cefotaxime and Wounds--Penetrating

Three days following revascularization of a foot injured in a boating accident, Aeromonas hydrophila cellulitis developed in the victim's foot and leg. The infection resolved with debridement and 10 days of cefotaxime therapy. A. hydrophila infection has not previously been reported in a revascularized extremity. Clinical response of an A. hydrophila cellulitis to cefotaxime is likewise undescribed. Our findings of a cefotaxime-sensitive Aeromonas infection and its successful treatment suggests that the organism should undergo further evaluation of cefotaxime sensitivity and that cefotaxime and other third-generation cephalosporins may have a role as broad-spectrum antibiotic agents in fresh-water trauma.

Topics: Adult; Aeromonas; Bacterial Infections; Cefotaxime; Cellulitis; Foot; Foot Injuries; Humans; Male; Skin Transplantation; Veins; Wounds, Penetrating

In this open, prospective, comparative study, 75 patients who sustained penetrating abdominal trauma were randomised to receive 1 of 3 antibiotic regimens preoperatively and for 3 to 5 days postoperatively. Group I received cefotaxime 2g 8-hourly, group II received cefoxitin 2g 6-hourly and group III received clindamycin (900 mg 8-hourly) and gentamicin 3 to 5 mg/kg/day in divided doses 8-hourly. The 3 groups were not statistically different in terms of age, sex, severity of injury, number of organs injured, colon injuries, shock, blood transfusions or positive intra-operative cultures. Septic complications occurred in 8% of patients in group I, in 4% of group II patients and in 8% of group III patients. Cefotaxime was the least costly regimen, followed by cefoxitin, then clindamycin and gentamicin. It may be concluded that single agent therapy with a broad spectrum cephalosporin is preferable to combination therapy on the basis of equivalent effectiveness, less toxicity and lower costs.

Topics: Abdominal Injuries; Bacterial Infections; Cefotaxime; Cefoxitin; Cephalosporins; Clindamycin; Costs and Cost Analysis; Drug Therapy, Combination; Gentamicins; Humans; Prospective Studies; Random Allocation; Wounds, Penetrating

Topics: Abdominal Injuries; Acute Disease; Adult; Ascitic Fluid; Bacterial Infections; Cefotaxime; Ceftizoxime; Female; Humans; Male; Microbial Sensitivity Tests; Peritonitis; Wounds, Penetrating