cefoxitin and Streptococcal-Infections

The authors report three trials of B-lactams and carbapenems for soft tissue infections treated on a surgical service: 1) cefmetazole versus cefoperazone, n = 44; 2) cefotetan versus cefoxitin, n = 24; and 3) meropenem versus imipenem, n = 44. A total of 138 hospitalized patients were enrolled with 112 meeting evaluability criteria. Four hundred twenty-three isolates were cultured (mean, three/patient) of which 67 per cent were aerobes and 33 per cent anaerobes. Cure rates for each trial were: 1) 93 per cent; 2) 92 per cent; 3) 100 per cent. Failures were caused by resistant organisms (Streptococcus group D, Bacteroides fragilis and Pseudomonas) appearing in incompletely drained infection sites. Three patients receiving meropenem had adverse effects (headache, nausea) and one receiving cefoxitin (truncal rash). Operative drainage and debridement remain the critical elements in therapy. Agents with longer half lives allowing twice daily dosing (cefmetazole and cefotetan) were as effective and less expensive than multiple doses of short-acting agents. The extended spectrum carbapenems are most useful for severe infections or resistant organisms.

Topics: Adult; Aged; Bacterial Infections; Carbapenems; Cefmetazole; Cefoperazone; Cefotetan; Cefoxitin; Cephalosporins; Drug Combinations; Drug Resistance, Microbial; Escherichia coli Infections; Female; Humans; Imipenem; Male; Meropenem; Middle Aged; Prospective Studies; Remission Induction; Skin Diseases, Infectious; Staphylococcal Infections; Streptococcal Infections; Thienamycins

Topics: Anti-Bacterial Agents; Cefoxitin; Cellulitis; Cephamycins; Female; Fusobacterium Infections; Fusobacterium necrophorum; Humans; Metronidazole; Middle Aged; Palatine Tonsil; Pharynx; Sexual Behavior; Streptococcal Infections; Streptococcus oralis

The relationships between capsulate and non-capsulate Bacteroides fragilis strains and Escherichia coli, and between capsulate and non-capsulate strains of the B. melaninogenicus group and Streptococcus pyogenes, were studied in a subcutaneous abscess model in mice. Selective antimicrobial agents directed against either aerobic or anaerobic bacteria were used alone or in combination to explore the effect of eradication of one component of the mixed infection. Single agent therapy effective against both aerobic and anaerobic flora was also employed. Single therapy of mixed infection directed at the elimination of only one organism (S. pyogenes, E. coli or Bacteroides sp.) caused significant reductions in the numbers of sensitive organisms and also smaller yet significant decreases in the numbers of insensitive organisms. However, the abscesses were not eliminated after such therapy. Combination therapy or use of a single agent (cefoxitin) directed against the aerobic and anaerobic components of the infection was more effective. Non-capsulate Bacteroides spp. became capsulate after passage in mice mixed with either S. pyogenes or E. coli. Therapy directed at the elimination of S. pyogenes and E. coli did not prevent the emergence of capsulate Bacteroides spp. These data demonstrate the synergy between all members of the B. fragilis group and E. coli and between the B. melaninogenicus group and S. pyogenes, and reiterate the need to direct antimicrobial therapy at the eradication of the aerobic and anaerobic components of mixed infections.

Topics: Abscess; Aerobiosis; Anaerobiosis; Animals; Bacteroides; Bacteroides fragilis; Bacteroides Infections; Cefoxitin; Disease Models, Animal; Drug Resistance, Microbial; Drug Therapy, Combination; Escherichia coli; Escherichia coli Infections; Gentamicins; Leucomycins; Male; Metronidazole; Mice; Microbial Sensitivity Tests; Prevotella melaninogenica; Skin Diseases; Streptococcal Infections; Streptococcus pyogenes

A case of streptococcus group G polyarthritis has been identified from blood and synovial fluid cultures and was sensitive to penicillin G. The clinical tendency to polyarticular infection by this organism and its discordant response to the antibiotics indicated by in vitro studies are discussed.

Topics: Arthritis, Infectious; Cefoxitin; Humans; Male; Middle Aged; Penicillin G; Penicillin V; Streptococcal Infections; Synovial Fluid

The possibility of reducing the incidence of postoperative recurrences of pilonidal fistulas by using preoperative doses of Cephoxitine and primary surgical closure is described.

Topics: Cefoxitin; Escherichia coli Infections; Humans; Pilonidal Sinus; Preoperative Care; Staphylococcal Infections; Streptococcal Infections

From 1979 to 1982, a large number of freshly isolated strains of bacteria were investigated at our institute with regard to their sensitivity to cefotaxime in comparison to other antibiotics. The isolates came from 42 clinics in the Rhine-Main region. The results of the investigations demonstrate that cefotaxime, due to its high stability against beta-lactamases, has advantages over to older cephalosporins, and even cefoperazon and cefoxitin. Despite increased use of cefotaxime, there was no change in the sensitivity of the organisms from 1979 to 1982.

Topics: Cefotaxime; Cefoxitin; Cephalosporins; Enterobacteriaceae; Enterobacteriaceae Infections; Humans; In Vitro Techniques; Microbial Sensitivity Tests; Moxalactam; Penicillin Resistance; Penicillins; Streptococcal Infections; Streptococcus

Cefoxitin, a parenteral cephamycin beta-lactam antibiotic was prospectively evaluated as a single drug alternative in 31 children with cellulitis and the results of therapy were compared retrospectively with those from prevailing multiple antibiotic therapy for cellulitis in 56 children. Periorbital and lower extremity cellulitis accounted for more than 60% of the cases in both study groups. The most common bacterial agents included Haemophilus influenzae, Staphylococcus aureus, and group A beta-hemolytic Streptococcus. In as many as 50% of the cases, no etiologic agent could be found. In addition to blood cultures, cellulitis leading edge aspirate cultures were helpful in establishing the etiologic diagnosis. Of 52 patients sampled in the combined studies, 21% had positive aspirate cultures in the presence of negative blood cultures. The outcome and mean duration of hospital stay were similar in both groups. No severe adverse reactions were encountered. The mean number of antibiotics used in the retrospective study was three (range 1 to 7) whereas cefoxitin alone was used in the prospective study. All organisms isolated in the prospective study were susceptible to cefoxitin. Single antibiotic therapy with cefoxitin appears to be as safe and as effective in the treatment of cellulitis in children as multiple antibiotic therapy.

Topics: Anti-Bacterial Agents; Cefoxitin; Cellulitis; Child; Child, Preschool; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Orbital Diseases; Prospective Studies; Retrospective Studies; Staphylococcal Infections; Streptococcal Infections; Streptococcus agalactiae

The effectiveness of penicillin G, fosfomycin, and cefoxitin alone and in combination was studied in vitro and in the treatment of left-sided Streptococcus sanguis endocarditis in rabbits. In vitro, the combinations penicillin G plus fosfomycin, penicillin G plus cefoxitin, and fosfomycin plus cefoxitin were synergistic or partially synergistic for S sanguis. Therapy with the combinations was more effective in eradicating the species from cardiac vegetations that was that with each antibiotic used alone.

Topics: Animals; Anti-Bacterial Agents; Cefoxitin; Drug Synergism; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Fosfomycin; Humans; Penicillin G; Rabbits; Streptococcal Infections; Streptococcus sanguis