Search

The antibacterial activity of N-formimidoyl thienamycin was compared with those of cefotaxime, cefoperazone, and piperacillin against 536 clinical aerobic isolates.

Cefoxitin was administered intravenously to 143 patients, 67% of whom were seriously ill. The rate of cure or improvement was 93%. The study was conducted in two phases; the first was an open, controlled clinical comparison of cefoxitin and cephalothin. In this phase, 28 patients received cefoxitin and 29 received cephalothin. In the second phase, cefoxitin alone was used for the treatment of an additional 115 patients. Twenty bacteremic patients treated with cefoxitin were cured or improved in 95% of cases. The infecting organism was eradicated in all bacteremic patients. All of 14 anaerobic or predominantly anaerobic infections were cured or improved. The infecting anaerobic organism was eliminated in 86% of the cases. Twenty-five patients infected by cephalothin-resistant, cefoxitin-susceptible gram-negative rods were cured. Three patients each with infective endocarditis and osteomyelitis were cured. The incidence of adverse experiences was: 1.4% drug eruption; 2% each asymptomatic serum transaminase elevation and leukopenia; and 2.5% asymptomatic eosinophilia. The incidence of severe thrombophlebitis was 5%. No permanent or serious adverse reactions were encountered. Although the numbers of patients in some categories were too small to permit statistical evaluation, I feel that cefoxitin may be a useful new antibiotic for treatment of infections caused by cehalothin-resistant bacteria and by anaerobic organisms.

Six patients undergoing chronic hemodialysis and 10 patients with chronic renal insufficiency hospitalized for nondialytic therapy received 1.0 g of cephapirin sodium by the intravenous route. The concentrations of cephapirin in arterial and venous plasma, dialysate, venous blood, and urine were measured during the ensuing 6 hr. The serum half-life of cephapirin was 105 to 108 min for the dialyzed patients and 95.9 min for the nondialyzed patients. Dialysis removed 22.8% of the administered dose. Nondialyzed patients excreted 19.5% of the administered dose in the urine. The concentration of cephapirin in the urine of all nondialyzed patients exceeded 50 mug/ml. The recovery of cephapirin in the urine collected for 6 hr after injection was from 34 to 770 mg (mean 195 mg). To maintain a concentration of cephapirin in the blood and urine which exceeds the minimal inhibitory concentration for most gram-positive and gram-negative microorganisms, nondialyzed patients should receive 15 to 18 mg of cephapirin per kg every 12 hr. Dialyzed patients should receive the same dose just prior to dialysis and every 12 hr thereafter.