Cefodizime and cefotaxime in acute exacerbations of chronic bronchitis: a randomized double-blind prospective study in 180 patients.
In a double-blind prospective study, 180 patients admitted to hospital with acute purulent exacerbations of chronic bronchitis were treated for seven days with twice daily 1 g intramuscular injections of either cefodizime or cefotaxime. Sputum cultures performed before, during and immediately after treatment showed complete eradication of the infection in 89/90 given cefodizime and 86/90 receiving cefotaxime. Some symptomatic Pseudomonas aeruginosa superinfections occurred with each agent. During the follow-up week, recurrences or reinfections after apparent clearance occurred in 15 patients given cefodizime and in 21 receiving cefotaxime. Pharmacokinetic studies in blood showed mean Cmax values of 50.8 mg/l for cefodizime and 36.5 mg/l for cefotaxime, corresponding values in the sputum being 1.61 and 0.62 mg/l. Mean AUC values in both blood and sputum were 2 1/2- to 3-fold higher for cefodizime. Some features suggested better performance by cefodizime than by cefotaxime, but the clinical results were not statistically significantly different.
Department of Respiratory Diseases, De Wever Ziekenhuis, Heerlen, The Netherlands.
F P
FP
Maesen
B I
BI
Davies
J J
JJ
van den Bergh
H L
HL
Gubbelmans
J C
JC
Meek
W H
WH
Geraedts
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001991:Bronchitis / Q000188:drug therapy*; D002439:Cefotaxime / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013183:Sputum / Q000378:metabolism
D002439:Cefotaxime; C033356:cefodizime