Journal of Antimicrobial Chemotherapy (1978) 4 (Suppl. B), 211-213
Comparison of cefoxitin sodium and cefazolin
M. Gurwith, W. Albrirton, B. Lank, G. Harding and A. Ronald
Departments of Medicine, Pediatrics, and Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada Cefoxitin sodium was compared to cefazolin in the treatment of infections involving pathogens believed to be susceptible to either antibiotic. Allocated on a random basis to either drug, 12 patients received cefazolin and 10 patients received cefoxitin. In the cefoxitin group, all 10 patients had a good initial clinical response and there was a good bacteriological response in all of the 9 patients who were evaluable. In the cefazolin group the bacteriologic response was good in 5 of 7 evaluable patients, and the clinical response was good in 10 of 11 patients, but there was one failure, a patient with staphylococcal bacteraemia who died. Relatively minor side effects were seen with both drugs. Cefoxitin and cefazolin appear to be similarly efficacious against enteric Gram-negative rods and Grampositive cocci (possibly excepting staphylococci).
Introduction We compared cefoxitin sodium, 2 g intravenously every 8 h, with cefazolin, 1 g intravenously every 8 h, in infections where the suspected pathogen was thought to be susceptible to either antibiotic. Materials and methods Patients were allocated on a random basis to either cefazolin (1 g intravenously every 8 h) or cefoxitin (2 g intravenously every 8 h). Twelve patients (Table 1), with a mean age of 46 and a median of 50 years, were treated with cefazolin. The infectious diagnosis was pneumonia in 4 patients, 2 of whom had pneumococcal bacteraemia. In 5 patients the diagnosis was cellulitis and/or furunculosis due to either Group A streptococci or Staphylococcus aureus. One patient with cirrhosis had staphylococcal bacteraemia; 1 patient with a neurogenic bladder had acute pyelonephritis; and 1 patient had the syndrome of disseminated gonococcal dermatitis/arthritis. In the cefoxitin group, there were 10 patients (Table 1) with a mean age of 39 and a median of 29-5 years. The infectious diagnosis was pneumonia in 4 patients, including 2 with pneumococcal bacteraemia. Three patients had cellulitis and/or furunculosis with either Staphylococcus aureus or Group A streptococci. One patient had acute pyelonephritis, 1 patient had a staphylococcal infection of a surgical wound, and 1 had the disseminated gonococcal dermatitis/arthritis syndrome. 0305-7453/78/0701-B211 801.00/0
211 © (1978) The British Society for Antimicrobial Chemotherapy
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M. Gurwith, W. Albritton, B. Lank, G. Harding and A. Ronald Table I. Patient population Number of patients
Mean age, years (median)
Cefazolin
12
46 (50)
4 pneumonia (2 with pncumococcal bacteraemia) 5 cellulitis/furunculosis 1 staphylococcal bacteraemia 1 acute pyelonephritis 1 disseminated gonococcal dermatitis/arthritis
Cefoxitin
10
39 (29-5)
4 pneumonia (2 with pneumococcal bacteraemia) 3 cellulitis/furunculosis 1 acute pyelonephritis 1 staphylococcus-infected surgical wound 1 disseminated gonococcal dermatitis/arthritis
Diagnosis
Results In the cefazolin group, there was one clinical and bacteriologic failure, which occurred in a patient with staphylococcal septicaemia. The patient did not respond clinically and died after 5 days of cefazolin therapy, still bacteraemic. In another patient, staphylococci persisted in a skin ulcer. Otherwise, a good clinical response was seen in 10 of 11 patients (Table 1), and a good bacteriologic response was seen in 5 of 7 patients where therapy could be evaluated. In the cefoxitin group, all 10 patients had a good initial clinical response (Table II), and all 9 patients with evaluable bacteriology had a good bacteriologic response. One patient had a bacteriologic relapse with reappearance of staphylococci in a surgical wound after discontinuation of cefoxitin therapy. Side effects in the cefazolin group included mild phlebitis in 6 patients and severe phlebitis in 1, allergic skin rash in 2 patients, vasculitis in 1 patient and increased alkaline phosphatase in 2 patients. Side effects in the cefoxitin group included mild phlebitis in Table II. Clinical and bacteriologic results of treatment Clinical
Bacteriologic
Side effects
Cefazolin
10 good (of 11 evaluable) 1 bacteraemia death
5 good (of 7 evaluable)
6 mild phlebitis 1 severe phlebitis 2 allergic skin rash 1 vasculitis 2 increased alkaline phospbatase
Cefoxitin
10 good
9 good (of 9 evaluable) (note: 1 bacteriologic relapse after discontinuation of therapy)
2 mild phlebitis 1 moderate phlebitis 1 allergic skin rash 2 increased alkaline phosphatase
Comparison of cefoxitin sodium and cefazolin
M. Gurwith, W. Albrirton, B. Lank, G. Harding and A. Ronald
Departments of Medicine, Pediatrics, and Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada Cefoxitin sodium was compared to cefazolin in the treatment of infections involving pathogens believed to be susceptible to either antibiotic. Allocated on a random basis to either drug, 12 patients received cefazolin and 10 patients received cefoxitin. In the cefoxitin group, all 10 patients had a good initial clinical response and there was a good bacteriological response in all of the 9 patients who were evaluable. In the cefazolin group the bacteriologic response was good in 5 of 7 evaluable patients, and the clinical response was good in 10 of 11 patients, but there was one failure, a patient with staphylococcal bacteraemia who died. Relatively minor side effects were seen with both drugs. Cefoxitin and cefazolin appear to be similarly efficacious against enteric Gram-negative rods and Grampositive cocci (possibly excepting staphylococci).
Introduction We compared cefoxitin sodium, 2 g intravenously every 8 h, with cefazolin, 1 g intravenously every 8 h, in infections where the suspected pathogen was thought to be susceptible to either antibiotic. Materials and methods Patients were allocated on a random basis to either cefazolin (1 g intravenously every 8 h) or cefoxitin (2 g intravenously every 8 h). Twelve patients (Table 1), with a mean age of 46 and a median of 50 years, were treated with cefazolin. The infectious diagnosis was pneumonia in 4 patients, 2 of whom had pneumococcal bacteraemia. In 5 patients the diagnosis was cellulitis and/or furunculosis due to either Group A streptococci or Staphylococcus aureus. One patient with cirrhosis had staphylococcal bacteraemia; 1 patient with a neurogenic bladder had acute pyelonephritis; and 1 patient had the syndrome of disseminated gonococcal dermatitis/arthritis. In the cefoxitin group, there were 10 patients (Table 1) with a mean age of 39 and a median of 29-5 years. The infectious diagnosis was pneumonia in 4 patients, including 2 with pneumococcal bacteraemia. Three patients had cellulitis and/or furunculosis with either Staphylococcus aureus or Group A streptococci. One patient had acute pyelonephritis, 1 patient had a staphylococcal infection of a surgical wound, and 1 had the disseminated gonococcal dermatitis/arthritis syndrome. 0305-7453/78/0701-B211 801.00/0
211 © (1978) The British Society for Antimicrobial Chemotherapy
212
M. Gurwith, W. Albritton, B. Lank, G. Harding and A. Ronald Table I. Patient population Number of patients
Mean age, years (median)
Cefazolin
12
46 (50)
4 pneumonia (2 with pncumococcal bacteraemia) 5 cellulitis/furunculosis 1 staphylococcal bacteraemia 1 acute pyelonephritis 1 disseminated gonococcal dermatitis/arthritis
Cefoxitin
10
39 (29-5)
4 pneumonia (2 with pneumococcal bacteraemia) 3 cellulitis/furunculosis 1 acute pyelonephritis 1 staphylococcus-infected surgical wound 1 disseminated gonococcal dermatitis/arthritis
Diagnosis
Results In the cefazolin group, there was one clinical and bacteriologic failure, which occurred in a patient with staphylococcal septicaemia. The patient did not respond clinically and died after 5 days of cefazolin therapy, still bacteraemic. In another patient, staphylococci persisted in a skin ulcer. Otherwise, a good clinical response was seen in 10 of 11 patients (Table 1), and a good bacteriologic response was seen in 5 of 7 patients where therapy could be evaluated. In the cefoxitin group, all 10 patients had a good initial clinical response (Table II), and all 9 patients with evaluable bacteriology had a good bacteriologic response. One patient had a bacteriologic relapse with reappearance of staphylococci in a surgical wound after discontinuation of cefoxitin therapy. Side effects in the cefazolin group included mild phlebitis in 6 patients and severe phlebitis in 1, allergic skin rash in 2 patients, vasculitis in 1 patient and increased alkaline phosphatase in 2 patients. Side effects in the cefoxitin group included mild phlebitis in Table II. Clinical and bacteriologic results of treatment Clinical
Bacteriologic
Side effects
Cefazolin
10 good (of 11 evaluable) 1 bacteraemia death
5 good (of 7 evaluable)
6 mild phlebitis 1 severe phlebitis 2 allergic skin rash 1 vasculitis 2 increased alkaline phospbatase
Cefoxitin
10 good
9 good (of 9 evaluable) (note: 1 bacteriologic relapse after discontinuation of therapy)
2 mild phlebitis 1 moderate phlebitis 1 allergic skin rash 2 increased alkaline phosphatase
