Bacteriological and clinical studies on flomoxef in the pediatric field

: Flomoxef (FMOX, 6315-S), a new parenteral oxacephem antibiotic, was studied bacteriologically and clinically. 1. The MIC and MBC values of FMOX and cefuzonam (CZON) were determined against strains of Staphylococcus aureus recently isolated from clinical materials. In MICs against methicillin- and cefazolin (CEZ)-sensitive strains, FMOX and CZON were almost equivalent. In MBC, FMOX showed lower values than CZON. Against resistant strains, both MIC and MBC values indicated that FMOX was superior to CZON, and particularly, values showed large differences in MBC. 2. FMOX was administered intravenously at doses of 20.0-35.1 mg/kg 3 or 4 times daily to 17 children aged 2 months to 8 years. The therapeutic effect was determined in 16 cases (pneumonia 9 cases, pyothorax 1, urinary tract infection 2, staphylococcal scalded skin syndrome 1, cellulitis 2 and arthritis 1). One remaining case was unevaluable and later found to be mycoplasmal pneumonia. The effect was determined as excellent in 10 cases and good in 6 cases. All the causative organisms detected in these evaluable cases were eliminated. 3. There were no symptoms or findings that suggested the occurrence of side effects of the drug in any of the 17 cases. With regard to laboratory values, a slight elevation of GPT was found in 1 case only. 4. In a case with pyothorax, the concentration of the drug in the pleural fluid determined on the day following the initiation of treatment was 18.2 micrograms/ml at 30 minutes after intravenous injection of the drug at 33 mg/kg. The concentration was 46.7 times as high as the MIC (0.39 micrograms/ml) against the causative organism S. aureus. 5. Two doses of FMOX were intravenously administered at the dose of 50 mg/kg to a female infant ventriculoperitoneal shunt infection which had been treated with other drugs. In this case showing relatively low cell counts of 171-240/mm3 in the ventricular fluid, concentrations of the drug measured by HPLC were as low as 0.53 and 0.98 micrograms/ml 1 hour after intravenous injection of the drug. 6. The above results suggested that FMOX is a new antibiotic drug easy to use and effective for the treatment of general infections in children.