Ceftizoxime (CZX), a parenteral cephalosporin derivative belonging to the so-called third generation cephalosporin is reported to have a broad antibacterial activity, particularly against Gram-negative aerobic bacilli and some anaerobes, such as Bacteroides fragilis and a good stability to is-lactamases.
Clinical study was performed on a total of 20 cases, 9 females (1 case had urinary tract infection 3 times) and 11 males, aged from 27 to 82 years.
All patients had the underlying diseases. They were bronchial asthma in 3 cases, influenza in 1, chronic pulmonary emphysema in 1, pulmonary fibrosis in 1, chronic bronchitis with strongyloidiasis in 1, lung cancer in 3, esophagus cancer in 2, stomach cancer in 1, hepatoma with urolithiasis in 1, liver cirrhosis with diabetes mellitus in 1, alcoholism with strongyloidiasis in 1, cholelithiasis in 1 and congestive heart failure in 1, respectively.
Clinical diagnoses for infections were 2-acute bronchitis, 2-exacerbation of chronic bronchitis, 2-bronchopneumonia, 2-pneumonia including one suspected case, 1-obstructive pneumonia, 2-secondary pulmonary infection, 1-pulmonary infection, 3-urinary tract infection (UTI), 1-UTI with sepsis, 1-sepsis, 1-sepsis with purulent meningitis, 1-biliary tract infection and 1-infected bronchoesophageal fistula.
CZX was given by intravenous drip infusion, at a dose of 1 to 2 g, twice daily for 3 to 15 days. Because of severity in infections and underlying diseases, some cases were treated either steroid, r-globulin preparations or other antibiotics in combination with CZX.
Twelve out of 15 cases assessed clinically responded satisfactorily to the treatment and efficacy rate was 80.0%. From the microbiological point of view, 3 strains of Haemophilus influenzae, 3 of Escherichia coli, 4 of Klebsiella pneumoniae, 2 of Enterobacter cloacae, and 1 of Proteus mirabilis were eradicated. One out of 2 strains of Acinetobacter calcoaceticus was also eradicated. Two strains of Pseudomonas aeruginosa, 1 of Pseudomonas maltophilia and 1 of Enterobacter aerogenes were still persistent after treatment.
One strain of Streptococcus pneumoniae was eliminated. Staphylococcus aureus was decreased in number after CZX therapy in 1 case. Streptococcus faecalis was not changed in number in 1 case.
Effectiveness of CZX was clinically evaluated as good or excellent in 4 (66.7%) out of 6 cases who had responded unsatisfactorily to other antibiotics treatment, such as cephalexin, minocycline, ampicillin, piperacillin, cefotiam and AC-1370.
Decreased values of hemoglobin and hematocrit in 3 cases seemed to be due to underlying DIC and malignancies. Thrombocytopenia in 1 case was due to DIC.
Elevations of S-GOT and S-GPT values were noted in 7 cases, and 6 of them were also due to underlying diseases or combination drug. Remainder was transient.
From the above mentioned results, this drug is considered to be one of the useful antibiotics for the treatment of Gram-negative bacterial infections developed in immunocompromised hosts.
