ro13-9904 and Bone-Diseases

In this multicentre study, 883 evaluable patients undergoing orthopedic surgery were randomly assigned to receive antiinfective prophylaxis with either ceftriaxone (Rocephin) or cefamandole. 25 patients in the ceftriaxone group and 29 patients in the cefamandole group (5.6 vs 6.5%) presented with infectious complications within the first 60 days after surgery. Delayed deep wound infections developed in only 1 of 435 patients in the ceftriaxone group compared with 4 of 413 patients in the cefamandole group. Both drugs were well tolerated. The infection rate was twice as high after surgery in conventional operating theatres than after treatment in hypersterile operating theatres (3.3 vs 6.5%); this difference is not statistically significant.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial Infections; Bone Diseases; Cefamandole; Ceftriaxone; Child; Female; Follow-Up Studies; Humans; Male; Middle Aged; Multicenter Studies as Topic; Muscular Diseases; Postoperative Complications; Premedication

Ceftriaxone, a broad-spectrum cephalosporin with a markedly extended half-life, was administered to 100 patients with 56 bone and 44 soft tissue infections. Sixty-eight received 1 g twice daily, and 32 received 2 g once daily intravenously. Overall, 91% had a satisfactory clinical response, with similar efficacies in both treatment regimens. In six patients, failure to achieve a cure correlated well with the development of resistance to ceftriaxone during therapy in Enterobacter and Pseudomonas species (two cases) and with superinfection with Bacteroides fragilis (four cases). In 41 patients, intravenous drug therapy was continued after discharge from the hospital. In this group, 1,093 patient-days of hospitalization were saved, amounting to $150,020 in cost savings. The prolonged half-life facilitated the administration of ceftriaxone in this setting.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Bone Diseases; Cefotaxime; Ceftriaxone; Child; Child, Preschool; Costs and Cost Analysis; Cross Infection; Female; Humans; Male; Middle Aged; Skin Diseases, Infectious

We investigated the combination of teicoplanin and ceftriaxone for its bactericidal activity against Staphylococcus aureus, Haemophilus influenzae type b and Streptococcus pneumoniae isolated from bone and joint infections in children. An increase in bactericidal activity was observed against isolates of S. aureus and H. influenzae when the antibiotics were tested at fractional MICs whereas indifference was observed at their MICs. Similar results were obtained at fractional MICs against S.pneumoniae, but the bactericidal activity fell by more than 1 x log 10 cfu/mL when the antibiotics were tested at or above their MICs.

Topics: Bacterial Infections; Bone Diseases; Ceftriaxone; Child, Preschool; Drug Interactions; Drug Resistance, Microbial; Drug Therapy, Combination; Haemophilus Infections; Humans; Infant; Joint Diseases; Microbial Sensitivity Tests; Penicillin G; Pneumococcal Infections; Staphylococcal Infections; Teicoplanin