cefsulodin and cefpiramide

The therapeutic efficacy and safety of Cefpiramide (CPM, SM-1652) at a 2 g/day dose were objectively compared with those of Cefsulodin (CFS) at a 2 g/day dose in patients with chronic complicated urinary tract infections (UTI) by P. aeruginosa in a double-blind study at 46 institutions in Japan. The results are as follows: The therapeutic efficacy was analyzed in 254 patients (136 cases administered CPM and 118 cases administered CFS) after excluding 20 cases as drop-out. Among 254 cases, the number of patients with infection of P. aeruginosa was 190 cases (100 cases administered CPM and 90 cases administered CFS), while that with infection of organisms other than P. aeruginosa was 64 cases (36 cases administered CPM and 28 cases administered CFS). By the administration of a 2 g/day dose for 5 days, the overall clinical effective rate of CPM was significantly higher than that of CFS in total patients. When the patients were classified into 2 groups with respect to causative organisms (P. aeruginosa and others), the clinical effective rate of CPM in patients with infections of P. aeruginosa was significantly higher than that of CFS, while the clinical effective rate of CPM in patients with infection of other organisms than P. aeruginosa was the same as that of CFS. As to the bacteriological effect on bacteriuria, the eradication rate of CPM was significantly higher than that of CFS not only against all causative organisms but also against P. aeruginosa. The rate of replacement by S. faecalis was significantly higher in the CFS-treated group than in the CPM-treated group. The same result was obtained on the rate of replacement by other organisms. The MIC values of CPM for isolated organisms before drug administration were lower than those of CFS. The incidence rates of side effects and the abnormal findings of clinical laboratory tests were the same for the CPM- and CFS-treated groups. From the results, it was concluded that CPM is a useful drug for the treatment of patients with chronic complicated urinary tract infections caused by P. aeruginosa.

Topics: Adult; Aged; Cefsulodin; Cephalosporins; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Injections, Intravenous; Male; Middle Aged; Pseudomonas Infections; Urinary Tract Infections

Cefpiramide was tested against 493 clinical isolates of Pseudomonas aeruginosa and the results of minimal inhibitory concentration, minimal bactericidal concentration, bactericidal rate, and time-kill synergy studies were compared with those obtained with seven other antipseudomonal agents. The minimal inhibitory concentrations of cefpiramide for P. aeruginosa were comparable to all of the agents tested. Minimal bactericidal concentration results were generally within one twofold dilution of the minimal inhibitory concentration values for all agents tested. Bactericidal rate studies showed that at concentrations of four times the minimal inhibitory concentration, all of the agents produced rapid killing. Results of time-kill synergy studies showed a marked synergistic interaction between cefpiramide and each of three aminoglycosides, gentamicin, tobramycin, and amikacin. These results suggest that cefpiramide may be useful in the therapy of infections due to P. aeruginosa.

Topics: Amikacin; Aminoglycosides; Anti-Bacterial Agents; Azlocillin; Cefoperazone; Cefsulodin; Ceftazidime; Cephalosporins; Drug Combinations; Drug Synergism; Gentamicins; Humans; Imipenem; Microbial Sensitivity Tests; Piperacillin; Pseudomonas aeruginosa; Thienamycins; Time Factors; Tobramycin

Cefpiramide (CPM) is a new cephalosporin with good activity against Pseudomonas. Sustained high serum concentrations are observed. We studied CPM killing kinetics using an in vitro model that simulates the pharmacokinetic profile observed in humans following a single intramuscular injection. The strain tested was Pseudomonas aeruginosa NCTC 8203. CPM was compared to cefoperazone (CPZ), cefsulodin (CFS) and ceftazidime (CTZ). These drugs differed only for the time-interval to bacterial regrowth that was in the following ascending order: CFS, CPZ, CTZ and CPM. This finding corroborates the fact that cefpiramide's pharmacokinetic properties allow wider space intervals between doses than for other drugs.

Topics: Cefoperazone; Cefsulodin; Ceftazidime; Cephalosporins; Humans; Kinetics; Models, Biological; Pseudomonas aeruginosa

Cefpiramide (SR 95445) (CPM) is a new cephalosporin with activity against Pseudomonas and a good bioavailability following parenteral administration. This drug is a first rather than second choice treatment in Pseudomonas infections. For this reason, investigation into cefpiramide's capacity to induce beta-lactamase production is especially interesting. A heavy inoculum of P. aeruginosa NCTC 8203, a strain that produces and inducible cephalosporinase (pI = 8.7) was incubated for 4 hours with CPM, cefsulodin (CFS), cefoperazone (CPZ) and ceftazidime (CTZ) in various concentrations. After collection and sonic treatment of the bacteria, the beta-lactamase activity was assayed using an acidimetric method and expressed as units of enzyme activity per mg proteins in the cell-free extract. The smallest increase in beta-lactamase production was recorded with CPM. The strongest inductor was CTZ. CFS and CPZ had an intermediate effect.

Topics: beta-Lactamases; Cefoperazone; Cefsulodin; Ceftazidime; Cephalosporinase; Cephalosporins; Drug Stability; Enzyme Induction; Pseudomonas aeruginosa