[Bacteriological and clinical studies of cefoxitin with special reference to anaerobic infections in the patients of abdominal surgery (author's transl)].

Both bacteriological and clinical studies of the effectiveness of cefoxitin (CFX) in the treatment of infections associated with abdominal surgery have been carried out at Tokyo Metropolitan Toshima Hospital from September 1979 through August 1980. The results of these studies are summarized in the following: 1. The clinical isolates from the 29 surgical patients were studied and anaerobes were found in 16 patients (55% of the patients). B. fragilis was found in 11 of the 16 patients (69%) from whom anaerobes were isolated. In all of these patients, aerobes were also isolated--most frequently E. coli or K. pneumoniae. 2. The in vitro antibacterial activity of cefoxitin (CFX) against 83 clinical isolates was compared to that of cephalothin (CET), cefazolin (CEZ) and carbenicillin (CBPC). The activity of CFX against Gram-positive bacteria was generally slightly inferior to that of the other 3 antibiotics. Among the Gram-negative aerobic organisms, CEZ was the most active against E. coli and CFX and CEZ against K. pneumoniae. However, CFX, with MIC's of 0.78-12.5 micrograms/ml, showed the greatest activity against B. fragilis, followed by CBPC, CEZ and CET, in order of decreasing activity. 3. CFX was administered in a 1-hour drip infusion to 3 patients following abdominal surgery, and concentrations of CFX in the serum and the exudate were measured. Peak serum concentrations were obtained at the end of the infusion, with a mean peak level of 97.93 micrograms/ml. Peak concentrations in the exudate were observed 30 to 60 minutes later and varied from 21.10 to 56.25 micrograms/ml. 4. Of the 20 patients administered of CFX, complete clinical and bacteriological data of anaerobic infections were available in 8 patients. The clinical evaluation was 'good' in 7 patients and 'fair' in 1. The bacteriological evaluation was 'eradicated' in 5 patients and 'decreased' in 3. As for side effects, elevations of S-GOT and S-GPT were observed in 4 of the 20 patients received CFX, but these abnormalities might also be attributable to other factors such as underlying disease, surgical intervention etc. No other side effects were found in these patients.