cefoxitin and Multiple-Myeloma

Topics: Adult; Amikacin; Anti-Bacterial Agents; Bacteremia; Catheterization, Central Venous; Catheters, Indwelling; Cefoxitin; Device Removal; Female; Humans; Leukemia; Lymphoma; Male; Middle Aged; Multiple Myeloma; Mycobacterium; Mycobacterium Infections; Retrospective Studies

Mycobacterium fortuitum is an uncommon, but well-recognized, pathogen in immunocompromised hosts, with special predilection for bone and soft tissue infections in solid organ transplant recipients. We describe a case of osteomyelitis due to this pathogen in a peripheral blood stem cell transplant recipient.

Topics: Administration, Oral; Adult; Amikacin; Anti-Bacterial Agents; Anti-Infective Agents; Biopsy; Cefoxitin; Cephamycins; Ciprofloxacin; Debridement; Hematopoietic Stem Cell Transplantation; Humans; Magnetic Resonance Imaging; Male; Microbial Sensitivity Tests; Multiple Myeloma; Mycobacterium fortuitum; Osteomyelitis; Tibia

Ten inpatients at the Second Department of Internal Medicine, Mie University Hospital, developed infections in the course of treatment for hematopoietic disorders and were administered cefoxitin (CFX). Patients suffered from the following infections: pharyngitis, 2; bronchitis, 2; pneumonia, 2; sepsis, 2; bacteremia, 1; suspected cases of bacteremia, 2; and fever of unknown origin, 1. The number of infections totaled 12 as 1 patient with pharyngitis also developed sepsis and 1 patient with pneumonia developed bacteremia. Duration for the administration of CFX ranged between 5 and 18 days with a total dosage of between 30 and 108 g. Of the 10 patients treated with CFX, 9 were treated concomitantly with micronomicin (MCR), doxycycline (DOXY), or sulbenicillin (SBPC), some were treated concomitantly with only 1 of the drugs and some were treated concomitantly with 2 of the drugs. The following clinical results were obtained: Following treatment, 4 patients were considered "excellent", 5, "good", and 3, "poor". Clinical efficacy rate was 75%. Four strains of Gram-positive cocci (1 strain of S. aureus, 2 strains of S. epidermidis and 1 strain of Streptococcus sp.) and 3 strains of Gram-negative rods (2 strains of P. aeruginosa and 1 strain of E. cloacae) were found in the clinical specimens of the 10 patients. These results differed somewhat from reported data that Gram-negative rods such as E. coli, Klebsiella sp., Pseudomonas sp., Serratia sp., are dominant. No serious side effects requiring cessation of treatment were observed. Elevations in the levels of S-GOT, S-GPT, serum alkaline phosphatase, blood urea nitrogen, etc. were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefoxitin; Drug Evaluation; Female; Humans; Leukemia; Lymphoma; Male; Middle Aged; Multiple Myeloma

Cefoxitin (CFX) was administered to 12 patients for evaluation of clinical effects of CFX against secondary infections complicated with hematopoietic malignancies, and the following results were obtained. 1. The clinical effects were excellent in 1 and good in 8 out or 11 cases with efficacy rate of 81.8%. Out of 12 cases treated with CFX, 1 case was excluded from clinical evaluation because of prophylactic use. It is noted that all cases with pyelitis showed good response to CFX. 2. The serum levels of CFX were determined in 1 patient with renal failure. After intravenous drip infusion of 2 g in 200 ml of glucose solution, the serum concentrations were 67.2 micrograms/ml and 7.53 micrograms/ml at 14 hours and 24 hours (after hemodialysis), respectively. 3. No side effects attributed to CFX were observed. These results indicate that CFX is an effective and safe antibiotic for the treatment of severe infections accompanying hematopoietic malignancies.

Topics: Adult; Bacterial Infections; Cefoxitin; Drug Evaluation; Female; Humans; Leukemia; Lymphoma; Male; Middle Aged; Multiple Myeloma