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Cefoxitin: clinical evaluation in thirty-eight patients
Abstract:
Clinical and bacteriological efficacy, patient tolerance, and toxicity of cefoxitin, a beta-lactamase-resistant cephamycin, were evaluated in 38 patients; 13 had soft tissue infection, 12 had pneumonia, 3 had urinary tract infection, 2 had peritonitis, and 4 had miscellaneous infections. In five patients, infection was clinically evident, though not bacteriologically proven. The latter patients were evaluated with regard to tolerance and toxicity only. Among the 34 infections in 33 patients, 71% were considered clinically cured; 86% of those patients who could be recultured were bacteriologically cured. Phlebitis was noted in 32% of the total group, and eosinophilia was observed in 16%. Unexplained deterioration in renal function occurred in two patients. Mean peak cefoxitin levels in serum were 72 mug/ml 30 min after a 2-g infusion and 32 mug/ml 30 min after a 1-g infusion. Cefoxitin was more active against facultatively and obligately anaerobic gram-negative organisms isolated from these patients than was cephalothin.
Insights
Cefoxitin, a cephamycin antibiotic, showed significant clinical and bacteriological efficacy in treating various infections. While generally well-tolerated, some patients experienced phlebitis or renal function changes.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Microbiology
Background:
- Cefoxitin is a beta-lactamase-resistant cephamycin antibiotic.
- Evaluating new antibiotics is crucial for combating resistant bacterial infections.
Purpose of the Study:
- To assess the clinical and bacteriological efficacy of cefoxitin.
- To evaluate patient tolerance and toxicity of cefoxitin.
- To compare cefoxitin's activity against anaerobic gram-negative organisms with cephalothin.
Main Methods:
- A study involving 38 patients with diverse infections (soft tissue, pneumonia, UTI, peritonitis, miscellaneous).
- Clinical and bacteriological outcomes were assessed.
- Patient tolerance and toxicity were monitored.
- Serum cefoxitin levels were measured after different infusion doses.
- In vitro activity against isolated anaerobic gram-negative organisms was tested.
Main Results:
- 71% of 34 infections were clinically cured.
- 86% of recultured patients achieved bacteriological cure.
- Phlebitis occurred in 32% and eosinophilia in 16% of patients.
- Two patients experienced unexplained renal function deterioration.
- Cefoxitin demonstrated superior activity against anaerobic gram-negative organisms compared to cephalothin.
Conclusions:
- Cefoxitin exhibits notable clinical and bacteriological efficacy in treating various infections.
- The antibiotic is generally well-tolerated, but potential side effects include phlebitis and renal function changes.
- Cefoxitin shows promising activity against anaerobic gram-negative bacteria.