cefpodoxime-proxetil and Skin-Diseases--Bacterial

This multicenter, randomized, double-blind study was designed to compare the safety and efficacy of cefpodoxime proxetil and cefaclor in the treatment of skin and soft tissue infections. Patients were aged > or = 12 years with acute (< or = 7 days duration), single-site skin or skin-structure infections. The 7- to 10-day treatment regimens were cefpodoxime proxetil (400 mg cefpodoxime) orally with food twice a day with cefaclor-matched placebo (orally, fasting, three times a day); or cefaclor (Ceclor; 500 mg anhydrous equivalent) orally, fasting, three times a day, with cefpodoxime-matched placebo (orally with food twice a day). Clinical progress and cultures were evaluated upon admission to the study; on study days 7-10 and 15-18; and 2-3 weeks after treatment. Cefpodoxime had lower minimum inhibitory concentrations against the majority of Staphylococcus species than did cefaclor. Both treatments were highly effective (99% pathogen eradication and 86% cure rate). These high eradication rates were not unexpected in this study of minor infections in which patients with resistant pathogens were excluded. Cefaclor had a higher failure rate [2 (4%) of 57], than did cefpodoxime [2 (1%) of 139; p not significant]. Most patients in both groups completed treatment as planned: 185 (74%) of 249 cefpodoxime-treated patients and 91 (75%) of 122 cefaclor-treated patients. Both treatments were well tolerated and considered safe and effective in the treatment of skin and skin structure infections. However, the twice-a-day dosing regimen for cefpodoxime proxetil compared with the three-times-a-day regimen for cefaclor may result in better patient compliance.

Topics: Administration, Oral; Adult; Bacterial Infections; Cefaclor; Cefpodoxime Proxetil; Ceftizoxime; Connective Tissue Diseases; Double-Blind Method; Drug Administration Schedule; Drug Resistance, Microbial; Female; Humans; Male; Middle Aged; Prodrugs; Safety; Skin Diseases, Bacterial; Staphylococcal Infections

The authors present their experience with antimicrobial treatment with cephalosporin of the third generation, cefpodoxime proxetil, in skin and soft tissue infections in a group of patients treated at the ambulatory department of the Surgical Clinic in Prague 10 in 1995. From the total number antimicrobial treatment was administered to 6 patients with a phlegmon, 5 patients with panaritium, 4 patients with an early infection after laparotomy, 3 with an abscess in the subcutaneous layer, and with cheilitis and bursitis of the olecranon in the remaining two patients. In addition to surgical treatment (incision, evacuation and drainage) cefpodoxime proxetil-200 mg after 12-hour intervals for 6-9 days-was administered to the patients. For microbiological examination a smear from the inflammatory focus and from the nasopharynx was used. The cefpodoxime proxetil serum level was assessed during the 1st-11th hour after administration of the antibiotic. All 20 patients recovered.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial Infections; Cefpodoxime Proxetil; Ceftizoxime; Female; Humans; Male; Middle Aged; Prodrugs; Skin Diseases, Bacterial; Soft Tissue Infections