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Objectives: To study clinical and laboratory characteristics of drug-induced pemphigus., Methods: Using direct immunofluorescence (IF), indirect IF, ELISA and immunoblotting to characterize 6 patients with drug-induced pemphigus (DIP) and compared them with 20 cases of idiopathic pemphigus., Results: All the 6 cases of DIP showed obvious itching (100%) and no damage to the oral mucosa. Five out of 6 DIP cases (83.33%) presented as pemphigus folicaeus (PF) since they contained circulating Dsg1-specific IgG, were sensitive to low doses of glucocorticoid, and had good prognosis. One case was showed as pemphigus vulgaris (PV). Dsg1-specific IgA was positive in peripheral blood of 4 cases (66.67%), and the antibody disappeared after treatment. In patients with idiopathic pemphigus, only 6 cases (30%) had mild itching, and 12 cases (60%) had oral mucosal lesions. Twelve cases (60%) were PV with anti-Dsg1 and -Dsg3 antibodies, and 8 cases (40%) were PF with anti-Dsg1 antibody only. One case (5%) had anti-Dsg1 IgA., Conclusion: Drug factors should be considered for pemphigus as some common antibiotics can cause pemphigus.

Objective: To report a case of cephalosporin-induced factor V inhibitor development, an uncommon but potentially fatal condition characterized by severe hemorrhage., Case Summary: A 71-year-old Chinese man presented with factor V inhibitors after a 7-day cephradine course for a urinary tract infection, characterized by abnormal prothrombin time (PT) and activated partial thromboplastin time (aPTT), gross hematuria, upper gastrointestinal bleeding, and left groin hematoma. Systemic corticosteroid administration restored his factor V activity levels, PT, and aPTT to within normal limits, and hemorrhagic symptoms resolved. Three weeks after successful treatment of bleeding diathesis, he received another 8-day cephradine course for cellulitis. After another 4 weeks, he suffered from recurrent factor V inhibitors presented with abnormal PT, aPTT, and upper gastrointestinal bleeding. The patient eventually died due to hemorrhagic shock despite a second course of corticosteroids., Discussion: Cephalosporins are known to cause coagulopathy via hypoprothrombinemia. Another pathway seldom mentioned in the literature is factor V inhibitor induction, which may result in factor V deficiency. In our patient, factor V deficiency due to inhibitors developed each time that the patient received repeated cephradine treatment. According to the Naranjo probability scale, the relation between the formation of factor V inhibitors and cephradine treatment was probable., Conclusions: Because cephalosporins are commonly used for their wide therapeutic index and few adverse effects, iatrogenic complications associated with these drugs may be neglected or underdiagnosed. On the basis of our patient's report, careful review of medical records to avoid reexposure to the offending drug cannot be overemphasized.

Basing on a case of toxic retinal lesions after subconjunctival injection of gentamycin and data from literature the author discusses suitability of this treatment after intraocular surgery. It seems that it should be used only in special cases, those with high risk of intraocular inflammation. The place of injection should be as far as possible from the surgical wound.

In a 7-year-old child Lyell's syndrome was observed with extensive bullous epidermal necrolysis with a very severe clinical course. The disease could have been explained as a toxic-allergic reaction to sefril and aspirin taken for pharyngitis.

Eighty-eight female patients with a history of recurrent urinary tract infections were treated according to a randomization scheme with either 1 g of cephradine every 12 h (47 patients) or 375 mg of amoxicillin-clavulanate every 8 h (41 patients) for 7 days. The treatments were equally effective (cure rates of 89% for cephradine and 88% for amoxicillin-clavulanate) and showed similar relapse rates (cephradine, 14%; amoxicillin-clavulanate, 11%). Adverse effects were similar in both groups (cephradine, 23%; amoxicillin-clavulanate, 22%).

The preliminary results of a trial to examine and compare the safety, tolerability and efficacy of a single dose of teicoplanin with three doses of cephradine combined with metronidazole are presented in a series of 113 patients undergoing elective vascular surgery. There were no obvious differences in the infection rates and sepsis indicators in either group. Neither drug regimen produced any evidence of renal or hepatic damage, though the levels of three hepatocellular enzymes, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl-transferase (GGT), were seen to be transiently elevated, peaking 7 days post-operatively. The trial continues.

Cefroxadine (CXD) is an orally administered synthesized cephalosporin antibiotic developed by Ciba-Geigy Limited (Switzerland) in 1972. We have studied the clinical effectiveness of this drug in a total of 45 cases of various types of infections in the dentistry and the oral surgery. The studies resulted in showing 18 markedly effective cases, 19 effective cases, 5 slightly effective cases, 1 ineffective case, and 2 unknown cases showing an effective rate of 82.2%. Side effects manifested in 2 cases, of which 1 case was considered to be attributable to CXD, and the occurrence frequency of side effects was as low as 2.2%. In bacteriological test, there were many cases of mixed infections by Gram-positive and Gram-negative bacteria, and these infections were those which are observed in high frequency in dentistry and oral surgery infections. As a result of an overall evaluation of CXD clinical effects, the drug considered to be an antibiotic which is highly useful in dentistry and oral surgery.

A study was made of the incidence of postoperative endocarditis and of septicaemia in early convalescence in 814 consecutive patients undergoing open-heart surgery. The results were related to the prophylactic antibiotic given to "cover" the operation. A subgroup of 150 patients was studied more intensively and the bacterial flora of the tracheal aspirates and catheter tips from these patients have been related to the antibiotics used. The results demonstrate that the use of a narrow spectrum agent (flucloxacillin) is associated with a modest change in bacterial flora at the two sites sampled, but that much more pronounced shifts in flora are found with a more broad spectrum agent (cephradine). The changes in flora have been related to the incidence of septicaemia in early convalescence, which was higher (7.7%) in the cephradine group than in the flucloxacillin group (0.9%). Since the overall incidence of prosthetic infection using flucloxacillin was acceptably low (0.49% of perfusions; 0.56% of valve insertions), it is concluded that narrow spectrum prophylaxis offers the better overall choice, at least until more objective comparisons are made.

A double-blind controlled trial of cefroxadine (CXD) 250 mg t.i.d. was undertaken to objectively evaluate its safety and effectiveness in the treatment of acute suppurative otitis media and acute exacerbation of chronic suppurative otitis media, using cephalexin (CEX) 250 mg q.i.d. as a control drug, and the following results were obtained. In the treatment of acute suppurative otitis media, the 2 drugs produced almost equal outcomes, showing no significant difference in assessments of both overall effects and usefulness. In the treatment of acute exacerbation of chronic suppurative otitis media, the 2 drugs exhibited no significant difference as well in overall effects by Wilcoxon's two-sample test. However, the CEX group had significantly more nonresponsive patients, i.e. 35.5% as compared with 9.7% of the CXD group (chi 2-test, P less than 0.05). In the assessment of clinical usefulness as well, no significant difference was observed between the 2 groups. In the assessment of overall effects based on the patients whose isolated organisms were sensitive to the drugs, CEX group had more patients not responding to the treatment of acute exacerbation of chronic suppurative otitis media (chi 2-test, P less than 0.05). Bacteriological effects were not significantly different between the 2 drugs in both acute suppurative otitis media and acute exacerbation of chronic suppurative otitis media. Overall safety rating was not significantly different between the 2 drugs. Side effects occurred as the symptoms of digestive organ in 2 patients each in both groups (equally an incidence of 2.6%). As for the improvement of each symptom after treatment (assessed on day 3), CXD was superior in the improvement rate of otorrhea volume as the main symptom of acute exacerbation of chronic suppurative otitis media, while CEX was superior in that of otoobstruction feeling. From the above findings, it is presumed that CXD is a safe drug which can exhibit equal or superior therapeutic effects to CEX in the treatment of acute suppurative otitis media and acute exacerbation of chronic suppurative otitis media, at 3/4 of the CEX dose level.

This report describes a patient who developed dyspnea and bilateral pulmonary infiltrates following exposure to cephradine. The role of cephradine was substantiated by rechallenge.

Two patients on antibiotic prophylaxis with cephradine after orthopaedic implant surgery developed pseudomembranous colitis. Routine administration of antibiotics after such surgery is the policy at many centres. Development of diarrhoea in these patients should be viewed seriously lest this condition is overlooked. Despite recent advances, pseudomembranous colitis can still have a fatal outcome.

Cephradine was compared to cephalexin a randomized, double-blind study for the treatment of bacterial infections in 162 children between four months and eleven years of age. In addition to evaluations of clinical and bacteriologic responses to therapy, the relative safety of the two cephalosporins was assessed for all children, including eight who were not included in the evaluation of drug efficacy. The children in the efficacy evaluation had either lobar pneumonia or skin infections and received oral suspensions of cephradine (25-110 mg/kg per day) or cephalexin (25-150 mg/kg per day) for five to fifteen days. Overall clinical and bacteriologic responses were nearly identical in the two groups, and both antibiotics proved to equally safe and effective for use paediatric practice.

Basic and clinical evaluations of cefroxadine were carried out in children, and the following results were obtained. 1. Cefroxadine 20 mg/kg was administered to 9 children with heart disease for the prophylaxis against infections before undergoing cardiocatheterization and cardioangiography, and serum levels were determined. Peak levels reached after 30 minutes in 4 of the 9 cases, with a mean peak level of 22.5 mcg/ml and after 1 hour in 5 cases, with a mean peak level of 16.2 mcg/ml. Half life was 3.1 hours in the former group in a 6-hour blood sampling (1.04 hours in a 2-hour sampling) while in the latter group it was 1.37 hours. 2. Clinical responses were evaluated in 56 children comprising 23 cases of pharyngitis, 8 of tonsillitis, 13 of scarlet fever, 10 of urinary tract infections and 2 of impetigo. Fifty of these cases had excellent and good responses showing a efficacy rate of 89.3%. 3. From 42 of the cases, 43 strains were isolated as causative organisms. Major organisms included 27 strains of S. pyogenes, 9 of E. coli and 3 of S. aureus. As for bacteriological responses, all strains were eradicated. 4. No severe side effects were observed except for diarrhea of 1 cases and eosinophilia of 2 cases. Furthermore, no children refused to take cefroxadine dry syrup.

100 patients with septic-surgical diseases were treated with the cephalosporine-derivate Cephradine (Sefril). 79 patients were treated by surgical intervention in advance of the antibiotic therapy, 21 by Sefril in combination with conservative therapy only. The continuance of medication amounted to two weeks in 94%. A complete healing of the pyogenic infection was obtained in 86 patients. Complications occured in 6%.

The cefradine-tobramycine association was used in 11 cases of septicaemia and in 10 cases of non-septicaemic severe poly-infections. In 15 cases, the treatment was undertaken because of the serious state of the patients before the bacteriologic results were known. This association is characterized by its great effectiveness and its very good tolerance, mainly from the renal point of view. The results shown here corroborate those two elements.

1) The half-life of serum concentration of cephradine (CED) in patients with normal renal function, was 30 minutes and it prolonged to 83 minutes when combined with probenecid. 2) In the patients with severely impaired renal function, mean serum concentration of CED was 33 mcg/ml 24 hours after 1 g intravenous injection. 3) In clinical observations of 17 cases with infections of lung, urinary tract, and bile duct, the treatment with CED showed excellent results in 5 cases, good in 6, undetermined in 1. No remarkable side effect was observed.

Cephradine was given to two control and twenty subjects with varying degrees of renal failure. Serum levels at various times were recorded and side-effects noted. Recommendations for dosage schedules for subjects with renal failure have been made.

A comparison of prophylactic antibiotic cover of cephradine or flucloxacillin in sixty patients with open fractures is reported. There were more infections in the flucloxacillin than in the cephradine group and gastrointestinal side-effects were more common. The overall incidence of infection in the whole group, two out of 60 or 3.3%, was acceptably low.

Clinical efficacy of cefroxadine dry syrup, a new oral cephalosporin antibiotic, was evaluated in children, and the following results were obtained. 1. Three children were given a single oral dose of about 10 mg/kg of the drug when fasting, and its blood concentrations were determined. Blood concentrations were maximum at 30 approximately 60 minutes, i.e., 16.9 approximately 18.2 microgram/ml, and markedly low at 4 hours. 2. Thirty-six patients with the following diseases were tested with 23.1 approximately 44.4 mg/kg/day of the drug in 3 to 4 divided doses; 21 patients with lacunar tonsillitis, 2 with tonsillitis, 1 with scarlet fever, 4 with bronchitis and tonsillitis, 2 with cystitis, 4 with pyelonephritis, 1 with impetigo and 1 with probable Mycoplasma pneumonia. An overall efficacy rate in 35 patients excluding the last mentioned case was 91.4%, i.e., excellent in 20, good in 12 and poor in 3, and an eradication rate of the causative organisms was 88.9%. 3. Adverse reactions noted were diarrhea in 1 patient, eruption and diarrhea in 1 transient neutropenia in 1, eosinophilia in 3 and an elevation of GOT and GPT in 1. None were significant. 4. Taste and flavor of the drug was considered to be well palatable to children. 5. Taking into consideration of the results of fundamental evaluation of the drug, cefroxadine dry syrup is considered to be a potent new antibiotic in children, and the recommended dose will be 10 mg/kg 3 to 4 times a day.

A patient developed acute interstitial nephritis following cephradine administration. The clinical illness preceding the interstitial nephritis and the eosinophilia in peripheral blood suggested an allergic reaction. Immunological studies demonstrated an allergy to cephradine and penicillins which was IgG2-mediated. It is probable, therefore, that allergy to cephradine caused the renal lesion from which there was full clinical and biochemical recovery.

We report the case of an unusual generalized pustular drug eruption caused by the cephalosporin cephradine. Previously reported pustular drug reactions are briefly reviewed. We suggest that a reaction to an administered drug should be considered in the differential diagnosis when a patient presents with fever and a diffuse pustular eruption.

Cefroxadine (CXD), an oral cephalosporin antibiotic was studied in the field of obstetrics and gynecology and the following results were obtained. CXD was orally given to 22 cases at daily dose of 1,500 mg 3 times a day. CXD administration was given to 22 cases in all; 4 with cervicitis, 6 with endometritis, 2 with puerperal fever, 4 with bartholinitis, 5 with adnexitis and 1 with vulvitis, respectively. Overall efficacy rate was 77.3% (17/22) (excellent 4, good 13, fair 5). As for side effects, a slight diarrhea was observed. CXD was considered to be a useful antibiotic in the field of obstetrics and gynecology by above the results.

Cefroxadine dry syrup was administered to 57 children with acute febrile respiratory tract infections and 2 children with scarlet fever in the dose of 40 mg/kg/day q.i.d. for 2 approximately 7 days. 65 strains of organism were isolated as pathogen from the 59 patients, and 50 of the 65 strains (76.9%) showed bacteriologically good responses. Clinically, 55 children (93.2%) had good response. Out of 63 strains isolated from the 57 cases with respiratory infections, 48 strains (76.2%) showed good bacteriological response. As for the type of pathogen, all strains of Staphylococcus aureus, 86.4% of Streptococcus haemolyticus and 90.0% of Streptococcus pneumoniae had good response, but as for Haemophilus influenzae it was only 47.6%. In one child, Streptococcus pneumoniae appeared during cefroxadine treatment in addition to the preexisting Haemophilus influenza. From the 4 children having no response for their respiratory infections, H. influenzae were isolated in 3 cases and Streptococcus haemolyticus was isolated in 1 case, before starting the treatment. As for side effects, mild diarrhea developed in only 3 children.

A study was made with the newly developed cefroxadine (CXD) dry syrup by measuring the serum level, urine excretion and recovery rate in 10 children who were orally administered 5, 10 and 20 mg/kg at 1 hour after meals and the following results were gained. Also, its clinical efficacies and side effects were investigated in the following cases who were treated with a mean dose of 33 mg/day divided into 3 to 4 portions for a period of 9 days on the average; viz. a total of 151 cases consisting of 9 cases of pharyngitis, 39 of tonsillitis, 11 of streptococcal infection, i.e. scarlet fever, 7 of bronchitis, 6 of pneumonia, 1 of otitis media, 6 of purulent lymphadenitis, 1 of purulent parotitis, 1 of subcutaneous abscess and 3 of impetigo. 1. The serum level tends to reach its maximum level within 1 hour after administration. The mean concentrations of 5, 10 and 20 mg/kg dose in the foregoing time were 6.35, 9.12 and 21.62 mcg/ml respectively and dose response was observed. CXD showed higher concentration than CEX, CED and CFT. The mean half-life periods of the 3 dose were 72, 84 and 66 minutes respectively and variations were observed, but the drugs maintains a satisfactory serum level. 2. The time which showed highest urine excretion was mainly in the 0 to 2 hours bracket and the average concentrations of 5 , 10 and 20 mg/kg dose in the foregoing time were 381.2, 771.7 and 1,577.7 mcg/ml respectively. The dose response was more evident than in the serum concentrations. The average recovery rates within 6 hours were 93.6, 88.3 and 94.3% respectively and they were similar to those of CEX, CED and CFT. 3. The clinical effects were evaluated were in 148 cases out of the total of 151 and 136 cases, or 91.9% showed good or excellent efficacy response. 4. The daily dose groups of less than 30 mg/kg and 31 to 40 mg/kg formed the majority and there was no difference in the comparison of the clinical effectiveness in these 2 groups. Administration of a daily dose of 20 to 40 mg/kg is sufficient for the treatment of the aforementioned mild diseases except for pneumonia. 5. The clinical effects were compared between the 3 and 4 times a day treatment groups, but there was no difference between these two groups with regard to the foregoing daily dose. The 3 times a day treatment is acceptable, but the 4 times a day treatment is preferable when pharmacokinetics if taken into account. 6. The bacteriological effects in 41 cases, or 97.6% out of the 42 cases were above the efficacy base line and a high efficacy rate was achieved. 7. With regard to side effects, diarrhea developed in 4 cases and eosinophilia in 6 cases, abnormal simultaneous increases in GOT and GPT in 1 case and 1 case each for abnormal values in LDH and BUN were seen in the clinical test values. The foregoing results show that CXD has high efficacy and safety and it can be said that it is a drug required in the pediatric field.

The clinical efficacy and safety of cefixime (CFIX), a new oral cephalosporin, were compared with those of cefroxadine (CXD) in patients suffering from acute lacunar tonsillitis in a double blind study. Two hundred and fifty two patients were given each orally 100 mg of CFIX b.i.d. or 250 mg of CXD t.i.d. for, in principle, 7 days. Number of patients evaluated for clinical efficacy was 202 (103 treated with CFIX and 99 treated with CXD). As for the backgrounds of patients, more severe cases were found in the CFIX group than in the CXD group (P less than 0.01). Efficacy rates evaluated by individual doctors were 88.3% in the CFIX group and 91.9% in the CXD group. There was no significant difference between the 2 groups. Efficacy rates on the third day after the initiation of treatment evaluated by the committee were 40.8% in the CFIX group and 47.9% in the CXD group with no significant difference. Efficacy rate on the 7th day, however, was 79.8% in the CFIX group and 93.4% in the CXD group, showing a significant difference (P less than 0.05). Bacteriological effectiveness were satisfactory for both groups with eradication rates of 93.4% for the CFIX and 96.9% for the CXD group. Number of patients evaluated for safety was 226 (110 treated with CFIX and 116 treated with CXD). No significant difference was observed between the 2 drug groups in incidences of side effects; gastrointestinal disturbances or rashes were noted in 6 patients (5.5%) of the CFIX group and in 5 patients (4.3%) of the CXD group. As for the abnormal laboratory findings, elevation of GOT & GPT was observed in 1 patients of the CFIX group. From these results, it was concluded that 100 mg b.i.d. of CFIX was as useful as 250 mg t.i.d. of CXD in the treatment of acute lacunar tonsillitis.

Cephradine 250 mg at night for 12 months was given as a prophylactic measure to 33 female patients of mean age 41.6 years, who had a history in the preceding 12 months of between three and 24 (median = 7) episodes of frequency and/or dysuria. When on such treatment the mean period between symptomatic attacks was 300 days, while before treatment attacks occurred at a mean frequency of 60.3 days. Thus, prophylactic cephradine increased the interval between attacks five-fold. In a total of 9002 patient-days of treatment, only five bacteriuric breakthrough infections occurred. 27% of the patients reported adverse effects "probably" or "possibly" related to treatment. Hence, cephradine appears to be as effective and better tolerated than macrocrystalline nitrofurantoin, presently the drug of choice for the prophylaxis of recurrent urinary infections.

Cephradine (CED) was administered intravenously to the patients with respiratory infection or urinary tract infection with the dosage of 1.0 approximately 4.0 g daily and their clinical effects were investigated. Good clinical effects of CED were obtained in 5 of 8 cases with respiratory infections and in 2 of 5 cases with urinary tract infections. Side effects were noted in 2 cases, but they improved rapidly by the cessation of the drug administration. One case developed skin eruption and the other case complained general burning, palpitation after intravenous injection and slight insomnia. CED is seemed to be effective antibiotic for the respiratory as well as urinary tract infections clinically. However it was advisable that careful attention should be paid when CED is administered to the patient having drug allergy or nephropathy.

To evaluate the efficacy, safety, and utility of cefroxadine (CXD) for the treatment of complicated urinary tract infections, a double blind study comparing CXD with cephalexin (CEX) was carried out. Patient received either 1,500 mg/day of CXD 3 times a day, or 2,000 mg/day of CEX 4 times a day for 5 days by oral route, and the following results were obtained. Of the 305 patients, clinical efficacies were evaluated in 220 cases (CXD 105 cases, CEX 115 cases) except that excluded or dropped out. Side effect was evaluated in 301 cases (CXD 150 cases, CEX 151 cases). There was no statistically significant difference in the back ground characteristics between the 2 groups. Overall clinical assessment by the committee according to the "Criteria for Evaluation of Clinical Efficacy of Antimicrobial Agents on Urinary Tract Infection" patients evaluated as better than "good" were 64 of 105 (61.0%) for CXD and 75 of 115 (65.2%) for CEX. The difference between the 2 groups was not statistically significant. In effect on pyuria, patients evaluated as better than "decreased" were 58 of 105 (55.2%) for CXD and 69 of 115 (60.0%) for CEX. The difference between the 2 groups was not statistically significant. In effect of bacteriuria, patients evaluated as better than "decreased" were 57 of 105 (54.3%) for CXD and 69 of 115 (60.0%) for CEX. The difference between the 2 groups was not statistically significant. Analyses were stratified according to classification by the type of infection, diagnosis, degree of pyuria before treatment, and bacterial count before treatment. There were no statistically significant differences between the 2 treatment groups as to any item. In evaluation by attending physician, patients evaluated as better than "good" were 81 of 140 (57.9%) for CXD, and 85 of 141 (60.3%) for CEX. Statistically significant difference was not observed between the 2 groups. In drug usefulness by attending physician, patients evaluated as better than "usefulness" were 106 of 140 (75.7%) for CXD, and 109 of 141 (77.3%) for CEX. The difference between the 2 groups was not statistically significant. In evaluation of the infections with sensitive species to both CXD and CEX by the committee according to "Criteria for Evaluation of Clinical Efficacy of Antimicrobial Agents on Urinary Tract Infections, overall clinical efficacies were evaluated in 102 (CXD 48 cases, CEX 54 cases) which were infected with sensitive species. There was no statistically significant difference in the back ground characteristics between the 2 treatment groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Urinary enzyme excretion was studied in 56 patients treated with cephalosporins in order to evaluate their potential nephrotoxicity. Only in 4 out of 56 patients (7%) was increased NAG, gamma-GT, AlP excretion seen. A rapid return to normal values was observed just after the end of the therapy.

A woman underwent joint replacement surgery with prophylactic antibiotic cover, and subsequently died as a result of pseudomembranous colitis. We have noted a high incidence of antibiotic diarrhoea with cephradine, and suggest that if administration of prophylactic antibiotics is restricted to 3 days or less, the incidence of diarrhoea would diminish, and the therapeutic value of the antibiotics would be maintained.

A double-blind trial was carried out comparing cephradine and ampicillin in the treatment of urinary tract infections in 42 females attending a hospital Department of Obstetrics and Gynaecology. Results showed that patients did better in the cephradine group than the ampicillin group, both bacteriologically and clinically. The numbers in each group were small, however, and did not reach statistical significance.

A new antibiotic cephradine was administered intravenously for 3 approximately 7 days at daily doses of 1.0 approximately 2.0 g to 56 patients, including 39 cases of acute urinary tract infections, 13 of chronic urinary tract infections and 4 for postoperative prophylaxis. Of 39 cases with acute urinary infections, definite response was seen in 35 cases and no definite response in 4 cases. Of 13 cases with chronic urinary tract infections, definite response was seen in 7 cases and no definite response in 6 cases. Good results were obtained clinically in 4 cases for prophylaxis of postoperative infections. No side effect was observed with cephradine with cephradine throughout the experiment.

48 non-pregnant domiciliary patients referred by general practitioners and 50 pregnant women were treated for bacteriuria with either 500 mg cephradine or 400 mg pivmecillinam every 6 h for 7 days. In the pregnant women, cure rates were over 90% after 2 weeks for both compounds, and after 6 weeks were 86% for cephradine and 78% for pivmecillinam. Cure rates in the non-pregnant were 83% for cephradine and 95% for pivmecillinam at 6 weeks. Seven patients (3 given cephradine, 4 given pivmecillinam) stopped treatment due to side-effects. Overall, side-effects (many of which were trivial) were more common in patients treated with cephradine (51%) than in those receiving pivmecillinam (33%). It is concluded that both drugs are highly effective in these two common types of urinary infection.

The antibacterial spectrum of cefroxadine was as wide as that of CEX, and its antibacterial effect was as strong as that of CEX or even 2-fold stronger against E. coli and Klebsiella. Cefroxadine was also proved to have stronger bactericidal or bacteriolytic effect than CEX and have better affinity with penicillin binding proteins. In clinical trials, an efficacy rate of 82.7% was achieved in a total of 2,009 cases of various infections analyzed. Cefroxadine displayed particularly good clinical and bacteriological effects for the infections of skin, soft tissues, respiratory tract and urinary tract. The rate of bacteria eradication in a total of 1,410 cases was 81.6%, showing good results against the bacteria such as S. aureus (83.9%, 167/199), E. coli (89.0%, 528/593), Klebsiella (78.0%, 78/100) and P. mirabilis (80.0%, 36/45). As for side effects, their incidence was a low of only 2.3%, the main ones being eruption and gastrointestinal symptoms just as recognized in conventional cephalosporins, and none of them was serious. Abnormal laboratory test values were only increases in eosinophil, S-GOT, S-GPT and Al-P values, and their incidence was low. From these findings, we may say that the drug is an effective, safe, and useful antibiotic among all other orally administered cephalosporins.