Adverse events associated with the use of oral cephalosporins/cephems

Diagnostic Microbiology and Infectious Disease

Volumn 57, Issue 3 SUPPL., 2007, Pages

  Mitropoulos, Isaac F ^a   Rotschafer, John C ^a   Rodvold, Keith A ^b  

^a UNIVERSITY OF MINNESOTA   (United States)

^b UNIVERSITY OF ILLINOIS AT CHICAGO   (United States)

Author keywords

Adverse events; Oral cephalosporins

Indexed keywords

AMOXICILLIN PLUS CLAVULANIC ACID; AZITHROMYCIN; CEFACLOR; CEFADROXIL; CEFALEXIN; CEFDINIR; CEFDITOREN; CEFIXIME; CEFPODOXIME; CEFPROZIL; CEFRADINE; CEFTIBUTEN; CEFTRIAXONE; CEFUROXIME AXETIL; CLARITHROMYCIN; LINEZOLID; LORACARBEF;

ABDOMINAL CRAMP; ABDOMINAL PAIN; ACIDOSIS; ACUTE KIDNEY TUBULE NECROSIS; AGITATION; ALANINE AMINOTRANSFERASE BLOOD LEVEL; ALKALINE PHOSPHATASE BLOOD LEVEL; AMINOTRANSFERASE BLOOD LEVEL; ANAPHYLAXIS; ANOREXIA; ANUS PRURITUS; ARTICLE; ASEPTIC MENINGITIS; ASPARTATE AMINOTRANSFERASE BLOOD LEVEL; ATAXIA; AUTOIMMUNE HEMOLYTIC ANEMIA; BRONCHITIS; BRONCHOSPASM; CANDIDIASIS; CHEMOTHERAPY INDUCED EMESIS; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; CONSTIPATION; COUGHING; DEPRESSION; DERMATITIS; DIARRHEA; DIPLOPIA; DISEASE ASSOCIATION; DIZZINESS; DRUG ERUPTION; DRUG FEVER; DRUG HYPERSENSITIVITY; DRUG INDUCED HEADACHE; DRUG MEGADOSE; DRUG SAFETY; DRUG USE; DRUG WITHDRAWAL; DYSPEPSIA; EOSINOPHILIA; ERYTHEMA MULTIFORME; FATIGUE; GASTROINTESTINAL SYMPTOM; GENITAL PRURITUS; GRAND MAL SEIZURE; HEMATURIA; HERXHEIMER REACTION; HOT FLUSH; HUMAN; INFECTION; INSOMNIA; INTERSTITIAL NEPHRITIS; INTERSTITIAL PNEUMONIA; LEUKOCYTOSIS; LEUKOPENIA; LOOSE FECES; LYMPHOCYTOSIS; MALAISE; MIGRAINE; NAUSEA; NEPHROTOXICITY; NERVOUSNESS; NEUTROPENIA; PAIN; PEMPHIGUS VULGARIS; PRIORITY JOURNAL; PRURITUS; PSEUDOMEMBRANOUS COLITIS; PSYCHOSIS; RESPIRATORY FAILURE; RIGOR; SEIZURE; SERUM SICKNESS; SIDE EFFECT; SKIN CANDIDIASIS; SOMNOLENCE; STEVENS JOHNSON SYNDROME; TASTE DISORDER; THROMBOCYTOPENIA; THRUSH; TINNITUS; TOXIC EPIDERMAL NECROLYSIS; UNSPECIFIED SIDE EFFECT; URTICARIA; VAGINA CANDIDIASIS; VAGINAL PRURITUS; VAGINITIS; XEROSTOMIA;

ADMINISTRATION, ORAL; ANTI-BACTERIAL AGENTS; CEPHALOSPORINS; HUMANS;

EID: 33847399623     PISSN: 07328893     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.diagmicrobio.2006.12.002     Document Type: Article

References (97)

1. Adelglass J., Bundy J.M., and Woods R. Efficacy and tolerability of cefprozil versus amoxicillin/clavulanate for the treatment of adults with severe sinusitis. Clin. Ther. 20 (1998) 1115-1129
2. Adler M., McDonald P.J., Trostmann U., Keyserling C., and Tack K. Cefdinir vs. amoxicillin/clavulanic acid in the treatment of suppurative acute otitis media in children. Pediatr. Infect. Dis. J. 19 (2000) S166-S170
3. Alvarez-Sala J.-L., Kardos P., Martinez-Beltran J., Coronel P., Aguilar L., and Group CAW. Clinical and bacteriological efficacy in treatment of acute exacerbations of chronic bronchitis with cefditoren-pivoxil versus cefuroxime-axetil. Antimicrob. Agents Chemother. 50 (2006) 1762-1767
4. Anne S., and Reisman R.E. Risk of administering cephalosporin antibiotics to patients with histories of penicillin allergy. Ann. Allergy Asthma Immunol. 74 (1995) 167-170
5. Block S.L., McCarty J.M., Hedrick J.A., Nemeth M.A., Keyserling C.H., and Tack K.J. Comparative safety and efficacy of cefdinir vs amoxicillin/clavulanate for treatment of suppurative acute otitis media in children. Pediatr. Infect. Dis. J. 19 (2000) S159-S165
6. Blumer J.L., McLinn S.E., Deabate C.A., Kafetzis D.A., and Perrotta R.J. Multinational multicenter controlled trial comparing ceftibuten with cefaclor for the treatment of acute otitis media. Members of the Ceftibuten Otitis Media International Study Group. Pediatr. Infect. Dis. J. 14 (1995) S115-S120
7. Boccazzi A., Tonelli P., De'Angelis M., Bellussi L., Passali D., and Careddu P. Short course therapy with ceftibuten versus azithromycin in pediatric streptococcal pharyngitis. Pediatr. Infect. Dis. J. 19 (2000) 963-967
8. Brogden R.N., and McTavish D. Loracarbef. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic efficacy. Drugs 45 (1993) 716-736
9. Brosof A.B. Five-day therapy with cephradine capsules, 500 mg BID, for the treatment of acute, uncomplicated urinary tract infections. Clin. Ther. 3 (1980) 285-291
10. Brumfitt W., and Hamilton-Miller J.M. Comparative study of cephradine and amoxicillin-clavulanate in the treatment of recurrent urinary tract infections. Antimicrob. Agents Chemother. 34 (1990) 1803-1805
11. Bucko A.D., Hunt B.J., Kidd S.L., and Hom R. Randomized, double-blind, multicenter comparison of oral cefditoren 200 or 400 mg BID with either cefuroxime 250 mg BID or cefadroxil 500 mg BID for the treatment of uncomplicated skin and skin-structure infections. Clin. Ther. 24 (2002) 1134-1147
12. Burt R.A. A review of the drug events reported by 12,917 patients treated with cephalexin. Postgrad. Med. J. 59 Suppl 5 (1983) 47-53
13. Capparelli F.J., Diaz M.F., Hlavnika A., Wainsztein N.A., Leiguarda R., and Del Castillo M.E. Cefepime- and cefixime-induced encephalopathy in a patient with normal renal function. Neurology 65 (2005) 1840
14. Cole P. Pharmacologic and clinical comparison of cefaclor in immediate-release capsule and extended-release tablet forms. Clin. Ther. 19 (1997) 617-625
15. Creel G.B., and Hurtt M. Cephalosporin-induced recurrent aseptic meningitis. Ann. Neurol. 37 (1995) 815-817
16. Dagan R., Shvartzman P., and Liss Z. Variation in acceptance of common oral antibiotic suspensions. Pediatr. Infect. Dis. J. 13 (1994) 686-690
17. Dajani A.S., Kessler S.L., Mendelson R., Uden D.L., and Todd W.M. Cefpodoxime proxetil vs. penicillin V in pediatric streptococcal pharyngitis/tonsillitis. Pediatr. Infect. Dis. J. 12 (1993) 275-279
18. Dave J., Heathcock R., Fenelon L., Bihari D.J., and Simmons N.A. Cephalexin induced toxic epidermal necrolysis. J. Antimicrob. Chemother. 28 (1991) 477-478
19. Drehobl M., Bianchi P., Keyserling C.H., Tack K.J., and Griffin T.J. Comparison of cefdinir and cefaclor in treatment of community-acquired pneumonia. Antimicrob. Agents Chemother. 41 (1997) 1579-1583
20. Dreis D.F., Winterbauer R.H., Van Norman G.A., Sullivan S.L., and Hammar S.P. Cephalosporin-induced interstitial pneumonitis. Chest 86 (1984) 138-140
21. Erikssen J., Midtvedt T., and Bergan T. Treatment of urinary tract infections with cephalexin. Scand. J. Infect. Dis. 2 (1970) 53-58
22. Fogarty C.M., Cyganowski M., Palo W.A., Hom R.C., and Craig W.A. A comparison of cefditoren pivoxil and amoxicillin/clavulanate in the treatment of community-acquired pneumonia: a multicenter, prospective, randomized, investigator-blinded, parallel-group study. Clin. Ther. 24 (2002) 1854-1870
23. Forbes C.D., Craig J.A., Mitchell R., and McNicol G.P. Acute intravascular haemolysis associated with cephalexin therapy. Postgrad. Med. J. 48 (1972) 186-188
24. Fung-Herrera C.G., and Mulvaney W.P. Cephalexin nephrotoxicity. Reversible nonoliguric acute renal failure and hepatotoxicity associated with cephalexin therapy. JAMA 229 (1974) 318-319
25. Gadde J., Spence M., Wheeler B., and Adkinson Jr. N.F. Clinical experience with penicillin skin testing in a large inner-city STD clinic. JAMA 270 (1993) 2456-2463
26. Gaig P., San Miguel M.M., Enrique E., and Garcia-Ortega P. Selective type-1 hypersensitivity to cefixime. Allergy 54 (1999) 901-902
27. Gehanno P., Barry B., Bobin S., and Safran C. Twice daily cefpodoxime proxetil compared with thrice daily amoxicillin/clavulanic acid for treatment of acute otitis media in children. Scand. J. Infect. Dis. 26 (1994) 577-584
28. Gooch W.M., Philips A., Rhoades R., Rosenberg R., Schaten R., and Starobin S. Comparison of the efficacy, safety and acceptability of cefixime and amoxicillin/clavulanate in acute otitis media. Pediatr. Infect. Dis. J. 16 (1997) S21-S24
29. Griffith R., and Black H. Cephalexin. Med. Clin. North Am. 54 (1970) 1229-1244
30. Guest N., and Langan C.E. Comparison of the efficacy and safety of a short course of ceftibuten with that of amoxycillin/clavulanate in the treatment of acute exacerbations of chronic bronchitis. Int. J. Antimicrob. Agents 10 (1998) 49-54
31. Gupta N., Bagga V., Parmar B.J., Kar K., Mukherjee A., Mehta S., and Moharana A.K. Efficacy and tolerability assessment of cefprozil in children with acute otitis media. Indian J. Pediatr. 71 (2004) 319-324
32. Gwaltney Jr. J.M., Savolainen S., Rivas P., Schenk P., Scheld W.M., Sydnor A., Keyserling C., Leigh A., and Tack K.J. Comparative effectiveness and safety of cefdinir and amoxicillin-clavulanate in treatment of acute community-acquired bacterial sinusitis. Cefdinir Sinusitis Study Group. Antimicrob. Agents Chemother. 41 (1997) 1517-1520
33. Harrison C.J. Changes in treatment strategies for acute otitis media after full implementation of the pneumococcal seven valent conjugate vaccine. Pediatr. Infect. Dis. J. 22 (2003) S120-S130
34. Ho M.W., Wang F.D., Fung C.P., and Liu C.Y. Comparative study of ceftibuten and cefixime in the treatment of complicated urinary tract infections. J. Microbiol. Immunol. Infect. 34 (2001) 185-189
35. Hogan D.J., and Rooney M.E. Toxic epidermal necrolysis due to cephalexin. J. Am. Acad. Dermatol. 17 (1987) 852-853
36. Hyslop D.L. Cefaclor safety profile: a ten-year review. Clin. Ther. 11 Suppl A (1988) 83-94
37. Ibia E.O., Schwartz R.H., and Wiedermann B.L. Antibiotic rashes in children: a survey in a private practice setting. Arch. Dermatol. 136 (2000) 849-854
38. Idsoe O., Guthe T., Willcox R.R., and de Weck A.L. Nature and extent of penicillin side-reactions, with particular reference to fatalities from anaphylactic shock. Bull. World Health Organ. 38 (1968) 159-188
39. Jacobs R.F., Brown W.D., Chartrand S., Darden P., Drehobl M.A., Yetman R., and Ossi M.J. Evaluation of cefuroxime axetil and cefadroxil suspensions for treatment of pediatric skin infections. Antimicrob. Agents Chemother. 36 (1992) 1614-1618
40. Jennings M.B., McCarty J.M., Scheffler N.M., Puopolo A.D., and Rothermel C.D. Comparison of azithromycin and cefadroxil for the treatment of uncomplicated skin and skin structure infections. Cutis 72 (2003) 240-244
41. Jick H., and Derby L.E. A large population-based follow-up study of trimethoprim-sulfamethoxazole, trimethoprim, and cephalexin for uncommon serious drug toxicity. Pharmacotherapy 15 (1995) 428-432
42. Kabins S.A., Kelner B., Walton E., and Goldstein E. Cephalexin therapy as related to renal function. Am. J. Med. Sci. 259 (1970) 133-142
43. Kammer R.B., and Short L.J. Cefaclor-summary of clinical experience. Postgrad. Med. J. 55 Suppl 4 (1979) 93-99
44. Kearns G.L., Wheeler J.G., Childress S.H., and Letzig L.G. Serum sickness-like reactions to cefaclor: role of hepatic metabolism and individual susceptibility. J. Pediatr. 125 (1994) 805-811
45. Kearns G.L., Wheeler J.G., Rieder M.J., and Reid J. Serum sickness-like reaction to cefaclor: lack of in vitro cross-reactivity with loracarbef. Clin. Pharmacol. Ther. 63 (1998) 686-693
46. Kelkar P.S., and Li J.T. Cephalosporin allergy. N. Engl. J. Med. 345 (2001) 804-809
47. King B., and Geelhoed G. Adverse skin and joint reactions associated with oral antibiotics in children: the role of cefaclor in serum sickness-like reactions. J. Paediatr. Child Health 39 (2003) 677-681
48. Klastersky J., Daneau D., and Weerts D. Cephradine. Antibacterial activity and clinical effectiveness. Chemotherapy 18 (1973) 191-204
49. Kumar A., Murray D.L., Hanna C.B., Krindler T.G., Jacobson K.D., Bundy J.M., Waxman K., Finnerty E.F., Folan D.W., Drucker W.R., Kane J.G., Durnell M., DiMattia A., and Hill C.D. Comparative study of cephalexin hydrochloride and cephalexin monohydrate in the treatment of skin and soft tissue infections. Antimicrob. Agents Chemother. 32 (1988) 882-885
50. Lawson A.A., McArdle T., and Ghosh S. Cephradine-associated immune neutropenia. N. Engl. J. Med. 312 (1985) 651
51. Leppter H., and Estler C.-J. Tolerability of oral cephalosporins. In: Moellering R. (Ed). Oral Cephalosporins (1997), Karger, Basel 160-182
52. Levine L.R. Quantitative comparison of adverse reactions to cefaclor vs. amoxicillin in a surveillance study. Pediatr. Infect. Dis. 4 (1985) 358-361
53. Lindbaek M., Hjortdahl P., and Johnsen U.L. Use of symptoms, signs, and blood tests to diagnose acute sinus infections in primary care: comparison with computed tomography. Fam. Med. 28 (1996) 183-188
54. Linder C.W., Nelson K., Paryani S., Stallworth J.R., and Blumer J.L. Comparative evaluation of cefadroxil and cephalexin in children and adolescents with pyodermas. Cefadroxil Once Daily Pyoderma Study Group. Clin. Ther. 15 (1993) 46-56
55. Longstreth K.L., Robbins S.D., Smavatkul C., and Doe N.S. Cephalexin-induced acute tubular necrosis. Pharmacotherapy 24 (2004) 808-811
56. Luger S.W., Paparone P., Wormser G.P., Nadelman R.B., Grunwaldt E., Gomez G., Wisniewski M., and Collins J.J. Comparison of cefuroxime axetil and doxycycline in treatment of patients with early Lyme disease associated with erythema migrans. Antimicrob. Agents Chemother. 39 (1995) 661-667
57. MacLoughlin G.J., Barreto D.G., de la Torre C., Pinetta E.A., del Castillo F., and Palma L. Cefpodoxime proxetil suspension compared with cefaclor suspension for treatment of acute otitis media in paediatric patients. J. Antimicrob. Chemother. 37 (1996) 565-573
58. Manoharan A., and Kot T. Cephalexin-induced haemolytic anaemia. Med. J. Aust. 147 (1987) 202
59. McCarty J.M., and Pierce P.F. Five days of cefprozil versus 10 days of clarithromycin in the treatment of an acute exacerbation of chronic bronchitis. Ann. Allergy Asthma Immun. 87 (2001) 327-334
60. McLinn S.E. Cefaclor: a decade of experience in acute otitis media. Clin. Ther. 11 Suppl A (1988) 35-47
61. McLinn S.E., McCarty J.M., Perrotta R., Pichichero M.E., and Reidenberg B.E. Multicenter controlled trial comparing ceftibuten with amoxicillin/clavulanate in the empiric treatment of acute otitis media. Members of the Ceftibuten Otitis Media United States Study Group. Pediatr. Infect. Dis. J. 14 (1995) S108-S114
62. Meyers B.R. Cefaclor revisited. Clin. Ther. 22 (2000) 154-166
63. Mocan H., and Beattie T.J. Acute tubular necrosis associated with cephalexin therapy. Clin. Nephrol. 24 (1985) 212
64. Mogabgab W.J. Treatment of urinary tract infections with cephradine. Curr. Ther. Res. Clin. Exp. 19 (1976) 520-528
65. Nadelman R.B., Luger S.W., Frank E., Wisniewski M., Collins J.J., and Wormser G.P. Comparison of cefuroxime axetil and doxycycline in the treatment of early Lyme disease. Ann. Intern. Med. 117 (1992) 273-280
66. Newman R.J., and McCollum C.M. Pseudomembranous colitis due to cephradine. Br. J. Clin. Pract. 33 (1979) 32-33
67. Package Insert. Suprax (cefixime). Lupin Pharmaceuticals. Baltimore, MD. Available at (2003). http://www.suprax.info/pdf/suprax_02.pdf%D (Accessed September 2006)
68. Package Insert. Vantin. Pharmacia Corporation. Kalamazoo, Michigan. Available at (2003). http://www.pfizer.com/pfizer/download/uspi_vantin.pdf (Accessed September 2006)
69. Package insert. Spectracef. Purdue Pharmaceutical Products. Stamford, CT. Available at (2005). http://www.pharma.com/PI/Prescription/SPECTRACEF.pdf (Accessed September 2006)
70. Parish L.C., Routh H.B., Miskin B., Fidelholtz J., Werschler P., Heyd A., Haverstock D., and Church D. Moxifloxacin versus cephalexin in the treatment of uncomplicated skin infections. Int. J. Clin. Pract. 54 (2000) 497-503
71. Perry C., and Brogden R. Cefuroxime axetil: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy. Drugs 52 (1996) 125-158
72. Pichichero M.E. A review of evidence supporting the American Academy of Pediatrics recommendation for prescribing cephalosporin antibiotics for penicillin-allergic patients. Pediatrics 115 (2005) 1048-1057
73. Platt R. Adverse effects of third-generation cephalosporins. J. Antimicrob. Chemother. 10 Suppl C (1982) 135-140
74. Platt R., Dreis M.W., Kennedy D.L., and Kuritsky J.N. Serum sickness-like reactions to amoxicillin, cefaclor, cephalexin, and trimethoprim-sulfamethoxazole. J. Infect. Dis. 158 (1988) 474-477
75. Powers R.D., Schwartz R., Snow R.M., and Yarbrough III D.R. Ofloxacin versus cephalexin in the treatment of skin, skin structure, and soft-tissue infections in adults. Clin. Ther. 13 (1991) 727-736
76. Puhakka H., and Virolainen E. Cefadroxil in the treatment of susceptible infections in infants and children. Drugs 32 Suppl 3 (1986) 21-28
77. Quintiliani R. Efficacy of a twice-daily regimen of cefadroxil in the treatment of respiratory tract infections. Drugs 32 Suppl 3 (1986) 43-49
78. Reidenberg B.E. Worldwide safety experience with ceftibuten pediatric suspension. Pediatr. Infect. Dis. J. 14 (1995) S130-S133
79. Saiman L., Goldfarb J., Kaplan S.A., Wible K., Edge-Padbury B., Naberhuis-Stehouwer S., and Bruss J.B. Safety and tolerability of linezolid in children. Pediatr. Infect. Dis. J. 22 (2003) S193-S200
80. Saker B.M., Musk A.W., Haywood E.F., and Hurst P.E. Reversible toxic psychosis after cephalexin. Med. J. Aust. 1 (1973) 497-498
81. San Pedro G.S., Cammarata S.K., Oliphant T.H., and Todisco T. Linezolid versus ceftriaxone/cefpodoxime in patients hospitalized for the treatment of Streptococcus pneumoniae pneumonia. Scand. J. Infect. Dis. 34 (2002) 720-728
82. Scholand J.F., Hodges G.R., Fass R.J., and Saslaw S. Clinical evaluation of cephradine, a new oral cephalosporin. Am. J. Med. Sci. 267 (1974) 111-116
83. Scott L.J., Ormrod D., and Goa K.L. Cefuroxime axetil: an updated review of its use in the management of bacterial infections. Drugs 61 (2001) 1455-1500
84. Sengupta J., Mondal A.K., Jain P., Garg R.D., Mathur N.C., and Moharana A.K. Comparative evaluation of cefpodoxime versus cefixime in children with lower respiratory tract infections. Indian J. Pediatr. 71 (2004) 517-521
85. Shenep J.L., Flynn P.M., Baker D.K., Hetherington S.V., Hudson M.M., Hughes W.T., Patrick C.C., Roberson P.K., Sandlund J.T., Santana V.M., Sixbey J.W., and Slobod K.S. Oral cefixime is similar to continued intravenous antibiotics in the empirical treatment of febrile neutropenic children with cancer. Clin. Infect. Dis. 32 (2001) 36-43
86. Smith J.W., Johnson J.E., and Cluff L.E. Studies on the epidemiology of adverse drug reactions. II. An evaluation of penicillin allergy. N. Engl. J. Med. 274 (1966) 998-1002
87. Speight T.M., Brogden R.N., and Avery G.S. Cephalexin: a review of its antibacterial, pharmacological and therapeutic properties. Drugs 3 (1972) 9-78
88. Steele R.W., Thomas M.P., and Begue R.E. Compliance issues related to the selection of antibiotic suspensions for children. Pediatr. Infect. Dis. J. 20 (2001) 1-5
89. Steurer M., and Schenk P. Efficacy and safety of cefdinir in the treatment of maxillary sinusitis. Eur. Arch. Otorhinolaryngol. 257 (2000) 140-148
90. Tanrisever B., and Santella P.J. Cefadroxil. A review of its antibacterial, pharmacokinetic and therapeutic properties in comparison with cephalexin and cephradine. Drugs 32 Suppl 3 (1986) 1-16
91. Therasse D.G. The safety profile of loracarbef: clinical trials in respiratory, skin, and urinary tract infections. Am. J. Med. 92 (1992) 20S-25S
92. van Zyl L., le Roux J.G., LaFata J.A., Volk R.S., Palo W.A., Flamm R., and Hom R.C. Cefditoren pivoxil versus cefpodoxime proxetil for community-acquired pneumonia: results of a multicenter, prospective, randomized, double-blind study. Clin. Ther. 24 (2002) 1840-1853
93. Verma S., and Kieff E. Cephalexin-related nephropathy. JAMA 234 (1975) 618-619
94. Wilber R.B., Doyle C.A., Durham S.J., Conetta B.J., DeGraw S.S., and Leigh A. Safety profile of cefprozil. Clin. Infect. Dis. 14 Suppl 2 (1992) S264-S271 (discussion S272)
95. Wiles C.M., Assem E.S., Cohen S.L., and Fisher C. Cephradine-induced interstitial nephritis. Clin. Exp. Immunol. 36 (1979) 342-346
96. Wilson J.P., Koren J.F., Daniel III R.C., and Chapman S.W. Cefadroxil-induced ampicillin-exacerbated pemphigus vulgaris: case report and review of the literature. Drug Intell. Clin. Pharm. 20 (1986) 219-223
97. Zeluff B.J., Lowe P., Koornhof H.J., and Gentry L.O. Evaluation of roxithromycin (RU-965) versus cephradine in pneumococcal pneumonia. Eur. J. Clin. Microbiol. Infect. Dis. 7 (1988) 69-71