[Concomitant therapy with cefmenoxime and cefsulodin for refractory complicated urinary tract infection (especially caused by Pseudomonas aeruginosa)]
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Abstract:
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.
Insights
This study evaluated cefmenoxime and cefsulodin for complicated urinary tract infections (c-UTI) likely caused by Pseudomonas aeruginosa. The combination therapy showed high efficacy and bacterial eradication rates with minimal side effects, suggesting its usefulness for refractory c-UTI.
Area of Science:
- Infectious Diseases
- Pharmacology
- Urology
Context:
- Complicated urinary tract infections (c-UTI) often involve challenging pathogens like Pseudomonas aeruginosa.
- Pseudomonas aeruginosa is a common cause of refractory and difficult-to-treat UTIs.
- Effective antimicrobial strategies are crucial for managing c-UTI and preventing complications.
Purpose:
- To assess the clinical efficacy and bacteriological response of concomitant cefmenoxime and cefsulodin therapy in patients with c-UTI.
- To evaluate the effectiveness of this combination regimen against Pseudomonas aeruginosa and other Gram-negative rods.
- To determine the safety and tolerability profile of the combined antibiotic treatment.
Summary:
- A total of 135 patients with c-UTI received intravenous cefmenoxime (2g) and cefsulodin (1g) twice daily for 5 days.
- Overall clinical efficacy was 73% in 91 evaluable patients, with a 75% efficacy rate in cases involving P. aeruginosa.
- Bacteriological eradication rates were high, reaching 91% overall and 82% for P. aeruginosa, with a low incidence of side effects.
Impact:
- Concomitant cefmenoxime and cefsulodin demonstrated significant efficacy in treating complicated urinary tract infections, including those caused by P. aeruginosa.
- The high bacterial eradication rates suggest this regimen is effective against a range of Gram-negative pathogens.
- The favorable safety profile indicates this dosage regimen is a viable option for refractory c-UTI.