Treatment of bacterial osteomyelitis and Staphylococcus aureus endocarditis and single-dose therapy for uncomplicated Neisseria gonorrhoeae infections: an overview

Abstract

Cefonicid is a new second-generation cephalosporin that has broad-spectrum antibacterial activity, achieves high peak serum concentrations, and has a long half-life. The high serum concentration and long half-life of cefonicid make it feasible to administer the drug once daily either intravenously or intramuscularly. For the treatment of bacterial osteomyelitis, a specific antibacterial agent is administered for four to eight weeks. Ideally, the optimal antibiotic should have good activity against organisms commonly implicated in bone infections, be easy to administer, be stable in inflammatory conditions, achieve good concentrations in bone, and have minimal toxicity. For treatment of Staphylococcus aureus endocarditis, the same criterion of minimal toxicity should be met for the agent used; in addition, it should have excellent antistaphylococcal activity in vivo and in vitro, be stable to beta-lactamase, and exhibit good bactericidal activity at trough serum levels. In uncomplicated Neisseria gonorrhoeae infections, the ideal antibiotic should be one that could be administered in a single dose in a small volume and would not be painful on intramuscular injection. The antibiotic should be nontoxic; stable to N. gonorrhoeae beta-lactamase; and reliably able to eradicate urethral, endocervical, rectal, and pharyngeal infections. Cefonicid may fulfill some of these criteria.