Efficacy of cefpirome in the treatment of septicaemia.
From a total of 4180 patients entered in 15 phase II-III clinical trials involving cefpirome, an analysis was carried out on 378 patients with bacteriologically confirmed or suspected septicaemia who were treated with cefpirome (n = 282) or comparator drugs (ceftazidime, n = 80; ceftriaxone, n = 15; imipenem/cilastatin, n = 1). Gram-negative organisms were the causative pathogens in over half of the patients, with Escherichia coli being the most common species found. The most frequently isolated Gram-positive bacterium was Streptococcus pneumoniae. Causative organisms were eradicated in over 90% of patients receiving cefpirome or comparators. Only 4/230 pathogens tested were resistant to cefpirome in vitro. Among patients with bacteriologically confirmed septicaemia, a satisfactory clinical response was documented in 131/176 (74%) cefpirome vs 34/50 (68%) ceftazidime vs 5/10 (50%) ceftriaxone recipients, improvement in 39/176 (22%) vs 11/50 (22%) vs 5/10 (50%), and failure in 6/176 (4%) vs 5/50 (10%) vs 0/10 (0%), respectively. Similar results were achieved in patients with 'suspected' septicaemia. Cefpirome 1 or 2 g twice daily offers an effective treatment option for patients with septicaemia. The higher dosage regimen produced superior bacteriological clearance rates and is therefore preferable in patients with severe septicaemia.
Norrby
S R
SR
Department of Infectious Diseases, University of Lund, Sweden.
Geddes
A M
AM
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D001419:Bacteria / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D006801:Humans; D008826:Microbial Sensitivity Tests; D016037:Single-Blind Method; D000097572:Cefpirome
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000097572:Cefpirome