cefoxitin and Osteomyelitis

Twenty-nine patients who incurred a transperitoneal low-velocity gunshot wound to their spine were evaluated for the occurrence of spinal infectious complications. All patients underwent an exploratory laparotomy to determine the extent of viscera involvement. No attempt was made to debride the involved spinal area, and the bullet was not removed unless it was easily accessible. Of the 21 patients with a parenchymal and/or noncolonic viscous injury, 17 (77%) were treated with intravenous (i.v.) antibiotics for a minimum of 5 days the remainder received treatment for a maximum of 48 h. All 8 patients with colonic injuries received a minimum of > or = 5 days of antibiotic treatment. Follow-up averaged 44.9 months (range 3-144 months). Only 1 (4.7%) patient with either a noncolonic or parenchymal perforation developed an infectious complication (subdiaphragmatic abscess); two patients (25%) with colonic perforations developed a psoas abscess. No patient developed a spinal infection. This study suggests that patients who sustain a transperitoneal low-velocity gunshot wound to their spine do not need to undergo spinal debridement and may be treated with parenteral antibiotics. Any course of broad-spectrum antibiotics for 5 days appears to minimize infectious complications. Bullet removal and missile tract debridement of the spine is not routinely necessary.

Topics: Adolescent; Adult; Antifungal Agents; Cefoxitin; Child; Colon; Discitis; Drug Therapy, Combination; Female; Gentamicins; Humans; Liver Abscess; Male; Meningitis; Middle Aged; Multiple Trauma; Osteomyelitis; Paralysis; Peritoneum; Psoas Abscess; Retrospective Studies; Spinal Cord Injuries; Spinal Injuries; Subphrenic Abscess; Treatment Outcome; Vancomycin; Viscera; Wounds, Gunshot

Topics: Adult; Anaerobiosis; Bacterial Infections; Cefoxitin; Cephalosporins; Clinical Trials as Topic; Female; Humans; Liver Abscess; Lung Abscess; Male; Osteomyelitis

Topics: Arthritis; Bacterial Infections; Cefoxitin; Cephalosporins; Clinical Trials as Topic; Empyema, Tuberculous; Endocarditis, Bacterial; Humans; Lung Abscess; Osteomyelitis; Pneumonia; Sepsis; Urinary Tract Infections

Topics: Adolescent; Adult; Cefoxitin; Cephalosporins; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Osteomyelitis; Staphylococcal Infections; Time Factors

Cefoxitin was administered intravenously to 143 patients, 67% of whom were seriously ill. The rate of cure or improvement was 93%. The study was conducted in two phases; the first was an open, controlled clinical comparison of cefoxitin and cephalothin. In this phase, 28 patients received cefoxitin and 29 received cephalothin. In the second phase, cefoxitin alone was used for the treatment of an additional 115 patients. Twenty bacteremic patients treated with cefoxitin were cured or improved in 95% of cases. The infecting organism was eradicated in all bacteremic patients. All of 14 anaerobic or predominantly anaerobic infections were cured or improved. The infecting anaerobic organism was eliminated in 86% of the cases. Twenty-five patients infected by cephalothin-resistant, cefoxitin-susceptible gram-negative rods were cured. Three patients each with infective endocarditis and osteomyelitis were cured. The incidence of adverse experiences was: 1.4% drug eruption; 2% each asymptomatic serum transaminase elevation and leukopenia; and 2.5% asymptomatic eosinophilia. The incidence of severe thrombophlebitis was 5%. No permanent or serious adverse reactions were encountered. Although the numbers of patients in some categories were too small to permit statistical evaluation, I feel that cefoxitin may be a useful new antibiotic for treatment of infections caused by cehalothin-resistant bacteria and by anaerobic organisms.

Topics: Adult; Bacterial Infections; Cefoxitin; Cephalosporins; Cephalothin; Clinical Trials as Topic; Drug Resistance, Microbial; Endocarditis, Bacterial; Humans; Osteomyelitis; Sepsis

Though prevalent in the environment, nontuberculous mycobacteria (NTM) have been increasingly identified as pathogenic. Sporadic reports of NTM infection of cardiac implantable electronic devices (CIEDs) have appeared but remain rare. This case describes a CIED infection with

Topics: Amikacin; Anti-Bacterial Agents; Anti-Infective Agents; Arrhythmias, Cardiac; Cefoxitin; Clarithromycin; Clofazimine; Drug Resistance, Bacterial; Epidural Abscess; Heroin Dependence; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium abscessus; Mycobacterium Infections, Nontuberculous; Osteomyelitis; Pacemaker, Artificial; Prosthesis-Related Infections

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

An 84-year-old man was admitted to the hospital with a diabetic foot ulcer and osteomyelitis of the calcaneum. While being treated with cefoxitin sodium, he experienced generalized exfoliative dermatitis, which subsided on discontinuation of therapy. To our knowledge, this is the first report of exfoliative dermatitis with a cephalosporin or related drug.

Topics: Aged; Cefoxitin; Dermatitis, Exfoliative; Diabetes Complications; Drug Eruptions; Foot Diseases; Humans; Male; Osteomyelitis; Skin Ulcer

An investigation conducted on healthy volunteers showed that cefoxitin quickly reaches high plasma concentrations, and is almost completely excreted via the urine within 6 hours. In a series of 21 cases treated with 2 g i.v. in 100 ml of a 5% glucose solution two or three times a day, a clinical cure was achieved in 20, and marked improvement in the remaining patient.

Topics: Bacillus subtilis; Bronchitis; Bronchopneumonia; Cefoxitin; Cholangitis; Cystitis; Drug Evaluation; Drug Tolerance; Gas Gangrene; Herpes Zoster; Humans; Kinetics; Osteomyelitis; Sepsis

30 patients were treated with i.v. cefoxitin (4-8 g/day), of which 20 had documented infections which included endocarditis (5), lung abscess (4), empyema (4), liver and subhepatic abscess (3), osteomyelitis (3), and pancreatic abscess (1). 14 patients had infections caused by anaerobic bacteria and 5 had endocarditis due to aerobic organisms. All but 2 patients with osteomyelitis of the mandible were cured. Adverse reactions were noted in 7 patients, mostly due to drug fever and leukocytosis; one had Coombs'-positive hemolytic anemia. The average serum cefoxitin levels were 24, 16, 12, and 4 microgram/ml at 1, 2, 3 and 4 h, respectively, and the average serum/pleural fluid ratio was 1:0.5 +/- 0.25. All anaerobic and aerobic isolates except one strain of Bacteroides fragilis were susceptible to cefoxitin at less than or equal to 32 microgram/ml. The concentration of cefoxitin in the tissues was measured in 8 rabbits; it was 4 +/- 1 microgram/ml in the heart and 2 +/- 0.5 microgram/ml in the femur and mandibular tissue, suggesting that the lack of response in cases of osteomyelitis could be due to inadequate antibiotic concentration in the bone. Our study suggests that cefoxitin can be used in the treatment of anaerobic infections and endocarditis due to susceptible organisms.

Topics: Abscess; Adult; Animals; Bacterial Infections; Bacteriological Techniques; Cefoxitin; Cephalosporins; Drug Evaluation; Empyema; Endocarditis, Bacterial; Female; Humans; Liver Abscess; Lung Abscess; Male; Osteomyelitis; Pancreatitis; Rabbits; Tissue Distribution

Topics: Bacterial Infections; Cefoxitin; Cephalosporins; Humans; Osteomyelitis; Skin Diseases, Infectious