Cephacetrile, a new derivative of
7-aminocephalosporanic acid, was evaluated in 27 patients.
Soft tissue infections due primarily to gram-positive cocci were treated in 16 patients; 12 had bacteriological and clinical cure, and 4 improved but the lesions resolved incompletely or cultures remained positive. Seven of eight patients with
respiratory tract infections were cured, including three with
pneumococcal pneumonia; the eighth proved to have a noninfectious process and failed to respond. Two patients with acute
urinary tract infections due to Escherichia coli had prompt clinical and bacteriological improvement, but follow-up was incomplete. One patient with
sepsis due to Staphylococcus aureus expired. Laboratory abnormalities observed during
cephacetrile therapy included mild
eosinophilia in four patients,
thrombocytosis in nine, direct Coombs' test positivity in four, and an elevated serum
glutamic pyruvic transaminase in eight patients. No evidence of nephrotoxicity was detected. Severe
superinfection due to Enterobacter species was observed in one patient. Mean peak serum concentrations of
cephacetrile were 22, 69, and 104 mug/ml after 1 g intramuscularly, 1 g intravenously, and 1.5 g intravenously, respectively. Thus, in early studies
cephacetrile was efficacious for selected
bacterial infections, but determination of its comparative value within the
cephalosporin group of
antibiotics requires further clinical investigation.