title: Comparison of the influence on renal function between cefepime and cefpirome.
abstract: Although known for their broad spectrum and curative efficacy on drug-resistant pathogens and as nephrotoxicity-free, impairments were observed on renal function during clinical treatment of the two most commonly used fourth-generation cephalosporins: Cefpirome and cefepime. The present study aimed to further explore the exact influences of them on renal function.In vitro, the cell viability of renal cells cultured in drug-combined medium was tested for six dilutions.In vivo, a clinical cohort study was carried out to detect the influence of cefpirome and cefepime on the serum creatinine (SCr) level of patients. Cefpirome had an inhibition rate with half maximal inhibitory concentration (IC50) of 143.5 µmol/l on renal mesangial cells, which was greater compared to the IC50of 7.702 µmol/l for cefepime. The clinical cohort study data revealed that cefpirome treatment could lead to a greater increase of the average SCr level compared to cefepime on days 3 and 7 during therapy, and in addition, a greater incidence of SCr >445 µmol/l, an indicator of clinical renal failure. Furthermore, patients with an average age >65 years were observed as more susceptible to an SCr rise caused by either cefpirome or cefepime, with a larger augment in the average SCr, as well as a higher incidence of SCr >445 µmol/l compared to patients aged <65 years. In conclusion, cefpirome may have more potential to cause renal impairment compared to cefepime, therefore, more caution and comprehensive analysis of patient conditions is required during the clinical choice of fourth-generation cephalosporins.
authors: Department of Respiratory Medicine, The First People's Hospital of Kunshan City, Affiliated to Jiangsu University, Kunshan, Jiangsu 215300, P.R. China.
authors: Mingzi
authors: M
authors: Jiang
authors: Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
authors: Jing
authors: J
authors: Yao
authors: Department of Pharmacy, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
authors: L I
authors: LI
authors: Zhang
authors: Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
authors: Tianming
authors: T
authors: Gao
authors: Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
authors: Yang
authors: Y
authors: Zhang
authors: Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
authors: Xiaoqing
authors: X
authors: Weng
authors: Department of Respiratory Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
authors: Ganzhu
authors: G
authors: Feng
keywords: fourth-generation cephalosporins; renal function