55.2, 8.4, 4.2 and 1.0 mcg/ml, respectively, with the half-lite of 0.96 hour. 4. A complete or partial clinical response to therapy with CMX was obtained in all 10 children with infectious diseases. 5. Bacteriological examination made on 3 patients showed that all bacteria had been eradicated, and that therapy was effective. The bacteria were E. coli in 2 patients and Proteus mirabilis in 1 patient. 6. The side effects produced were neutropenia, eosinophilia and skin eruption in 1 patient, and diarrhea in 1 patient.

Topics: Adolescent; Cefmenoxime; Cefotaxime; Child; Child, Preschool; Drug Resistance, Microbial; Escherichia coli; Female; Humans; Infant; Klebsiella pneumoniae; Male; Pseudomonas aeruginosa; Respiratory Tract Infections; Salmonella; Serratia marcescens; Staphylococcus aureus; Urinary Tract Infections

Topics: Absorption; Alanine Transaminase; Aspartate Aminotransferases; Cefmenoxime; Cefotaxime; Child; Child, Preschool; Drug Resistance, Microbial; Escherichia coli; Female; Haemophilus influenzae; Humans; Infant; Infusions, Parenteral; Male; Respiratory Tract Infections; Staphylococcus aureus

The antimicrobial activity of cefmenoxime (CMX) against clinical isolated organisms was measured; CMX was more active than cefotiam and cefazolin against Escherichia coli and Haemophilus influenzae. The serum concentrations of CMX following intravenous injection of 20 mg/kg were 25.6, 10.3, 3.0 micrograms/ml at 30, 60, 120 minutes after injection, respectively. CMX was excreted 60.9% in urine within 6 hours after injection. CMX was administered clinically to 22 pediatric patients with various infections (respiratory tract infection 16 including 1 pyothorax, urinary tract infection 4, tonsillitis with sinusitis 2) at the dose of 39 approximately 96 mg/kg/day for 4 approximately 9 days, and the following satisfactory results were obtained; excellent in 11, good in 9, and poor in 2. The rate of satisfactory clinical response was 90.9%. Eosinophilia 2 cases, slight elevation of transaminase 3 cases, slight elevation of BUN 1 case and transient diarrhea 1 case were observed. But no other serious side effects were observed.

Topics: Cefmenoxime; Cefotaxime; Child; Child, Preschool; Drug Resistance, Microbial; Enterococcus faecalis; Female; Haemophilus influenzae; Humans; Infant; Male; Respiratory Tract Infections; Staphylococcus; Staphylococcus aureus; Streptococcus pneumoniae

Topics: Adolescent; Cefmenoxime; Cefotaxime; Child; Child, Preschool; Drug Resistance, Microbial; Humans; Klebsiella pneumoniae; Proteus mirabilis; Proteus vulgaris; Pseudomonas aeruginosa; Respiratory Tract Infections; Staphylococcus aureus

Cefotaxime was given to 26 patients with serious infections resistant to other antibiotics. 15 patients were suffering from septicaemia due to Gram-negative bacilli, which were caused either by a single organism (13 cases:" of which Serratia in 6, Klebsiella in 3) or by several organisms (2 cases); 7 had upper urinary tract infections (caused by Serratia in 4 patients), and 6 had miscellaneous infections (two of these were purulent post-operative meningitis). The pathogens were usually resistant to ampicillin and cephalothin. Cefotaxime was administered at a daily dose of 3 g in 22 patients, irrespective of the renal function, and of 6 g in 4 patients (2 meningitis). Treatment included an aminoglycoside in 12 cases. The efficacy of cefotaxime was very satisfactory in 23 of the 26 patients.

Topics: Adult; Aged; Cefotaxime; Cephalosporins; Drug Resistance, Microbial; Enterobacteriaceae Infections; Female; Humans; Male; Meningitis; Middle Aged; Pseudomonas Infections; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Our investigation of cefotiam in pediatric infection produced the following results: 1. Cefotiam was administered intravenously by one shot or drip infusion in 20 patients with infectious diseases. These diseases consisted of 13 pneumonia, 3 upper respiratory tract infections, 3 pyelonephritis, 2 other urinary tract infections and one purulent meningitis. Cefotiam was effective in all cases. 2. Transient elevation in serum GOT, GPT, Al-P and LDH was observed in 3 cases. But other side effect was not noted in any cases.

Topics: Age Factors; Anti-Bacterial Agents; Cefotaxime; Cefotiam; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Infusions, Parenteral; Injections, Intravenous; Male; Meningitis; Respiratory Tract Infections; Urinary Tract Infections

Topics: Bronchi; Cefotaxime; Cephalosporins; Humans; Kinetics; Respiratory Tract Infections; Saliva

Topics: Cefotaxime; Cephalosporins; Humans; Respiratory Tract Infections; Trachea

Topics: Bronchial Diseases; Cefotaxime; Cephalosporins; Female; Humans; Lung Diseases; Male; Pleural Effusion; Respiratory Tract Infections; Sputum

Topics: Bacterial Infections; Cefotaxime; Cephalosporins; Drug Resistance, Microbial; Female; Humans; Male; Meningitis; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Topics: Adolescent; Adult; Age Factors; Aged; Bacterial Infections; Cefotaxime; Cephalosporins; Child; Child, Preschool; Female; Gonorrhea; Humans; Infant; Infant, Newborn; Male; Meningitis; Middle Aged; Respiratory Tract Infections; Sepsis; Sex Factors

Topics: Adolescent; Adult; Aged; Cefazolin; Cefotaxime; Cephalosporins; Drug Evaluation; Female; Humans; Male; Middle Aged; Respiratory Tract Infections