cefoxitin and Chronic-Disease

Two prospective studies were undertaken to examine the role of bacteria in the outcome after excision and primary suture for chronic pilonidal sinus disease. In the first study 52 consecutive patients were given cloxacillin as prophylaxis. In a second randomised study 51 patients were given 2 g cefoxitin intravenously (n = 25) or no prophylaxis (n = 26). From 49 out of 98 patients (50%) no microorganisms were isolated from sinuses preoperatively. Wound complications were observed postoperatively in 61% of the patients (63/103). A postoperative bacteriology sample was positive in 47 of 49 samples (96%). Preoperative presence of bacteria was not significantly associated with wound complications. Anaerobe isolates were present in 40% of patients preoperatively whereas aerobes were cultured in 43% postoperatively. After an observation period of 30-42 months, recurrences were 13% among the patients (7/52) who had been given cloxacillin. No recurrences were seen in the last study after an observation period of 18-30 months, for an overall 7% in both studies. We conclude that preoperative bacterial isolates, usually anaerobes, in chronic pilonidal sinuses do not influence the complication rate since bacterial isolates from infected wounds are mostly aerobes.

Topics: Adolescent; Adult; Antibiotic Prophylaxis; Bacteria; Cefoxitin; Child; Chronic Disease; Cloxacillin; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pilonidal Sinus; Postoperative Complications; Prospective Studies; Recurrence; Surgical Wound Infection

Treatment of chronic pilonidal sinus with excision and primary suture is followed by a relatively high proportion of wound infections. The role of preoperative antibiotic prophylaxis in improving results is not clear.. One hundred fifty-three patients with chronic pilonidal sinus were operated on with radical excision and primary suture and randomized to receive a single dose antibiotic prophylaxis of 2 g cefoxitin intravenously (n = 78) or no prophylaxis (n = 75).. The most common complications consisted of partial, slight separation of wound edges with slight discharge. In the group with cefoxitin, 34 patients (44 percent) had complications compared with 32 patients (43 percent) in the group without prophylaxis. Fifty-four patients (69 percent) healed within four weeks in the group with cefoxitin, whereas 48 (64 percent) healed within four weeks in the group without prophylaxis. After a follow-up period of six to 30 months, two patients in each group had not healed. Including these, two patients (3 percent) had recurrences in the group with cefoxitin and five patients (7 percent) in the group without prophylaxis (p = 0.41).. The immediate and short-term results after excision and primary suture for chronic pilonidal sinus are not influenced significantly by a single dose prophylaxis of 2 g cefoxitin.

Topics: Adolescent; Adult; Aged; Cefoxitin; Chronic Disease; Combined Modality Therapy; Female; Humans; Male; Middle Aged; Pilonidal Sinus; Premedication; Surgical Wound Infection; Suture Techniques; Treatment Outcome

Continuous and twice-daily cefoxitin dosing was used in a highly lethal model of acute peritonitis in mice using intraperitoneal (IP) Klebsiella pneumoniae (Kpn). The purpose was to use antibiotics to create a model of chronic infection. Male Balb/c mice (averaging 20 g body weight) were inoculated IP with 10(3) colony-forming units (CFU) Kpn serotype 2. Controls received subcutaneous saline either twice daily or continuously. Antibiotic groups received 300 mg/kg per day of cefoxitin either twice daily or continuously. Survival and daily weight losses were determined. Another group was inoculated with 10(3) Kpn given twice daily saline or cefoxitin and harvested at 24 hours. Leukocyte counts were performed on peritoneal exudate cells (PEC) and peripheral blood. Cultures determined Kpn counts in blood, lung, and PEC. By 24 hours, saline-treated animals had lost more weight than cefoxitin mice (1 g vs. 2 g, P < 0.05). Continuous cefoxitin showed significant advantage with 50 per cent mortality at 5 days. Kpn levels were not significantly altered by cefoxitin. Cefoxitin treatment extended chronicity by preventing weight loss and increasing survival in a highly lethal, monomicrobial peritonitis model. This model will allow future study of specific host defense mechanisms over a prolonged time period.

Topics: Animals; Anti-Bacterial Agents; Ascitic Fluid; Bacteremia; Cefoxitin; Chronic Disease; Colony Count, Microbial; Disease Models, Animal; Injections, Subcutaneous; Klebsiella Infections; Klebsiella pneumoniae; Leukocyte Count; Lung; Male; Mice; Mice, Inbred BALB C; Neutrophils; Peritonitis; Random Allocation; Serotyping; Survival Rate; Weight Loss

The simple mucin-type carbohydrate antigens Tn, sialyl-Tn and T represent the mucin core oligosaccharide structures that are produced in the initial steps of mucin biosynthetic pathway. Utilising monoclonal antibodies anti-Tn antigen, anti-sialyl-Tn antigen and anti-T antigen, we have investigated the expression of the simple mucin-type carbohydrate antigens in 47 biopsy specimens of antral mucosa with chronic active gastritis, 25 of which had Helicobacter pylori infection. The Tn immunoreactivity, localised at the supranuclear region of surface and glandular mucous cells, was observed in all samples, independently from H. pylori status. The sialyl-Tn antigen, mainly localised in the cytoplasm of glandular mucous cells and in goblet cells vacuoles, was seen in 56% of the cases with H. pylori infection and in 41% of the cases in the H. pylori-negative group. In addition, the T antigen was found in the cytoplasm of surface and glandular mucous cells in 16% of the H. pylori-positive group, whereas the percentage of positive cases was reduced to 5% in H. pylori-negative patients, with an exclusive localisation in the cytoplasm of glandular mucous cells; after neuraminidase treatment, the percentage of T antigen-positive cases was increased to 28% in H. pylori-positive cases and to 27% in negative cases. No significant relationships between H. pylori infection and Tn, sialyl-Tn or T antigen immunoexpression were encountered in our cases. Therefore, we maintain that the inflammatory infiltrate may itself play an important role in the expression of simple mucin-type carbohydrate antigens in chronic active antral gastritis.

Topics: Adult; Antibodies, Monoclonal; Antigens, Tumor-Associated, Carbohydrate; Antigens, Viral, Tumor; Biopsy; Chronic Disease; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Immunoenzyme Techniques; Male; Middle Aged; Pyloric Antrum

Topics: Antigens, Tumor-Associated, Carbohydrate; Chronic Disease; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans

The aim of this study was to evaluate the expression of blood group Tn and sialyl-Tn antigens in the pancreas to determine whether they could help to interpret histochemically needle biopsies obtained from the pancreas. Lectin and immunohistochemistry was carried out using the biotin-labeled Vicia villosa agglutinin isolectin B4 and the mouse monoclonal antibody MLS102 to detect the Tn and sialyl-Tn blood-group antigens in the pancreas. All the pancreatic ductal adenocarcinomas (11/11) were positively stained by V. villosa agglutinin and MLS102 monoclonal antibody. None of the normals or chronic pancreatitics bound MLS102 monoclonal antibody. The acini of all the normals and chronic pancreatitics were V. villosa agglutinin positive, which was absent in the normal ductal cells and present only sparingly in the chronic pancreatitis ductal tissues (10/16). Thus, both the Tn and the sialyl-Tn blood-group antigens are present in pancreatic ductal tissues that have undergone malignant transformation. MLS102 is superior to V. villosa agglutinin in distinguishing malignant from normal and nonmalignant pancreatic tissues in needle biopsies.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Antigens, Tumor-Associated, Carbohydrate; Biomarkers, Tumor; Biopsy, Needle; Chronic Disease; Humans; Immunohistochemistry; Lectins; Pancreas; Pancreatic Neoplasms; Pancreatitis; Plant Lectins

Carbohydrate antigens representing some of the initial steps in mucin O-linked glycosylation were examined in specimens of normal pancreas, chronic pancreatitis, and pancreatic adenocarcinoma. Tn antigen, recognized by Vicia villosa lectin, was expressed by all specimens of normal pancreas (acinar cells) and pancreatic cancers and all but one case of chronic pancreatitis. Sialosyl Tn antigen, recognized by monoclonal antibody TKH2, was expressed in a cancer-associated fashion, being completely absent in normal pancreas but expressed by 56% of chronic pancreatitis and 97% of pancreatic cancers. T antigen, recognized by monoclonal antibody AH9-16, was expressed in 68% of normal pancreas (acinar cells), 67% of chronic pancreatitis, and 48% of pancreatic cancer tissues. These results indicate that normal acinar cells of the pancreas are capable of expressing selected carbohydrate structures associated with the initial steps of mucin glycosylation. The marked expression of sialosyl Tn compared with T antigen in pancreatic cancers suggests that with malignant transformation there is selective usage of glycosyltransferase enzymes involved in mucin oligosaccharide synthesis.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Antibodies, Monoclonal; Antigens, Neoplasm; Antigens, Tumor-Associated, Carbohydrate; Biomarkers, Tumor; Chronic Disease; Disaccharides; Humans; Immunoenzyme Techniques; Pancreas; Pancreatic Neoplasms; Pancreatitis

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

1. Serum and sputum concentrations of cefoxitin were measured at fixed intervals following a one hour drip infusion of 2 g to a total of three patients with chronic respiratory tract diseases. The peak levels in serum were found to be 142.1-273.6 microgram/ml at the end of the infusion and those in sputum were found to be 0.92-2.30 microgram/ml at 2 to 4 hours after initiation of the infusion. 2. Cefoxitin was administered to a total of five patients with chronic respiratory tract infections who had failed to respond to the previous treatments with conventional antibiotics. The results were that in one case the therapeutic effect was judged as excellent, in three cases as good, and in one case it was difficult to evaluate. In all cases, there was no significant abnormality indicative of side effects regarding clinical symptoms and laboratory tests of renal and hepatic functions. In a view of the findings stated above, it is considered that cefoxitin is a new antibiotic which can be used for the treatment of chronic respiratory tract infections.

Topics: Aged; Cefoxitin; Chronic Disease; Drug Evaluation; Female; Humans; Kinetics; Male; Middle Aged; Respiratory Tract Infections; Sputum; Time Factors

The therapeutic efficacy of cefoxitin (CFX) in chronic respiratory tract infection was evaluated in patients who poorly responded to other antibiotics. To 20 patients, CFX was administered 2 g b.i.d. intravenously by drip infusion. Clinical efficacy was judged based on the criteria by score. 1. Bacterial elimination rate with CFX was 73.7%. 2. A clinical cure rate was 80.0% was obtained by doctors in charge. 3. According to the score assessment, the overall clinical effectiveness rate was 60.0%, clinical symptom cure rate was 85.0% and improvement rate of X-ray findings was 55.0%. 4. Usefulness rate which was assessed by clinical effect and side effect was 70.0%. 5. No side effects and abnormal laboratory findings were observed in this study. We used the new antibiotic CFX in patients with chronic respiratory tract infections who responded poorly to other antibiotics and obtained satisfactory results. Especially CFX indicated more effective possibility in cases from whom Gram-negative bacilli was isolated.

Topics: Adult; Aged; Bacteria; Cefoxitin; Chronic Disease; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Respiratory Tract Infections

On 24 patients with chronic obstructive bronchitis the Cefuroxim and Cefoxitin concentrations in the sputum were investigated during 11 days after intravenous injections. The concentrations of Cefuroxim were above the minimal concentrations necessary to block growing of bacteria. Cefoxitin showed lower concentrations. Different pharmacokinetics for both of the test substances may be responsible for the different results.

Topics: Adult; Aged; Bronchitis; Cefoxitin; Cephalosporins; Chronic Disease; Female; Humans; Male; Middle Aged; Sputum