BACKGROUND: Cefoxitin has demonstrated in vitro resistance to hydrolysis by extended-spectrum beta-lactamases. METHODS: We evaluated the microbiological and clinical efficacy of cefoxitin in 33 patients treated for an infection related to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Clinical and microbiological outcomes were assessed from the initiation of cefoxitin therapy to the latest information available in the patient's medical file. RESULTS: The 33 patients were mainly males (n = 26), aged 70 years (median, minimum-maximum: 23-93) and main sites of infection were urinary (n = 23) and catheter-related bloodstream infections (n = 4). Escherichia coli and Klebsiella pneumoniae were isolated in 19 and 14 subjects, respectively. The clinical outcome was favorable in 30 of 33 patients in the first 48 h after the start of cefoxitin, and in 20 (of 24 evaluable) at the end of follow-up. Six microbiological failures were documented and resistance to cefoxitin emerged in two strains of K. pneumoniae. CONCLUSIONS: Cefoxitin could be considered as a carbapenem-sparing antibiotic for some ESBL-E infections, preferentially those related to E. coli.
BACKGROUND:Cefoxitin has demonstrated in vitro resistance to hydrolysis by extended-spectrum beta-lactamases. METHODS: We evaluated the microbiological and clinical efficacy of cefoxitin in 33 patients treated for an infection related to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E). Clinical and microbiological outcomes were assessed from the initiation of cefoxitin therapy to the latest information available in the patient's medical file. RESULTS: The 33 patients were mainly males (n = 26), aged 70 years (median, minimum-maximum: 23-93) and main sites of infection were urinary (n = 23) and catheter-related bloodstream infections (n = 4). Escherichia coli and Klebsiella pneumoniae were isolated in 19 and 14 subjects, respectively. The clinical outcome was favorable in 30 of 33 patients in the first 48 h after the start of cefoxitin, and in 20 (of 24 evaluable) at the end of follow-up. Six microbiological failures were documented and resistance to cefoxitin emerged in two strains of K. pneumoniae. CONCLUSIONS:Cefoxitin could be considered as a carbapenem-sparing antibiotic for some ESBL-E infections, preferentially those related to E. coli.
Authors: O Senard; M Lafaurie; P Lesprit; Y Nguyen; X Lescure; A Therby; V Fihman; N Oubaya; R Lepeule Journal: Eur J Clin Microbiol Infect Dis Date: 2019-09-11 Impact factor: 3.267
Authors: Wasim S El Nekidy; Manal M Abdelsalam; Ahmad R Nusair; Rania El Lababidi; Ruba Z Dajani; Terrence J Lee St John; Islam M Ghazi Journal: Hosp Pharm Date: 2021-12-30
Authors: Sarah Melissa Nørgaard; Camilla Skaarup Jensen; Josefine Aalestrup; Christina M J E Vandenbroucke-Grauls; Mark G J de Boer; Alma Becic Pedersen Journal: Antimicrob Resist Infect Control Date: 2019-11-04 Impact factor: 4.887