Treatment of scleroma with ceforanide

L. A. Cone, S. M. Barton and D. R. Woodard

Three patients with rhinoscleroma who presented with nasal and pharyngeal symptoms are described. Treatment with ceforanide, a new second-generation cephalosporin with high intrinsic activity against Klebsiella, and possessing a long half-life, was used as outpatient treatment. A total of 120 g of ceforanide was administered over a period of two months. All three patients showed signs of clinical improvement, but only two of three became bacteriologically sterile at the end of two months; one patient relapsed bacteriologically but not clinically, once the drug was discontinued. Second- and third-generation cephalosporins appear to have excellent activity against the causative pathogens of rhinoscleroma. Because of the impracticality of administering these agents parenterally over prolonged periods of time, there is a need for the development of an oral cephalosporin with similar intrinsic activity and beta-lactamase stability. Perhaps the novel beta-lactam antibiotics such as the penems and monobactams, some of which can be administered orally, will answer that need.