Comparison of oral cefpodoxime proxetil and cefaclor in the treatment of skin and soft tissue infections.
This multicenter, randomized, double-blind study was designed to compare the safety and efficacy of cefpodoxime proxetil and cefaclor in the treatment of skin and soft tissue infections. Patients were aged > or = 12 years with acute (< or = 7 days duration), single-site skin or skin-structure infections. The 7- to 10-day treatment regimens were cefpodoxime proxetil (400 mg cefpodoxime) orally with food twice a day with cefaclor-matched placebo (orally, fasting, three times a day); or cefaclor (Ceclor; 500 mg anhydrous equivalent) orally, fasting, three times a day, with cefpodoxime-matched placebo (orally with food twice a day). Clinical progress and cultures were evaluated upon admission to the study; on study days 7-10 and 15-18; and 2-3 weeks after treatment. Cefpodoxime had lower minimum inhibitory concentrations against the majority of Staphylococcus species than did cefaclor. Both treatments were highly effective (99% pathogen eradication and 86% cure rate). These high eradication rates were not unexpected in this study of minor infections in which patients with resistant pathogens were excluded. Cefaclor had a higher failure rate [2 (4%) of 57], than did cefpodoxime [2 (1%) of 139; p not significant]. Most patients in both groups completed treatment as planned: 185 (74%) of 249 cefpodoxime-treated patients and 91 (75%) of 122 cefaclor-treated patients. Both treatments were well tolerated and considered safe and effective in the treatment of skin and skin structure infections. However, the twice-a-day dosing regimen for cefpodoxime proxetil compared with the three-times-a-day regimen for cefaclor may result in better patient compliance.
Stevens
D L
DL
VA Medical Center, Boise, Idaho 83702.
Pien
F
F
Drehobl
M
M
D000284:Administration, Oral; D000328:Adult; D001424:Bacterial Infections / Q000188:drug therapy; D002433:Cefaclor / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015296:Ceftizoxime / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003240:Connective Tissue Diseases / Q000188:drug therapy*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011355:Prodrugs / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012449:Safety; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy; D000097627:Cefpodoxime Proxetil
D002433:Cefaclor; D015296:Ceftizoxime; D011355:Prodrugs; D000097627:Cefpodoxime Proxetil