[Lyme neuroborreliosis with acute meningitis as the presenting manifestation: report of a case].

To enhance the understanding of Lyme disease, a case of Lyme neuroborreliosis with acute meningitis as the presenting manifestation was reported. The diagnosis was confirmed by elevated serum antibody response to B. burgdorferi using both ELISA and Western blotting, excluding other causes of neurological abnormalities and the typical response of our patient to antibiotics. This case indicates the existence of Lyme disease in Beijing area. If the etiology of a meningitis with lymphocytic pleocytosis is not known, it is important that Lyme neuroborreliosis should be considered as one of the differential diagnoses and detection of antibody to B. burgdorferi in serum and cerebrospinal fluid performed in time. A brief review of the literature including epidemiology, clinical menifestations, diagnosis and treatment of Lyme disease was made.

[Comparative trial of the clinical efficacy and tolerance of cefatrizine (Cefaperos) and cefpodoxime proxetil (Orelox) in superinfections of chronic obstructive bronchopneumopathies in adults in urban practice]. / Essai comparatif de l'efficacité et de la tolérance clinique entre la céfatrizine (Cefaperos) et le cefpodoxime proxétil (Orelox) dans les surinfections des bronchopneumopathies chroniques obstructives de l'adulte en médecine de ville.

In order to compare the clinical efficacy and safety of cefatrizine (Cefaperos) and cefpodoxime proxetil (Orelox) in the treatment of secondarily infected chronic obstructive pulmonary disease (COPD) in adults, a multicentre, randomized, open study was conducted by 60 general practitioners in two parallel groups of patient suffering from COPD complicated by an acute episode of superinfection (Anthoniesen stages 2 and 3). After verification of the eligibility criteria, written consent and randomization, the patients received, for 10 days, either cefatrizine at the dose of 1 g/day or cefpodoxime proxetil at the dose of 400 mg/day. A self-assessment form was given to the patient. A telephone visit was planned for D3. The final visit on D11 +/- 1 evaluated clinical efficacy (success or failure) and safety. The study population was composed of 250 patients with a mean age of 59.9 +/- 15.9 years (sex ratio M/F = 1.5). The principal etiology of COPD was chronic bronchitis in 67.5% of patients, longstanding asthma in 24.5% and emphysema in 6.8%. The mean history of the disease was 13.0 +/- 10.8 years. The Anthoniesen score was equal to 2 in 73.6% of patients, 3 in 8.8% of patients and 1 in 17.6% of patients. No significant difference concerning these criteria was observed between the two study groups. The clinical success rate was equivalent in the two groups. The time to regression of clinical signs tended to be shorter, up until the sixth day (mainly between D4 and D6) for patients treated with cefatrizine (p = 0.09; NS). The clinical safety was considered to be good and was comparable in the two study groups. This study concluded on the equivalent clinical efficacy of cefatrizine and cefpodoxime proxetil in the treatment of superinfections of COPD in general practice (97.5% and 99%, respectively), with a satisfactory and comparable safety, but with a much lower cost of treatment for cefatrizine. This conclusion is particularly important in the context of opposable medical references, as, although the treatment of superinfections of COPD by second and third generation cephalosporins is frequently proposed, the prescription of a less expensive cephalosporin appears to be more relevant.

[Treatment of acute otitis media: comparative study of efficacy of cefatrizine and amoxicillin-clavulanic acid]. / Traitement des otites moyennes aiguës: étude comparative de l'efficacité de la céfatrizine et de l'amoxicilline-acide clavulanique.

Fourty hospitalized patients (15 children, 25 adults) suffering from acute otitis media have been treated with either cefatrizine or amoxycillin-clavulanic acid. Bacteriological samples were done during surgery by tympanocentesis (N = 33) or by sampling of middle ear fluid specimens (13). H. influenzae was the most common isolate, following by Enterobacteriaceae, S. aureus, P. aeruginosa, and S. pneumoniae. We conclude that these two antibiotics can be used for treatment of acute otitis media in our country even in adults where the order of frequency of bacteria is different from those reported in children.

[Randomized study of cefatrizine versus cefaclor in conjunctivitis otitis syndrome]. / Etude randomisée céfatrizine versus céfaclor dans le syndrome otite-conjonctivite.

The association conjunctivitis-otitis is highly suggestive of Haemophilus influenzae infection. This conjunctivitis otitis syndrome could be a good model to assess the efficacy of different antibiotic regimen in the treatment of acute otitis media due to HI without tympanocentesis. This prospective randomized trial compared the efficacy of two orally cephalosporins which demonstrate in vitro an activity against HI. This study was conducted from 4.20.1988 to 3.15.1989 and involved 73 children with COS examined in an outpatient clinic. The mean age was 17.7 months. Before treatment culture were taken from the lower palpebral conjunctivae. 81 strains was found: HI 61 (beta-lactamase-producing 15), Streptococcus pneumoniae 16, Branhamella Catarrhalis 4. The 73 patients were treated with 40 to 50 mg/kg/day of the test drug for ten days, 25 with Cefaclor in 3 divided dose (group 1), 24 with Cefatrizine in 3 divided dose (group 2), 24 with Cefatrizine in 2 divided dose (group 3). The recoveries was obtained in 17/25 in the group 1, 18/24 in the group 2, 15/24 in the group 3. There was no significant difference between the 3 groups.

[Cefatrizine in dentistry. Clinical study]. / La cefatrizina in odontostomatologia. Indagine clinica.

The Authors evaluated the cefatrizine clinical effects on 50 patients with infectious diseases. The statistical analysis of results show a high efficacy and safety with no relevant side effects.

Controlled multicenter clinical comparison between two cefatrizine administration schedules: a contribution to improvement of compliance in clinical nonhospital use of antibiotics.

Eight Italian clinical centers carried out a controlled double-blind/double-dummy evaluation of the effectiveness of two different administration schedules of cefatrizine, an orally active cephalosporin. The first schedule provided for once-a-day administration of 1.5 gm of the drug, and the second one for twice-a-day administration of 0.75 gm. The trial included 160 patients affected by bacterial diseases of the respiratory apparatus. The two drug administration schedules were found to be equivalent in clinical and bacteriological results and in tolerability.

Comparison of cefatrizine and erythromycin for pediatric ear, nose, and throat infections.

A comparison was made of cefatrizine in dosages of 75 mg/kg/day administered once daily or twice daily and erythromycin in a mean daily dosage of 50 mg/kg given in three divided doses for the treatment of acute infections of the ear, nose, and throat in children. Temperature was recorded twice a day during therapy. At the end of treatment, a clinical evaluation of cure, improvement, or failure was made, based on defervescence and abatement of symptoms. All ten children given cefatrizine once daily were cured (P less than or equal to 0.05), as were eight of ten given cefatrizine twice daily and four of ten given erythromycin. The remaining eight patients were improved. One patient given cefatrizine had diarrhea, which appeared on the fifth day of treatment. No other side effects were observed. Cefatrizine appeared to be similarly effective whether given once a day or twice a day; further trials are warranted to confirm the efficacy of once-daily treatment with this cephalosporin.

Cefatrizine: a clinical overview.

Cefatrizine, a new oral cephalosporin, proved effective in the treatment of a wide range of bacterial infections in both adult and paediatric patients. Adverse reactions mild and mainly limited to gastrointestinal disturbances.

Determination of cefatrizine levels in blood, tonsils, paranasal sinuses and middle ear.

Levels of cefatrizine, a new oral cephalosporin, were determined in blood and in tonsils, paranasal sinus secretions and middle ear exudates from 18 patients with acute infections at these sites. Three and six hours after administration of 500 mg cefatrizine satisfactory levels of the antibiotic were found at all the sites examined. Levels in the tonsils and middle ear were higher than those in blood, while lower levels were recorded in nasal secretions.

Determinations of tissue levels of cefatrizine in blood, lungs and bronchi.

A study was carried out in 12 patients, divided into two groups of 6, to determine tissue levels of cefatrizine in lung (group I) and bronchial secretions (group II) following a single oral dose of 500 mg. In group I, specimens of blood and lung tissue were collected after 2 h from one subgroup of 3 patients and after 3 h from the other subgroup of 3. Average levels were 8.5 and 7.0 mcg/ml for blood and 1.2 and 1.4 mcg/ml for lung tissue respectively. In group II blood and bronchial secretion concentrations were evaluated at the 2nd, 3rd and 6th hours from administration. Average values were 9.1 and 7.7 mcg/ml in blood at 2h and 3h respectively, whereas the average bronchial secretion concentration at the 3rd hour was 10.4 mcg/ml in the first subgroup. In the second subgroup the mean level in blood collected at the 2nd hour was 8.9 mcg/ml, and 2.5 and 4.1 mcg/ml respectively in blood and bronchial secretions at the 6th hour. Cefatrizine levels in bronchial secretions were higher than those in blood at both the 3rd and the 6th hour from administration: this kinetic peculiarity of the drug will doubtless play an important role in the therapeutic efficacy of cefatrizine.

[Experimental and clinical studies of cefatrizine in oral infections (author's transl)].

Investigation was made on the therapeutic effect of a new antibiotic, cefatrizine(CFT), in oral infections according to the following procedure. Results are summarized as follows. Determination was made on the MIC of CFT against 8 clinical isolates of S. epidermidis, 5 of S. aureus and 7 of E. coli in comparison with those of CEX and PBPC. MICs of CFT against S aures were demonstrated 3.13 to 6.25 mcg/ml which were superior to those of CEX and ABPC. CFT was administered orally in a dose of 500 mg at an hour and a half before the extraction of the impacted wisdom tooth in the mandibula. During the operation, gingival and blood specimens were collected and each CFT level was determined. The mean CFT level in the gingiva reached to 0.95 mcg/ml and that in the blood to 5.77 mcg/ml. According to these experimental results, CFT was administered to patients with moderate oral infection at a dose of 500 mg and clinical assessment was made according to the criteria established by Japanese Society of Oral Surgeons. As the results, the effectiveness rate of CFT was 85%. No serious side effect was observed. From the results of the present study, CFT may be effective for moderate oral surgery infections.