The efficacy and safety of cefmenoxime was evaluated in 50 patients with serious bacterial infections. These included 26 pneumonias, 18 urinary tract infections, 2 soft tissue infections, 2 bacteremias, 1 renal abscess, and 1 peritonitis. A satisfactory clinical response was seen in 47 patients (94%). Eosinophilia and thrombocytosis were seen in several patients but were generally mild and transient.Cefmenoxime is a semisynthetic cephalosporin with an expanded spectrum of activity against many gram-positive and gram-negative bacteria (1, 5). We report the results of an open clinical trial designed to assess the efficacy and safety of cefmenoxime for the therapy of serious bacterial infections.Patients were hospitalized at the Kings County Hospital or Downstate Medical Centers, Brooklyn, N.Y., or at the Veterans Administration Hospital, East Orange, N.J. Patients were enrolled if they had a suspected or confirmed bacterial infection and had no effective prestudy antimicrobial therapy. Only adults were entered, apd patients were excluded if they had a history of hypersensitivity to 3-lactam compounds.A total of 60 patients were entered, and 50 patients completed therapy and were evaluable. Ten were unevaluable. They included two patients with pulmonary tuberculosis, two patients who left the hospital against medical advice, four patients with protocol violations (e.g., no cultures obtained), one patient who was critically ill and died after receiving only one dose of the study drug, and one patient with femoral osteomyelitis from which Enterobacter cloacae was isolated. This patient responded clinically to cefmenoxime, but the extremity was amputated for reasons other than antibiotic failure, and this confounded proper evaluation.Pretreatment ,hest radiographs and cultures of blood, urine, and other appropriate substances were obtained. The diagnosis of pneumonia was based on a chest X-ray infiltrate and on a Gram stain of sputum or bronchial aspirate containing a predominant organism thought not to be contaminated by oropharyngeal flora and sputum cultures. Criteria for the diagnosis of urinary tract infections included a febrile illness associated with flank pain, dysuria, and urine cultures growing :-105 colonies per ml of a urinary pathogen on two occasions. X rays and cultures were repeated 48 to 72 h later and several times during and after therapy when clinically indicated.Our patients received 1.5 to 12 g of cefmenoxime per day, depending upon the type and severity of infection. Most patients received 3 to 4 grams per day. Cefmenoxime was administered parenterally, and peak and trough levels were assayed in 35 patients. These concentrations were determined by the agar well diffusion technique (2). MICs and MBCs for all bacterial isolates in 35 patients were determined by the microtiter broth dilution technique (8).Therapeutic efficacy was evaluated by clinical and bacteriological criteria for each patient with a bacteriologically * Corresponding author.documented infection who received more than 5 days of ...
