cefoxitin and Respiratory-Tract-Infections

Topics: Bacterial Infections; Bacteroides Infections; Cefamandole; Cefazolin; Cefonicid; Cefoxitin; Cefuroxime; Cephalosporins; Gonorrhea; Haemophilus Infections; Humans; Respiratory Tract Infections; Structure-Activity Relationship

A controlled randomized trial with blind assessment of end results is described comparing the efficacy of 1 g of intravenous ceftriaxone at induction of anesthesia with 1 g of intravenous cefoxitin (three times) administered every 8 hours starting at induction in preventing pulmonary and wound infection after upper abdominal operations. There were 150 adults who underwent biliary or gastroduodenal operations who were randomized to each protocol. A total of 123 patients completed the protocol--59 received ceftriaxone and 64 cefoxitin. Chest infection was defined as pyrexia plus clinical and/or radiologic signs of consolidation or the production of purulent sputum. Wound infection was defined as purulent wound discharge. There was a significant reduction (19% versus 42%, P < 0.05) in chest complications and in wound infection (0% versus 8%, P < 0.05) in the ceftriaxone group compared with the cefoxitin group. It is concluded that for biliary and gastroduodenal operations, 1 g of ceftriaxone is superior to 1 g of cefoxitin (three times) administered every 8 hours and that this effect is likely to be due to the prolonged bactericidal blood levels produced by a single dose of ceftriaxone.

Topics: Biliary Tract Surgical Procedures; Cefoxitin; Ceftriaxone; Costs and Cost Analysis; Drug Administration Schedule; Duodenum; Female; Humans; Male; Middle Aged; Premedication; Respiratory Tract Infections; Stomach; Surgical Wound Infection

The efficacy and safety of cefmetazole and cefoxitin were compared in a randomized open-label parallel trial in 68 hospitalized adult patients with lower respiratory tract infections. Of 40 patients evaluable for efficacy, 23/25 (92%) in the cefmetazole group and 13/15 (87%) in the cefoxitin group demonstrated a favourable clinical response. The causative bacteria were eradicated in 30/32 (94%) and 13/14 (93%) of isolates in the cefmetazole and cefoxitin groups, respectively. A total of 51 adverse events was noted in 68 patients: 36 in 26 patients (55%) in the cefmetazole group and 15 in 12 patients (57%) in the cefoxitin group. These events were reversible, and except in one patient who was treated for oral candidiasis, did not require any therapeutic intervention or prolonged hospitalization. Cefmetazole appears to be as safe and effective as cefoxitin in the treatment of lower respiratory tract infections of hospitalized patients.

Topics: Aged; Aged, 80 and over; Cefmetazole; Cefoxitin; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Random Allocation; Respiratory Tract Infections

Ninety patients at the Wilmington Medical Center were enrolled in a comparative study to evaluate the efficacy and toxicity of ticarcillin plus clavulanic acid in the treatment of a variety of infections. Forty-seven women with obstetric or gynecologic infections were randomly assigned to receive ticarcillin plus clavulanic acid or cefoxitin. Forty-three patients with gram-negative septicemia or lower respiratory tract infection were given ticarcillin plus clavulanic acid or tobramycin plus piperacillin in a randomized fashion. Of the 47 women with obstetric or gynecologic infections, 23 were randomly assigned to receive ticarcillin plus clavulanic acid, and 24 were randomly assigned to receive cefoxitin. Several patients in each group had underlying diseases such as diabetes, obesity, and hypertension. Of the 27 pathogens isolated in the group receiving ticarcillin plus clavulanic acid, 26 (96 percent) were eradicated, including all three ticarcillin-resistant pathogens. In the cefoxitin-treated group, 31 of the 33 (94 percent) pathogens were eliminated, including all four ticarcillin-resistant organisms. Three reinfections or superinfections occurred, and cefoxitin therapy failed to eliminate an enterococcus isolate from the endometrium in one patient. The clinical response in both treatment groups was excellent. Either cure or clinical improvement was achieved for all 18 sites of infection in the ticarcillin plus clavulanic acid-treated group and for all 22 sites in the cefoxitin-treated group. There were no systemic drug reactions in either treatment group. In one patient in the cefoxitin-treated group, local phlebitis developed at the infusion site. This reaction responded to local therapy. There were no local reactions among the patients receiving ticarcillin plus clavulanic acid. Of the 43 patients with gram-negative septicemia or lower respiratory tract infection, 21 were randomly assigned to receive ticarcillin plus clavulanic acid and 22 were assigned to receive tobramycin plus piperacillin. Thirty-six patients had gram-negative sepsis, and seven patients had lower respiratory tract infection. Nine of the 36 patients suspected of having gram-negative sepsis were not evaluable because no pathogen was isolated prior to treatment. Twenty-two of the 27 patients treated for septicemia had good clinical and microbiologic responses. Three of the seven patients with pneumonia were not evaluable. Of the four evaluable patients, two had pneumococcus pneum

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefoxitin; Clavulanic Acid; Clavulanic Acids; Drug Combinations; Female; Gram-Negative Bacteria; Hospitalization; Humans; Male; Penicillins; Piperacillin; Respiratory Tract Infections; Sepsis; Ticarcillin; Tobramycin

Fifty-nine patients with serious infections were assigned at random in a two-to-one ratio to receive either cefmenoxime or cefoxitin given intravenously in a dosage of 0.5 to 2.0 g every six hours. Of 44 patients evaluable for efficacy, eight had concomitant bacteremia and all but 10 had serious underlying disease. The average duration of therapy was seven days. All patients with skin and soft tissue infections were cured after treatment with either antibiotic. Cefmenoxime achieved clinical and bacteriologic cures in 92 and 83 percent, respectively, of 12 patients with pneumonia and in 100 and 82 percent of 11 patients with urinary tract infections. Cefoxitin therapy resulted in clinical and bacteriologic cures in all four patients with pneumonia. Among 10 patients with urinary tract infection, respective cure rates were 90 and 50 percent. Both antibiotics were well tolerated. One cefmenoxime-treated patient discontinued treatment because of a rash.

Topics: Adult; Bacterial Infections; Cefmenoxime; Cefotaxime; Cefoxitin; Drug Administration Schedule; Drug Evaluation; Female; Humans; Infusions, Parenteral; Male; Random Allocation; Respiratory Tract Infections; Skin Diseases, Infectious; Urinary Tract Infections

A comparative study was conducted using cefmenoxime, a new extended spectrum cephalosporin, versus cefoxitin. Entry into the study was based on a computer-generated randomization (two cefmenoxime to one cefoxitin). An intravenous dose of cefmenoxime (0.5 to 1 g every six hours) or cefoxitin (1 to 2 g every six hours) was administered to patients suspected of having serious bacterial infections. Six patients had urinary tract infections. Four who received cefmenoxime, including two with positive blood cultures, had eradication of bacteremia. One of the two who received cefoxitin had significant bacteriuria, and the urine was clear after treatment. Twenty-four patients were treated for lower respiratory tract infections. All 15 patients who received cefmenoxime had clinical and bacteriologic cures. Two of the nine patients who received cefoxitin continued to have the pathogens at the end of the treatment period. Both patients had a neoplasm of the lung. All 11 patients who had soft tissue infections (nine of whom received cefmenoxime) responded well. Both antibiotics were well tolerated.

Topics: Bacterial Infections; Cefmenoxime; Cefotaxime; Cefoxitin; Clinical Trials as Topic; Humans; Random Allocation; Respiratory Tract Infections; Urinary Tract Infections

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Female; Humans; Injections, Intravenous; Male; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

Cefoxitin (CFX) at a daily dose of 3 to 12 grams was administered to patients who had hematopoietic disorders as underlying diseases and having severe infections. Efficacy and safety of the drug were evaluated. The underlying diseases in the 64 patients included in the evaluation of efficacy were acute myelocytic leukemia (30 cases), acute lymphocytic leukemia (9), acute promyelocytic leukemia (3), acute monocytic leukemia (2), chronic myelocytic leukemia-blastic crisis (10), erythroleukemia (2), malignant lymphoma (2), aplastic anemia (2), and others (4). The infections were septicemia in 3 patients, suspected septicemia in 47, respiratory tract infections in 7, oral infections in 3, urinary tract infections in 2, and others in 2. The clinical efficacy of CFX was 'excellent' in 13 patients, 'good' in 26, 'fair' in 6, 'poor' in 19 for an efficacy rate of 60.9%. The efficacy rate classified according to infections was 66.7% in septicemia, 66.0% in suspected septicemia, 42.9% in respiratory tract infections and 66.7% in oral infection. The organisms isolated from the patients with septicemia were E. coli in 2 patients and B. cereus in 1. B. cereus was not susceptible to CFX. The efficacy rate was 60.0% in the 10 patients whose causative organisms were identified and 61.1% in the 54 patients whose causative organisms were not identified. There was no significant difference in the efficacy rate between the patients who had failed to respond to prior antibiotic therapy and those treated with CFX from the beginning. The efficacy rates for the former group (23 patients) and for the latter group (41 patients) were 56.5% and 63.4%, respectively. The efficacy rate in patients with an initial neutrophil count less than 500/mm3 (35 cases) and from 501 to 1,000/mm3 (13 cases) were 57.1% and 76.9%, respectively. Side effects which might have been caused by CFX were skin eruptions in 2 patients (2.6%) and transient elevation of GOT and GPT in 1 patient (1.3%) among 76 patients who were evaluated for safety. CFX was considered to be a markedly useful and safe drug in the treatment of patients with hematopoietic disorders who developed severe infections.

Topics: Adolescent; Adult; Aged; Anemia, Aplastic; Cefoxitin; Child; Clinical Trials as Topic; Female; Humans; Leukemia; Lymphoma; Male; Middle Aged; Respiratory Tract Infections; Sepsis

The Authors illustrate the results obtained in treatment of various types of infection in patients hospitalised in an intensive care surgical department with cephoxitin, a new semisynthetic antibiotic derivate of the cephalosporin group. In view of the severity of the treated cases, the Authors consider the results obtained to be satisfactory.

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Cross Infection; Female; Humans; Intensive Care Units; Male; Middle Aged; Postoperative Complications; Respiratory Tract Infections; Surgical Wound Infection; Urinary Tract Infections

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cefoxitin; Cephalosporins; Child; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections; Sepsis; Urinary Tract Infections

Topics: Adult; Aged; Anaerobiosis; Bacterial Infections; Cefoxitin; Cephalosporins; Cephalothin; Clinical Trials as Topic; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections

Some strains of Bacteroides fragilis species are associated with diarrhea as a result of enterotoxin production (bft or fragilysin). Fragilysin is activated by C11 protease (fpn) and together with C10 protease (bfp) play a significant role in its invasiveness. The objectives of this study were to investigate the proportion of clinical isolates from extra-intestinal sources that are toxin producers and characterize the genes mediating toxin production. Clinical isolates submitted to our reference laboratory over the last 13 years were screened for toxin production using PCR technique. All stool isolates were excluded. The isolates were tested for their susceptibility to 8 antimicrobial agents by E test. Carbapenem resistance gene cfiA was detected by PCR.. A total of 421 B. fragilis isolates were viable. Out of these, bft was detected in 210 (49.9%) isolates. Of the 210 bft-positive isolates, 171 (81.4%), 33 (15.7%) and 6 (2.8%) harbored bft-1, bft-2, and bft-3 genes, respectively. Twenty (9.5%) of the bft-positive strains originated from bloodstream infections. Twenty-five, 20 and 9 strains harbored bfp-1, bfp-2 and bfp-3 gene, respectively. Two, 3, 4 bfp isotypes were detected simultaneously in some of strains. The resistance rates against amoxicillin-clavulanic acid was 32%, clindamycin 62%, cefoxitin 26%, imipenem 11%, meropenem 17%, metronidazole 4%, piperacillin 61% and tigecycline 14%. A chromosomally located cfiA gene that encode metallo-β-lactamase was identified in only 34 isolates (16.2%).. The prevalence of enterotoxin-producing B. fragilis was high among the extra-intestinal isolates. Metronidazole was the most active agent against all isolates. There was no statistically significance difference between resistance rates among bft-positive and bft-negative isolates except for clindamycin.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Toxins; Bacteroides fragilis; Bacteroides Infections; Cefoxitin; Clindamycin; Drug Resistance, Bacterial; Feces; Female; Humans; Imipenem; Kuwait; Male; Meropenem; Metronidazole; Microbial Sensitivity Tests; Piperacillin; Prevalence; Prospective Studies; Respiratory Tract Infections; Sepsis; Tigecycline; Wound Infection

The in vitro activity of cefoxitin and imipenem was compared for 43 strains of the Mycobacterium abscessus complex, mostly isolated from cystic fibrosis patients. The MICs of imipenem were lower than those of cefoxitin, although the number of imipenem-resistant strains was higher according to the CLSI breakpoints. Strain comparisons indicated that the MICs of cefoxitin were significantly higher for Mycobacterium bolletii than for M. abscessus. The MICs of both β-lactams were higher for the rough morphotype than for the smooth morphotype. The clinical impact of the in vitro difference between the activity of imipenem and that of cefoxitin remains to be determined.

Topics: Anti-Bacterial Agents; Cefoxitin; Colony Count, Microbial; Cystic Fibrosis; Humans; Imipenem; Microbial Sensitivity Tests; Nontuberculous Mycobacteria; Respiratory Tract Infections

Topics: Administration, Oral; Anti-Bacterial Agents; Biological Availability; Blister; Cefoxitin; Cefuroxime; Humans; Metabolic Clearance Rate; Respiratory Tract Infections

Cefoxitin (CFX) was administered to 12 patients with respiratory tract infections, including mainly patients with pulmonary suppuration or pyothorax. The results were as follows: CFX was effective in 75% of the total patients, and in 83% of the 6 patients with pulmonary suppuration or pyothorax. Microorganisms which were considered to be causative were isolated in 8 of 12 patients. Bacteriological responses were "eradicated" in 4 patients, "replaced" in 3 patients, "unchanged" in 1 patient. A slight elevation of S-GPT was observed in one patient and elevation of A1-P in another following CFX administration; however, these values returned to normal shortly after completion of drug administration. No adverse effects, allergic symptoms or laboratory abnormalities were observed.

Topics: Adolescent; Adult; Aged; Alanine Transaminase; Cefoxitin; Drug Evaluation; Empyema; Female; Humans; Infusions, Parenteral; Lung Abscess; Male; Middle Aged; Respiratory Tract Infections

The clinical effects of cefoxitin (CFX) were studied in 31 cases of respiratory tract infections. The results were as follows: As for the clinical effects, CFX was excellent in 5 cases, good in 13, fair in 8 and poor in 5 out of 31 patients; the efficacy rate was 58.1%. The efficacy rate was 57.1% in bronchopneumonia, 61.1% in pneumonia and 50.0% in acute exacerbation of chronic respiratory tract infections. The efficacy rate was 70.6% in the group of 4 g/day or less and 42.9% in the group of 6 g/day or more. The efficacy rate was 50.0% in 6 cases that had not been responded to other antibiotics previously. As for side effects, skin eruption was observed in only 1 patient. No abnormality was observed in laboratory tests due to CFX. In conclusion, CFX is a useful drug in the treatment of respiratory tract infections.

Topics: Adult; Aged; Cefoxitin; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Respiratory Tract Infections

Cefoxitin (CFX) was used in 9 patients who had respiratory tract infections and following results were obtained: CFX was used in 2 patients with acute pneumonia, 2 with lung abscess, 3 with a mixed infection of lung cancer, 1 with a mixed infection of pulmonary tuberculosis and 1 with empyema. The overall efficacy rate was 77.8%; results were excellent in 2, good in 5 and poor in 2. Bacteriologically, all strains except P. aeruginosa were eradicated after treatment. No side effects were observed. A slight transient elevation of transaminase was observed in 1 patient after doses of 4 approximately 8 g daily. From the above, CFX seems to be a useful and safe drug as an initial choice in the treatment of respiratory tract infections.

Topics: Adult; Aged; Cefoxitin; Drug Evaluation; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

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

Cefoxitin, a new beta-lactamase-resistant cephamycin, was evaluated in 66 patients for clinical and bacteriological efficacy, serum levels, tolerance, and toxicity. Seventeen patients had soft tissue infections, 14 had pleuropulmonary infections, 14 had intraabdominal infections, 13 had pelvic infections, and 8 had urinary tract infections. Among the 66 patients, 62 were cured and 4 could not be evaluated. Twelve patients had hospital-acquired infections, 31 had underlying disease, and 45 required a surgical procedure. Isolates included 116 aerobic and 72 anaerobic bacteria. Cefoxitin was more active than cephalothin against facultative and obligate anaerobic gram-negative organisms isolated from these patients. Mean peak cefoxitin levels in sera were 52 micrograms/ml after a 2-g infusion and 30 micrograms/ml after a 1-g infusion. Phlebitis occurred in two patients, eosinophilia in one, rash in two, vasculitis in one, and transient rises in SGOT and SGPT in two. Cefoxitin appears to be a safe and effective drug for the treatment of many aerobic, anaerobic, and mixed aerobic-anaerobic infections.

Topics: Adult; Aerobiosis; Aged; Anaerobiosis; Bacteria; Bacterial Infections; Cefoxitin; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

A total of 42 patients who were suffering from respiratory tract infections were treated with cefoxitin, and the following results were obtained. 1. Out of 32 patients clinically evaluated, excellent or good responses were observed in 30 patients (94%). 2. Presumed causative organisms were isolated in 14 patients. The organisms were eradicated in 11 patients and the eradication rate was 79% (11/14). The number of the organisms decreased or unchanged in 1 patient each. In other 1 patient the pathogenic agent was replaced with other agents during the course of treatment. 3. As for the side effects, skin eruption was observed in 3 patients. One patient received drugs other than cefoxitin concomitantly that might have caused the eruption. Another patient had an allergic history to many antibiotics. In 4 patients slight elevations of S-GOT and S-GPT were observed but improved soon after the completion of cefoxitin treatment. In 1 patient an elevation of serum creatinine was observed but this was not attributed to the administration of cefoxitin. 4. From the results stated above, cefoxitin is considered to be a safe and effective antibiotic which can be one of the first-choice antibiotics for the treatment of respiratory tract infections.

Topics: Adolescent; Adult; Age Factors; Aged; Cefoxitin; Drug Evaluation; Female; Humans; Infusions, Parenteral; Injections, Intravenous; Male; Middle Aged; Respiratory Tract Infections; Sex Factors

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Cholangitis; Female; Humans; Male; Middle Aged; Peritonitis; Respiratory Tract Infections; Surgical Wound Infection; Urinary Tract Infections

Topics: Aminoglycosides; Anti-Bacterial Agents; Bacterial Infections; Carbenicillin; Cefoxitin; Cephamycins; Chloramphenicol; Clindamycin; Drug Combinations; Female; Gastrointestinal Diseases; Genital Diseases, Female; Gram-Negative Anaerobic Bacteria; Humans; Male; Moxalactam; Respiratory Tract Infections; Skin Diseases, Infectious; Suppuration; Ticarcillin

1. Serum and sputum concentrations of cefoxitin were measured at fixed intervals following a one hour drip infusion of 2 g to a total of three patients with chronic respiratory tract diseases. The peak levels in serum were found to be 142.1-273.6 microgram/ml at the end of the infusion and those in sputum were found to be 0.92-2.30 microgram/ml at 2 to 4 hours after initiation of the infusion. 2. Cefoxitin was administered to a total of five patients with chronic respiratory tract infections who had failed to respond to the previous treatments with conventional antibiotics. The results were that in one case the therapeutic effect was judged as excellent, in three cases as good, and in one case it was difficult to evaluate. In all cases, there was no significant abnormality indicative of side effects regarding clinical symptoms and laboratory tests of renal and hepatic functions. In a view of the findings stated above, it is considered that cefoxitin is a new antibiotic which can be used for the treatment of chronic respiratory tract infections.

Topics: Aged; Cefoxitin; Chronic Disease; Drug Evaluation; Female; Humans; Kinetics; Male; Middle Aged; Respiratory Tract Infections; Sputum; Time Factors

The therapeutic efficacy of cefoxitin (CFX) in chronic respiratory tract infection was evaluated in patients who poorly responded to other antibiotics. To 20 patients, CFX was administered 2 g b.i.d. intravenously by drip infusion. Clinical efficacy was judged based on the criteria by score. 1. Bacterial elimination rate with CFX was 73.7%. 2. A clinical cure rate was 80.0% was obtained by doctors in charge. 3. According to the score assessment, the overall clinical effectiveness rate was 60.0%, clinical symptom cure rate was 85.0% and improvement rate of X-ray findings was 55.0%. 4. Usefulness rate which was assessed by clinical effect and side effect was 70.0%. 5. No side effects and abnormal laboratory findings were observed in this study. We used the new antibiotic CFX in patients with chronic respiratory tract infections who responded poorly to other antibiotics and obtained satisfactory results. Especially CFX indicated more effective possibility in cases from whom Gram-negative bacilli was isolated.

Topics: Adult; Aged; Bacteria; Cefoxitin; Chronic Disease; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Respiratory Tract Infections

Topics: Anti-Bacterial Agents; Bacterial Infections; Cefoxitin; Cefuroxime; Humans; Lung Diseases; Postoperative Complications; Respiratory Tract Infections; Surgical Procedures, Operative

Topics: Anaerobiosis; Anti-Bacterial Agents; Bacterial Infections; Brain Diseases; Cefoxitin; Clindamycin; Gastrointestinal Diseases; Humans; Metronidazole; Penicillins; Postoperative Complications; Respiratory Tract Infections

The objective of the study was to evaluate the concentrations obtained in serum and bronchial secretions after administration of five beta-lactam antibiotics: cephradin (1 g per os) and cefoxitin (2 g i.v. infusion), amoxycillin (1.0 g per os), bacampicillin (0.4 g and 0.8 g per os) and ampicillin (1.0 g per os). 123 adult patients were included in the study and received a single dose of the tested drug. Serum and mucus samples were collected simultaneously 30 minutes, 1, 2 or 4 hours after administration of the drugs. Mucus samples were taken by fibroscopy but in some patients the samples were collected through a tracheostomy cannula which allowed sampling at different time intervals. The results show that the concentrations of penicillins in bronchial secretions increase progressively between one and four hours after administration of the drugs. Bronchial levels obtained after oral administration of ampicillin are low, not more than 5 to 10% of serum levels. The other antibiotics tested show worthwhile concentrations in bronchial secretions, especially with cephalosporins and bacampicillin which exhibits higher serum and bronchial concentrations than ampicillin.

Topics: Amoxicillin; Ampicillin; Anti-Bacterial Agents; Bronchi; Cefoxitin; Cephradine; Humans; Respiratory Tract Infections

Topics: Adult; Aged; Cefoxitin; Cephalosporins; Female; Humans; Male; Middle Aged; Respiratory Tract Infections