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[Therapeutic effects of cefoxitin in the treatment of various infections in children (author's transl)].
In order to ascertain the therapeutic effects of cefoxitin (CFX), a new semisynthetic cephamycin antibiotic, it was administered to pediatric patients with several infections. There were 8 patients with acute respiratory disease (ARD), 3 with urinary tract infection (UTI), 2 with appendicitis complicated with peritonitis, 2 with scarlet fever, one each of left coxitis, infected medial cervical cyst, febrile illness after a V-P shunt operation, purulent parotitis and intractable diarrhea with fever, namely, a total of 20 patients aged from one month to 11 years 6 months. A CFX vial which contained 1 g of CFX was used in two ways, i.e., one shot intravenous injection and drip infusion. The dosage of the drug varied from 57 to 121 mg/kg/day and the administration was continued from 2 to 20 days. Clinical effects were evaluated as follows: when cardinal symptoms disappeared within 3 days it was considered to be 'excellent'; within 5 days 'good'; and no change of clinical symptoms within 5 days 'poor'. The bacteriological effect was expressed as 'eliminated', 'unchanged' and 'undetermined'. Clinical efficacy evaluated as 'excellent' occurred in 11 cases, 'good' in 8 cases and 'poor' in 1 case, the efficacy rate being 95.0%. When classified by the disease, the efficacy rate was as follows: 'good' to 'excellent' in 7 out of the 8 cases of ARD, 'excellent' in all of the 3 cases of UTI, 'good' and 'excellent' in the 2 cases of scarlet fever and in the 2 cases of peritonitis, 'excellent' in each case of left coxitis, purulent parotitis and intractable diarrhea with fever, 'good' in each case of infected medial cervical cyst and febrile illness with a V-P shunt operation. From the bacteriological point of view, 'eliminated' occurred in 5 cases, 'reduced' in 1 case and 'undetermined' in the 2 cases of ARD, 'eliminated' in all of the 3 cases of UTI, 'eliminated' in 1 case and 'undetermined' in the 1 case of peritonitis, 'undetermined' in the 2 cases of scarlet fever, 'eliminated' in each case of infected medial cervical cyst and purulent parotitis and 'undetermined' in the other cases. Antimicrobial efficacy measured by MIC was compared with CEZ and CET, and the results were as follows: CFX was inferior to the two cephalosporins for S. aureus, it was between CEZ and CET for H. influenzae and H. parainfluenzae, and CFX was superior to CEZ and CET for E. coli. All of the 3 antibiotics had poor antimicrobial efficacy for P. aeruginosa and S. faecalis. There were neither clinical side effects nor abnormal laboratory findings which were obviously attributable to CFX during and after administration of the drug.
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