cefoxitin and Peritoneal-Diseases

Topics: Abscess; Ampicillin; Animals; Anti-Bacterial Agents; Bacteroides fragilis; Bacteroides Infections; Cefotetan; Cefoxitin; Cephamycins; Drug Therapy, Combination; Escherichia coli; Escherichia coli Infections; Male; Mice; Mice, Inbred C3H; Microbial Sensitivity Tests; Penicillins; Peritoneal Diseases; Sulbactam

The recovery of Candida albicans along with bacteria from the abdomen in the setting of peritonitis is becoming increasingly common. It is not known whether the interactions between the fungal and bacterial elements of these infections are synergistic, competitive, or neutral. To study this question, we have examined the effects of both the addition of C. albicans to a solely bacterial infection caused by Escherichia coli and Bacteroides fragilis, and the deletion of various components of this system using directed antimicrobial therapy. In a mixed infection, both C. albicans and bacteria contributed to mortality, since only the combination of cefoxitin and amphotericin B improved survival (from 50% to 90%). The addition of C. albicans to the bacterial inoculum increased the recovery of abscesses, but only to the number seen with fungal infection alone, implying two fairly independent processes. Although the number of bacteria recovered from abscesses at 10 days postinfection was unchanged with the addition of fungi, the deletion of the bacterial component of mixed infections led to the overgrowth of C. albicans. We conclude that this model of mixed C. albicans/E. coli/B. fragilis peritonitis is best characterized as two nonsynergistic, parallel infections with incomplete competition, allowing the survival of all three organisms to eventual abscess formation.

Topics: Abscess; Amphotericin B; Animals; Bacteroides fragilis; Bacteroides Infections; Candida albicans; Candidiasis; Cefotetan; Cefoxitin; Clindamycin; Colony Count, Microbial; Drug Combinations; Escherichia coli; Escherichia coli Infections; Male; Mice; Mice, Inbred BALB C; Peritoneal Diseases; Peritonitis; Survival Rate

Strains of Bacteroides fragilis group isolated from peritoneal pus were tested for susceptibility to cefalotin, cefamandole, cefoxitin, clindamycin and metronidazole. Clindamycin and metronidazole were found to display the lowest MIC and MBC values. The median serum level of these antimicrobials was 2-4 times as high as the MIC effective against 100% of strains. The most active cephalosporin was the cephamycin derivative cefoxitin that inhibited 98% of strains at 16 mg/l which corresponds with the usual median serum level achieved at commonly recommended treatment regimens. The MICs of 16 mg/l to cefalotin and cefamandole were found in 9.8% and 3.7% of strains, respectively. These findings are consistent with data reported in the literature. Attention is also centered on the mode of antimicrobial action, principles of bacterial resistance and on factors which are co-responsible for the therapeutic effectiveness of the antimicrobials studied.

Topics: Abscess; Bacteroides; Bacteroides Infections; beta-Lactamases; Cefamandole; Cefoxitin; Cephalosporins; Cephalothin; Clindamycin; Humans; Metronidazole; Peritoneal Diseases

Lethal fecal peritonitis was created in 253 rats. The rats were then randomized to receive injections of saline solution or clindamycin and gentamicin. All rats received a saline solution lavage and were then further divided to receive a lavage with saline solution, gentamicin, clindamycin or cefoxitin. At the end of nine days, all surviving rats were sacrificed and examined for abscesses. All groups receiving clindamycin and gentamicin parenterally as well as those receiving a lavage with gentamicin or cefoxitin had a significantly better survival rate than did the control group. There was no difference in the number of abscesses in any group receiving antibiotics. Therefore, in this study, no benefit was achieved from an antibiotic lavage in rats receiving effective parenteral therapy.

Topics: Abscess; Animals; Cefoxitin; Clindamycin; Feces; Gentamicins; Peritoneal Diseases; Peritonitis; Random Allocation; Rats; Rats, Inbred Strains; Therapeutic Irrigation