cefoxitin and Pneumonia

The different patterns of pneumonia are classified and show the various manifestations of the disease, indicating the necessary specific diagnostic procedures. Only by description and recognition of the possible pathogenic agents, an adequate therapy can be initiated as described in the last chapter.

Topics: Aminoglycosides; Amoxicillin; Anti-Bacterial Agents; Antibodies, Bacterial; Antibody Specificity; Biopsy; Cefoxitin; Cephalosporins; Clindamycin; Cross Infection; Erythromycin; Humans; Legionnaires' Disease; Lung; Metronidazole; Penicillin G; Pneumonia; Radiography, Thoracic; Serologic Tests; Sputum; Tetracycline

In a randomized multicenter clinical trial on antibiotic prophylaxis, 1,319 patients in 23 ICUs were enrolled over a 4-month period. The end-point of the study was the prevention of early onset pneumonia (EOP), defined as acquired pneumonia diagnosed within 4 days of ICU admission; this accounted for greater than 50% of overall pneumonia. Patients eligible for the study were divided into three groups which received either cefoxitin (2 g iv for three doses/8 h), penicillin G (2 million U iv for four doses/6 h), or no antibiotic (control group). In the overall population, the incidence of EOP was 6.1% in the prophylaxis recipients vs. 7.2% in the control group (a 15.3% reduction). No statistically different rates of pneumonia or death were found among the groups. Patients with impaired reflexes on admission or prolonged ventilatory support were noted to have a lower incidence of EOP and an improved outcome when treated with cefoxitin.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cefoxitin; Child; Child, Preschool; Clinical Trials as Topic; Cross Infection; Female; Humans; Infant; Intensive Care Units; Male; Middle Aged; Multicenter Studies as Topic; Penicillin G; Pneumonia; Premedication; Random Allocation

Controversy persists regarding the use of antibiotics in association with t tube thoracostomy for trauma patients. We conducted a prospective randomized study of patients requiring tube thoracostomy for pneumo- and/or hemothorax complicating blunt or penetrating thoracic trauma in an attempt to assess the efficacy of prophylactic antibiotic therapy. Fifty-eight patients were included in the study. The control group (Group I) included 28 patients who received no antibiotic therapy: the experimental group (Group II) included 30 patients who received cefoxitin (1.0 gm IV q 6 h) commencing before tube thoracostomy and terminating 12 hours after its removal. The incidence of infectious complications (pneumonia and/or empyema) was recorded. Among the patients not receiving antibiotics, eight of 28 (29%) developed infectious chest complications. Of the patients receiving antibiotics, there was one infectious complication (3%). This difference is statistically significant (p = 0.0227). Cultures demonstrated significant conversion from negative to positive both within each group and between groups. The organism most commonly recovered was S. aureus. Our findings strongly suggest that patients requiring tube thoracostomy for trauma, whether blunt or penetrating, should receive the benefit of systemic prophylactic antibiotic therapy.

Topics: Adolescent; Adult; Cefoxitin; Empyema; Female; Hemothorax; Humans; Intubation; Male; Middle Aged; Pneumonia; Pneumothorax; Premedication; Prospective Studies; Random Allocation; Thoracic Injuries

In this randomized, double-blind study, the effectiveness of a single-agent prophylactic antibiotic in reducing infections after radical abdominal hysterectomy with pelvic and para-aortic lymphadenectomy was compared with a placebo. A total of 12 doses of cefoxitin (2g) or placebo were given to 70 patients, starting the evening before surgery. Because of tumor spread beyond the cervix, radical hysterectomy was not performed in 17 patients who were, therefore, excluded from the study. Analysis of 53 patients who completed the study revealed that 15% of cefoxitin patients had surgical site-related infections compared with 52% of placebo patients (P = .005). Significant differences between the groups were also observed in nonsurgical site-related infections (23 versus 48%), overall morbidity (58 versus 89%), and the need for additional antibiotic therapy (38 versus 67%). Socioeconomic status was a significant risk factor with 57% of staff patients demonstrating increased site-related infections as compared with 17% of private patients (P = .002). No clinically significant side effects were observed. The authors recommend the use of antibiotic prophylaxis in patients undergoing radical abdominal hysterectomy for gynecologic malignancies.

Topics: Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Hysterectomy; Lymph Node Excision; Middle Aged; Pneumonia; Postoperative Complications; Premedication; Random Allocation; Risk; Socioeconomic Factors; Surgical Wound Infection; Urinary Tract Infections

Topics: Adult; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Female; Humans; Mezlocillin; Pelvic Inflammatory Disease; Penicillins; Pneumonia; Skin Diseases, Infectious; Urinary Tract Infections

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; Aged; Cefoxitin; Cephalosporins; Cephalothin; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Pneumonia; Radiography; Suppuration

We report the description of a novel plasmid-encoded AmpC beta-lactamase gene (blaCMY-10) from Enterobacter aerogenes K9911729 that was isolated from a patient suffering from pneumonia in South Korea.. Using antibiotic susceptibility testing, plasmid analysis, transconjugation and Southern blot analysis, the cefoxitin resistance phenotype reflects the presence of a large plasmid [pYMG-1 (130 kb)] in Ent. aerogenes K9911729. One beta-lactamase with the pI of 8.0 from transconjugant of Ent. aerogenes K9911729 was identified by isoelectric focusing on a gel. A 1475 bp DNA fragment containing the blaCMY-10 gene, identified on pYMG-1 of Ent. aerogenes K9911729, was sequenced and an open reading frame coding for 382 amino acid, CMY-10, was found. The 37 class C beta-lactamases were subclassified into 1a to 1j and CMY-10 into 1a by phylogenetic analysis. A sequence identical to the common regions in In6, In7 and a novel integron from pSAL-1 was found upstream from blaCMY-10 gene at nucleotide 1-71.. These results clearly show that blaCMY-10 gene belongs to the group of ampC-related bla genes. Homology analysis among AmpC enzymes or ampC genes implied that integration of the chromosomal ampC gene into a large resident plasmid, followed by transconjugation, was involved in the evolution of blaCMY-10 gene.. The first identification of the blaCMY-10 gene is of concern as chromosomal beta-lactamases may cause serious therapeutic problems if their genes are translocated onto plasmids.

Topics: Base Sequence; beta-Lactamases; Blotting, Southern; Cefoxitin; Conjugation, Genetic; Drug Resistance, Bacterial; Enterobacter aerogenes; Humans; Isoelectric Focusing; Phylogeny; Plasmids; Pneumonia; Polymerase Chain Reaction

A patient with acute myelomonocytic leukemia who experienced a spontaneous remission, is reported. He had precedent and concurrent bacterial infections as most of these cases described. Low peripheral WBC and myeloblasts, Auer-rod positive blasts, bone marrow eosinophilia with atypical eosinophils, and a partial deletion of chromosome 16 were favorable prognostic parameters. A brief review of the literature and possible explanations for the regulation of granulopoiesis are presented.

Topics: Adult; Cefoxitin; Drug Therapy, Combination; Humans; Leukemia, Myeloid, Acute; Male; Pneumonia; Remission, Spontaneous; Tobramycin

Several antimicrobial agents were evaluated for activity against experimental Legionella micdadei pneumonia in guinea pigs. Erythromycin, rifampin, doxycycline, and sulfamethoxazole-trimethoprim produced significant reductions in mortality. Penicillin, cefazolin, cefoxitin, chloramphenicol, and gentamicin were not efficacious even though, at the doses administered, the peak concentrations of these agents in serum substantially exceeded their MICs for the test strain. It is suggested that the poor performance of the latter group of agents resulted from poor penetration into cells in which L. micdadei was multiplying.

Topics: Animals; Anti-Bacterial Agents; Bacterial Infections; Cefazolin; Cefoxitin; Chloramphenicol; Doxycycline; Drug Combinations; Erythromycin; Gentamicins; Guinea Pigs; Kinetics; Legionella; Male; Penicillin G; Pneumonia; Rifampin; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

An experimental Klebsiella pneumoniae pneumonia in rats was used to study the effect of protein binding of cefoxitin and cefazolin on their therapeutic activity. Both cephalosporins were similar with respect to their antimicrobial activity against the K. pneumoniae in vitro, but they differed in their degree of protein binding, being 34% for cefoxitin and 89 to 93% for cefazolin in uninfected rats and 24 and 71 to 83%, respectively, in infected rats. Various doses of these agents were administered by continuous infusion, which started 5 h after bacterial inoculation and continued for 65 h. Antimicrobial response was evaluated with respect to the numbers of bacteria recovered from lung and blood at the end of treatment. An inhibitory effect of protein binding on the in vivo antimicrobial activity was demonstrated. Cefoxitin was therapeutically effective at a constant plasma level that reached the MIC. To obtain a similar effect with cefazolin the plasma level of that drug had to be increased to a concentration more than three times the MIC.

Topics: Animals; Blood Proteins; Cefazolin; Cefoxitin; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Pneumonia; Protein Binding; Rats; Time Factors

This clinical trial was designed to evaluate the efficacy, safety and patient tolerance of cefoxitin (CFS) in 46 patients who were admitted to the hospitals from June 1983 to April 1984. The daily doses of CFX for 34 patients (ages ranged from 6 to 75 years old) were 2 to 8 g to prevent the infections and for 12 patients (ages ranged from 55 to 81 years old) were 2 to 6 g to treat the infections by intravenous drip infusion 1 or 3 times a day in divided doses. The following results were obtained. All of 34 patients with intracranial operation who received CFX for prevention of postoperative infections showed good results. Of 12 patients with postoperative pneumonia, infections of urinary tract and late meningitis, 11 patients showed good results. One patient was discontinued on the 3 days because of the drug eruption which improved 3 days after. The side effect was noted in only 1 patient. This was eruption which improved 3 days after the stop of the administration. The influences to the laboratory data due to CFX were not recognized. The results of this study demonstrated that CFX was an excellent drug for the prevention and treatment of the postoperative infections in the neurosurgical field because of high efficacy rate and safety.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Brain Diseases; Cefoxitin; Child; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Pneumonia; Postoperative Complications; Premedication; Urinary Tract Infections

The efficacy of cefoxitin, mezlocillin, latamoxef and metronidazole in anaerobic lung infection was studied using a rabbit model. A mixture of Bacteroides fragilis, Peptococcus morbillorum, Eubacterium lentum and Fusobacterium nucleatum was inoculated transtracheally to produce infection within the lung. Mezlocillin was most effective, achieving bacteriologic cure in 5 out of 8 animals. With cefoxitin therapy, 4 out of 8 became bacteriologically sterile. Severe diarrhea with elevated titers of Clostridium difficile toxin was noted in most cefoxitin-treated animals. Latamoxef- and metronidazole-treated animals had apparently healed lesions, but cultures were positive in 6 and 7 out of 8 in each group, respectively. The commonest pathogen isolated in the last two groups was P. morbillorum. The therapeutic superiority of mezlocillin over metronidazole and latamoxef was statistically significant (p less than or equal to 0.05).

Topics: Animals; Anti-Bacterial Agents; Bacteria, Anaerobic; Bacteroides fragilis; Bacteroides Infections; Cefoxitin; Eubacterium; Fusobacterium Infections; Male; Metronidazole; Mezlocillin; Microbial Sensitivity Tests; Moxalactam; Peptococcus; Pneumonia; Rabbits

Topics: Adult; Aged; Cefoxitin; Dose-Response Relationship, Drug; Drug Evaluation; Female; Humans; Male; Middle Aged; Pneumonia; Respiratory Tract Infections

Ten patients with sepsis and pneumonia complicated by leukemia or lung cancer were treated with cefoxitin (CFX) at daily dose of 6 g. The following results were obtained. 1. Clinical effects of CFX were good in 5 patients, fair in 2 and poor in 3 with effective rate of 50%. 2. Out of 8 patients with sepsis, 5 showed good response to CFX and effective rate was 62.5%. 3. Bacteriological outcomes were eradicated in 1, unchanged in 1, replaced in 2 and unknown in 6 cases. 4. Diarrhea was observed in 1 patient but this was not considered related to CFX therapy. 5. No abnormal laboratory finding due to CFX was observed. 6. It should be considered that 6 g or more of CFX is given in case of severe infections, such as sepsis or pneumonia complicated by serious underlying diseases.

Topics: Adult; Aged; Cefoxitin; Drug Evaluation; Female; Humans; Infusions, Parenteral; Leukemia; Lung Neoplasms; Male; Middle Aged; Pneumonia; Sepsis

Topics: Adolescent; Adult; Aged; Cefoxitin; Erythromycin; Female; Humans; Legionnaires' Disease; Male; Middle Aged; Pneumonia; Rifampin; Spain

Topics: Cefoxitin; Cephalosporins; Drug Antagonism; Drug Therapy, Combination; Enterobacteriaceae; Humans; Immunodiffusion; Penicillin G; Penicillins; Pneumonia; Pseudomonas aeruginosa

1) Cefoxitin (CFX) was administered to seven patients: two with acute pneumonia, two with acute pyelonephritis, one with pyonephrosis complicated to pyelolithotomy, one with acute cystitis and one with CONN syndrome complicated to liver cirrhosis. 2) Response to the CFX treatment was excellent in three patients, good in three, and poor in one. 3) No side effect was observed in all cases. In two patients in whom CFX and furosemide were concomitantly administered, no aggravation of the renal function was observed.

Topics: Acute Disease; Adult; Aged; Cefoxitin; Cephalosporins; Cystitis; Drug Evaluation; Female; Humans; Male; Middle Aged; Nephrosis; Pneumonia; Pyelonephritis

Clinical and bacteriological efficacy, patient tolerance, and toxicity of cefoxitin, a beta-lactamase-resistant cephamycin, were evaluated in 38 patients; 13 had soft tissue infection, 12 had pneumonia, 3 had urinary tract infection, 2 had peritonitis, and 4 had miscellaneous infections. In five patients, infection was clinically evident, though not bacteriologically proven. The latter patients were evaluated with regard to tolerance and toxicity only. Among the 34 infections in 33 patients, 71% were considered clinically cured; 86% of those patients who could be recultured were bacteriologically cured. Phlebitis was noted in 32% of the total group, and eosinophilia was observed in 16%. Unexplained deterioration in renal function occurred in two patients. Mean peak cefoxitin levels in serum were 72 mug/ml 30 min after a 2-g infusion and 32 mug/ml 30 min after a 1-g infusion. Cefoxitin was more active against facultatively and obligately anaerobic gram-negative organisms isolated from these patients than was cephalothin.

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Cephalosporins; Drug Evaluation; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Peritonitis; Pneumonia; Urinary Tract Infections