In vitro antimicrobial activity of cefmenoxime (SCE-1365) and clinical evaluation of therapeutic effects on respiratory tract infections

Akira Watanabe, Seiichi Aonuma, Kikuo Onuma, Masako Sasaki, Kotaro Oizumi, Kiyoshi Konno

    Research output: Contribution to journalArticle

    Abstract

    In vitro antimicrobial activity of cefmenoxime (CMX, SCE-1365), a new derivative of cephalosporin, was examined by the method of Japan Society for Chemotherapy. Also, therapeutic efficacy of the drug in treatment of patients with respiratory tract infections were observed. The minimum inhibitory concentrations (MICs) of cefmenoxime against 27 clinical isolates of Escherichia coli ranged from 0.1 μg/ml and below to 200 μg/ml. Of these 27 isolates tested, 15 were inhibited at 0.2 μg/ml and below of cefmenoxime. Of the 7 isolates which were resistant to more than 400 μg/ml of cefazolin 5 isolates were inhibited at 25 μg/ml of cefmenoxime. Thus, it was found that antimicrobial activity of cefmenoxime against Escherichia coli was much more potent than that of cefazolin. The MICs of cefmenoxime against Enterobacter were 6.25 μg/ml and below in 8 of 10 isolates tested. While cefazolin inhibited 3 of 10 isolates at 3.13μg/ml and the remaining 7 isolates at 200 μg/ml or more. All of the 32 strains tested of Serratia marcescens were inhibited at 25 μg/ml and below of cefmenoxime. In contrast, concentrations of cefazolin more than 400 μg/ml were required for the inhibition of growth of 31 of 32 strains tested of Enterobacter. From these results, it was evident that cefmenoxime was much superior to cefazolin in inhibitory activity against Serratia and Enterobacter. MICs of cefmenoxime against Pseudomonas aeruginosa ranged from 12.5 μg/ml to more than 400 μg/ml, and only 8 of 27 strains tested were inhibited at 50 μg/ml and below. Cefmenoxime was slightly more potent against Pseudomonas than sulbenicillin, and it was much more active than cefazolin. A daily dose of 2 to 4 grams of cefmenoxime was given to a total of 16 patients by intravenous drip infusion. These patients consisted of 10 patients with pneumonia, 3 patients with infection associated with lung cancer and one patient with infection each associated with bronchiectasis, pulmonary tuberculosis and fibrosis, respectively. Clinical response to the treatment with cefmenoxime was excellent in 4 patients, good in 8 patients and fairly good in the remaining 4 patients. From the sputum of these patients the following 10 potential pathogens were recovered at the start of the treatment with cefmenoxime; 5 strains of Haemophilus influenzae, 4 strains of Klebsiella pneumoniae and a strain of Enterobacter. All of these pathogens were eradicated during the therapy with cefmenoxime. An elevation of slight degree of sGOT and sGPT was observed in 3 patients and that of sGOT alone in one patient. These abnormal values of liver function tests returned to normal levels after the cessation of cefmenoxime.

    Original languageEnglish
    Pages (from-to)311-324
    Number of pages14
    JournalChemotherapy
    Volume29
    DOIs
    Publication statusPublished - 1981 Jan 1

    ASJC Scopus subject areas

    • Pharmacology (medical)
    • Infectious Diseases
    • Pharmacology
    • Drug Discovery
    • Oncology

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