cefsulodin and Pseudomonas-Infections

Cephalosporins modified at the C-3 and C-7 positions of the cephem-nucleus have high antimicrobial activity and are safe. With evolution through first, second, and third generations, they have gained increasing gram-negative activity, but often at the expense of potency against gram-positive organisms. All third-generation cephalosporins have some intrinsic anti-Pseudomonas activity, indicating their potential benefit in the treatment of acute pulmonary exacerbations in patients with cystic fibrosis. Rational therapy in this clinical setting requires recognition of the pharmacodynamic and pharmacokinetic idiosyncrasies intrinsic to this patient population. When these priorities are recognized, only two of the available agents, cefsulodin and ceftazidime, appear to be of any therapeutic value. Both agents have been evaluated extensively in the treatment of acute pulmonary exacerbation in cystic fibrosis, and both have been found to be safe and effective.

Topics: Cefsulodin; Ceftazidime; Cephalosporins; Clinical Trials as Topic; Cystic Fibrosis; Humans; Kinetics; Lung Diseases; Pseudomonas Infections; Structure-Activity Relationship

Topics: Anti-Bacterial Agents; beta-Lactamases; beta-Lactams; Cefoperazone; Cefotaxime; Cefsulodin; Ceftazidime; Ceftriaxone; Cephalosporins; Cephamycins; Drug Stability; Lactams; Moxalactam; Penicillins; Pseudomonas aeruginosa; Pseudomonas Infections; Thienamycins

The efficacy of cefsulodin against infections caused by Pseudomonas aeruginosa was investigated first in an open trial and then in a controlled comparative study in which ticarcillin was used. The first trial consisted of 16 patients with proven Pseudomonas aeruginosa infections, 9 of whom also received an aminoglycoside. In the second trial 28 such patients were evaluated (14 on cefsulodin 1 g 4 times daily and 14 on ticarcillin 5 g 4 times daily); all patients also received an aminoglycoside. The results of the two trials were similar in that 75% of the patients of the first trial and 86% of the second group exhibited an excellent or good response to cefsulodin. For the ticarcillin group a similar response was noted. In the first trial the sensitivity of P. aeruginosa did not change markedly, whereas one strain of the cefsulodin group became resistant in the second trial. Pharmacokinetic data were in agreement with those reported in the literature. Side effects were rare.

Topics: Adult; Aged; Aged, 80 and over; Aminoglycosides; Anti-Bacterial Agents; Cefsulodin; Clinical Trials as Topic; Drug Resistance, Microbial; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Penicillins; Pseudomonas Infections; Random Allocation; Ticarcillin

Cephalosporins modified at the C-3 and C-7 positions of the cephem-nucleus have high antimicrobial activity and are safe. With evolution through first, second, and third generations, they have gained increasing gram-negative activity, but often at the expense of potency against gram-positive organisms. All third-generation cephalosporins have some intrinsic anti-Pseudomonas activity, indicating their potential benefit in the treatment of acute pulmonary exacerbations in patients with cystic fibrosis. Rational therapy in this clinical setting requires recognition of the pharmacodynamic and pharmacokinetic idiosyncrasies intrinsic to this patient population. When these priorities are recognized, only two of the available agents, cefsulodin and ceftazidime, appear to be of any therapeutic value. Both agents have been evaluated extensively in the treatment of acute pulmonary exacerbation in cystic fibrosis, and both have been found to be safe and effective.

Topics: Cefsulodin; Ceftazidime; Cephalosporins; Clinical Trials as Topic; Cystic Fibrosis; Humans; Kinetics; Lung Diseases; Pseudomonas Infections; Structure-Activity Relationship

Cefsulodin sodium is a narrow-spectrum cephalosporin with marked in vitro activity against clinical isolates of Pseudomonas aeruginosa. We have studied the antibiotic in a clinical trial in 10 patients admitted to the Pediatric Ward of the University of Virginia Medical Center with cystic fibrosis and recurrent acute lower respiratory tract infections with P. aeruginosa isolated from their sputa. The patients received 500 to 1,500 mg of cefsulodin every 6 hours by intravenous infusion for 10 to 22 days. Mean peak drug levels in plasma after 500, 1,000, and 1,500 mg were 46, 71, and 90 micrograms/ml, respectively, and the mean minimal inhibitory concentration of all organisms was 7.5 micrograms/ml. Detectable levels of cefsulodin in sputa were found in approximately half of the random samples and ranged from 2 to 5 micrograms/ml. The clinical response was satisfactory in nine (90%) of the patients. One patient gained weight and had improved pulmonary function tests but showed no reduction in sputum production and no improvement in arterial blood gas values. In pulmonary function tests, four of five patients tested showed an average 43% increase in forced vital capacity after initiation of therapy and five of five had an average 51% increase in forced expired volume in 1 s. No adverse effects were observed.

Topics: Adolescent; Adult; Cefsulodin; Cephalosporins; Clinical Trials as Topic; Cystic Fibrosis; Humans; Pseudomonas aeruginosa; Pseudomonas Infections; Sputum

We have investigated the effectiveness of seven new beta-lactam antibiotics, azlocillin, piperacillin, ceftazidime, cefsulodin, cefoperazone, latamoxef (moxalactam), and cefotaxime, against acute pulmonary exacerbations caused by Pseudomonas aeruginosa in cystic fibrosis. Three hundred and fifty-five strains of Ps aeruginosa isolated from 310 sputum cultures (190 cystic fibrosis patients) were tested for susceptibility to the drugs by determination of minimal inhibitory concentrations (MIC). The highest activity was shown by ceftazidime (6% resistant strains) followed by cefsulodin and piperacillin (15 and 16% resistant strains); very low activity was found for cefotaxime and latamoxef (moxalactam). Ceftazidime was the most active drug against 32 pseudomonas isolates that were resistant to both carbenicillin and aminoglycosides (78% susceptible). A randomized, double-blind trial of azlocillin, piperacillin, ceftazidime, cefsulodin or cefoperazone was performed in 111 cystic fibrosis patients with predominant and susceptible pseudomonas in their sputum. Results were evaluated by a clinical, radiological and bacteriological scoring system: the best results were obtained with ceftazidime, followed by cefsulodin and piperacillin. However, pseudomonas was eradicated in only 22 (23%) of the cases with the most active drugs and persisted or reappeared in all the cases 1 to 3 months later. Ceftazidime always eradicated Staph. aureus and Haemophilus influenzae associated with pseudomonas. Similar eradication occurred nearly always with cefsulodin but rarely with the other drugs. No serious drug reaction occurred but a later fever and rash with piperacillin, transient diarrhoea with cefoperazone, vomiting with cefsulodin, and very frequent eosinophilia with ceftazidime should be mentioned. These five drugs offer, in varying degree, alternatives to traditional anti pseudomonas antibiotics in cystic fibrosis pulmonary infections, but they should be used only against well-proven resistant strains. Ceftazidime is best and cefotaxime and latamoxef (moxalactam) least useful.

Topics: Adolescent; Alcohol Deterrents; Anti-Bacterial Agents; Azlocillin; Cefoperazone; Cefotaxime; Cefsulodin; Ceftazidime; Cephalosporins; Child; Clinical Trials as Topic; Cystic Fibrosis; Double-Blind Method; Eosinophilia; Humans; Moxalactam; Penicillins; Piperacillin; Pseudomonas Infections; Random Allocation; Respiratory Tract Infections

The therapeutic efficacy and safety of Cefpiramide (CPM, SM-1652) at a 2 g/day dose were objectively compared with those of Cefsulodin (CFS) at a 2 g/day dose in patients with chronic complicated urinary tract infections (UTI) by P. aeruginosa in a double-blind study at 46 institutions in Japan. The results are as follows: The therapeutic efficacy was analyzed in 254 patients (136 cases administered CPM and 118 cases administered CFS) after excluding 20 cases as drop-out. Among 254 cases, the number of patients with infection of P. aeruginosa was 190 cases (100 cases administered CPM and 90 cases administered CFS), while that with infection of organisms other than P. aeruginosa was 64 cases (36 cases administered CPM and 28 cases administered CFS). By the administration of a 2 g/day dose for 5 days, the overall clinical effective rate of CPM was significantly higher than that of CFS in total patients. When the patients were classified into 2 groups with respect to causative organisms (P. aeruginosa and others), the clinical effective rate of CPM in patients with infections of P. aeruginosa was significantly higher than that of CFS, while the clinical effective rate of CPM in patients with infection of other organisms than P. aeruginosa was the same as that of CFS. As to the bacteriological effect on bacteriuria, the eradication rate of CPM was significantly higher than that of CFS not only against all causative organisms but also against P. aeruginosa. The rate of replacement by S. faecalis was significantly higher in the CFS-treated group than in the CPM-treated group. The same result was obtained on the rate of replacement by other organisms. The MIC values of CPM for isolated organisms before drug administration were lower than those of CFS. The incidence rates of side effects and the abnormal findings of clinical laboratory tests were the same for the CPM- and CFS-treated groups. From the results, it was concluded that CPM is a useful drug for the treatment of patients with chronic complicated urinary tract infections caused by P. aeruginosa.

Topics: Adult; Aged; Cefsulodin; Cephalosporins; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Injections, Intravenous; Male; Middle Aged; Pseudomonas Infections; Urinary Tract Infections

Topics: Adult; Cefsulodin; Cephalosporins; Chronic Disease; Clinical Trials as Topic; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Otitis Media; Otorhinolaryngologic Diseases; Pseudomonas Infections

Topics: Adolescent; Age Factors; Cefsulodin; Cephalosporins; Child; Child, Preschool; Clinical Trials as Topic; Drug Resistance, Microbial; Female; Humans; Male; Pseudomonas aeruginosa; Pseudomonas Infections

Topics: Adult; Cefsulodin; Cephalosporins; Clinical Trials as Topic; Drug Resistance, Microbial; Female; Genital Diseases, Female; Genitalia, Female; Humans; Middle Aged; Pseudomonas aeruginosa; Pseudomonas Infections

These studies were designed to determine the combined inhibitory effect of a human monoclonal antibody (MAb) and cefsulodin on Pseudomonas aeruginosa renal infection in a neutropenic condition.. Protection against the infection of mice was estimated by survival rate and bacterial numbers in the kidney and blood. Opsonophagocytic assay by human polymorphonuclear neutrophils (PMNs) and fluorescence activated cell sorter (FACS) analysis were also examined.. Treatment of infected mice with MAb combined with a suboptimal dose of cefsulodin prevented the mice from developing pyelonephritis and bacteremia and resulted in a significantly higher survival rate than treatment with either MAb or cefsulodin alone (p < 0.01). When bacteria were preexposed to cefsulodin, a significant enhancement in opsonophagocytic killing with MAb was observed. Fluorescence activated cell sorter analysis suggested that the bacteria incubated with 1/4 minimal inhibitory concentration (MIC) of cefsulodin showed greater binding of MAb to bacteria than the control.. The combination therapy with human antilipopolysaccharide MAb and cefsulodin is useful for P. aeruginosa pyelonephritis in neutropenic hosts.

Topics: Animals; Antibodies, Monoclonal; Bacteremia; Cefsulodin; Cephalosporins; Combined Modality Therapy; Female; Flow Cytometry; Humans; Lipopolysaccharides; Mice; Mice, Inbred BALB C; Neutropenia; Neutrophils; Phagocytosis; Pseudomonas Infections; Pyelonephritis

Episodes of septic arthritis caused by Pseudomonas aeruginosa occurred in a patient with an infected vascular graft. He responded well to antibiotic therapy and removal of the graft was not required. The aetiology of this unusual cause of septic arthritis is discussed.

Topics: Aged; Arthritis, Infectious; Blood Vessel Prosthesis; Cefsulodin; Ciprofloxacin; Drug Therapy, Combination; Humans; Male; Prosthesis-Related Infections; Pseudomonas Infections; Recurrence

Nosocomial infections by Pseudomonas aeruginosa seen in a general intensive care unit from January 1987 through December 1989 were studied. Use of piperacillin, ticarcillin, cefsulodine, ceftazidime, and imipenem over the same period were recorded. Rate of infection by P. aeruginosa among the 1,844 patients admitted during the study period was 3.2%; 32% of all nosocomial infections during this period were due to P. aeruginosa. The proportion of P. aeruginosa strains exhibiting in vitro susceptibility to ticarcillin rose from 45.5% in 1987 to 59% in 1988 and 86% in 1989. Concomitantly, the proportion of P. aeruginosa strains simultaneously resistant to ticarcillin, piperacillin, cefsulodine and ceftazidime fell from 32% to 18.5% then 0%. A statistically significant correlation was found between the decrease in piperacillin use and the fall in penicillinase-producing ticarcillin-resistant strains of P. aeruginosa. Because piperacillin has undesirable effects on the intestinal flora and promotes the emergence of resistant strains of P. aeruginosa, the authors now use narrow spectrum antimicrobial agents as first line treatment of nocosomial infections.

Topics: Cefsulodin; Ceftazidime; Cross Infection; Drug Resistance, Microbial; Female; Humans; Imipenem; Intensive Care Units; Male; Middle Aged; Piperacillin; Pseudomonas aeruginosa; Pseudomonas Infections; Ticarcillin

Pharmacokinetic studies on cefsulodin (CFS) were carried out in perinatal mothers and infants. The results obtained are summarized as follows. 1. CFS was promptly absorbed upon intravenous drip infusion in pregnant women, producing dose-related peak serum levels. Placental transference to the fetus occurred quickly and at high levels. Upon intravenous drip infusion of 1-2 g of CFS, drug concentration of the cord blood and amniotic fluid exceeded MICs of clinically isolated strains of Pseudomonas aeruginosa. These levels in cord blood ranged 3.3-16.9 micrograms/ml upon 1 g intravenous drip infusion and 0.8-21.6 micrograms/ml upon 2 g intravenous drip infusion, and in amniotic fluid they were 1.3-15.6 micrograms/ml upon 1 g administration and 5.5-17.9 micrograms/ml upon 2 g administration. The drug was transferred into newborn infant through placenta, showing no tendency to accumulate. According to the above results, it appears possible to successfully prevent or treat perinatal infections through administration of the dose of 1-2 g twice daily. 2. Moreover, newborn infants delivered from mothers receiving CFS administration showed no laboratory test abnormalities. 3. The penetration of CFS into mother's milk occurred at low levels, and the transference from milk to newborn infants appeared to occur at even low levels. The above results have demonstrated that CFS is a clinically useful antibiotic for prophylaxis and treatment of perinatal Pseudomonas infections.

Topics: Cefsulodin; Female; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Maternal-Fetal Exchange; Milk, Human; Pregnancy; Pseudomonas aeruginosa; Pseudomonas Infections

Standardized burns without experimental infection and such with infection by a constant number of bacteria of a fixed Pseudomonas-aeruginosa-strain were treated differently. Silver sulfadiazine- and Cefsulodin-cream, Polyvidon-iodine-ointment (PVP-Jod), and hyperbaric oxygen (OHP) were used to them. The courses of healing were checked by determination of the wound area daily. The best results showed the experimental uninfected untreated wounds. Wounds infected by Pseudomonas were healing most quickly by immediate and continuous application of hyperbaric oxygen. By silver sulfadiazine- and Cefsulodin-cream treated burns showed statistical significant better results than the control group. The courses of healing were significantly poorer in delayed application of OHP (only from the 8th day after the burn) or in case of therapy with PVP-iodine alone.

Topics: Administration, Topical; Animals; Burns; Cefsulodin; Female; Guinea Pigs; Hyperbaric Oxygenation; Ointments; Povidone-Iodine; Pseudomonas Infections; Silver Sulfadiazine; Wound Healing; Wound Infection

Experimental meningitis was induced in rats with Pseudomonas aeruginosa. Bacteria were inoculated in the second ventricle. Twenty hours later cefsulodin penetration was studied in CSF by on-line cannula system which permitted sampling of CSF in the third ventricle. Comparison with healthy animals indicated breakdown of the blood-CSF barrier and high concentrations of cefsulodin were found in CSF.

Topics: Animals; Cefsulodin; Male; Meningitis; Pseudomonas Infections; Rats; Rats, Inbred Strains

Cefsulodin is a third generation cephalosporin with specific antipseudomonas activity. We used cefsulodin in combination with aminoglycosides in 15 cystic fibrosis patients treatments. There were 13 children or adolescents, 4 to 19 years old with chronic Pseudomonas aeruginosa lung infections: 9 patients had acute exacerbations of infection with occasionally important respiratory insufficiency and 5 patients had a regimen of regular treatment every 3 months. Cefsulodin was given after record of bacterial sensitivity to antibiotics, at the mean posology of 100 mg/kg, IV, tid. The combination with aminoglycosides was systematic: tobramycin (6 mg/kg/day), netilmicin (6 mg/kg/day) or amikacin (30 mg/kg/day). Duration of treatment was 9 to 15 days.. --clinical improvement in all patients, important in 13 patients and moderate in 2 patients;--respiratory function improvement in 11 patients;--pulmonary radiography improvement in 10 patients;--Pseudomonas were eradicated in 8 patients but temporarily and were found after treatment in 7 patients, 5 with lower number, 2 with higher number. Clinical and biological tolerance was excellent. The present study shows the interest of cefsulodin use in combination with aminoglycosides in this pathology.

Topics: Adolescent; Adult; Aminoglycosides; Anti-Bacterial Agents; Cefsulodin; Child; Child, Preschool; Cystic Fibrosis; Drug Therapy, Combination; Female; Humans; Lung Diseases; Male; Pseudomonas Infections; Superinfection

Techniques for demonstrating synergy in vitro were compared in testing different beta-lactam-aminoglycoside combinations against 30 isolates of Pseudomonas aeruginosa. Poor concordance was noted among the results from chequerboard and 6 h and 24 h time-kill methods. Comparison of in-vitro synergy results with clinical outcome in 14 patients with pseudomonas infection showed that antagonism in the 24 h time-kill method was the most reliable prognostic indicator of clinical and bacteriological outcome. Although more than 70% of patients were cured clinically with cefsulodin or ticarcillin with tobramycin or amikacin, pseudomonas resistant to the beta-lactam emerged in 7 of 14 patients (50%); of those seven, three had poor clinical outcome. The rationale of adding aminoglycoside to beta-lactams against P. aeruginosa to prevent emergence of resistance needs closer examination.

Topics: Adult; Aged; Amikacin; Aminoglycosides; Anti-Bacterial Agents; Cefsulodin; Drug Synergism; Drug Therapy, Combination; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Penicillin Resistance; Pseudomonas aeruginosa; Pseudomonas Infections; Ticarcillin; Tobramycin

The rat granuloma pouch model was used to study the penetration of imipenem into inflammatory exudate and its efficacy in an experimental local infection. Rats were given a single intravenous injection of drug via the tail vein at a dose of 40 mg/kg. The peak concentrations of imipenem, ceftizoxime, cefazolin, and cefsulodin in exudates ranged from 10.1 to 12.3 mg/l, except that ampicillin achieved only 5.4 mg/l. Imipenem rapidly reached peak concentration after injection, but the half life for elimination of imipenem from exudate was 77.7 min, which was shorter than that of other beta-lactam antibiotics. Imipenem exhibited more rapid reduction in bacterial growth than cefsulodin in an experimental local infection with Pseudomonas aeruginosa in the pouch model. The results suggested that imipenem was an effective agent in treating the local infection.

Topics: Animals; Anti-Bacterial Agents; Cefazolin; Cefotaxime; Cefsulodin; Ceftizoxime; Exudates and Transudates; Granuloma; Imipenem; Inflammation; Male; Pseudomonas aeruginosa; Pseudomonas Infections; Rats; Rats, Inbred Strains; Thienamycins

The clinical efficacy of the combination therapy with cefmenoxime plus cefsulodin was studied in patients with complicated urinary tract infections caused by Pseudomonas aeruginosa. Patients received 1 g of CMX and 1 g of CFS concomitantly twice a day by 1-hour intravenous drip infusion. Of a total of 127 patients who received medication, 82 patients were evaluated on the 5th day. The overall clinical efficacy of treatment was evaluated by the criteria proposed by the UTI Committee, Japan, as excellent, moderate or poor. It was excellent in 15%, moderate in 55% and poor in 30%. Of the 143 strains isolated from 82 patients, 115 strains (80%) were eradicated. The eradication rate of P. aeruginosa was 83%. Subjective side effects were observed in 3 (2.4%) of the patients. Drug-related aggravations in laboratory test results were observed in 8 (7.5%), but most of them were minimal and reversible. The results of this study suggest that a combination of cefmenoxime and cefsulodin might be useful in the treatment of complicated urinary tract infections caused by P. aeruginosa.

Topics: Candidiasis; Cefmenoxime; Cefotaxime; Cefsulodin; Drug Therapy, Combination; Enterobacteriaceae Infections; Humans; Pseudomonas Infections; Urinary Tract Infections

Cefmenoxime (2 g) and cefsulodin (1 g) were given twice daily for 5 days by concomitant intravenous drip infusion (mixed infusion) to 135 patients with complicated urinary tract infection (c-UTI) probably caused by Pseudomonas aeruginosa. The clinical efficacy was evaluated according to the criteria proposed by the UTI committee in Japan. Ninety one subjects met the criteria for c-UTI and were evaluable for drug efficacy. P. aeruginosa was detected in 44 cases (including mixed infection with other organisms). The overall efficacy rate was 73% of the 91 cases; 75% of the 44 cases with P. aeruginosa and 70% in the 47 cases without P. aeruginosa infection. As to bacteriological response, the eradication rate was 91% (105/116) for all cases. By organism, the eradication rate for P. aeruginosa, Serratia spp. and Citrobacter spp. were 82 (36/44), 100 (12/12) and 100% (10/10), respectively. The eradication rate for gram-negative rods was 93% (99/107). Twenty-three strains appeared after treatment, and the majority of them (13) were yeast-like organisms. There was only one strain of P. aeruginosa. As for side effects, eruption was found in 2 cases. Cefmenoxime and cefsulodin were administered concomitantly to patients with c-UTI which was suspected to be caused by P. aeruginosa. The high overall efficacy rate of about 70% on the average was obtained regardless of the causative organism and disease state. The eradication rate of as high as about 90% was obtained excluding Enterococcus faecalis. Neither severe side effects nor abnormal laboratory values were found. It appeared, therefore, that this dosage regimen was useful for the treatment of refractory complicated urinary tract infection.

Topics: Anti-Infective Agents, Urinary; Cefmenoxime; Cefotaxime; Cefsulodin; Chronic Disease; Drug Administration Schedule; Drug Evaluation; Drug Therapy, Combination; Humans; Pseudomonas Infections; Urinary Tract Infections

Cefsulodin, a narrow-spectrum cephalosporin with excellent antipseudomonal activity was used to treat 48 patients with 51 Pseudomonas aeruginosa infections. These included osteomyelitis, infected prostheses, post-operative and post-traumatic superficial wounds, decubitus and stasis ulcers, lower respiratory tract infections and infections of the urinary tract. Many of the patients were compromised by underlying debilitating conditions such as severe trauma, diabetes mellitus, vascular impairment, and abuse of alcohol and drugs. In cases of polymicrobial infections, a concomitant non-antipseudomonal antibiotic was sometimes administered. Cefsulodin was administered intravenously to 47 patients and by intramuscular injections to one individual. The dosage ranged from 0.5 to 2.0 g every six hr and duration of therapy was from 4 to 70 days. A satisfactory clinical response was observed in 88% of the patients. P. aeruginosa was eradicated from 76% of the infection sites. Failures, which included relapse within one year, were generally associated with prior severe trauma or vascular impairment in cases of osteomyelitis. Reinfections and superinfections developed in 12 individuals. Adverse reactions reported for two patients were nausea and vomiting. A third patient had transient increases in alkaline phosphatase and SGOT. These data indicate that cefsulodin is an effective and safe antibiotic in various types of P. aeruginosa infections.

Topics: Adult; Aged; Aged, 80 and over; Cefsulodin; Female; Humans; Male; Middle Aged; Osteomyelitis; Pseudomonas Infections; Respiratory Tract Infections; Urinary Tract Infections; Wound Infection

Male patients with spinal cord injury and urinary tract infection with Pseudomonas aeruginosa were treated with cefsulodin (1.0 or 1.5 Gm) every six hours or an aminoglycoside (amikacin 5 mg/Kg or tobramycin 1 mg/Kg) every eight hours for seven days. The study was discontinued after treating 6 patients with aminoglycosides because of the poor results with these antibiotics. At five to nine days after completing treatment P. aeruginosa was eliminated from the urine of 12 to 15 patients (80%) treated with cefsulodin and 3 of 6 patients (50%) treated with an aminoglycoside. When examined at four to six weeks 5 of 15 (33%) of the cefsulodin group had persistent infection or relapse, while 5 of 6 (83%) infections treated with an aminoglycoside either persisted or relapsed. Cefsulodin was discontinued in 1 patient, known to be allergic to penicillin, because of hypersensitivity resulting in periorbital edema and rash. No other serious side effects were noted with cefsulodin or the aminoglycosides. These results indicate that cefsulodin is an effective antibiotic in the treatment of urinary tract infection with P. aeruginosa in patients with neurogenic bladder resulting from spinal cord injury and confirmed previous observations of a poor response of Pseudomonas urinary tract infection to aminoglycosides in this group of patients.

Topics: Adult; Amikacin; Aminoglycosides; Anti-Bacterial Agents; Cefsulodin; Humans; Male; Middle Aged; Pseudomonas Infections; Spinal Cord Injuries; Time Factors; Tobramycin; Urinary Tract Infections

The article reports on the incidence, the conditions of occurrence, possibilities and successes of treatment with certain (combinations of) antibiotics, in dealing with cases of pseudomonas meningitis. The various possible substances used for treatment are discussed. Rates of penetration and CSF concentrations of azlocillin and cefsulodin are stated. Alternative possibilities for treatment are pointed out.

Topics: Aminoglycosides; Anti-Bacterial Agents; Azlocillin; Bacteriological Techniques; Brain Injuries; Cefsulodin; Cephalosporins; Diagnosis, Differential; Fosfomycin; Humans; Meningitis; Penicillins; Polymyxins; Pseudomonas Infections

The inadequacy of the present medical therapy of Pseudomonas aeruginosa endocarditis prompted an investigation of the in vitro activities of aztreonam, cefsulodin, and imipenem compared with that of ticarcillin against 37 strains of P. aeruginosa isolated from patients with endocarditis. Inhibitory and bactericidal activities were studied for each beta-lactam alone and in combination with tobramycin. All agents showed excellent inhibitory activity. Imipenem was the most inhibitory beta-lactam yet lacked inhibitory synergy against 95% of the strains and bactericidal synergy against 62%. Tolerance to imipenem was seen in six strains. Aztreonam alone was bactericidal against 46% of the strains (at 16 micrograms/ml) and showed bactericidal synergy in 70%. Cefsulodin alone was even less active but similar to aztreonam synergistically. Ticarcillin and tobramycin inhibited all strains as single agents and showed universal bactericidal synergy in combination. None of the new beta-lactams showed consistent superiority to the presently used agent, ticarcillin.

Topics: Anti-Bacterial Agents; Aztreonam; Cefsulodin; Drug Synergism; Endocarditis, Bacterial; Humans; Imipenem; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections; Thienamycins; Ticarcillin; Tobramycin

Experimental intraabdominal abscesses were produced in mice by intraperitoneal injection of Bacteroides fragilis and Pseudomonas aeruginosa. The therapeutic efficacy of rifampicin and cefsulodin alone, and in combination was investigated in this in-vivo experimental mixed intraabdominal abscess model. Treatment with rifampicin at 10, and 25 mg/kg or cefsulodin at 50, and 100 mg/kg singly or in combinations prevented mortality as compared to 68% mortality rate occurring in the untreated mice. Rifampicin, at 25 mg/kg dose, was very effective in preventing abscess formation and produced bacterial eradication. It prevented abscess formation in 80% of the mice and eradicated both Bacteroides and Pseudomonas in 100% and 75% of the abscesses of the mice. Cefsulodin failed to reduce the incidence of abscess formation, and to eradicate Bact. fragilis from the abscesses, although it significantly decreased Ps. aeruginosa in the abscesses. The combination of rifampicin at 10 mg/kg and cefsulodin at 100 mg/kg was more effective than either of the antibiotics alone and was as effective as rifampicin alone at 25 mg/kg levels. This combination was bactericidal against both organisms in the infected mice.

Topics: Abscess; Animals; Bacteroides fragilis; Bacteroides Infections; Cefsulodin; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Mice; Peritoneal Diseases; Pseudomonas aeruginosa; Pseudomonas Infections; Rifampin

Patients with chronic complicated urinary tract polymicrobial infections due to Pseudomonas aeruginosa and other bacteria were treated with cefsulodin using cefotiam or cefmenoxime as a concomitant drug. Each drug was given to the patients in daily dose of 1 or 2 g by drip infusion twice a day for 5 to 16 days. The results were as follows: Overall clinical efficacy was excellent in 7 cases (44%), moderate in 6 cases (38%) and poor in 3 cases (19%), the effectiveness rate being 81.3%. Bacteriologically, 38 strains (88.4%) were eradicated, 1 strain decreased and 4 strains unchanged out of the 43 clinical isolates from the patients. No side effects and no abnormalities of laboratory findings were observed.

Topics: Aged; Bacterial Infections; Cefmenoxime; Cefotaxime; Cefotiam; Cefsulodin; Cephalosporins; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Pseudomonas Infections; Urinary Tract Infections

We isolated a Pseudomonas aeruginosa strain which was initially cefsulodin-susceptible (J1, MIC = 4 g/l) and became resistant (J2, MIC greater than 64 g/l) after 12 days of treatment of the patient with cefsulodin. Strain J2 had a constitutive beta-lactamase with hydrolytic activities similar to those of a cephalosporinase and an isoelectric point at 8.1. This enzyme (Case) may be related to the ld type. Concomitant development of resistances to various beta-lactams stable to Case suggests that other mechanisms of resistance may be involved.

Topics: Cefsulodin; Cephalosporins; Drug Resistance, Microbial; Female; Humans; Pseudomonas aeruginosa; Pseudomonas Infections; Time Factors

A case of P. aeruginosa septicaemia originating from a pace-maker electrode is described. Cure was obtained by surgical ablation of the contaminated electrode by a right thoracotomy and monotherapy with cefsulodin, an antibacterial agent. Nephrotoxicity was observed during treatment and regressed after its withdrawal. No other potentially nephrotoxic drug was used. The therapeutic indications of new beta-lactamase stable cephalosporins are reviewed.

Topics: Acute Kidney Injury; Aged; Cefsulodin; Humans; Male; Pacemaker, Artificial; Pseudomonas Infections; Sepsis; Time Factors

The objective of this study was to evaluate the penetration of cefsulodin, a new cephalosporin active against Pseudomonas aeruginosa, into the bronchial secretions. The study was carried out in 28 patients with respiratory infections; 11 patients received a single dose of 1 g i.v. (bolus); 17 patients received multiple doses of 1 g every 8 h for 48 h. Simultaneous samples of blood and bronchial secretions were collected 30 min and 1, 2, 4 and 6 h after injection. Bronchial secretions were obtained from 23 patients by means of fiberoptic bronchoscopy and in 5 tracheostomized patients (with severe respiratory insufficiency) through a tracheostomy cannula. The assays of cefsulodin were performed by means of the microbiological agar diffusion technique. The results of the study showed a noticeable penetration of the drug into the bronchial secretions, with a mean peak reaching 3.1-5.3 micrograms/ml at the 3rd or 4th hour, a slow elimination and residual levels at 6 h ranging between 2.0 and 6.0 micrograms/ml. The rate of penetration was not influenced by the administration of multiple doses of the drug. The ratios between bronchial concentrations and simultaneous serum concentrations ranged between 10 and 30%, corresponding to the usual values found for other cephalosporins. In conclusion, this study provides satisfactory results and confirms the presence of bronchial levels capable of inhibiting P. aeruginosa.

Topics: Bronchi; Bronchoscopy; Cefsulodin; Cephalosporins; Humans; Kinetics; Pseudomonas Infections

This study compares the in vitro activity of three cephalosporins - ceftazidime, cefoperazone, cefsulodin and their monobactam analogues for 144 strains of Pseudomonas aeruginosa. Media variation studies are performed and the effect of human serum and anaerobic conditions on MIC is investigated. A significant inoculum effect is considered as a sign of instability against beta-lactamases. Ceftazidine inhibits nearly all pseudomonads at concentrations between 2 and 4 micrograms/ml being significantly more active than the other antibiotics tested. The level of activity of all monobactams tested is lower than that of the homologous cephalosporins. The counterpart of ceftazidine is also the most effective monobactam but the counterpart of cefsulodin shows no activity against pseudomonads.

Topics: beta-Lactamase Inhibitors; Cefoperazone; Cefsulodin; Ceftazidime; Cephalosporins; Chemical Phenomena; Chemistry; Clavulanic Acid; Clavulanic Acids; Drug Resistance, Microbial; Humans; Monobactams; Penicillanic Acid; Pseudomonas aeruginosa; Pseudomonas Infections; Sulbactam

During the period 1971-75, 51 cystic fibrosis (CF) patients who contracted chronic P. aeruginosa infection were treated at the Danish CF centre with anti-pseudomonas chemotherapy only when their clinical condition deteriorated considerably. During the period 1976-80, 58 CF patients who contracted chronic P. aeruginosa infection were treated at the Danish CF centre with anti-pseudomonas chemotherapy on a regular basis every 3 months. Each routine 24 day-course of chemotherapy consisted of tobramycin in combination with carbenicillin or other beta-lactam antibiotics with activity against P. aeruginosa. In case of allergy or resistant strains monotherapy with tobramycin was used. The 5-year survival of CF patients from the time of the onset of the chronic P. aeruginosa infection increased from 54% in the first period to 82% in the second period (p less than 0.05), and lung function (peak expiratory flow rate) also improved significantly. It is concluded that intensive "maintenance" chemotherapy against P. aeruginosa improves survival and quality of life of CF patients although permanent eradication of P. aeruginosa is not accomplished.

Topics: Adult; Anti-Bacterial Agents; Carbenicillin; Cefsulodin; Cephalosporins; Cystic Fibrosis; Drug Therapy, Combination; Female; Humans; Male; Peak Expiratory Flow Rate; Pseudomonas Infections; Tobramycin

The clinical evaluation for cefsulodin (CFS) against P. aeruginosa was studied in postoperative infections of chronic otitis media by means of washing the middle ear with the drug, and the following results were obtained; CFS treatment was given to 5 cases, and the clinical responses were excellent in 4 and good in 1 case. P. aeruginosa in otorrhea was eradicated within several days, and otorrhea disappeared in all the cases. No side effect was observed in all cases.

Topics: Administration, Topical; Adolescent; Adult; Aged; Cefsulodin; Cephalosporins; Drug Evaluation; Female; Humans; Male; Otitis Media; Postoperative Complications; Pseudomonas Infections

Topics: Animals; Cefoperazone; Cefsulodin; Ceftazidime; Cephalosporins; Cephamycins; Drug Evaluation, Preclinical; Guinea Pigs; Moxalactam; Pneumonia; Pseudomonas Infections; Ticarcillin; Tobramycin

The pharmacokinetics and therapeutic efficacy of gentamicin and cefsulodin were studied in an abscess model in the rat induced by Pseudomonas aeruginosa and a foreign body. Both agents reached therapeutic concentrations in the abscess fluid and its ultrafiltrate and persisted longer in the abscess fluid than in blood. Gentamicin did not prevent the development of abscesses or reduce the bacterial inoculum when administered immediately following the induction of the abscesses. Cefsulodin sterilized 82.7 per cent of abscesses in 61.5 per cent of injected rats. Low oxygen tension present in the abscess was probably responsible for the inefficacy of gentamicin in this model, while not significantly diminishing the antibacterial activity of cefsulodin.

Topics: Abscess; Anaerobiosis; Animals; Cefsulodin; Cephalosporins; Disease Models, Animal; Female; Gentamicins; Male; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections; Rats

20 patients with cystic fibrosis and chronic pulmonary Pseudomonas aeruginosa infection underwent a total of 23 courses of treatment with a new cephalosporin, cefsulodin. The patients were given 100-150 mg/kg/day in 3 divided doses for 14 days, alone or in combination with tobramycin. Maximum serum levels were around 150 microgram/ml and 6-h levels above 5 micrograms/ml. 90% of the infecting strains were sensitive to 5 micrograms/ml in vitro. Apart from discomfort in direct relation to intravenous bolus injection the drug was well tolerated. Clinical improvement was pronounced, and in 5 cases. P. aeruginosa disappeared from bronchial secretions. Patients allergic to carbenicillin tolerated cefsulodin without signs of allergy. Cefsulodin thus appears to be an effective alternative to carbenicillin in the treatment of severe P. aeruginosa infections.

Topics: Adolescent; Adult; Cefsulodin; Cephalosporins; Child; Cystic Fibrosis; Drug Evaluation; Female; Humans; Lung Diseases; Male; Pseudomonas aeruginosa; Pseudomonas Infections

An anti-P. aeruginosa, cephalosporin, cefsulodin (CFS) was administered to 2 patients who were affected with inveterate urinary tract infection at ages of 1 year 8 months and 2 years, and another with pneumonia combined with lung fibrosis and bronchiectasia at 3 years. The clinical responses in 3 cases were "good" in 2 and "fair" in 1. The bacteriological responses to 3 strains of P. aeruginosa isolated in this clinical study were "eradicated" in 1, "decreased" in 1, and "unchanged" in 1. No side effects were observed.

Topics: Age Factors; Cefsulodin; Cephalosporins; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Humans; Infant; Male; Pseudomonas aeruginosa; Pseudomonas Infections

Topics: Adolescent; Age Factors; Cefsulodin; Cephalosporins; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male; Pseudomonas aeruginosa; Pseudomonas Infections

Antimicrobial, pharmacokinetic and clinical evaluation of cefsulodin (CFS) was made and the following results were obtained. 1. Antimicrobial activity of CFS against P. aeruginosa was similar to a little lower than that of GM. Antimicrobial activity of CFS against S. aureus was similar to that of SBPC and against E. coli CFS showed lower antimicrobial activity. 2. Twenty or 50 mg/kg CFS was administered by 1 hour intravenous drip infusion. Average serum levels at the completion of the infusion were 35.1 +/- 8.0, 114.5 +/- 36.1 micrograms/ml and 1.6 +/- 0.7, 4.5 +/- 3.2 micrograms/ml at 6 hours afterward with the half life times of 1.50, 1.29 hours respectively. In case of 12.1 mg/kg 1 hour intravenous drip infusion, peak serum level was 13.4 micrograms/ml at the completion of infusion, and the concentration in the sputum was 1.0 micrograms/ml at 5 hours after completion of infusion. Average serum levels of CFS by one shot infusion of 20 mg/kg were 58.4 +/- 6.8 micrograms/ml, 2.7 +/- 2.5 micrograms/ml at 15 minutes and 6 hours after injection respectively. Half-life time was 1.54 hours. Average urinary excretion rates of CFS were 64.4%, 64.2% and 48.9% up to 6 hours after 1 hour intravenous drip infusion of 20 mg/kg, 50 mg/kg CFS and one shot intravenous of 20 mg/kg CFS respectively. 3. CFS was administered to 2 pneumonia cases caused by P. aeruginosa, i.e. one was 15 years and 11 months old male accompanying bronchial asthma and the another 4 years old male with LENNOX syndrome. Neither bacteriological nor clinical efficacy was, however, observed. Side effect as well as bacterial superinfection were not observed.

Topics: Adolescent; Age Factors; Cefsulodin; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Escherichia coli; Female; Humans; Male; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcus aureus

Clinical studies on cefsulodin (CFS) in 6 patients with Pseudomonas aeruginosa infection were carried out and the results as follows. 1. Among 4 patients administered CFS intravenously, 3 patients (urinary tract infection 1, acute purulent otitis media 1, aspiration pneumonia 1) responded well. 2. Two patients with respiratory infection were treated CFS by nebulization. One responded well and another fair. 3. No side effects were observed.

Topics: Administration, Intranasal; Adolescent; Age Factors; Cefsulodin; Cephalosporins; Child; Drug Evaluation; Female; Humans; Infant, Newborn; Injections, Intravenous; Male; Pseudomonas Infections; Sputum

Cefsulodin (CFS) was evaluated for its safety and efficacy in 14 children with Pseudomonas aeruginosa infections. The diagnoses included pneumonia (4), sepsis (1), presumed sepsis (4), acute postoperative ascending cholangitis (1), acute postoperative peritonitis with wandering pneumonia (1), acute enterocolitis with acute UTI (1), recurrent UTI (1), and acute cystitis (1). CFS was administered intravenously with a daily dose of 93 to 299 mg/kg in the cases with normal renal functions. CFS was effective in all but one case both clinically and bacteriologically. A case of pneumonia whose isolate was resistant to CFS responded poorly. Mild transient eosinophilia was observed in 3 cases, but no severe adverse reactions were encountered. Peak MIC values of 18 clinical isolates of P. aeruginosa were 1.56 mcg/ml, 0.39 to 0.78 mcg/ml and 12.5 mcg/ml for CFS, gentamicin, and sulbenicillin, respectively. A half life of the serum CFS levels was 1.09 hours after intravenous bolus injection of 20 to 25 mg/kg of CFS (n = 2). A cerebrospinal-fluid level and biliary levels measured in cases with inflamed meninges or with cholangitis were well above the MIC value. From the present study, CFS appeared to be a safe and effective antibiotic when used in children with susceptible Pseudomonas infections. Combined use of another antibiotic should be considered in the case with polymicrobial infections because of the CFS's very narrow spectrum.

Topics: Adolescent; Age Factors; Cefsulodin; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Infant, Newborn; Male; Pseudomonas Infections

A few studies on cefsulodin (CFS) were performed and the following results were obtained. 1. High blood concentration was obtained with intravenous drip infusion of this drug, but it did not last long. 2. In 6 to 12 hours after the conclusion of the infusion, 52-81% of the dose was excreted in active condition. 3. Pseudomonas aeruginosal abscess was completely cured by intravenous drip infusion of this drug. A decrease in Pseudomonas aeruginosa was noted in urine in the case of acute pyelonephritis and in sputum in the case of pneumonia. The minimum inhibitory concentrations of this drug against P. aeruginosa isolated from various materials were below 12.5 micrograms/ml for all strains. 4. In all the patients including 3-month-old infants to whom 55-200 mg/kg of this drug was intravenously drip infused for 5 days, systemic or topical adverse reactions were not recognized. Nor did this drug give any effect on general blood condition, and liver and kidney functions. We plan to further study the clinical efficacy of this drug by adding more cases affected with P. aeruginosa in children.

Topics: Age Factors; Cefsulodin; Cephalosporins; Child, Preschool; Drug Evaluation; Humans; Infant; Infusions, Parenteral; Male; Pseudomonas Infections

A new cephalosporin cefsulodin (CFS) was studied basically and clinically and the following results were obtained. 1. The serum levels of 25 mg/kg of CFS administered intravenously were 39.5 mcg/ml after 30 minutes, 22.6 mcg/ml after 1 hour, 11.6 mcg/ml after 2 hours, 6.0 mcg/ml after 4 hours and 2.1 mcg/ml after 6 hours. The half life from serum was 84 minutes. 2. Clinical response on 4 cases of Pseudomonas aeruginosa infections were all good. 3. The slight elevations of GOT, GPT were observed by the drug administrations in 1 case. From the above results, CFS was effective drug to P. aeruginosa infections by intravenous administration of 25 mg/kg of CFS.

Topics: Age Factors; Cefsulodin; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Male; Pseudomonas Infections

Pharmacokinetic and clinical evaluations of cefsulodin (CFS) were made and the following results were obtained. 1. Pharmacokinetic study Three hundred fifty grams of CFS (20 mg/kg) was administered by 30 minutes intravenous drip infusion to 7 years old child (17.5 kg in weight). Serum concentrations of CFS at the end of the infusion and 1,1.5,2.5,6.5 hours thereafter were 46.0,44.9,23.0,11.9 mcg/ml and 0.6 mcg/ml respectively. Urinary recovery rate until 6 hours from the start of infusion was 66.2%. 2. Clinical study CFS was administered to the case of bronchitis with cystic fibrosis of the pancreas and bronchiectasia (treatment was made 2 times), and each 1 case of pyelonephritis with renal calculus and measles pneumonia with infantile spasm. All infections were caused by P. aeruginosa and administration and dosage of CFS was 47 to 86 mg/kg/day, 2 to 4 times daily by intravenous injection or intravenous drip infusion for 5 to 11 days. Result was good in 3 infections (2 cases) and fair in 1 case, i.e. measles pneumonia. Effectiveness rate was 75.0%. Side effect as well as abnormal change of laboratory findings were not observed. Thus, CFS is considered to be the useful drug for the treatment of pediatric infection caused by P. aeruginosa.

Topics: Age Factors; Cefsulodin; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infusions, Parenteral; Injections, Intravenous; Kinetics; Pseudomonas Infections

Our investigation of cefsulodin in pediatric Pseudomonas infect ion produced the following results. 1. Cefsulodin (CFS) was administered intravenously by one shot or drip infusion in 3 patients with Pseudomonas infections. These diseases consisted of pneumonia with IgA deficiency, ALL with opportunistic infection, UTI with paraplegia due to spina bifida. CFS was effective in all cases. 2. Transient eosinophilia was observed in 1 case. But other side effect was not noted in any cases.

Topics: Adolescent; Age Factors; Cefsulodin; Cephalosporins; Child; Drug Evaluation; Humans; Infant; Infusions, Parenteral; Injections, Intravenous; Male; Pseudomonas Infections

Topics: Adolescent; Adult; Aged; Cefsulodin; Cephalosporins; Female; Humans; Infusions, Parenteral; Male; Middle Aged; Otitis Media; Pseudomonas Infections; Suppuration

Topics: Adolescent; Adult; Cefsulodin; Cephalosporins; Child; Drug Evaluation; Humans; Infusions, Parenteral; Male; Middle Aged; Otitis Media; Pseudomonas Infections; Suppuration

The clinical effect of cefsulodin (CFS) on Pseudomonas species infections in otorhinolaryngologic field was studied in 10 patients. The overall clinical effectiveness was 80% (excellent 4, good 4, poor 2). The bacteriological response of CFS against Pseudomonas species was evaluated from 11 strains. Eradication rate of Pseudomonas species was 82%. In 1 case, body temperature was rised after injection. No abnormal laboratory findings, relating to the drug, were observed after treatment.

Topics: Adult; Cefsulodin; Cephalosporins; Child; Drug Evaluation; Female; Humans; Male; Middle Aged; Otitis Media; Pseudomonas Infections

The clinical effect of cefsulodin (CFS) on Pseudomonas aeruginosa infections in otorhinolaryngology was studied in 10 patients. The overall clinical effectiveness was 80% (excellent 2, good 6, poor 2). Eradication rates of P. aeruginosa was 60%. No side effect and positive skin test were found in any cases. Examination of laboratory data before and after the administration revealed no abnormal findings in every cases.

Topics: Adult; Aged; Cefsulodin; Cephalosporins; Chronic Disease; Drug Evaluation; Female; Humans; Male; Middle Aged; Otitis Media; Pseudomonas Infections; Surgical Wound Infection

Clinical evaluation of cefsulodin (CFS) in treatment of infection in otorhinolaryngologic field was carried out and the following result was obtained. 1. Daily 1 to 5 gram of CFS was administered in divided dose to 9 cases of chronic purulent middle ear infection and postoperative wound infection. Clinical effectiveness was excellent, good and fair in 1, 2 and 5 cases, respectively. 2. No side effect as well as abnormal change of laboratory finding was observed. As for ototoxicity to be the most concerned matter of physicians, CFS seems to have no special problem. Thus, CFS is considered to be the useful drug for the treatment of chronic purulent middle ear infection and postoperative wound infection caused by P. aeruginosa in the field of otorhinolaryngology, and synergistic clinical effect will be expected by the combination therapy with other antibiotics or local administration of CFS.

Topics: Cefsulodin; Cephalosporins; Chronic Disease; Drug Evaluation; Female; Humans; Male; Otitis Media; Pseudomonas Infections; Surgical Wound Infection

Topics: Adolescent; Adult; Cefsulodin; Cephalosporins; Child; Drug Evaluation; Female; Humans; Male; Middle Aged; Otorhinolaryngologic Diseases; Pseudomonas Infections; Tissue Distribution

The in-vitro antibacterial activity of ceftazidime was compared with that of cefsulodin and ticarcillin against 140 strains of Pseudomonas aeruginosa. Against 123 clinical isolates, geometric mean MICs were 1499mg/l for ticarcillin, 15 mg/l for cefsulodin and 2.1 mg/l for ceftazidime. Against constitutive beta-lactamase producers (93 strains), and according to the type of enzyme (TEM-1, carbenicillinases, oxacillinases), ceftazidime had similar activity but MICs of cefsulodin were particularly affected by highly ticarcillin-resistant (carbenicillinase pIs 53, 5.7 and 575) strains. Against ticarcillin-resistant (constitutive beta-lactamase non-producers) and ticarcillin-susceptible strains, the MICs of ceftazidime were slightly lower than those of cefsulodin.

Topics: Anti-Bacterial Agents; beta-Lactamases; Cefsulodin; Ceftazidime; Cross Infection; Drug Resistance, Bacterial; Humans; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections; Ticarcillin

Laboratory and clinical studies on cefsulodin (CFS), a new antipseudomonal cephalosporin antibiotic, were carried out and the following results were obtained. 1. The MIC of CFS against P. aeruginosa showed the peak of susceptibility at 3.13 mcg/ml in the inoculum size of 10(8) cells/ml and at 1.56 mcg/ml in the inoculum size of 10(8) cells/ml. It has a higher superiority as compared with gentamicin or piperacillin and gentamicin-resistant strains of P. aeruginosa were sensitive to CFS. 2. CFS was given to 3 patients with acute pneumonia and 5 patients with chronic cystitis which were all due to P. aeruginosa. Clinical effects were good in 2 patients and poor in a patient with acute pneumonia, and those were good in 3 patients and poor in 2 patients with chronic cystitis. Side effects were not recognized at all.

Topics: Adult; Aged; Cefsulodin; Cephalosporins; Cystitis; Drug Evaluation; Female; Gentamicins; Humans; Male; Middle Aged; Penicillin Resistance; Penicillins; Piperacillin; Pneumonia; Pseudomonas aeruginosa; Pseudomonas Infections

Cefsulodin (CFS), a new antipseudomonas cephalosporin, was clinically evaluated for treatment of the Pseudomonas aeruginosa infections in the surgical field to obtain the following results. 1. CFS was administered to total 11 cases of the surgical infections caused by P. aeruginosa, comprising of 5 cases with wound infections, 3 cases with infected burn and 1 case each with muscular abscess, decubitus and postoperative pneumonia in 0.5 approximately 1 g twice a day by intravenous bolus or drip infusion. Good clinical responses were obtained in 9 out of 11 cases (81.8%). 2. Bacteriological responses were observed in all cases. P. aeruginosa was eradicated in 9 cases and suppressed in 2 cases by CFS treatment. However, replacement of pathogens with the other organisms was observed in 6 out of 8 cases caused by P. aeruginosa only. 3. Neither objective and subjective side effects nor abnormalities of laboratory tests associated with CFS treatment were observed. 4. It can be, therefore, concluded that CFS is one of the useful drugs for treatment of the surgical infections caused by P. aeruginosa.

Topics: Adult; Aged; Burns; Cefsulodin; Cephalosporins; Child; Drug Evaluation; Female; Humans; Male; Middle Aged; Pseudomonas Infections; Surgical Wound Infection

Cefsulodine, a new B-lactamase-resistant cephalosporin, was used parenterally in combination with systemic and topical tobramycin to treat a patient with meningitis and ventriculitis due to Os, aeruginosa. Cefsulodine concentrations were measured simultaneously in serum and in cerebral ventricles. With doses of 500 mg four times a day, diffusion of the drug into meningeal spaces was rather poor, but with doses of 2 grams 8-hourly (100 mg/Kg/day cefsulodine concentrations in the ventricles were equal or superior to the average MICs against most Pseudomonas species. However, concurrent systemic and local administration of an aminoglycoside is required to ensure full bactericidal effect.

Topics: Cefsulodin; Cephalosporins; Cerebral Ventricles; Encephalitis; Humans; Male; Middle Aged; Pseudomonas Infections

Pseudomonas aeruginosa infections of twenty children in various age-groups were treated with Cefsulodin. Fifty percent of these cases received additional other antibiotics due to vital indication. In different underlying diseases such as IRDs, enteritis, omphalitis, necrotizing enterocolitis and urinary tract infection, this treatment achieved in eleven cases a lasting and in seven cases a temporary elimination of pseudomonas aeruginosa. No side effects were seen.

Topics: Anti-Bacterial Agents; Cefsulodin; Cephalosporins; Child; Child, Preschool; Drug Administration Schedule; Drug Therapy, Combination; Humans; Infant; Infant, Newborn; Pseudomonas Infections