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[Clinical studies on cefmenoxime in the intensive care unit]
Abstract:
Two to 6 g of CMX was administered daily to 9 patients who were admitted to ICU, i.e. 5 cases with pneumonia and 4 with sepsis. In all cases, CMX was administered concomitantly with aminoglycoside which had been administered, and additional administration of other antibiotics was avoided. Bacteriologically, P. aeruginosa was isolated from 4 cases, K. pneumoniae from 4 cases, S. marcescens, P. mirabilis and P. cepacia respectively from 1 case. The CMX treatment was considered effective in 4 of 5 pneumonia cases and in 3 of 4 sepsis cases. In total, 7 of 9 cases responded effectively. The clinical effective rate was 77.8%. Elevation of GOT and GPT values was noticed in 1 case, however, the causality with CMX administration was unclear.
Insights
Colistin (CMX) showed a 77.8% clinical effective rate in 9 ICU patients with pneumonia or sepsis. This antibiotic combination therapy was effective in most patients, with unclear causality for minor liver enzyme elevation.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Pharmacology
Background:
- Intensive Care Unit (ICU) patients often present with severe infections like pneumonia and sepsis.
- Multidrug-resistant bacteria pose a significant challenge in treating these infections.
- Colistin (CMX) is a polymyxin antibiotic with activity against Gram-negative bacteria.
Observation:
- Nine ICU patients (5 pneumonia, 4 sepsis) received daily doses of 2-6g of CMX.
- CMX was administered concomitantly with existing aminoglycoside therapy, avoiding additional antibiotics.
- Bacterial isolates included Pseudomonas aeruginosa, Klebsiella pneumoniae, Serratia marcescens, Proteus mirabilis, and Pseudomonas cepacia.
Findings:
- CMX treatment was effective in 4 out of 5 pneumonia cases (80%) and 3 out of 4 sepsis cases (75%).
- Overall, 7 out of 9 patients (77.8%) responded effectively to the CMX treatment.
- One patient experienced elevated GOT and GPT levels, but the link to CMX was uncertain.
Implications:
- CMX, in combination with aminoglycosides, demonstrates significant clinical efficacy in treating severe ICU infections.
- This therapeutic approach may be valuable for managing infections caused by challenging Gram-negative pathogens.
- Further investigation is warranted to fully elucidate the safety profile and optimal use of CMX in critical care settings.