fosfomycin and Cellulitis

We investigated the distribution of the broad-spectrum antibiotic fosfomycin in infected soft tissue of patients with uncomplicated cellulitis of the lower extremities or diabetic foot infection using in vivo microdialysis. Our findings suggest that fosfomycin exhibits good and similar penetration into the fluid in the interstitial space in inflamed and noninflamed soft tissue in patients.

Topics: Area Under Curve; Cellulitis; Diabetic Foot; Female; Fosfomycin; Half-Life; Humans; Male; Microdialysis; Middle Aged; Tissue Distribution

A 54-aged woman consulted with right buccal phlegmon caused by lower apical periodontitis. The primary chemotherapy using flomoxef induced allergic skin eruption. A decision was made for using clindamycin, levofloxacin and fosfomycin as chemotherapeutic agents. Cultured organisms from the abscess revealed the mixed infection with Streptococcus sanguis, Veillonella sp., Prevotella loescheii, Wolinella spp. On 12th hospital day, her serum CRP turned to negative. This case carried numerous implications for the use of antibiotics as chemotherapy agents.

Topics: Adult; Anti-Bacterial Agents; Cellulitis; Cephalosporins; Clindamycin; Drug Eruptions; Drug Therapy, Combination; Female; Fosfomycin; Humans; Levofloxacin; Ofloxacin; Periapical Abscess

Fifty cases of extensive and necrotizing perineal cellulitis ("perineal gangrene") are reported. The disease, remarkable for its many anatomical and bacteriological varieties, is regarded as a therapeutic requiring multidisciplinary management. Bacteriological samples were polymicrobial in 40 cases. Streptococcus D and aerobic Gram-negative bacilli were isolated in 21 patients. The initial antibiotic treatment had to be modified on ten occasions in 36 patients who were given penicillin G in high doses and on five occasions in 14 patients who received a beta-lactam antibiotic active against anaerobes. Nineteen patients (38 p. 100) died; death was directly related to the sepsis in 16 cases. The death rate was the same in the two treatment groups (11/36 and 5/14) and similar to that found in the literature. The authors advocate an ureidopenicillin, fosfomycin and imidazole combination as a substitute for the conventional penicillin G, aminoglycoside, imidazole combination, since the former is active against Streptococcus D and has better tissue penetration.

Topics: Adult; Aged; Aged, 80 and over; Bacteria, Anaerobic; Bacterial Infections; Cellulitis; Drug Therapy, Combination; Female; Fosfomycin; Gangrene; Humans; Hyperbaric Oxygenation; Imidazoles; Male; Middle Aged; Penicillin G; Perineum

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Cellulitis; Child; Child, Preschool; Female; Fosfomycin; Humans; Infant; Infant, Newborn; Male; Middle Aged; Mouth Diseases; Periapical Abscess; Periodontitis; Stomatitis