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Prospective comparison of cefoxitin and cefazolin in infections caused by aerobic bacteria
Abstract:
Intravenous cefazolin and cefoxitin were compared in a prospective randomized trial in infections where the suspected pathogen was expected to be susceptible to both antibiotics. In the cefazolin group (12 patients) the diagnosis was pneumonia in 4, including 2 with pneumococcal bacteremia, soft tissue infection in 5, Staphylococcus aureus bacteremia in 1, acute pyelonephritis in 1, and disseminated gonococcal infection in 1. In the cefoxitin group (10 patients) the diagnosis was pneumonia in 4, including 2 with pneumococcal bacteremia, soft tissue infection in 4, acute pyelonephritis in 1, and disseminated gonococcal infection in 1. In the cefazolin group receiving an evaluable course of therapy, a good clinical response was seen in 10 of 11 patients, and a bacteriological response was seen in 5 of 7. Cefazolin failed to eradicate S. aureus bacteremia in 1 patient and S. aureus in a skin ulcer of another patient. All 10 cefoxitin patients had good clinical and bacteriological responses, but in 1 patient S. aureus colonization of a postoperative wound recurred after discontinuation of the drug. Side effects in both groups included skin rash, phlebitis, and elevation of the serum alkaline phosphatase. Both cefoxitin and cefazolin appeared effective in infections caused by susceptible aerobic pathogens with the possible exception of S. aureus, although all 11 strains of S. aureus isolated in this study were susceptible in vitro to both antibiotics. Cefoxitin appeared to be equivalent to cefazolin in efficacy and occurrence of side effects.
Insights
Cefazolin and cefoxitin showed similar effectiveness in treating infections from susceptible aerobic bacteria. Both antibiotics were generally well-tolerated, though cefazolin had limited success against Staphylococcus aureus infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- Bacterial infections necessitate effective antibiotic treatments.
- Cefazolin and cefoxitin are cephalosporin antibiotics with distinct spectra of activity.
- Comparative efficacy studies are crucial for guiding clinical antibiotic selection.
Purpose of the Study:
- To compare the clinical and bacteriological efficacy of intravenous cefazolin and cefoxitin.
- To evaluate the safety and side effect profiles of both antibiotics.
- To assess antibiotic effectiveness in various infections caused by susceptible pathogens.
Main Methods:
- Prospective randomized trial comparing cefazolin and cefoxitin.
- Inclusion of patients with infections suspected to be susceptible to both agents.
- Evaluation of clinical and bacteriological response rates and adverse events.
Main Results:
- Both cefazolin and cefoxitin demonstrated good clinical and bacteriological responses in most patients.
- Cefazolin showed limitations in eradicating Staphylococcus aureus infections.
- Cefoxitin achieved good responses, with one case of recurrent S. aureus colonization.
- Side effects were comparable, including rash, phlebitis, and elevated alkaline phosphatase.
Conclusions:
- Cefoxitin and cefazolin are effective against susceptible aerobic pathogens.
- Both antibiotics exhibit similar efficacy and side effect profiles.
- Cefazolin may be less effective for Staphylococcus aureus infections compared to cefoxitin.