Comparison of cefonicid and cefazolin for treatment of soft-tissue infections

Cefonicid was compared with cefazolin for the treatment of serious infections of soft tissue. According to a randomized, prospective protocol designed to assign twice as many patients to cefonicid, 38 patients were treated with cefonicid and 19 patients, with cefazolin. Dosages used were 1.0 g once daily intramuscularly or intravenously for cefonicid and 0.5-1.0 g three times a day intramuscularly or intravenously for cefazolin. Clinical diagnoses included cellulitis (39 patients), abscesses (14), infected ulcers (3), and bursitis (1). Bacteriologic diagnoses included Staphylococcus aureus alone (8 patients), group A Streptococcus alone (13), combined S. aureus plus streptococci (8), viridans group streptococci alone (1), and mixed anaerobes (1). Gram-negative rods were isolated from 11 patients, all in mixed cultures with gram-positive species. For two patients, gram-negative organisms were thought to be etiologic. All 57 patients responded satisfactorily to treatment. Treatment with either drug was neither interrupted nor discontinued because of toxicity. Both cefonicid and cefazolin appear to be effective for the treatment of infections of skin and soft tissues. Cefonicid has the advantage of once-daily dosing.