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Cefoxitin therapy in aerobic, anaerobic, and mixed aerobic-anaerobic infections
Abstract:
Cefoxitin, a new beta-lactamase-resistant cephamycin, was evaluated in 66 patients for clinical and bacteriological efficacy, serum levels, tolerance, and toxicity. Seventeen patients had soft tissue infections, 14 had pleuropulmonary infections, 14 had intraabdominal infections, 13 had pelvic infections, and 8 had urinary tract infections. Among the 66 patients, 62 were cured and 4 could not be evaluated. Twelve patients had hospital-acquired infections, 31 had underlying disease, and 45 required a surgical procedure. Isolates included 116 aerobic and 72 anaerobic bacteria. Cefoxitin was more active than cephalothin against facultative and obligate anaerobic gram-negative organisms isolated from these patients. Mean peak cefoxitin levels in sera were 52 micrograms/ml after a 2-g infusion and 30 micrograms/ml after a 1-g infusion. Phlebitis occurred in two patients, eosinophilia in one, rash in two, vasculitis in one, and transient rises in SGOT and SGPT in two. Cefoxitin appears to be a safe and effective drug for the treatment of many aerobic, anaerobic, and mixed aerobic-anaerobic infections.
Insights
Cefoxitin, a new cephamycin antibiotic, demonstrated high clinical efficacy and safety in treating 66 patients with various aerobic and anaerobic infections. This beta-lactamase-resistant drug proved effective against diverse bacterial pathogens.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Beta-lactamase resistance is a growing challenge in treating bacterial infections.
- Cephamycins represent a class of antibiotics with potential against resistant organisms.
- Cefoxitin is a novel cephamycin with beta-lactamase resistance.
Purpose of the Study:
- To evaluate the clinical and bacteriological efficacy of cefoxitin.
- To assess serum levels, tolerance, and toxicity of cefoxitin.
- To compare cefoxitin's activity against cephalothin in specific patient populations.
Main Methods:
- Clinical and bacteriological evaluation in 66 patients with diverse infections.
- Serum level determination after 1-g and 2-g cefoxitin infusions.
- Monitoring for adverse events including phlebitis, rash, and laboratory abnormalities.
Main Results:
- Cefoxitin achieved a 94% cure rate (62/66 patients).
- Demonstrated superior activity against anaerobic gram-negative organisms compared to cephalothin.
- Mean peak serum levels were 52 µg/ml (2g) and 30 µg/ml (1g).
- Adverse events were generally mild, including phlebitis (2), rash (2), and transient liver enzyme elevations (2).
Conclusions:
- Cefoxitin is a safe and effective antibiotic for treating aerobic, anaerobic, and mixed infections.
- Its beta-lactamase resistance makes it a valuable option for challenging bacterial infections.
- Further research may explore its role in hospital-acquired infections and post-surgical care.