cefoxitin and Urinary-Tract-Infections

Topics: Administration, Oral; Cefazolin; Cefoxitin; Central Nervous System Diseases; Cephacetrile; Cephalexin; Cephaloglycin; Cephaloridine; Cephalosporins; Cephalothin; Cephapirin; Cephradine; Gastrointestinal Diseases; Humans; Infusions, Parenteral; Kinetics; Lung Diseases; Urinary Tract Infections

Topics: Age Factors; Aged, 80 and over; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefoxitin; Cystectomy; Female; Fosfomycin; Humans; Male; Postoperative Complications; Prospective Studies; Treatment Outcome; Urethra; Urinary Bladder Neoplasms; Urinary Tract Infections

To discuss the effect and safety of preventive administration of antibiotics to patients with benign prostatic hyperplasia (BPH) before urodynamic examination.. A total of 256 BPH patients to undergo urodynamic examination were randomly divided into a control group (n = 118) and a trial group (n = 138). The former received no pre-treatment while the latter were given cefoxitin sodium iv at 1.0 g 30 minutes before complete urodynamic examination. Then we compared the incidence rates of urinary tract infection between the two groups.. Statistically significant differences were found in the incidence rate of urinary tract infection between the control and trial groups (20.3% [24/118] vs 7.3% [10/138], P < 0.01), as well as in those with diabetes mellitus (6.7% [3/45] vs 23.5% [8/34], P < 0.05), those with residual urine > 50 ml (5.4% [3/56] vs 18.5% [10/54], P < 0.05), and those with both diabetes mellitus and residual urine (9.5% [2/21] vs 44.4% [8/18], P < 0.05). Only 3 patients (2.2%) in the trial group had mild adverse drug reactions.. For BPH patients, particularly those with diabetes mellitus and residual urine, preventive administration of antibiotics before urodynamic examination is safe and can effectively protect the patients against urinary tract infection.

Topics: Antibiotic Prophylaxis; Cefoxitin; Humans; Male; Prostatic Hyperplasia; Urinary Tract Infections; Urodynamics

This study evaluates the safety and efficacy of cefmetazole in comparison with cefoxitin in the parenteral treatment of patients hospitalized with acute urinary tract infections. Of the 49 evaluable patients, 27 were randomized to cefmetazole and 22 to cefoxitin. There was clinical success in 26 (96%) patients and bacteriological cure in 22 (81%) patients receiving cefmetazole. This compares with clinical success in 21 (95%) patients and bacteriological cure in 17 (77%) patients randomized to cefoxitin. There were no adverse reactions associated with either antibiotic. This study indicates that the clinical and bacteriological outcome was similar.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cefmetazole; Cefoxitin; Female; Humans; Injections, Intravenous; Male; Middle Aged; Random Allocation; Urinary Tract Infections

A prospective, double-blind study was performed to evaluate the comparative efficacy of single- and multiple-dose antimicrobial prophylaxis for preventing infection in high-risk patients undergoing cesarean section. One hundred fifty-eight patients were randomly assigned to receive either a single perioperative dose of mezlocillin, three doses of mezlocillin or three doses of cefoxitin. The incidence of endometritis was 5.9%, 4.0% and 4.0%, respectively. The incidence of febrile morbidity was 5.9%, 2.0% and 6.1%, respectively. These differences are not statistically significant. The single perioperative dose of mezlocillin was as effective as the three-dose regimen of either mezlocillin or cefoxitin.

Topics: Adult; Bacterial Infections; Cefoxitin; Cesarean Section; Double-Blind Method; Endometritis; Female; Humans; Mezlocillin; Postoperative Complications; Pregnancy; Premedication; Prospective Studies; Random Allocation; Urinary Tract Infections

Topics: Cefoxitin; Cesarean Section; Chorioamnionitis; Clavulanic Acid; Clavulanic Acids; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Endometritis; Female; Humans; Penicillins; Pregnancy; Premedication; Prospective Studies; Ticarcillin; Urinary Tract Infections

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

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

Cefotetan was compared with cefoxitin in the treatment of hospitalized patients with complicated as well as uncomplicated urinary tract infections. Cefotetan produced high peak and trough plasma and urine concentrations with a twice-daily dosing schedule. The intravenous administration of 1 or 2 g of cefotetan every 12 h was effective in treating urinary tract infections due to susceptible Gram-negative bacteria and compared favourably with the results obtained with 1 or 2 g of cefoxitin every 8 h. Similar types of non-serious adverse reactions occurred with both drugs.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Cefotetan; Cefoxitin; Cephalosporins; Cephamycins; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; 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

We performed a randomized, double-blind trial on a relatively low-risk population comparing the use of three doses of cefoxitin vs. placebo in the prevention of infection following primary cesarean section. Major site-related morbidity (endometritis, wound infection and septicemia) was significantly reduced in the cefoxitin group (8.9% vs. 27.8%; p = 0.017). Febrile morbidity alone tended to occur in the cefoxitin group (15.6% vs. 3.7%; p = 0.091), and all five urinary tract infections occurred in the cefoxitin group as well. Total morbidity was therefore not significantly different (cefoxitin, 35.6%; placebo, 31.5% [not significant]). Duration of hospitalization (mean, 6.0 days) and need for further postoperative antibiotic therapy were similar in the two groups. Our study demonstrated a modest benefit from the perioperative use of antibiotics in relatively low-risk patients undergoing primary cesarean section. Issues that need further study include definition of the optimal prophylactic regimen and of high-risk populations for whom prophylaxis would be most helpful.

Topics: Adult; Cefoxitin; Cesarean Section; Clinical Trials as Topic; Double-Blind Method; Endometritis; Female; Fever; Humans; Placebos; Postoperative Complications; Pregnancy; Premedication; Sepsis; 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: Cefotaxime; Cefotiam; Cefoxitin; Drug Evaluation; Female; Humans; Male; Urinary Tract Infections

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

To determine the efficacy of perioperative cefoxitin in preventing infections after primary cesarean section, a randomized placebo-controlled, double-blind clinical trial was performed. Among 266 participants, those who received three perioperative 2 gm doses of cefoxitin (138) had significantly fewer serious infections (19.5% vs. 4.3%), fewer urinary tract infections (10.7% vs. 4.4%), less standard febrile morbidity (9.4% vs. 3.6%), and fewer courses of antibiotics postoperatively (23.4% vs. 11.6%). There was no reduction in the length of hospitalization. Use of perioperative cefoxitin umbilical cord is clamped are safe and efficacious in preventing infection after primary cesarean section.

Topics: Cefoxitin; Cesarean Section; Clinical Trials as Topic; Endometritis; Female; Fever; Humans; Infant, Newborn; Intraoperative Care; Postoperative Care; Pregnancy; Prospective Studies; Puerperal Infection; Random Allocation; Sepsis; Urinary Tract Infections

There were 110 patients with preoperative sterile urine who underwent transurethral resection of the prostate and were included in a prospective, randomized, double-blind study that compared the effects of cefoxitin, a cephalosporin, to a placebo. The 2 treatment groups were comparable in age, weight of patient, general condition, diagnosis, preoperative instrumentation, operating time, weight of resected tissue and blood loss. Cefoxitin significantly lowered the incidence of infection, as indicated 3 and 7 days postoperatively, from 26.4 to 3.9 per cent and from 42 to 6.5 per cent, respectively. We were not able to correlate infection to age, general condition, diagnosis, operating time, preoperative instrumentation, weight of resected tissue or blood loss. No statistical difference was found between the 2 treatment groups in the incidence and degree of postoperative fever. These data suggest that prophylactic antibiotics should be administered preoperatively to uninfected patients who undergo transurethral resection of the prostate to prevent postoperative urinary tract infection.

Topics: Aged; Cefoxitin; Humans; Male; Middle Aged; Placebos; Premedication; Prostatectomy; Urinary Tract Infections

Topics: Cefotaxime; Cefoxitin; Cephalosporins; Gentamicins; Humans; 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; Cefoxitin; Cephalosporins; Clinical Trials as Topic; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Time Factors; 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: Cefoxitin; Cephalosporins; Clinical Trials as Topic; Humans; Kidney Diseases; Urinary Tract Infections

urinary tract infection (UTI) comes second after respiratory infections in most communities and hospital settings, affecting people of all ages. Frequent use of antibiotics to manage UTI has resulted in development of resistance, calling upon policymakers to fast-track and enforce policies that guide the use of antibiotics in the country. This study intended to determine the current antibiotic resistance to uropathogens among patients attending Kericho County Referral Hospital.. three hundred urine samples from eligible participants were cultured and bacteria colonies identified using biochemical tests. Antibiotic sensitivity was done using Kirby Bauer disk diffusion method on Mueller Hinton Agar.

Topics: Anti-Bacterial Agents; Bacteria; Cefoxitin; Ciprofloxacin; Drug Resistance, Microbial; Escherichia coli; Gentamicins; Hospitals; Humans; Kenya; Microbial Sensitivity Tests; Referral and Consultation; Staphylococcal Infections; Urinary Tract Infections

Endocarditis due to extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is a rare but challenging condition. Its treatment relies on carbapenems alone or in combination, and no alternative has been described to date. The cephamycin cefoxitin has been used for treatment of mild ESBL-producing Enterobacteriaceae infections.. We report two patients with nosocomial endocarditis due to ESBL-producing Escherichia coli and Klebsiella pneumoniae who underwent clinical failure or adverse event, respectively, during treatment with imipenem-cilastatin. The first patient was subsequently treated with cefoxitin combined with ciprofloxacin with a favorable outcome. In the second patient, the endocarditis relapsed following a 6-week treatment with cefoxitin and fosfomycin. In time-kill assays, the cefoxitin/ciprofloxacin and cefoxitin/fosfomycin combinations showed synergistic effect.. These cases illustrate that cefoxitin is an interesting alternative to carbapenems, even in severe infections such as endocarditis. Pharmacokinetic optimization and combination with another synergistic antibiotic should be considered whenever possible.

Topics: Anti-Bacterial Agents; beta-Lactamases; Carbapenems; Cefoxitin; Cilastatin, Imipenem Drug Combination; Ciprofloxacin; Endocarditis; Enterobacteriaceae; Escherichia coli; Escherichia coli Infections; Fosfomycin; Humans; Microbial Sensitivity Tests; Urinary Tract Infections

Cefoxitin has demonstrated good in vitro activity against extended spectrum beta-lactamase (ESBL)-producing Escherichia coli (ESBL-Ec) and is regarded as a carbapenem-sparing beta-lactam alternative in urinary tract infections. Its efficacy has never been compared to carbapenems in male UTIs. Our study aimed to compare the clinical and microbiological efficacy of cefoxitin (FOX) and carbapenems (CP) in febrile M-UTI due to ESBL-Ec (F-M-UTI). We conducted a multicenter retrospective cohort study of patients with F-M-UTI treated with FOX or CP as definitive therapy, between January 2013 and June 2015, in six French acute care teaching hospitals. The clinical and microbiological efficacies of FOX and CP were compared using multivariable logistic regression models, adjusting for propensity scores. Of the 66 patients included, 23 patients in FOX group and 27 in CP group had clinical assessment at follow-up. Median follow-up after end of treatment was 63 days (interquartile range 26-114). Clinical success was observed for 17/23 (73.9%) and 22/27 (81.5%) patients and microbiological success for 11/19 (57.9%) and for 6/12 (50.0%) patients in FOX and CP groups respectively. We did not find any significant difference for clinical (OR = 0.90, 95% CI [0.12; 6.70]) neither microbiological (OR = 0.85, 95% CI [0.05; 14.00]) success between CP and FOX groups in univariate and multivariable models. In the FOX group, high dose with use of continuous infusion was associated with clinical success. These results add evidence that FOX is an effective alternative treatment to carbapenems for M-UTI caused by ESBL-Ec, particularly when high doses and continuous infusion are used.

Topics: Aged; Anti-Bacterial Agents; beta-Lactamases; Carbapenems; Cefoxitin; Escherichia coli; Escherichia coli Infections; Fever; Humans; Male; Middle Aged; Propensity Score; Retrospective Studies; Urinary Tract Infections

The emergence of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) infections requires re-assessment of therapeutic choices. Here we report the efficacy of cefoxitin-based antibiotic therapy for ESBL-E prostatitis. A prospective study including patients with ESBL-E prostatitis resistant to trimethoprim/sulfamethoxazole and fluoroquinolones from January 2014 to March 2016 was conducted. Cefoxitin was administered by continuous infusion for 3 weeks in the case of acute bacterial prostatitis or 6 weeks in the case of chronic bacterial prostatitis (CBP), with intravenous fosfomycin for the first 5 days. Urological investigations were performed to diagnose underlying urinary tract pathology. Clinical and microbiological efficacy were evaluated 3 months (M3) and 6 months (M6) after the end of therapy. A total of 23 patients were included in the study. The median patient age was 74 years (range 48-88 years). Of the 23 infections, 14 (61%) were CBP and 12 (52%) were healthcare-associated infections. The bacteria involved were Escherichia coli in 11 cases, Klebsiella pneumoniae in 10 cases and Klebsiella oxytoca in 2 cases. Clinical cure was observed in 19/23 patients (83%) at M3 and in 17/22 patients (77%) at M6. Urocultures were sterile in 13/23 patients (57%) at M3 and in 9/19 patients (47%) and M6. Urinary colonisation was observed in 6/19 patients (32%) with clinical cure at M3 and 5/14 patients (36%) with clinical cure at M6. No resistance to cefoxitin was detected. Surgical treatment was required for 7/23 patients (30%). In conclusion, cefoxitin-based antibiotic therapy is suitable for difficult-to-treat ESBL-E infections such as prostatitis.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; beta-Lactamases; Cefoxitin; Cross Infection; Escherichia coli; Escherichia coli Infections; Fluoroquinolones; Fosfomycin; Humans; Klebsiella Infections; Klebsiella oxytoca; Klebsiella pneumoniae; Male; Microbial Sensitivity Tests; Middle Aged; Pilot Projects; Prospective Studies; Prostatitis; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

To describe the epidemiology and susceptibility of pathogens (including ESBL producers) from hospital-acquired (HA) versus community-acquired (CA) urinary tract infections (UTIs) and ICU- versus non-ICU-associated intra-abdominal infections (IAIs) in Turkey as a part of the SMART study.. : For this report, Gram-negative pathogens (363 from UTIs and 458 from IAIs) were collected in 2011 and 2012 at six hospitals in Turkey. HA versus CA UTIs and ICU- versus non-ICU-associated IAIs were compared for the species isolated, percentage of ESBL-positive isolates by species and susceptibility for overall and individual Gram-negative species.. : Escherichia coli was the most common pathogen identified in HA (40.2%) and CA (73.9%) UTIs and ICU-associated (25.8%) and non-ICU-associated (43.3%) IAIs. The rate of ESBL-positive E. coli was significantly higher in HA than in CA UTIs (50.5% versus 38.2%, P  <   0.001) and in non-ICU-associated than in ICU-associated IAIs (52.5% versus 29.2%, P  = 0.029). Of the drugs studied, only amikacin was active against ≥90% of pathogens in UTIs, while ertapenem, imipenem and amikacin were active against ≥90% of E. coli ; and imipenem, amikacin and cefoxitin were active against ≥90% of Klebsiella pneumoniae in IAIs.. Our findings demonstrated that E. coli continues to be the principal pathogen of UTIs and IAIs in Turkey. Along with a high rate of ESBL-positive isolates, high antimicrobial resistance among Gram-negative bacilli from either UTIs or IAIs was noted particularly in the case of HA UTIs and ICU-associated IAIs, with a higher likelihood of carbapenem- or amikacin-based therapy to provide the broadest activity against bacterial pathogens.

Topics: Amikacin; Anti-Bacterial Agents; beta-Lactams; Carbapenems; Cefoxitin; Community-Acquired Infections; Cross Infection; Enterobacteriaceae; Ertapenem; Escherichia coli; Humans; Imipenem; Intensive Care Units; Intraabdominal Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Turkey; Urinary Tract Infections

Urinary tract infections (UTIs) are one of the most common diseases by which humans seek medical help and are caused mainly by uropathogenic Escherichia coli (UPEC). Studying the virulence and antibiotic resistance of UPEC with respect to various phylogenetic groups is of utmost importance in developing new therapeutic agents. Thus, in this study, we analysed the virulence factors, antibiotic resistance and phylogenetic groups among various UPEC isolates from children with UTIs. The phylogenetic analysis revealed that majority of the strains responsible for UTIs belonged to the phylogenetic groups B2 and D. Of the 58 E. coli isolates, 79·31% belonged to group B2, 15·51% to group D, 3·44% to group A and 1·72% to B1. Simultaneously, the number of virulence factors and antibiotic resistance exhibited were also significantly high in groups B2 and D compared to other groups. Among the isolates, 44·8% were multidrug resistant and of that 73% belonged to the phylogenetic group B2, indicating the compatibility of antibiotic resistance and certain strains carrying virulence factor genes. The antibiotic resistance profiling of UPEC strains elucidates that the antimicrobial agents such as chloramphenicol, cefoxitin, cefepime, ceftazidime might still be used in the therapy for treating UTIs.. As the antibiotic resistance pattern of uropathogenic Escherichia coli varies depending on different geographical regions, the antibiotic resistance pattern from this study will help the physicians to effectively administer antibiotic therapy for urinary tract infections. In addition, the frequency of virulence factors and antibiotic resistance genes among various phylogenic groups could be effectively used to draw new targets for uropathogenic Escherichia coli antibiotic-independent therapies. The study emphasizes need of public awareness on multidrug resistance and for more prudent use of antimicrobials.

Topics: Anti-Bacterial Agents; Cefepime; Cefoxitin; Ceftazidime; Cephalosporins; Child; Chloramphenicol; Drug Resistance, Multiple, Bacterial; Escherichia coli Infections; Escherichia coli Proteins; Humans; Microbial Sensitivity Tests; Phylogeny; Republic of Korea; Urinary Tract Infections; Uropathogenic Escherichia coli; Virulence Factors

Plasmid-mediated AmpC β-lactamases (PMACBLs) in Enterobacteriaceae encode resistance to third-generation cephalosporins, and these can mediate carbapenem resistance when associated with porin loss. However, no standardized phenotypic method is available for detecting these enzymes in the clinical microbiology laboratory. Limited data are available concerning the frequency of PMACBLs in Enterobacteriaceae in Brazil. This study was conducted in response to an increased cefoxitin (CFO) resistance rate of 3.7% in Escherichia coli isolates from urine samples from patients with suspected urinary tract infections during 2010. We collected 2,266 E. coli isolates prospectively during January 2012. A total of 109 (4.8%) isolates were nonsusceptible to CFO. These strains were further examined using multiplex PCR for the presence of genes encoding PMACBLs and using inhibitor assays with CFO and ceftazidime (CAZ) disks with and without phenylboronic acid. Pulsed-field gel electrophoresis was used to evaluate clonal dissemination. Genes encoding PMACBLs were detected in 1.8% of the isolates from inpatients and 0.46% of isolates from outpatients. The most prevalent gene was blaCMY-2 and blaCMY-4 was also detected. The phenotypic analysis showed 100% sensitivity and specificity for CMY-2 and CMY-4 when CFO-resistant isolates with a minimum zone diameter difference of 5 mm for CAZ or CAZ and CFO were considered positive. Although most of the isolates were nonclonal, one clonal group with two isolates was observed. Thus, the most frequent PMACBL in E. coli from São Paulo, Brazil is CMY-2, and both clonal and plasmid-mediated dissemination occur.

Topics: Aged; Anti-Bacterial Agents; Bacterial Proteins; beta-Lactamases; Brazil; Cefoxitin; Cephalosporin Resistance; Electrophoresis, Gel, Pulsed-Field; Escherichia coli; Escherichia coli Infections; Female; Gene Expression; Gene Transfer, Horizontal; Humans; Incidence; Inpatients; Male; Molecular Epidemiology; Multiplex Polymerase Chain Reaction; Outpatients; Phylogeny; Plasmids; Urinary Tract Infections

Infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) have become a major public health issue worldwide. Cefoxitin is a second-generation cephalosporin and is associated with a strong in vitro activity against ESBL.. We conducted a prospective monocentric cohort study from 2012 to 2015 to evaluate the clinical efficacy and safety of cefoxitin in 15 patients treated for urinary tract infection (UTI) caused by ESBL-E, without any severity criteria.. We included 15 patients; 11 were male patients with defined risk factors for ESBL-E. Ten patients presented with male UTI, three with pyelonephritis, and two with cystitis. Escherichia coli was the predominant pathogen. All patients had a positive outcome with a good tolerance (a skin rash without any sign of severity was observed in one patient). Microbiological cure was obtained in 9 patients out of 10 at the end of treatment.. Cefoxitin is an alternative treatment to carbapenems for urinary tract infections caused by ESBL-producing Enterobacteriaceae.

Topics: Anti-Bacterial Agents; Bacterial Proteins; beta-Lactam Resistance; beta-Lactamases; Cefoxitin; Drug Eruptions; Escherichia coli Infections; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Middle Aged; Prospective Studies; Treatment Outcome; Urinary Tract Infections; Uropathogenic Escherichia coli

Plasmid-mediated AmpC (pAmpC) and ESBL co-production was detected in Escherichia coli a major etiologic agent of urinary tract infection. Isolates resistant to cefoxitin by CLSI methodology were tested for pAmpC beta-lactamase using phenylboronic acid and ESBLs by combined disk diffusion method. pAmpC/ESBL genes were characterized by PCR and sequencing. Transconjugation experiments were done to study the transfer of pAmpC and ESBL production from clinical isolates as donor to E. coli J53 AziR as recipient. Incompatibility groups of transmissible plasmids were classified by PCR-based replicon typing (PBRT). Among 148 urine culture positive isolates, E. coli was reported in 39.86 % (59/148), with 93.22 % (55/59) of cefoxitin resistance. pAmpC production was detected in 25, with varied distribution of blaCMY-2 and blaDHA-1type genes alone (n = 13 and 7 respectively) or in combination (n = 5). ESBL co-production was observed in 88 % (22/25) of pAmpC producing isolates with predominance of blaTEM (n = 20). Twenty-three transconjugants showed transmission of pAmpC-and ESBL-resistant genes with co-carriage of blaCMY-2 and blaTEM (n = 15) in plasmids of IncF type (n = 9) being predominant, followed by IncI1 (n = 4) and IncH1 (n = 2) in combination. All clinical isolates were clonally diverse. Resistance against different beta-lactams in uropathogenic E. coli has been an emerging concern in resource- poor countries such as India. Knowledge on the occurrence of AmpC beta-lactamases and ESBL amongst this pathogen and its transmission dynamics may aid in hospital infection control.

Topics: Anti-Bacterial Agents; beta-Lactam Resistance; beta-Lactamases; Cefoxitin; Conjugation, Genetic; Disk Diffusion Antimicrobial Tests; Escherichia coli Infections; Gene Transfer, Horizontal; Genetic Variation; Genotype; Humans; India; Molecular Typing; Plasmids; Polymerase Chain Reaction; Sequence Analysis, DNA; Urinary Tract Infections; Uropathogenic Escherichia coli

To identify the age- and sex-specific antimicrobial susceptibility patterns of Gram-negative bacteria (GNB) in outpatient febrile urinary tract infections (UTIs) in Korea.. A total 2262 consecutive samples collected from patients aged 1-101 years with febrile UTIs, during the period January 2012 to December 2014, were analyzed in this multicentre, retrospective cohort study.. The sensitivities to cefotaxime and cefoxitin were over 85% for females but under 75% for males. Sex played an important role in the susceptibility of GNB to cefotaxime (p<0.001) and cefoxitin (p<0.001). The sensitivity to ciprofloxacin (age >20 years) was under 75% in both sexes, and was not influenced by sex (p=0.204). Age distributions of the incidences of resistance to cefotaxime, cefoxitin, and ciprofloxacin (age >20 years) were similar to the age distribution of the incidence of GNB, which indicates that the resistance patterns to these drugs were not affected by age (Kolmogorov-Smirnov test, female/male: p=0.927/p=0.509, p=0.193/p=0.911, and p=0.077/p=0.999, respectively).. Age is not a considerable factor in determining the antibiotic resistance in febrile UTIs. Ciprofloxacin should be withheld from both sexes until culture results indicate its use. Second- or third-generation cephalosporins such as cefoxitin and cefotaxime can be used empirically only in females.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cefotaxime; Cefoxitin; Child; Child, Preschool; Ciprofloxacin; Cohort Studies; Drug Resistance, Bacterial; Fever; Gram-Negative Bacteria; Humans; Incidence; Infant; Male; Microbial Sensitivity Tests; Middle Aged; Republic of Korea; Retrospective Studies; Sex Factors; Urinary Tract Infections; Young Adult

The efficacy of fosfomycin alone or combined with cefoxitin was investigated in vitro and in a murine model of urinary tract infection due to susceptible Escherichia coli CFT073-RR and its transconjugant CFT073-RR Tc (pblaCTX-M-15) harbouring a plasmid carrying the blaCTX-M-15 gene. In vitro, the combination of cefoxitin and fosfomycin was synergistic and bactericidal and prevented the emergence of fosfomycin-resistant mutants of CFT073-RR and CFT073-RR Tc (pblaCTX-M-15) that were selected with fosfomycin alone. In vivo, the combination conferred an advantage in terms of kidney sterilisation of mice infected with either strain compared with fosfomycin monotherapy.

Topics: Animals; Anti-Bacterial Agents; beta-Lactam Resistance; beta-Lactamases; Cefoxitin; Drug Synergism; Drug Therapy, Combination; Escherichia coli; Escherichia coli Infections; Female; Fosfomycin; Mice; Mice, Inbred CBA; Microbial Sensitivity Tests; Urinary Tract Infections

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

We investigated the efficiency of the cephamycin cefoxitin as an alternative to carbapenems for the treatment of urinary tract infections (UTIs) due to Escherichia coli producing CTX-M-type extended-spectrum β-lactamases. The susceptible, UTI-inducing E. coli CFT073-RR strain and its transconjugant CFT073-RR Tc (pbla(CTX-M-15)), harboring a bla(CTX-M-15) carrying-plasmid, were used for all experiments. MICs of cefoxitin (FOX), ceftriaxone (CRO), imipenem (IMP), and ertapenem (ETP) for CFT073-RR and CFT073-RR Tc (pbla(CTX-M-15)) were 4 and 4, 0.125 and 512, 0.5 and 0.5, and 0.016 and 0.032 μg/ml, respectively. Bactericidal activity was similarly achieved in vitro against the two strains after 3 h of exposure to concentrations of FOX, IMI, and ETP that were 2 times the MIC, whereas CRO was not bactericidal against CFT073-RR Tc (pbla(CTX-M-15)). The frequencies of spontaneous mutants of the 2 strains were not higher for FOX than for IMP or ETP. In the murine model of UTIs, mice infected for 5 days were treated over 24 h. Therapeutic regimens in mice (200 mg/kg of body weight every 3 h or 4 h for FOX, 70 mg/kg every 6 h for CRO, 100 mg/kg every 2 h for IMP, and 100 mg/kg every 4 h for ETP) were chosen in order to reproduce the percentage of time that free-drug concentrations above the MIC are obtained in humans with standard regimens. All antibiotic regimens produced a significant reduction in bacterial counts (greater than 2 log(10) CFU) in kidneys and bladders for both strains (P < 0.001) without selecting resistant mutants in vivo, but the reduction obtained with CRO against CFT073-RR Tc (pbla(CTX-M-15)) in kidneys was significantly lower than that obtained with FOX. In conclusion, FOX appears to be an effective therapeutic alternative to carbapenems for the treatment of UTIs due to CTX-M-producing E. coli.

Topics: Animals; Anti-Bacterial Agents; Bacterial Load; beta-Lactamases; beta-Lactams; Carbapenems; Cefoxitin; Ceftriaxone; Conjugation, Genetic; Disease Models, Animal; Drug Administration Schedule; Ertapenem; Escherichia coli; Escherichia coli Infections; Female; Humans; Imipenem; Kidney; Mice; Microbial Sensitivity Tests; Mutation Rate; Plasmids; Urinary Bladder; Urinary Tract Infections

Staphylococcus saprophyticus is a uropathogenic bacterium that causes acute uncomplicated urinary tract infections, particularly in female outpatients. We investigated the dissemination and antimicrobial susceptibilities of 101 S. saprophyticus isolates from the genitourinary tracts of patients in Japan. Eight of these isolates were mecA positive and showed beta-lactam resistance. Pulsed-field gel electrophoresis showed that only some isolates were isogenic, indicating that the mecA gene was apparently acquired independently by mecA-positive isolates through staphylococcal cassette chromosome mec (SCCmec). Type determination of SCCmec by multiplex PCR showed a nontypeable element in the eight mecA-positive isolates. Sequence analysis of the entire SCCmec element from a prototype S. saprophyticus strain revealed that it was nontypeable with the current SCCmec classification due to the novel composition of the class A mec gene complex (IS431-mecA-mecR1-mecI genes) and the ccrA1/ccrB3 gene complex. Intriguingly, the attachment sites of SCCmec are similar to those of type I SCCmec in S. aureus NCTC 10442. Furthermore, the genes around the mec gene complex are similar to those of type II/III SCCmec in S. aureus, while those around the ccr gene complex are similar to those of SCC15305RM found in S. saprophyticus ATCC 15305. In comparison with known SCCmec elements, this S. saprophyticus SCCmec is a novel type.

Topics: Bacterial Proteins; Chromosomes, Bacterial; Electrophoresis, Gel, Pulsed-Field; Methicillin Resistance; Molecular Sequence Data; Polymerase Chain Reaction; Sequence Analysis, DNA; Staphylococcal Infections; Staphylococcus; Urinary Tract Infections

We report the description of a new plasmid-encoded AmpC-type beta-lactamase gene (bla(CMY-11)) from Escherichia coli K983802.1 that was isolated from a patient in South Korea suffering from a urinary tract infection. Antibiotic susceptibility testing, plasmid analysis, pI determination, transconjugation and Southern blot analysis were carried out to investigate the resistance mechanism to cefoxitin. PCR, sequencing and sequence analysis were used to identify and analyse the beta-lactamase gene (bla(CMY-11)) responsible for the cefoxitin resistance. CMY-11 and bla(CMY-11) are compared with other class C beta-lactamases and their genes to determine phylogenetic relationships. The cefoxitin-resistance phenotype of E. coli K983802.1 reflects the presence of a large plasmid [pYMG-2 (130 kb)]. A beta-lactamase with a pI value of 8.0 from a transconjugant of E. coli K983802.1 was identified by isoelectric focusing. A 1478 bp DNA fragment from pYMG-2 containing bla(CMY-11) was sequenced and an open reading frame coding for a 382 amino acid peptide (CMY-11) was found. Phylogenetic analysis clearly shows that bla(CMY-11) belongs to the group of ampC-related bla genes. It is likely that bla(CMY-11) evolved from bla(CMY-1) via bla(CMY-10).

Topics: Amino Acid Sequence; Bacterial Proteins; Base Sequence; beta-Lactamases; Cefoxitin; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Female; Humans; Korea; Middle Aged; Molecular Sequence Data; Plasmids; Urinary Tract Infections

Infections after oesophageal surgery are studied on sixty patients who received perioperatively two antibiotics (cefoxitin and amikacin). Postoperative infection rate is 62% (pneumopathies: 27%, leakage of cervical anastomoses: 17%). Different parameters which can induce postoperative infection are analyzed. The only significative data are the duration of total parenteral nutrition and of intensive care stay. The commonest isolated organisms are gram negative bacilli (61%) and streptococci (30%). Yeasts infections are frequent, and significantly correlated with antibiotic treatment duration.

Topics: Aged; Amikacin; Bacterial Infections; Cefoxitin; Esophageal Diseases; Female; Gram-Negative Bacteria; Humans; Lung Diseases; Male; Middle Aged; Parenteral Nutrition; Postoperative Complications; Premedication; Prospective Studies; Urinary Tract Infections

Topics: Cefoxitin; Enterobacteriaceae; Enterobacteriaceae Infections; Female; Humans; Infant; Ticarcillin; Tobramycin; Urinary Tract Infections

The clinical efficacy of combination therapy using Cefoxitin (CFX) and Amikacin (AMK) was studied in 19 patients with complicated urinary tract infections. Patients received 2 g of CFX i.v. and 100 mg of AMK i.m. twice a day. The overall clinical efficacy of treatment was evaluated by the criteria proposed by the UTI Committee, Japan, as excellent, moderate or poor. The overall clinical efficacy was excellent in 89%, moderate in 5% and poor in 5% of the patients. Of the 21 strains isolated from the patients, 20 strains (95%) were eradicated. No subjective side effects were observed. Drug-related aggravation in laboratory tests were observed slight elevations of glutomic-oxalacefic transaminase, glutamic-pyruvic transaminase and alkaliphosphatase in 2 cases, but all of them were minimal and reversible. Underlying condition-related aggravation was observed a slight elevation of BUN and creatinine clearance in 1 case. These results suggest that the combination therapy with CFX and AMK might be useful in the treatment of complicated urinary tract infections.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amikacin; Cefoxitin; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Urinary Tract Infections

Among 185 patients with nonneutropenic, community-acquired gram-negative bacillary bacteremias, clinical risk factors for cefoxitin resistance included any antibiotic taken within the last three weeks (25.6% cefoxitin resistance), long-term bladder catheterization or surgical urinary diversion (23.3%), hospitalization within the last 30 days (22.9%), and nursing home residence before admission (20.8%). Patients with none of these risk factors were less likely to have cefoxitin-resistant bacteremias (0.9%). When these risk factors were examined in the subgroups of urinary tract and non-urinary tract sources of community-acquired gram-negative bacillary bacteremia, they were also helpful in predicting sensitivity to trimethoprim-sulfamethoxazole and gentamicin. The presence of one or more of the risk factors identified may be a useful adjunct in determining initial empiric antimicrobial therapy for community-acquired gram-negative bacillary bacteremia.

Topics: Cefoxitin; Child; Clindamycin; Cross Infection; Drug Combinations; Drug Resistance, Microbial; Gentamicins; Gram-Negative Bacteria; Humans; Retrospective Studies; Risk; Sepsis; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Catheterization; Urinary Diversion; Urinary Tract Infections

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

Amdinocillin has previously been shown to be synergistic with other beta-lactam antibiotics against many gram-negative bacteria. We evaluated the safety, efficacy, and microbiologic activity of combination amdinocillin and cefoxitin treatment in 17 patients with complicated urinary tract infections caused by multiply-resistant Serratia marcescens. Patients were treated with amdinocillin, 40 mg/kg per day, and cefoxitin, 100 mg/kg per day, for five to 14 days. In vitro synergistic activity was observed for 17 isolates using broth checkerboard testing and for nine isolates using combination disc diffusion testing. Of the 17 patients treated, 11 were bacteriologically cured, one failed to respond, and five patients had a relapse after initial improvement. Relapses followed short-duration therapy. Amdinocillin with cefoxitin was well tolerated. Combination amdinocillin and cefoxitin therapy was efficacious and safe in treating complicated urinary tract infections caused by multiply-resistant S. marcescens.

Topics: Adult; Aged; Amdinocillin; Cefoxitin; Drug Therapy, Combination; Enterobacteriaceae Infections; Humans; Injections, Intravenous; Male; Middle Aged; Penicillanic Acid; Serratia marcescens; Urinary 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

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

Two elderly women suffered an acute deterioration of renal function after treatment with cefoxitin sodium. One with stable chronic renal failure due to reflux nephropathy underwent a rapid deterioration of renal function which proved fatal. The other woman had rheumatoid arthritis and developed acute tubular necrosis after treatment with gentamicin and cefoxitin. All the data suggested that the antibiotic was responsible for the deterioration in renal function. The dose of cefoxitin should be reduced in patients with renal functional impairment. Cefoxitin should either be used with great caution or not prescribed in combination with aminoglycoside antibiotics.

Topics: Acute Kidney Injury; Aged; Aminoglycosides; Arthritis, Rheumatoid; Cefoxitin; Creatinine; Escherichia coli Infections; Female; Gentamicins; Humans; Kidney; Urea; Urinary Tract Infections

Topics: Aged; Bacterial Infections; Cefoxitin; Female; Humans; Male; Urinary Tract Infections

Topics: Adult; Aged; Bacteria; Bacterial Infections; Cefoxitin; Drug Evaluation; Drug Resistance, Microbial; Female; Genital Diseases, Female; Humans; Middle Aged; Urinary Tract Infections

Topics: Adult; Aged; Bacterial Infections; Cefoxitin; Female; Humans; Kidney Diseases; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis; Urinary Tract Infections

Cefoxitin is a useful new chephamycin antibiotic available for IM of IV administration. It is a bactericidal beta-lactam antibiotic indicated for treatment of serious infections caused by a wide spectrum of gram-negative aerobic and anaerobic bacteria. Specific indications include: 1) polymicrobial infections (aerobic gram-negative rods and anaerobic bacteria); 2) nosocomial cephalothin-resistant gram-negative bacillary infections; 3) penicillin-resistant staphylococcal infections, and 4) anaerobic infections (pelvic, intraabdominal). Cefoxitin can be used as a single drug alternate to a two-drug antibiotic regimen (such as a cephalosporin-aminoglycoside combination) in polymicrobic infections of the pelvis, abdomen, skin, bones, or muscles. Cefoxitin is a significant drug in the armamentarium against anaerobic bacteria, particularly Bacteroides species. Since cefoxitin is highly resistant to staphylococcal beta-lactamase, it is effective against penicillin-resistant staphylococci. Cefoxitin has been effective in treating serious nosocomial infections caused by resistant aerobic gram-negative rods and anaerobic bacteria.

Topics: Bacteria; Bacterial Infections; Cefoxitin; Female; Humans; Infant; Infant, Newborn; Pelvic Inflammatory Disease; Surgical Wound Infection; Urinary Tract Infections

Topics: Aged; Cefoxitin; Cephalosporins; Cross Infection; Drug Evaluation; Drug Resistance, Microbial; England; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; London; Male; Urinary Tract Infections

1) Serum concentrations of cefoxitin (CFX) was lower than that of cefazolin (CEZ), but the tissue concentrations of CFX were higher in ovary, oviduct and uterus compared with CEZ. 2) CFX was administered to 15 patients with moderate intrapelvic or urinary tract infections at a dose of 4 g per day for 5 to 7 days. The overall results obtained were as follows; excellent in 6 cases, good in 6 cases. The CFX treatment was effective in all patients, 8 cases, with intrapelvic infections. 3) The majority of organisms detected were E. coli (12 strains), and the antimicrobial activity of CFX against them was superior to those of CEZ and CET. 4) No side effects and abnormal laboratory findings were observed. 5) It is considered that CFX will be a useful drug in the field of obstetrics and gynecology.

Topics: Adnexal Diseases; Adult; Cefazolin; Cefoxitin; Cephalosporins; Escherichia coli; Fallopian Tubes; Female; Humans; Leiomyoma; Middle Aged; Myometrium; Ovary; Urinary Tract Infections; Uterine Neoplasms

Topics: Cefoxitin; Cephalosporins; Cross Infection; Drug Resistance, Microbial; Escherichia coli Infections; Humans; Intensive Care Units; Urinary Tract Infections

Topics: Adolescent; Adult; Bacterial Infections; Bone Diseases; Cefoxitin; Cephalosporins; Humans; Middle Aged; Muscular Diseases; Urinary Tract Infections

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