Cefmenoxime therapy in bacterial osteomyelitis

Abstract

Cefmenoxime, a new parenteral beta-lactamase-resistant cephalosporin, was evaluated for safety and efficacy in 15 patients (10 male and five female) with acute (1 patient) and chronic (14 patients) osteomyelitis. Diagnosis was made by culture of the surgical biopsy specimen. Osteomyelitis was treated with 8 to 12 g of cefmenoxime per day (mean 9.1 g) for 42 to 66 days (mean 47.3). Staphylococcus aureus was the most frequently isolated organism. Minimum inhibitory concentrations (MICs) of cefmenoxime were determined and all pathogens were inhibited by 12.5 micrograms/ml or less, except for Enterobacter cloacae and Acinetobacter species, both of which had an MIC of 25.0 micrograms/ml. All patients had at least one surgical debridement. Of the 15 patients, 10 (67 percent) had the osteomyelitis "arrested." These patients have been followed up five to 14 months after completion of cefmenoxime therapy. Toxicity studies indicated mild elevations in serum glutamic oxalacetic transaminase and serum glutamic pyruvic transaminase in two patients. Cefmenoxime appears to be a safe and effective antibiotic in the treatment of osteomyelitis.