A comparative study of cefepime and ceftazidime in the treatment of community-acquired lower respiratory tract infections.
Antibiotic treatment for community-acquired pneumonia must target Gram-positive pathogens, especially frequently isolated organisms such as Streptococcus pneumoniae. The severity of community-acquired pneumonia is often related to underlying factors. Occasionally it may be complicated by staphylococcal or Gram-negative bacillary infection. We have compared the safety and efficacy of cefepime 1 g bd with ceftazidime 1 g tds as empirical treatment in adults with community-acquired lower respiratory tract infections (LRTIs). One hundred and thirty-one patients with moderate to severe LRTIs were randomized to two treatment groups: 87 received cefepime and 44 received ceftazidime. The treatment groups were comparable with regard to sex, age and treatment duration. Of the 116 pathogens isolated, 57 were Gram-positive (46 strains of S. pneumoniae) and 59 were Gram-negative (33 strains of Haemophilus influenzae). Of the 111 patients evaluated, clinical cure rates were 87% (65/75) in the cefepime group and 86% (31/36) in the ceftazidime group. Pathogen eradication rates were 95% (74/78 and 36/37, respectively) in both groups. Both drugs were well tolerated and the incidence of adverse events in each group was comparable. Cefepime 2 g per day (1 g bd) was as safe and effective as ceftazidime 3 g per day (1 g tds) in the treatment of community-acquired LRTIs.
Léophonte
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P
Service de Pneumologie, Hôpital Rangueil, Toulouse, France.
Bertrand
A
A
Nouvet
G
G
Muir
J F
JF
Lucht
F
F
Delaval
P
P
Depierre
A
A
Hughes
F
F
Ulmer
M
M
Grès
J J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000187:drug effects; D000077723:Cefepime; D002442:Ceftazidime / Q000009:adverse effects / Q000627:therapeutic use*; D002511:Cephalosporins / Q000009:adverse effects / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012141:Respiratory Tract Infections / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology
D002511:Cephalosporins; D000077723:Cefepime; D002442:Ceftazidime