cefoxitin and Acute-Disease

International studies could already prove a correlation between alexithymia and expressive suppression. This relationship has only been marginally considered in the German literature so far. The prioritized aim of the present study was to investigate a correlative and factorial relationship between alexithymia and expressive suppression.. A total of 317 persons participated in an online survey. Data on alexithymia and expressive suppression were collected using the German versions of the Toronto alexithymia scale (TAS-26) and the emotion regulation questionnaire (ERQ).. The results indicate that the TAS-26 scales in the components "difficulty in identifying feelings" and "difficulty in describing feelings" and the ERQ scale "suppression" in the component of "expressive suppression" have a common construct, which is referred to with the term speechlessness.. The online version contains supplementary material available at 10.1186/s40623-021-01518-w.. Even though the present study confirmed expected differences in complications and morbidity, it suggested that oncoplastic surgery is oncologically safe. Patients undergoing NSM/SSM should be followed closely to allow early detection and treatment of frequently associated complications and ensure timely start of adjuvant therapy.

Topics: Acacia; Acute Disease; Adaptive Immunity; Adolescent; Adult; Aged; Aged, 80 and over; Animals; Animals, Newborn; Anti-Bacterial Agents; Antibodies, Monoclonal; Antigens, Tumor-Associated, Carbohydrate; Biofilms; Biomarkers; Child; Child, Preschool; CRISPR-Cas Systems; Cytokines; Escherichia coli; Female; Gene Expression Profiling; Gene Knockout Techniques; Humans; Hypercalcemia; Hyperoxia; I-kappa B Kinase; Immunity, Cellular; Infant; Infant, Newborn; Inflammation; Interleukin-1 Receptor-Like 1 Protein; Interleukin-13; Kidney; Macrophage Activation; Macrophages; Male; Membrane Transport Modulators; Mice; Mice, Inbred BALB C; Microbial Sensitivity Tests; Middle Aged; Mutation; NF-kappa B p50 Subunit; Oxidative Stress; Pancreatitis; Phenotype; Plant Bark; Plant Extracts; Plant Stems; RNA-Seq; Severity of Illness Index; Sodium-Phosphate Cotransporter Proteins, Type IIa; Sodium-Phosphate Cotransporter Proteins, Type IIc; Staphylococcus aureus; THP-1 Cells; Toll-Like Receptors; Transcription Factor RelA; Transcriptome; Vitamin D3 24-Hydroxylase; Young Adult

A statistical analysis of 58 reports involving 101 clinical trials and over 4,000 patients revealed that there was no statistically significant difference in the cure rates between single-agent and combination therapy. Also, there was no difference in the cure rates between antibiotic regimens that cover Chlamydia trachomatis and those that do not. However, there was a difference in cure rates when regimens with good antianaerobe activity were compared to those with poor coverage of anaerobes. There was a statistically significantly higher cure rate when "newer" regimens (mainly the second and third generations of cephalosporins and newer penicillins) were compared to "older" regimens (mainly penicillin and tetracycline). In 91 comparisons there were no statistically significant differences between regimens with a > 90% cure rate. Optimum therapy is discussed in terms of the cure rate, coverage of known pathogens and antibiotic toxicity. The original and revised recommendations of the Centers for Disease Control for the treatment of acute pelvic inflammatory disease are also reviewed.

Topics: Acute Disease; Anti-Bacterial Agents; Aztreonam; Cefotetan; Cefoxitin; Chlamydia Infections; Chlamydia trachomatis; Clindamycin; Drug Evaluation; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Gentamicins; Humans; Pelvic Inflammatory Disease; Tetracycline Resistance

Trovafloxacin, a broad-spectrum fourth-generation quinolone with gram-positive and gram-negative aerobic and anaerobic bacterial activity, is available in oral and intravenous formulations. The objective of this prospective, multicenter, double-blind, randomized study was to compare the efficacy of trovafloxacin with that of cefoxitin, an approved drug for treatment of acute gynecologic infections, together with amoxicillin/clavulanic acid as oral follow-on treatment.. Patients with a clinical diagnosis of acute pelvic infection received either intravenous alatrofloxacin with oral trovafloxacin follow-on (trovafloxacin) or a combined regimen of cefoxitin followed by amoxicillin/clavulanic acid for a maximum of 14 days. The primary endpoint was clinical response to therapy on follow-up at day 30.. Clinical success rates were comparable between the trovafloxacin (n = 107) and comparative (n = 119) groups at study end (90% vs. 86%, respectively; 95% confidence interval, -4.5, 12.5). Among clinically evaluable patients, clinical success rates for infections involving Enterococcus species were higher with trovafloxacin than with the comparative regimen at the end of treatment (96% and 85%) and at study end (96% and 86%).. Intravenous alatrofloxacin followed by oral trovafloxacin for a maximum of 14 days of total therapy was efficacious in the treatment of acute pelvic infections.

Topics: Acute Disease; Adolescent; Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents; Cefoxitin; Cephamycins; Clavulanic Acid; Double-Blind Method; Enterococcus; Female; Fluoroquinolones; Humans; Middle Aged; Naphthyridines; Pelvic Inflammatory Disease; Penicillins; Prospective Studies; Treatment Outcome

Acute appendicitis is the most common acute surgical disease in childhood and it still presents frequent septic complications. This prospective and randomized study compares the efficacy of two cephalosporins (cefoxitin and ceftizoxime) in terms of clinical response, in vitro activity and characteristics of use in clinical practice.. Of the 288 children with acute appendicitis admitted over a period of 15 months, 148 received cefoxitin (100 mg/kg/24 h; Group I) and 140 ceftizoxime (100 mg/kg/24 h; Group II) RESULTS: No significant differences were seen between these two groups in clinical response or infectious complication rates. In addition, activities of both antimicrobial agents against pathogens recovered from the peritoneal cultures of all patients were similar. The overall most common isolates were E. coli (75.5%), bacteroides species (33.7%) and Pseudomonas (32.4%).. We conclude that ceftizoxime is as effective as cefoxitin and can be surely employed in the treatment of acute appendicitis in children. Its addition, its longer half-life simplifies its use in clinical practice.

Topics: Acute Disease; Adolescent; Appendicitis; Bacterial Infections; Cefoxitin; Ceftizoxime; Cephalosporins; Cephamycins; Child; Child, Preschool; Female; Humans; Infant; Male; Postoperative Complications; Prospective Studies

A prospective, double-blind study was performed to examine the effects of prophylactic cefotetan and cefoxitin in postoperative wound infection for patients with nonperforated acute appendicitis.. One hundred thirty-six of 179 patients with a clinical diagnosis of appendicitis were evaluated and divided into three groups: group 1 received 2 g cefotetan preoperatively, group 2 received 2 g cefoxitin preoperatively, and group 3 received 2 g cefoxitin preoperatively followed by three postoperative doses.. The overall wound infection rate was 4.6 percent. Group 2 (single-dose cefoxitin) had a significantly higher wound infection rate (11.1 percent) than group 1 (single-dose cefotetan) (zero percent) or group 3 (multiple-dose cefoxitin) (1.9 percent).. Single-dose cefotetan and multiple-dose cefoxitin are equally effective. However, because of the greater convenience and markedly decreased cost, single-dose cefotetan is the prophylaxis of choice in appendectomy for nonperforated appendicitis.

Topics: Acute Disease; Adult; Appendectomy; Appendicitis; Cefotetan; Cefoxitin; Double-Blind Method; Female; Humans; Male; Premedication; Prospective Studies; Surgical Wound Infection

This six-center, prospective, open-label clinical trial compared the efficacy and safety of three regimens recommended by the Centers for Disease Control and Prevention (CDC) for the treatment of women hospitalized for acute pelvic inflammatory disease (PID). The study focused on the response to inpatient therapy, not on long-term prevention of sequelae. A severity score was used for objective comparison of the degree of illness before and after therapy. Women were randomly assigned (in a 1:1:1 ratio) to treatment with cefoxitin plus doxycycline, clindamycin plus gentamicin, or cefotetan plus doxycycline. Two hundred seventy-five (94.2%) of 292 evaluable women required no alteration in therapeutic regimen. The three regimens produced almost identical cure rates. No serious adverse clinical or laboratory events were observed. In short, the three regimens recommended by the CDC for inpatient therapy of acute PID were similarly effective and safe.

Topics: Acute Disease; Adolescent; Adult; Cefotetan; Cefoxitin; Centers for Disease Control and Prevention, U.S.; Clindamycin; Doxycycline; Drug Therapy, Combination; Female; Gentamicins; Hospitalization; Humans; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Prospective Studies; Severity of Illness Index; United States

A randomized prospective study of antibiotic prophylaxis using a single dose of either cefoxitin or piperacillin is presented. The trial was carried out in Al Ain Hospital in the period 1989-1992 on 250 adult patients with non-perforated appendicitis. One group (124 patients) received 2 g cefoxitin, the other group (126 patients) 2 g piperacillin. Antibiotics were administered intravenously in the operating theatre immediately before surgery. Wound infection occurred in three patients, 2.4% of the cefoxitin group and in five patients (4%) of the second group (with no significant difference). The commonest infecting organisms were Escherichia coli (5 out of 8). Mean hospital stay for patients with wound infection was 15 days (range 12-21) compared with 6 days, (range 4-8) for non-infected cases. Prophylactic cefoxitin or piperacillin were each therefore similarly effective in minimizing the rate of wound infections in patients with non-perforated appendicitis.

Topics: Acute Disease; Adolescent; Adult; Appendectomy; Appendicitis; Cefoxitin; Combined Modality Therapy; Female; Humans; Infusions, Intravenous; Length of Stay; Male; Middle Aged; Piperacillin; Premedication; Prospective Studies; Surgical Wound Infection

The clinical efficacy and safety of clindamycin-gentamicin versus doxycycline-cefoxitin in the treatment of acute pelvic inflammatory disease was evaluated in a comparative, randomized, prospective, multicenter study. Ten investigators enrolled 170 patients. Those judged to be eligible for efficacy were 60/88 (68%) who received the clindamycin-gentamicin regimen and 55/82 (67%) of those treated with cefoxitin-doxycycline. A successful clinical outcome was attained for 52/60 (87%) and 46/55 (84%) for patients treated with clindamycin-gentamicin and cefoxitin-doxycycline, respectively, a difference that was not statistically significant. In the clindamycin-gentamicin series, 8/8 (100%) of patients with positive C. trachomatis culture at baseline were culture negative at the late follow-up 21-35 days after treatment. For those given cefoxitin-doxycycline, 9/11 (82%) who had C. trachomatis at pretreatment showed eradication at follow-up. Neisseria gonorrhoeae was present at baseline in 8/60 (13%) of the clindamycin-gentamicin patients and in 9/55 (16%) of those treated with cefoxitin-doxycycline. Of those who had appropriate follow-up cultures performed, 6 in the clindamycin-gentamicin group and 8 in the cefoxitin-doxycycline series, all showed eradication of the organism. It is concluded that clindamycin-gentamicin and cefoxitin-doxycycline have similar clinical cure rates for acute pelvic inflammatory disease, and based on this limited experience, it is suggested that the clindamycin-gentamicin combination will satisfactorily eradicate Chlamydia trachomatis and Neisseria gonorrhoeae when either or both of these pathogens are present.

Topics: Acute Disease; Adolescent; Adult; Cefoxitin; Clindamycin; Doxycycline; Drug Therapy, Combination; Female; Gentamicins; Humans; Middle Aged; Pelvic Inflammatory Disease; Prospective Studies

Ampicillin-sulbactam (750 mg) given orally twice daily for 10 days was evaluated for the treatment of acute pelvic inflammatory disease (PID) in an ambulatory setting in Nairobi, Kenya. The first 26 women received ampicillin-sulbactam in an open-label fashion, and the remaining 75 women were randomly selected to receive either ampicillin-sulbactam (n = 38) or cefoxitin (2 g) intramuscularly and probenecid (1 g) orally, followed by doxycycline (100 mg) orally twice daily for 10 days (n = 37). Women were enrolled in a sexually transmitted disease clinic and were followed for clinical and microbiologic responses at 1 to 2 weeks and 4 to 6 weeks posttreatment. Women had a later follow-up visit to note interim pregnancy or underwent hysterosalpingography for fertility outcome assessment. The short-term clinical response rates were 70% for ampicillin-sulbactam and 72% for cefoxitin-doxycycline (P = 0.47). Among Chlamydia trachomatis-infected women treated with ampicillin-sulbactam, three had microbiologic relapse. The post-PID tubal obstruction rates were similar in the two groups: 18% for ampicillin-sulbactam and 33% for cefoxitin-doxycycline (P = 0.31). Neither regimen was highly effective as a therapy for acute PID. These data strongly argue that primary prevention must be the goal for a reduction of PID morbidity and show that improved therapy for the treatment of PID in the ambulatory setting is needed.

Topics: Acute Disease; Adult; Ambulatory Care; Ampicillin; Cefoxitin; Doxycycline; Drug Therapy, Combination; Fallopian Tubes; Female; Fertility; Follow-Up Studies; Humans; Hysterosalpingography; Pelvic Inflammatory Disease; Sulbactam

The object of this randomized study was to compare the safety and efficacy of oral ofloxacin, 400 mg twice daily for 10 days, versus intramuscular cefoxitin, 2 gm, plus oral probenecid, 1 gm, followed by oral doxycycline, 100 mg twice daily for 10 days, in the outpatient treatment of uncomplicated acute salpingitis. Thirty-eight women (53%) had Neisseria gonorrhoeae from their pretreatment endocervical or endometrial cultures, and 18 had Chlamydia trachomatis (25%). Thirty-five of 37 women (95%) treated with the ofloxacin regimen were clinically cured, and 34 of 35 (97%) were cured with the cefoxitin-doxycycline regimen (p = 0.52). One clinical failure occurred in each group with N. gonorrhoeae infection, and one failure occurred in the ofloxacin group because of side effects. The bacteriologic response for N. gonorrhoeae in both groups was 100%. The eradication of C. trachomatis was 100% (10/10) for the cefoxitin/doxycycline group and 86% (6/7) for ofloxacin. The side effects were similar in both groups of subjects. In this study both regimens were effective for the outpatient treatment of uncomplicated acute salpingitis.

Topics: Acute Disease; Adult; Ambulatory Care; Cefoxitin; Chi-Square Distribution; Chlamydia Infections; Chlamydia trachomatis; Doxycycline; Drug Therapy, Combination; Female; Gonorrhea; Humans; Ofloxacin; Probenecid; Salpingitis

In this prospective trial, 130 hospitalized patients with acute pelvic inflammatory disease based on clinical criteria were randomly treated with intravenous gentamicin plus clindamycin (N = 63) or cefoxitin plus doxycycline (N = 67) for at least 4 days, followed by oral clindamycin or doxycycline, respectively, for a total of 14 days. Pre-treatment cultures were obtained for endocervical Neisseria gonorrhoeae and Chlamydia trachomatis, and for endometrial C trachomatis and aerobic and anaerobic bacteria. Overall, 46 subjects (35%) had endocervical cultures positive for N gonorrhoeae. Endocervical and endometrial cultures were positive for C trachomatis in 16 and 6%, respectively. Ninety-five percent of patients had at least one aerobic bacterium, 38% had at least one anaerobic bacterium, and only 2% had no organisms isolated from their endometrium. Fifty-seven subjects taking gentamicin-clindamycin (90.5%) and 64 subjects taking cefoxitin-doxycycline (95.5%) were clinically cured, a nonsignificant difference. Three subjects treated with gentamicin-clindamycin and one treated with cefoxitin-doxycycline required hysterectomy or salpingectomy for cure. Follow-up examinations and cultures were performed in 84% of the subjects. Post-treatment cultures for N gonorrhoeae were negative in all cases tested. Post-treatment endocervical and endometrial C trachomatis cultures were negative in ten of 11 subjects treated with gentamicin-clindamycin and in eight of nine treated with cefoxitin-doxycycline, a nonsignificant difference. We conclude that gentamicin-clindamycin and cefoxitin-doxycycline have similar clinical cure rates for acute pelvic inflammatory disease and are equivalent in eradicating genital N gonorrhoeae and C trachomatis.

Topics: Acute Disease; Adult; Bacteria; Cefoxitin; Cervix Uteri; Clindamycin; Doxycycline; Drug Therapy, Combination; Endometrium; Female; Gentamicins; Humans; Pelvic Inflammatory Disease; Prospective Studies; Randomized Controlled Trials as Topic

A total of 54 women with acute salpingitis were treated intravenously with ampicillin/sulbactam or cefoxitin in a prospective, randomized, ongoing study. Of the organisms isolated, Gram-negative species (excluding Neisseria gonorrhoeae) were considerably more likely to produce beta-lactamase than were Gram-positive species. Clinical efficacy was 94% for 2 g ampicillin plus 1 g sulbactam and 89% for 2 g cefoxitin, all given intravenously every 6 h. The addition of sulbactam, an irreversible beta-lactamase inhibitor, to ampicillin restored both the microbiological and clinical activities of ampicillin. Both regimens were equally safe and demonstrated good efficacy in the treatment of the acute, symptomatic phase of infection.

Topics: Acute Disease; Adult; Ampicillin; beta-Lactamase Inhibitors; beta-Lactamases; Cefoxitin; Drug Therapy, Combination; Female; Humans; Injections, Intravenous; Pelvic Inflammatory Disease; Prospective Studies; Remission Induction; Sulbactam

In a prospective, block-randomized, multicenter study, the safety and efficacy of cefoxitin in preoperative prophylaxis were studied. 1735 patients undergoing appendectomy were evaluable, and half of these patients received 2 g of cefoxitin before undergoing operation. The patients were divided into three groups: patients with a normal appendix, patients with an acutely inflamed appendix, and patients with a gangrenous appendix. The study showed for each group a significant reduction of the incidence of wound infection in patients receiving prophylaxis. However, intra-abdominal abscess formation was not influenced by preoperative antibiotic prophylaxis. Consequently, routine preoperative prophylaxis is recommended before appendectomy.

Topics: Abdomen; Abscess; Acute Disease; Adult; Appendectomy; Appendicitis; Cefoxitin; Denmark; Female; Humans; Male; Multicenter Studies as Topic; Premedication; Prospective Studies; Random Allocation; Surgical Wound Infection

Sixty-two women were randomized in a double-blind fashion to receive one of two antibiotic regimens for the treatment of clinically diagnosed pelvic inflammatory disease. Thirty of 31 patients (96.8%) receiving a combination of cefoxitin with doxycycline and 28 of 31 (90.3%) receiving a combination of clindamycin with amikacin responded to therapy (P = not significant). Chlamydia trachomatis, Neisseria gonorrhoeae, or both were isolated from 13.3, 7.0, and 4.8% of patients, respectively. Of the four patients not responding to therapy, all had inflammatory complexes. Cefoxitin/doxycycline and clindamycin/amikacin are both effective in the treatment of pelvic inflammatory disease.

Topics: Acute Disease; Amikacin; Anti-Bacterial Agents; Cefoxitin; Cervix Uteri; Chlamydia trachomatis; Clindamycin; Clinical Trials as Topic; Double-Blind Method; Doxycycline; Drug Therapy, Combination; Female; Humans; Neisseria gonorrhoeae; Pelvic Inflammatory Disease; Prospective Studies; Random Allocation

Acute pelvic inflammatory disease remains the major medical and economic consequence of sexually transmitted diseases among young women. The polymicrobial origins of pelvic inflammatory disease have been well documented and the major organisms recovered from the upper genital tract in patients with pelvic inflammatory disease include Chlamydia trachomatis, Neisseria gonorrhoeae, and mixed anaerobic and aerobic bacteria. This study was undertaken to compare the efficacy and safety of cefotetan plus doxycycline with that of cefoxitin plus doxycycline in the treatment of hospitalized patients with acute pelvic inflammatory disease. A total of 68 hospitalized patients with acute pelvic inflammatory disease were entered and randomized into two treatment groups: cefotetan (n = 32) and cefoxitin (n = 36). There were six tuboovarian abscesses in each group. C. trachomatis was recovered from 7 (10%) and N. gonorrhoeae from 48 (71%) of the patients. Anaerobic and aerobic bacteria were recovered from the upper genital tract in 53 (78%) of the patients. Cefotetan plus doxycycline and cefoxitin plus doxycycline demonstrated high rates of initial clinical response in the treatment of acute pelvic inflammatory disease. Clinical cure was noted in 30 (94%) of the cefotetan plus doxycycline group and 33 (92%) of the cefoxitin plus doxycycline group. Four failures were sonographically diagnosed tuboovarian abscesses that responded to clindamycin plus gentamicin therapy. The fifth failure was an uncomplicated case that did not respond to cefoxitin and doxycycline and required additional therapy. At 1 week and 3 weeks, respectively, the posttreatment cultures demonstrated eradication, in all instances, of N. gonorrhoeae and C. trachomatis. These regimens also were very effective in eradicating anaerobic and aerobic pathogens from the endometrial cavity. Both regimens were well tolerated by the patients, and few adverse drug affects were noted.

Topics: Acute Disease; Adolescent; Adult; Cefotetan; Cefoxitin; Cephamycins; Chlamydia Infections; Doxycycline; Drug Therapy, Combination; Female; Gonorrhea; Hospitalization; Humans; Pelvic Inflammatory Disease

To more clearly understand the microbiology of acute salpingitis in our patients and to evaluate the clinical efficacy and safety of recommended and new therapeutic regimens, 126 women who met clinical diagnostic criteria for acute community-acquired pelvic inflammatory disease underwent endocervical and endometrial cultures prior to random intravenous therapy with cefoxitin plus doxycycline, ceftizoxime plus doxycycline or ceftizoxime alone (two regimens). Nine women (7%) had Chlamydia, and 70 (56%) had gonococci in endometrial specimens (P less than .001). Only two women (3.4%) given monotherapy required altered medical therapy, and none required surgery. Parenteral combination therapy was associated more frequently with adverse clinical and laboratory events.

Topics: Acute Disease; Adolescent; Adult; Bacteria; Bacterial Infections; Cefoxitin; Ceftizoxime; Doxycycline; Drug Administration Schedule; Drug Therapy, Combination; Endometritis; Female; Humans; Microbial Sensitivity Tests; Prospective Studies; Random Allocation; Salpingitis; Uterine Cervicitis

In this study, 17 women were treated for uncomplicated acute pelvic inflammatory disease requiring hospitalisation for therapy, and 5 women were treated for the same infection complicated by pelvic abscesses. Treatment regimens were sulbactam 1g plus ampicillin 2g (14 women) or cefoxitin 2g (8 women) given by intravenous infusion every 6 hours. On the third day of therapy, a rash developed in 1 woman who was being successfully treated for uncomplicated disease with sulbactam/ampicillin. The other 21 women were cured. No other adverse clinical reactions and no significant abnormal laboratory results were observed with either regimen. Bacteriological efficacy, 98% for sulbactam/ampicillin and 94% for cefoxitin, closely paralleled clinical efficacy. Sulbactam, a suicide-type beta-lactamase inhibitor, appears to have restored and expanded the antibacterial activity of ampicillin.

Topics: Acute Disease; Adolescent; Adult; Ampicillin; Bacteria, Anaerobic; Cefoxitin; Drug Combinations; Female; Humans; Pelvic Inflammatory Disease; Sulbactam

Two hundred eighty-seven women were treated in a multicenter, randomized, comparative study to compare the safety and efficacy of cefotetan every 12 hours with that of cefoxitin every 6 or 8 hours in the treatment of acute obstetric and gynecologic pelvic infections. The most frequent primary diagnoses in both groups were endometritis and pelvic inflammatory disease; 24 of these patients were also bacteremic. The mean duration of treatment was 5.2 and 5.4 days for the cefotetan and cefoxitin groups, respectively, and the total doses administered were 18.1 and 32.1 gm, respectively. The rate of clinical failure for the cefotetan group was 8.5% and 12.2% for the cefoxitin group. Laboratory and clinical adverse reactions were infrequent and none was serious; both antimicrobials were well tolerated. These results suggest the administration of cefotetan provided adequate clinical and bacteriologic effectiveness in the treatment of hospital- and community-acquired, polymicrobial obstetric and gynecologic pelvic infections.

Topics: Acute Disease; Adult; Bacterial Infections; Cefotetan; Cefoxitin; Cephamycins; Clinical Trials as Topic; Cross Infection; Endometritis; Female; Genital Diseases, Female; Humans; Pelvic Inflammatory Disease; Random Allocation

Topics: Acute Disease; Aged; Bacterial Infections; Cefotetan; Cefoxitin; Clinical Trials as Topic; Female; Humans; Male

Sulbactam/ampicillin and cefoxitin were compared in the treatment of 20 patients with acute salpingitis diagnosed during laparoscopy. Results were evaluated during laparoscopic follow-up at 2 months. Sulbactam/ampicillin appeared to be a better treatment, producing better results in tubal patency, adhesions and persistent inflammation than cefoxitin. In addition, the combination of sulbactam/ampicillin with doxycycline appears to provide better results than the combination of cefoxitin with doxycycline in chlamydial salpingitis. It is concluded that sulbactam/ampicillin is an effective treatment for nonchlamydial salpingitis.

Topics: Acute Disease; Adult; Ampicillin; Cefoxitin; Chlamydia Infections; Doxycycline; Drug Therapy, Combination; Female; Fertility; Humans; Penicillanic Acid; Prognosis; Salpingitis; Sulbactam; Tissue Adhesions

Sixty patients with acute uncomplicated pelvic infection were treated with cefoxitin or ampicillin alone, the purpose being to show that a relatively cheap antimicrobial agent (ampicillin) could be used. The groups (30 patients in each) were clinically comparable (P greater than 0,01--Hotelling T-square test). In the first group 2 g ampicillin was administered intravenously on admission followed by 1 g intravenously 4-hourly, and in the second group 2 g cefoxitin was administered intravenously on admission followed by 1 g intravenously every 8 hours. A good response was obtained in both groups. On the basis of cost ampicillin would seem to be the treatment of choice in uncomplicated acute pelvic infection.

Topics: Acute Disease; Adolescent; Adult; Ampicillin; Cefoxitin; Clinical Trials as Topic; Female; Humans; Pelvic Inflammatory Disease; Random Allocation

Single-incision laparoscopic appendectomy (SILA) has a higher rate of wound infection than the multiport technique. The purpose of this project was to determine whether the use of topical antibiotic powder reduces surgical site infections (SSIs) in pediatric patients who undergo SILA.. Patients aged 0-21 years who underwent SILA for acute appendicitis from April 2015 to November 2016 were included in this quality improvement initiative. Cefoxitin powder was placed in the umbilical wound before skin closure. Data were prospectively collected and outcome measures were compared with a historical cohort who underwent SILA before the implementation of antibiotic powder.. There were 108 patients in the historical group (HIST) and 126 in the powder group (POWD). The groups were similar in age (HIST: 11.5 ± 3.6 versus POWD: 12.2 ± 3.7 years, P = .15) and body mass index percentile (HIST: 57.6 ± 30.7 versus POWD: 58.8 ± 27.8, P = .84). Operative time was longer in the powder group (HIST: 26.5 ± 7.5 versus POWD: 29.7 ± 8.9 minutes, P = .004). Length of stay (HIST: 0.2 ± 0.4 versus POWD: 0.1 ± 0.4 days, P = .06), 30-day return to emergency department (HIST: 7% versus POWD: 8%, P = 1.0), and hospital readmissions (HIST: 5% versus POWD: 2%, P = .8) were similar. There was a significantly lower rate of superficial SSIs in the powder group (HIST: 4.6% versus POWD: 0%, P = .02).. In pediatric patients undergoing SILA for acute appendicitis, the use of cefoxitin powder in the umbilical wound is a simple intervention to reduce the incidence of superficial SSIs.

Topics: Acute Disease; Administration, Topical; Adolescent; Anti-Bacterial Agents; Appendectomy; Appendicitis; Cefoxitin; Child; Female; Humans; Laparoscopy; Length of Stay; Male; Operative Time; Patient Readmission; Powders; Surgical Wound Infection; Treatment Outcome; Umbilicus

This study sought to compare the antimicrobial susceptibility rates between acute uncomplicated cystitis patients with failed initial antimicrobial treatment, who were considered unresolved cases, and newly presenting acute uncomplicated cystitis patients without recent antimicrobial use within 3 months and to determine whether different treatment strategies should be applied according to recent antimicrobial exposure (RAE). Female acute uncomplicated cystitis patients with Escherichia coli growth, who visited our hospital's urology department from 2010 to 2014, were divided according to RAE. The antimicrobial susceptibility of E. coli was compared between the group with RAE and the group with no antimicrobial exposure (NAE) within 3 months. The total number of acute uncomplicated cystitis patients with E. coli growth was 259: 40 patients comprised the RAE group and 219 patients formed the NAE group. The mean age was significantly older and previous recurrent cystitis history was higher in the RAE group (p < 0.05). Furthermore, the antimicrobial susceptibility of E. coli to amoxicillin-clavulanic acid, cefotaxime, cefoxitin, ciprofloxacin, and trimethoprim-sulfamethoxazole was significantly lower in the RAE group, with susceptibility results of 64.7%/88.0% (RAE/NAE), 77.5%/89.0%, 79.4%/95.3%, 31.3%/64.2%, and 42.5%/70.6%, respectively. RAE was an independent factor for antimicrobial resistance. This study showed that antimicrobial susceptibilities were significantly lower in acute uncomplicated cystitis patients with failed initial antimicrobial treatment, who are defined as unresolved cases. Our results suggest that first-line antimicrobials might show poor efficacy in cases of unresolved, acute uncomplicated cystitis and alternative or secondary antimicrobials should be considered in these cases.

Topics: Acute Disease; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cefotaxime; Cefoxitin; Ciprofloxacin; Cystitis; Drug Resistance, Multiple, Bacterial; Escherichia coli; Escherichia coli Infections; Female; Humans; Microbial Sensitivity Tests; Middle Aged; Recurrence; Treatment Failure; Trimethoprim, Sulfamethoxazole Drug Combination

Edwardsiella tarda (E. tarda) has recently become recognized as a pathogen in humans. Here we report a new case of E. tarda bacteraemia complicated by acute pancreatitis and pyomyoma. A 46-year-old female came to our emergency room complaining of sudden onset of left upper quadrant pain and vomiting for the previous few hours after drinking three bottles of wine. An abdominal computed tomography (CT) scan revealed multiple biliary stones, acute pancreatitis with extensive inflammatory change, and a large uterine myoma. Fever, watery diarrhoea, and mild suprapubic discomfort with vaginal spotting were noted soon after admission. The patient's blood cultures yielded E. tarda and symptoms subsided after antibiotic therapy. Fever and severe suprapubic pain with rebound tenderness developed 12 days later. Repeat abdominal CT scan revealed an enlarged uterine myoma with central necrosis. The patient subsequently underwent anterior total hysterectomy and bilateral salpingo-oophorectomy, revealing a uterine myoma with infarction and abscess formation. The patient recovered uneventfully and was discharged 1 week later.

Topics: Acute Disease; Amikacin; Anti-Bacterial Agents; Bacteremia; Blood Chemical Analysis; Cefoxitin; Cephamycins; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Humans; Hysterectomy; Middle Aged; Myoma; Ovariectomy; Pancreatitis; Tomography, X-Ray Computed; Uterus

Topics: Acute Disease; Ampicillin; Cefoxitin; Child; Cholecystitis; Female; Humans; Salmonella typhi; Typhoid Fever

This article reviews the rationale for the therapy of acute salpingitis and the conceptual basis for the length of therapy. The key to therapy of acute salpingitis is the need to accommodate polymicrobial etiology, polymicrobial bacterial superinfection, and the potential presence of penicillinase-producing strains of Neisseria gonorrhoeae into a therapeutic equation that has been determined by the appropriate staging of disease. The anticipated therapeutic response identified for monomicrobial disease due to Neisseria gonorrhoeae constitutes the end titration point for drug administration. Duration of continued therapy beyond this point is governed by the need to complete therapy for Chlamydia trachomatis or to assure resolution of advanced disease.

Topics: Acute Disease; Anti-Bacterial Agents; Cefoxitin; Chlamydia Infections; Chlamydia trachomatis; Doxycycline; Drug Therapy, Combination; Female; Gonorrhea; Humans; Metronidazole; Neisseria gonorrhoeae; Penicillinase; Salpingitis; Time Factors

The secretion of cephalothin and cefoxitin in stimulated pure pancreatic juice was studied in 13 persons after intravenous administration of antibiotics. Of all these studied, three had acute relapsing pancreatitis, five chronic pancreatitis, and five were control subjects. Antibiotic levels were measured in paired pure pancreatic juice and serum samples at fixed time intervals after administration. Cephalothin was detected in very low levels (1 to 1.8 micrograms/ml) in the pure pancreatic juice of four of the six persons studied (3 micrograms/ml). Although therapeutic levels were not obtained in stimulated pure pancreatic juice with either antibiotic, additional studies evaluating antibiotic levels in unstimulated pure pancreatic juice and in pancreatic tissue would be helpful in assessing the role of antibiotic therapy in the treatment of pancreatitis.

Topics: Acute Disease; Bacterial Infections; Cefoxitin; Cephalothin; Cholangiopancreatography, Endoscopic Retrograde; Chronic Disease; Humans; Pancreatic Juice; Pancreatitis; Premedication; Secretin

Appendicitis remains one of the commonest paediatric surgical emergencies in a busy paediatric surgical practice. In spite of improved diagnostic skills and surgical care, the incidence of severe appendicitis has remained unaltered in children over the past few decades and therefore remains a therapeutic challenge. A protocol for the treatment of severe appendicitis was instituted in the Division of Paediatric Surgery at the Royal Canberra Hospital by the author from 1981 to 1984 inclusive, and the results of treatment according to the protocol are presented. The results suggest that an aggressive approach to gangrenous and perforated appendicitis can result in very low morbidity from sepsis. The protocol is discussed.

Topics: Acute Disease; Appendectomy; Appendicitis; Cefoxitin; Child; Drug Therapy, Combination; Humans; Metronidazole; Postoperative Care; Premedication; Surgical Wound Infection

One hundred fifty-five patients with 157 febrile episodes were treated with amdinocillin or amdinocillin and cefoxitin as second-line therapy, or amdinocillin and ticarcillin or carbenicillin as initial therapy in three separate studies. Overall responses were 57 percent, 55 percent, and 54 percent for amdinocillin, amdinocillin-cefoxitin, and amdinocillin-ticarcillin or amdinocillin-carbenicillin, respectively. In all three studies, patients with septicemia responded less often than patients with other infections. Most patients were profoundly neutropenic at the initiation of therapy, and both the initial neutrophil level and neutrophil trend during therapy influenced response. A significant number of superinfections occurred when amdinocillin alone was used. Although amdinocillin, alone or in combination with cefoxitin, appeared effective as second-line therapy in infections with organisms shown sensitive in vitro, the combination of amdinocillin and ticarcillin or carbenicillin was only moderately effective in initial therapy for neutropenic, febrile, cancer patients.

Topics: Acute Disease; Adolescent; Adult; Aged; Amdinocillin; Bacterial Infections; Carbenicillin; Cefoxitin; Drug Therapy, Combination; Female; Humans; Leukemia; Leukocyte Count; Male; Middle Aged; Neutrophils; Penicillanic Acid; Penicillins; Sepsis; Ticarcillin

The Gainesville staging of acute salpingitis subdivides the complexity of clinical disease into four major stages. Each stage is predicated upon distinct therapeutic goals and different therapeutic regimens for achieving the principal goal of each stage.. The classical signs of salpingitis are fever, bilateral adnexal tenderness and/or the presence of masses, and signs of an elevated white blood count (WBC) and erythrocite sedimentation rate. These are absent in the majority of women. Acute salpingitis should be suspected in any woman with lower abdominal discomfort and can be verified by needle culdocentesis. Proper staging can be a deciding factor in the patient's cure and future fertility and helps in the selection of antibiotics. The presence or absence of Neisseria gonorrhoeae should be determined first. Some complicating factors during these procedures include: 1) the presence of an IUD when disease within the fallopian tubes tends to be more advanced than can be ascertained from clinical findings, 2) prior inflammatory disease of the fallopian tube, and 3) bilateral tubal ligation. If peritonitis has been inferred by the demonstration of rebound tenderness or by culdocentesis, confirmation can be achieved by ultrasonography or CAT scan of the pelvis. Once the variables have been identified the information can be assessed according to the current classification of acute salpingitis; staging is an attempt to create clinical subjects based upon the fact that each differs in its major therapeutic goal. For acute salpingitis without peritonitis, therapy is with doxycycline. For acute salpingitis with peritonitis, in order to preserve fallopian structure and function, there has to be adequate coverage for principal venereal pathogens, and treatment is a combination of cefoxitin and doxycycline. For acute salpingitis with evidence of tubal occlusion or ruptured tuboovarian complex treatment is with penicillin, clindamycin, and tobramycin. For a case of ruptured tuboovarian complex combinations of antibiotics are used and if these fail surgery is indicated.

Topics: Acute Disease; Anti-Bacterial Agents; Bacterial Infections; Cefoxitin; Chlamydia Infections; Doxycycline; Female; Humans; Peritonitis; Salpingitis

Topics: Acute Disease; Adult; Bronchitis; Bronchopneumonia; Cefoxitin; Female; Humans; Male; Middle Aged

Topics: Acute Disease; Adult; Amikacin; Bacterial Infections; Cefoxitin; Drug Therapy, Combination; Humans; Infusions, Parenteral; Kanamycin; Leukemia; Lincomycin; Middle Aged; Penicillins; Ticarcillin

Topics: Acute Disease; Aged; Cefoxitin; Female; Humans; Leukopenia

Cefoxitin (mefoxin), a new semisynthetic cephamycin antibiotic, resistant to degradation by beta-lactamase enzymes produced by bacteria. In vitro, cefoxitin is active against virtually all clinically important gram-negative facultative bacteria other than Pseudomonas and Enterobacter spp., gram-positive aerobic bacteria other than the enterococcus, and clinically important anaerobic organisms, including Bacteroides fragilis. This broad antibacterial spectrum suggested that cefoxitin might be an effective single antibiotic agent for the treatment of mixed aerobic-anaerobic infections in obstetric and gynecologic patients. In this investigation, the efficacy and safety of cefoxitin was evaluated in 109 patients--68 with salpingitis, 25 with endomyometritis, 9 with pelvic cellulitis, and 7 with pelvic abscesses. An average of 2.5 bacteria were isolated from each patient. Aerobic bacteria alone was isolated in 38% of patients, anaerobic bacteria alone in 25%, and a combination of aerobic and anaerobic bacteria was isolated in 37% of patients. Overall, 100 of 109 (92%) infections responded to treatment with cefoxitin alone. The major cause of treatment failure was the presence of abscesses requiring surgical drainage. In addition to being an effective single agent for the management of pelvic infections, cefoxitin proved to be safe and well tolerated by patients.

Topics: Abscess; Acute Disease; Adolescent; Adult; Aerobiosis; Anaerobiosis; Bacterial Infections; Bacteroides Infections; Cefoxitin; Cellulitis; Cephalosporins; Female; Gonorrhea; Humans; Middle Aged; Pelvis; Salpingitis

1) Cefoxitin (CFX) was administered to seven patients: two with acute pneumonia, two with acute pyelonephritis, one with pyonephrosis complicated to pyelolithotomy, one with acute cystitis and one with CONN syndrome complicated to liver cirrhosis. 2) Response to the CFX treatment was excellent in three patients, good in three, and poor in one. 3) No side effect was observed in all cases. In two patients in whom CFX and furosemide were concomitantly administered, no aggravation of the renal function was observed.

Topics: Acute Disease; Adult; Aged; Cefoxitin; Cephalosporins; Cystitis; Drug Evaluation; Female; Humans; Male; Middle Aged; Nephrosis; Pneumonia; Pyelonephritis

Cefoxitin is a new cephamycin antibiotic that has recently become available for clinical trial. We report here the results of an uncontrolled trial of cefoxitin treatment in 31 hospital patients with various acute infections, 20 of whom were cured. Serum, urine, and bile concentrations of cefoxitin greatly exceeded the minimum inhibitory concentration (MIC) required for clinically important Gram-negative organisms. We conclude that cefoxitin will have a place in the management of serious infections, particularly in the abdominal cavity and renal tracts.

Topics: Acute Disease; Adult; Aged; Cefoxitin; Cephalosporins; Humans; Infections; Middle Aged