cefoxitin and Pyelonephritis

Cefoxitin could be an alternative to carbapenems in extended-spectrum-beta-lactamase-producing Escherichia coli (ESBL-EC) infections. However, pharmacological and clinical data regarding cefoxitin are limited. Using a recent pharmacological model and the MICs of ESBL-EC collected from pyelonephritis, we determined the probabilities to reach four pharmacological targets: free cefoxitin concentrations above the MIC during 50% and 100% of the administration interval (T>MIC = 50% and T>MIC = 100%, respectively) and free cefoxitin concentrations above 4× MIC during 50% and 100% of the administration interval (T>4MIC = 50% and T>4MIC = 100%, respectively). Cefoxitin could be used to treat ESBL-EC pyelonephritis, but administration modalities should be optimized according to MICs in order to reach pharmacological targets.

Topics: Anti-Bacterial Agents; beta-Lactam Resistance; beta-Lactamases; Carbapenems; Cefoxitin; Drug Administration Schedule; Drug Dosage Calculations; Escherichia coli; Escherichia coli Infections; Gene Expression; Humans; Microbial Sensitivity Tests; Models, Statistical; Pyelonephritis; Urinary Tract Infections

Topics: Adult; Ampicillin; Anemia, Hemolytic; Cefoxitin; Female; Furosemide; Humans; Pregnancy; Pregnancy Complications; Pyelonephritis; Respiration Disorders; Thrombocytopenia

In the E. coli pyelonephritis, induced in female Wistar rats by retrograde infection (high pressure reflux), we investigated the influence of 1) the time of commencement of therapy, 2) the renal bacterial counts, i.e. the inflammatory activity of the pyelonephritis after endovesical instillation of cultures with different bacterial concentrations, and 3) the level of infection resistance of the experimental animal strain on the therapeutic response of the model infection with single doses of cefoxitin (150 mg/ml) and cefotaxime (5 mg/ml). Early commencement of therapy post inoculation was therapeutically advantageous provided the intrarenal multiplication of the infective organisms was not delayed or the initial bacterial concentrations were not too high. The mild form of pyelonephritis with lower renal bacterial concentrations and poor inflammatory activity after endovesical instillation of a low inoculum (10(4) cfu/ml) was less amenable to treatment than the inflammatory active pyelonephritis with high renal bacterial counts, using a high inoculum (10(7) cfu/ml). High renal bacterial counts after retrograde inoculation of an E. coli culture of 10(8) cfu/ml resulted in significant reduction of bacterial counts 48, 72 and 96 h post infectionem, with i.m. application of cefoxitin 12 h prior. For Wistar rat strain Bor:WIST, which showed a stronger infection resistance with lower renal bacterial concentrations and a stronger tendency to spontaneous healing, application of a single dose of cefotaxime (5 mg/ml) was therapeutically ineffective, whereas, in contrast, with Han: WIST rats the acute phase of E. coli pyelonephritis could be treated effectively.

Topics: Animals; Cefotaxime; Cefoxitin; Disease Models, Animal; Escherichia coli; Escherichia coli Infections; Female; Kidney; Pyelonephritis; Rats; Rats, Inbred Strains

Topics: Animals; beta-Lactamases; Cefamandole; Cefoxitin; Cephalosporins; Drug Resistance, Microbial; Escherichia coli; Plasmids; Pyelonephritis; Rats

Ascending pyelonephritis was successfully produced in rats by means of direct inoculation with a virulent strain of Escherichia coli into the bladder enclosing a glass ball. 3-Carbamoyloxymethyl-7-alpha-methoxy-7-[2(2-thienyl)-acetamido]-3-cephem-4-carboxylic acid (cefoxitin) or cefazolin as a control drug was applied to the affected rats characterized by purulent inflammation in pelvis and medulla sometimes accompanied with abscess formation in medulla and/or coretex 3 days after challenge. The treatments were performed at an i.v. dose of 40 mg/kg 3 times a day for 5 consecutive days. The improvement of the disease, that is disappearance of the bacilli in the kidney, improvement of BUN value and of histopathological findings in cefoxitin-treated animals was approximately equal to that in cefazolin-treated ones. Both antibiotics exhibited great effectiveness against purulent pyelonephritis, however, not sufficiently effective against medullar and cortical abscesses. Chemotherapeutic effect of cefoxitin on experimental pyelonephritis was discussed with special reference to its distribution into the affected tissues.

Topics: Animals; Blood Urea Nitrogen; Cefazolin; Cefoxitin; Cephalosporins; Male; Pyelonephritis; Rats

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