An overview: evaluation of cefonicid in infections of the urinary tract, lower respiratory tract, and skin and soft tissue.

Infections of the urinary and lower respiratory tracts and of skin and soft tissue constitute a large proportion of infections requiring antimicrobial therapy. For many antimicrobial agents, one dose will cure lower urinary tract infection. In contrast, relapse of upper tract infection is common even after two weeks of treatment. In comparing the efficacy of antimicrobial agents in urinary infection, it is critical that patients assigned to different agents be equivalent. The questions about cefonicid in urinary infection that must be addressed concern (1) adverse effects and tolerability, (2) cost, and (3) rationale for the use of a parenteral preparation in uncomplicated urinary infection. In lower respiratory tract infections, therapeutic efficacy is difficult to evaluate primarily because of the difficulty in determining the causative role of the organisms isolated from sputum. The inclusion of information from gram-stained preparations reduces the diagnostic error. As far as cefonicid in treatment of pneumonia is concerned, the high serum protein binding reported and the relatively high minimal inhibitory concentrations for gram-positive cocci must be addressed. In skin and soft-tissue infections, therapeutic efficacy is difficult to evaluate because of the lack of isolates and the self-limited nature of many cutaneous infections.