cefoxitin and Infections

Care of casualties in the tactical combat environment should include the use of prophylactic antibiotics for all open wounds. Cefoxitin was the antibiotic recommended in the 1996 article "Tactical Combat Casualty Care in Special Operations." The present authors recommend that oral gatifloxacin should be the antibiotic of choice because of its ease of carriage and administration, excellent spectrum of action, and relatively mild side effect profile. For those casualties unable to take oral antibiotics because of unconsciousness, penetrating abdominal trauma, or shock, cefotetan is recommended because of its longer duration of action than cefoxitin.

Topics: Administration, Oral; Adult; Antibiotic Prophylaxis; Cefotetan; Cefoxitin; Clinical Trials as Topic; Humans; Infection Control; Infections; Infusions, Parenteral; Military Medicine; United States; Wounds and Injuries

Prophylactic effect of cefoxitin against postoperative infection at a dose of 2 g intravenous (single dose 30 minutes before the operation) was investigated using fever index in patients who underwent the elective, nonradical abdominal hysterectomy. The results obtained are summarized as follows. Total fever index values were 12.9 +/- 10.0 degree-hours in the control group (n = 39), 11.3 +/- 9.7 degree-hours in the study group (n = 39). There were no statistical significance between both groups. Data from this investigation does not suggest the concept that prophylactic antibiotics are beneficial in the reduction of postoperative infection. The results of this prospective study reflected in unnecessity of antibiotic prophylaxis in abdominal hysterectomy.

Topics: Adult; Cefoxitin; Cystitis; Female; Humans; Hysterectomy; Infection Control; Infections; Middle Aged; Parametritis; Postoperative Complications; Prospective Studies; Random Allocation; Surgical Wound Infection

Prescribing antibiotics for perioperative prophylaxis in common surgical procedures presents an ideal target for educational intervention. In this situation, antibiotics are often used inappropriately, with consequent excess expense and risk of morbidity. We developed an educational intervention aimed at the choice and appropriate dosing of antibiotics for the prophylaxis of cesarean sections. Person-to-person educational messages targeted at authoritative senior department members were supplemented by brief reminders on a structured antibiotic order form. Time-series analyses were conducted on 34 months of antibiotic use data for 2,783 cesarean sections to estimate the trend of magnitude and significance of discontinuities associated with the start of the program. Prior to the intervention, 95% of sections receiving prophylaxis were given cefoxitin and 3% were given cefazolin. After the intervention, these proportions were reversed, with the shift in use occurring immediately after the intervention (p less than .001). Two years after the intervention, virtually all patients undergoing cesarean sections who receive antibiotic prophylaxis are given cefazolin. Savings from this change alone accounted for over $26,000 each year, or $47.36 per patient-day of prophylaxis. Substantial changes in prescribing practices for routine procedures can be accomplished through the implementation of a coordinated educational program that enlists influential senior staff members in a department in which policy-making is highly centralized, coupled with a structured educational ordering system. Lasting improvements in clinical practices may be brought about by means that are noncoercive, inexpensive and well-accepted by medical staff.

Topics: Anti-Bacterial Agents; Cefoxitin; Cesarean Section; Drug Prescriptions; Drug Utilization; General Surgery; Humans; Infection Control; Infections; Medical Staff, Hospital; Premedication

Topics: Adult; Aged; Anti-Bacterial Agents; Cefoxitin; Female; Humans; Infections; Intestinal Neoplasms; Male; Middle Aged; Premedication; Retrospective Studies; Risk

The clinical significance of a concomitant, non-specific influence of antibiotics on immune defence mechanisms was studied by evaluating the death rate in mice experimentally infected with highly resistant or primarily resistant microorganisms. It could be shown that the mortality rate of mice infected with Enterobacter cloacae or Candida albicans significantly increased under treatment with cefoxitin, whereas treatment with cefotaxine or lamoxactam either had no effect, or even resulted in a better survival rate in comparison to controls. These results run parallel to an inhibition (cefoxitin) or stimulation (cefotaxime and lamoxactam) of antibody production. The effect of cefoxitin on the course of experimental infections could be compensated for by the concomitant application of sodium-8-chlorotheophyllinate which promotes antibody formation. None of these antibiotics showed any additional effect in animals treated with cyclophosphamide. From these observations it was concluded that the influence of antibiotics on certain immunological parameters assayed in vitro may be reflected in comparable effects on the course of infections in vivo; this implies that under certain clinical conditions, the immunological side-effects of antibiotics may be of practical therapeutic significance.

Topics: Animals; Anti-Bacterial Agents; Antibody Formation; Candidiasis; Cefotaxime; Cefoxitin; Cephamycins; Cyclophosphamide; Drug Therapy, Combination; Enterobacter; Enterobacteriaceae Infections; Infections; Male; Mice; Mice, Inbred BALB C; Moxalactam; Theophylline

Topics: Adolescent; Adult; Aged; Cefoxitin; Drug Evaluation; Female; Hematologic Diseases; Humans; Infections; Infusions, Parenteral; Male; Middle Aged; Sepsis

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