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[Clinical and bacteriological evaluation of cefmenoxime in the newborn infant]
J Sarlangue1, C Quentin, F Megraud
1Hôpital des Enfants, Bordeaux.
Abstract:
Cefmenoxime (CMX) has been administered under parenteral injection to 39 neonates delivered at term, nearly always by monotherapy in an average dosage of 86.8 mg/kg/day. CMX has been used 31 times in first line therapy and 8 times after failure of association Ampicillin-Gentamicin. 25 strains have been identified: 16 E. coli (9 Ampicillin resistant), 7 P. mirabilis (1 Ampicillin resistant), 1 K. oxytoca and 1 Streptococcus B. The neonates group with septicaemia (1 with arthritis) has been cured without after-effects as urinary tract infections and systemic infections. 2 respiratory tract infections have been improved, the others have been cured. Bacterial samples have always been sterilized within 2 days. Local tolerance (IV or/and IM injection) has been very good. No clinical or biological abnormality has been imputed to treatment. Cefmenoxime appears very effective on enterobacteriaceae (MIC range 0.05-0.5 mg/l) and can be used in newborn infections.
Insights
Cefmenoxime (CMX) effectively treated bacterial infections in 39 neonates, showing excellent tolerance and rapid bacterial sterilization. This cephalosporin antibiotic is a promising option for treating serious newborn infections.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Neonatal infections pose significant risks, necessitating effective and safe antimicrobial agents.
- Enterobacteriaceae are common pathogens in neonatal sepsis, often exhibiting antibiotic resistance.
- Parenteral antibiotic therapy is crucial for treating severe infections in newborns.
Purpose of the Study:
- To evaluate the efficacy and safety of Cefmenoxime (CMX) in treating bacterial infections in neonates.
- To assess CMX's effectiveness against identified bacterial strains, including Ampicillin-resistant E. coli.
- To determine the tolerability and clinical outcomes of CMX administration in a neonatal population.
Main Methods:
- Parenteral administration of Cefmenoxime (CMX) to 39 term neonates at an average dose of 86.8 mg/kg/day.
- CMX used as monotherapy in most cases, including first-line treatment and after failure of Ampicillin-Gentamicin.
- Identification of 25 bacterial strains, predominantly E. coli and P. mirabilis, with susceptibility testing.
Main Results:
- Complete cure rates were observed in neonates with septicemia and urinary tract infections.
- Respiratory tract infections showed improvement or cure in all cases.
- Bacterial samples were consistently sterilized within 2 days of CMX treatment.
- Excellent local tolerance (IV/IM) and no treatment-related clinical or biological abnormalities were reported.
Conclusions:
- Cefmenoxime demonstrates high efficacy against Enterobacteriaceae, with low Minimum Inhibitory Concentrations (MICs).
- CMX is a safe and effective therapeutic option for neonatal bacterial infections.
- The drug's favorable safety profile and rapid bactericidal activity support its use in newborns.