-
Annals of Internal Medicine Jul 1985Cefamandole and cefoxitin, introduced only 7 years ago, are now the most commonly prescribed parenteral antibiotics in the United States. These drugs are similar to the... (Review)
Review
Cefamandole and cefoxitin, introduced only 7 years ago, are now the most commonly prescribed parenteral antibiotics in the United States. These drugs are similar to the first-generation cephalosporins in toxicity, but their in-vitro spectrum of activity is greater. Their serum half-lives are longer than those of cephalothin and cephapirin but shorter than that of cefazolin. Although cefamandole has been recommended in empiric therapy for patients with community-acquired pneumonia and as a prophylactic agent for patients having various surgical procedures, other regimens are less expensive and just as effective. Cefamandole should not be used to treat intra-abdominal, enterobacter, or ampicillin-resistant Haemophilus influenzae infections. Cefoxitin is effective in the treatment and prevention of mixed aerobic-anaerobic skin and soft-tissue, intra-abdominal, gynecologic, and penicillinase-producing, spectinomycin-resistant Neisseria gonorrhoeae infections. Cefoxitin represents a greater advance than cefamandole in our continuing search for safe and more effective antimicrobial agents.
Topics: Bacteria; Bacterial Infections; Cefamandole; Cefoxitin; Child; Costs and Cost Analysis; Drug Resistance, Microbial; Female; Humans; Infant; Kinetics; Premedication
PubMed: 3890658
DOI: 10.7326/0003-4819-103-1-70 -
Reviews of Infectious Diseases 1979Cefoxitin, a new cephamycin antibiotic that is active against aerobic and anaerobic bacteria, was studied by 35 investigators in the United States. Of 657 patients... (Clinical Trial)
Clinical Trial Review
Cefoxitin, a new cephamycin antibiotic that is active against aerobic and anaerobic bacteria, was studied by 35 investigators in the United States. Of 657 patients eligible for evaluation of efficacy of the compound, 69% were cured and 92% were cured or improved on clinical grounds. Bacteriologic response to therapy with cefoxitin was equally good for infections due to gram-positive cocci (94% cured), gram-negative bacilli (87% cured), and anaerobes (95% cured). Cefoxitin was effective clinically and bacteriologically in the eradication of infections due to organisms resistant to ampicillin, cephalothin, chloramphenicol, tetracycline, and aminoglycosides. Overall rates of favorable response to cefoxitin therapy by disease were: lower respiratory tract infections, 90%; urinary tract infections, 87%; intraabdominal infections, 90%; gynecologic infections, 94%; and septicemia, 84%. Cefoxitin was tolerated well, and major abnormalities of hematologic, hepatic, renal, or central nervous system function were encountered rarely. Resistance to cefoxitin did not develop among gram-negative cocci, anaerobes, or gram-negative bacilli in the medical centers in which the antibiotic was used.
Topics: Bacterial Infections; Cefoxitin; Clinical Trials as Topic; Humans; United States
PubMed: 400937
DOI: 10.1093/clinids/1.1.233 -
Reviews of Infectious Diseases 1979The cephamycins are a family of beta-lactam antibiotics that are produced by actinomycetes and are structurally similar to the cephalosporins. They are characterized by... (Review)
Review
The cephamycins are a family of beta-lactam antibiotics that are produced by actinomycetes and are structurally similar to the cephalosporins. They are characterized by the presence of a 7-alpha-methoxyl group, which confers unusually high resistance to beta-lactamases. Cefoxitin, the first semisynthetic cephamycin, is resistant to almost all beta-lactamases. Cefoxitin retains the 3-carbamoyl group of cephamycin C and thus has excellent metabolic stability. Cefoxitin is bactericidal and almost devoid of any inoculum effect. Active against many cephalothin-resistant gram-negative bacteria, cefoxitin demonstrates a very broad spectrum that includes indole-positive Proteus and many strains of Serratia. In contrast to that of the cephalosporins, cefoxitin's spectrum of activity against anaerobic pathogens includes Bacteroides fragilis. The therapeutic effectiveness of cefoxitin in experimental infections in mice confirms the excellent characteristics of this semisynthetic cephamycin and indicates that it should be a very valuable agent for treatment of bacterial infections.
Topics: Animals; Bacterial Infections; Cefoxitin; Cephamycins; Gram-Negative Bacteria; Gram-Positive Bacteria; Microbial Sensitivity Tests; Molecular Structure
PubMed: 400941
DOI: 10.1093/clinids/1.1.73 -
JAMA Sep 2023
Topics: Cefoxitin; Pancreaticoduodenectomy; Piperacillin, Tazobactam Drug Combination; Antibiotic Prophylaxis; Anti-Bacterial Agents
PubMed: 37721616
DOI: 10.1001/jama.2023.12773 -
JAMA Sep 2023
Comparative Study
Topics: Cefoxitin; Pancreaticoduodenectomy; Piperacillin, Tazobactam Drug Combination; Antibiotic Prophylaxis; Anti-Bacterial Agents
PubMed: 37721615
DOI: 10.1001/jama.2023.12776 -
JAMA Sep 2023
Comparative Study
Topics: Cefoxitin; Pancreaticoduodenectomy; Piperacillin, Tazobactam Drug Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis
PubMed: 37721612
DOI: 10.1001/jama.2023.12779 -
JAMA Sep 2023
Comparative Study
Topics: Cefoxitin; Pancreaticoduodenectomy; Piperacillin, Tazobactam Drug Combination; Antibiotic Prophylaxis; Anti-Bacterial Agents
PubMed: 37721617
DOI: 10.1001/jama.2023.12770 -
Critical Care (London, England) Nov 2023Despite cefoxitin's in vitro resistance to hydrolysis by extended-spectrum beta-lactamases (ESBL), treatment of ESBL-producing Klebsiella pneumoniae (KP) infections with...
Cefoxitin versus carbapenems as definitive treatment for extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteremia in intensive care unit: a propensity-matched retrospective analysis.
BACKGROUND
Despite cefoxitin's in vitro resistance to hydrolysis by extended-spectrum beta-lactamases (ESBL), treatment of ESBL-producing Klebsiella pneumoniae (KP) infections with cefoxitin remains controversial. The aim of our study was to compare the clinical efficacy of cefoxitin as definitive antibiotic therapy for patients with ESBL-KP bacteremia in intensive care unit, versus carbapenem therapy.
METHODS
This retrospective study included all patients with monomicrobial bacteremia hospitalized in intensive care unit between January 2013 and January 2023 at the University Hospital of Guadeloupe. The primary outcome was the 30-day clinical success defined as a composite endpoint: 30-day survival, absence of relapse and no change of antibiotic therapy. Cox regression including a propensity score (PS) and PS-based matched analysis were performed for endpoint analysis.
RESULTS
A total of 110 patients with bloodstream infections were enrolled. Sixty-three patients (57%) received definitive antibiotic therapy with cefoxitin, while forty-seven (43%) were treated with carbapenems. 30-day clinical success was not significantly different between patients treated with cefoxitin (57%) and carbapenems (53%, p = 0.823). PS-adjusted and PS-matched analysis confirmed these findings. Change of definitive antibiotic therapy was more frequent in the cefoxitin group (17% vs. 0%, p = 0.002). No significant differences were observed for the other secondary endpoints. The acquisition of carbapenem-resistant Pseudomonas aeruginosa was significantly higher in patients receiving carbapenem therapy (5% vs. 23%, p = 0.007).
CONCLUSIONS
Our results suggest that cefoxitin as definitive antibiotic therapy could be a therapeutic option for some ESBL-KP bacteremia, sparing carbapenems and reducing the selection of carbapenem-resistant Pseudomonas aeruginosa strains.
Topics: Humans; Cefoxitin; Carbapenems; Retrospective Studies; Klebsiella pneumoniae; Escherichia coli; Anti-Bacterial Agents; Bacteremia; beta-Lactamases
PubMed: 37915017
DOI: 10.1186/s13054-023-04712-2 -
Reviews of Infectious Diseases 1979Cefoxitin was administered by the intramuscular route to 102 patients who had infections of mild or moderate severity. The assessment of clinical and bacteriologic... (Clinical Trial)
Clinical Trial
Cefoxitin was administered by the intramuscular route to 102 patients who had infections of mild or moderate severity. The assessment of clinical and bacteriologic outcome was derived from data for 79 patients. Assessments of tolerance and safety were made for all patients who received 1 g of cefoxitin diluted in 1 ml of 0.5% or 1.0% lidocaine four times daily. Cure or improvement occurred in 45 of 47 patients with skin or soft tissue infections, in all of 16 patients with lower respiratory tract infections, and in 10 of 12 patients with urinary tract infections. One patient developed acute tubular necrosis. Eosinophilia was seen in 7% of patients treated with cefoxitin. The intramuscular preparation was not painful to 96% of the patients. Cefoxitin given by the intramuscular route can be used as an alternative to intravenous cefoxitin for treatment of mild or moderate infections, for continuation of treatment when the intravenous route is not appropriate, and for treatment of ulcers of polymicrobial etiology on ischemic extremities or on extremities of diabetic patients.
Topics: Abscess; Bacterial Infections; Cefoxitin; Cellulitis; Clinical Trials as Topic; Humans; Injections, Intramuscular; Respiratory Tract Infections; Skin Diseases, Infectious; Urinary Tract Infections
PubMed: 400934
DOI: 10.1093/clinids/1.1.224 -
Acta Medica Portuguesa Oct 1993Cefoxitin is a second generation cephalosporin commonly used to treat anaerobic and mixed infections. The authors reviewed the recently published data about the efficacy... (Review)
Review
Cefoxitin is a second generation cephalosporin commonly used to treat anaerobic and mixed infections. The authors reviewed the recently published data about the efficacy of cefoxitin; its utility in different clinical entities, patterns of resistance and resistance mechanisms, indications and reliability of in vitro susceptibility testing. These data indicate the need for determining susceptibility patterns of anaerobics at each hospital and point out to the essential close communication between the microbiologist and clinician to the rational treatment of anaerobic infections.
Topics: Bacteria, Anaerobic; Bacterial Infections; Cefoxitin; Drug Resistance, Microbial; Humans; Microbial Sensitivity Tests
PubMed: 8285118
DOI: No ID Found