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Sixty neutropenic patients with infection were studied in a randomized trial comparing treatment with latamoxef (moxalactam) alone or with cephradine and tobramycin. The two treatment groups were comparable in respect to their clinical sites of infection, degree of neutropenia underlying malignancy, and organisms. Forty-two bacterial isolates were obtained from various clinically infected sites. All but two of these isolates were sensitive to latamoxef (30 highly sensitive, ten moderately sensitive). In contrast 29 of the isolates were resistant to cephradine and eight were resistant to both cephradine and tobramycin. Control of infection was achieved in 72% of patients treated with latamoxef and 55% treated with cephradine plus tobramycin. Latamoxef appears to be an effective antibiotic for the treatment of neutropenic patients with infection.

Ten cases of various kinds of dermatoses underwent cephradine by injection. Two cases injected cephradine intramuscularly resulted in severe pain. Three of 4 cases with pyogenic skin infection revealed excellent results. Three cases were prevented from secondary infection. Adverse effects such as vertigo were avoided by lowering the speed of intravenous injection. No abnormal findings of serum GOT and GPT levels after the completion of the treatment was noted in 7 of 8 cases, but one case which was administrated large dosis of corticosteroid concomitantly revealed elevated level in this finding.

We describe the occurrence of antibiotic-associated pseudomembranous colitis in two cases of Henoch Schonlein purpura. We discuss the potential diagnostic difficulties and suggest that Henoch Schonlein purpura may predispose to the development of antibiotic-associated pseudomembranous colitis.

Cefroxadine (CXD), an orally active cephalosporin antibiotic, has a broad spectrum and a bactericidal action. The efficacy of CXD in the surgical field was investigated and the following results were obtained. CXD was administered to 31 cases in all; 13 cases with mastitis, 9 with wound infection, 4 with infected atheroma, 3 with periproctal abscess and 2 with phlegmon, respectively. The daily dose was ranged from 750 mg to 1,500 mg. Clinical effects were good in 27 cases and fair in 4 cases, and the effective rate was 87.1%. As to side effects, a slight diarrhea was observed in 1 case, but the symptom was disappeared after 2 days without a special treatment.

Cefroxadine dry syrup was studied clinically and the following results were obtained. The drug was administered to 19 cases of bacterial infections: acute tonsillitis (6), acute bronchitis (6), scarlet fever (2), acute pyelonephritis (4) and acute cystitis (1). The daily dose was about 30 approximately 50 mg/kg except for 1 patient. The drug was given orally, 3 times a day and the duration of administration was from 4 to 11 days. The overall efficacy rate was 100%, i.e., excellent in 17 cases, good in 2 cases. One patient experienced a mild S-GOT elevation and another patient in mild vomiting. From the results obtained in this study, cefroxadine dry syrup seems to be useful in the treatment of infectious diseases of children.

Clinical study of cefroxadine (CXD), an orally active cephalosporin, for the treatment of infections in the field of obstetrics and gynecology was carried out and the following results were obtained. Fifteen strains were isolated in present study. These isolates were mainly E. coli and anaerobes (Peptococcus sp., Peptostreptococcus sp.). The distribution of susceptibilities to CXD of E. coli was between 6.25 approximately 12.5 micrograms/ml and that of anaerobes was between 0.39 approximately 1.56 micrograms/ml. These results were similar to those of CEX. CXD was used in the treatment of 11 patients (endometritis 1 case, adnexitis 3 cases, bartholinitis 7 cases). In overall clinical efficacies, patients evaluated as better than "good" were 10 out of 11 (90.9%). Skin eruption was observed in 2 cases. No abnormality in laboratory findings was recognized.

In order to evaluate effectiveness of cefroxadine (CXD) in the treatment of bacterial infections of children, the clinical studies were carried out. CXD was orally administered to 30 patients at daily dose of 27.5 approximately 50.0 mg/kg (average 32.3 mg/kg) in 3 approximately 4 divided dose for 3 approximately 10 days (average 4.9 days). The overall efficacy rate in 30 cases was 93.3%, i.e., excellent 22 (73.3%), good in 6 (20.0%), fair in 1 (3.3%) and poor in 1 case (3.3%). Drug eruption and transient eosinophilia were observed in 1 case each out of 30 cases (6.7%), but any other abnormality was not observed throughout this series. Based on the above results, CXD was thus considered to be a useful antibiotic in treatment of pediatric infections.

1. Cefroxadine dry syrup was in principle administered at the dosage of 10 mg per kilogram of body weight 3 times a day. 2. Evaluation was done in 4 grades, i.e. excellent, good, fair and poor. 3. According to subjective judgement by attending doctors, 'excellent' or 'good' was recorded in 90.7%. 4. If the evaluation was partially standardized, 'excellent' or 'good' was obtained in 74.8% of total 163 cases and in 78.7% of 108 impetigo cases. 5. Side effects were observed in 3 cases (diarrhea 1, fever 2). No direct correlation of these complaints with the administration of the present drug was confirmed.

Cefroxadine and cephalexin were compared in a double-blind study in patients with established, complicated urinary tract infections. The patients were treated orally with 1 g t.i.d. for five days. Bacterial counts in the urine were determined one, three and eight hours after the first dose and on the second, third and fifth days of treatment. A significant reduction in the bacterial count was seen one and three hours after the first dose and to a much greater extent eight hours after the dose. Reductions in the bacterial count were more frequent in the group treated with cefroxadine. The results during the first eight hours indicate that cefroxadine kills more rapidly than cephalexin; this is in agreement with the experimental findings. It is still uncertain whether the transient differences observed in the rates of inhibition are of clinical relevance.

Cefroxadine (CXD) capsules and dry syrup, an oral cephem antibiotic, were administered into 120 cases with ocular infections and the following results were obtained: The daily dose of CXD capsule was ranged from 500 to 1,500 mg and that of CXD dry syrup from 17.9 to 85.7 mg/kg, and the duration of CXD administration was from 2 days to 14 days. Clinical response rates classified by diagnosis The clinical response rates were 77.8% (14/18) in blepharitis, 86.7% (26/30) in hordeolum, 62.5% (5/8) in meibomianitis, 74.6% (44/59) in conjunctivitis, 100% (2/2) in corneal infiltration, 100% (1/1) in cellulitis of the lid, in dacryocystitis and in corneal ulcer, respectively. Clinical response classified by isolated organisms The response rates on S. aureus were 80.0% (20/25), on S. epidermidis 75.8% (47/62) and on S. pneumoniae 66.7% (2/3), respectively. The overall clinical response rate on Gram-positive bacteria was 78.3% (94/120). The response rates on H. influenzae, Acinetobacter spp., P. mirabilis, E. coli and Moraxella spp. were ranged from 42.9 to 100%. The sensitivity distributions of clinically isolated S. aureus and S. epidermidis to CXD were ranged from 1.56 to greater than 100 micrograms/ml and from 0.39 to 12.5 micrograms/ml, respectively. The former showed a peak at 3.13 micrograms/ml and the latter in 1.56 micrograms/ml. Side effects in 3 cases (2.3%) out of 129 were observed. That is; glossitis, thirst feeling and palpitation in each case, respectively.

The clinical and pharmacokinetic studies of cefroxadine (CXD) dry syrup were conducted, and the following results were obtained. 1. A single dose of CXD either 10 mg/kg or 20 mg/kg was given to 2 patients each, and serum levels were peaked in the range of about 10 to 11 microgram/ml. 2. About 30 mg/kg of CXD per day was administered to 47 infants and children (37; upper and lower respiratory tract infection, 3; urinary tract infection, 7; Others) aged from 6 months to 8 years and 1 month weighing 8 to 29 kg, and a 97.8% (44 out of 45) of clinical response was obtained except for 2 cases whose efficacies were uncertain. 3. As the drug-induced side effects, only transient loose stool was observed in 2 cases. This, however, allowed to continue the treatment.

We report 16 orthopaedic patients who had antibiotic-associated diarrhoea (pseudomembranous colitis) after operation. There was an association with the use of cephradine and with the prolongation of prophylaxis for more than three peri-operative doses. Five cases occurred as a cluster, suggesting that the causative agent, Clostridium difficile, may be infectious in some situations.