cefpiramide and Bacterial-Infections

Cefpiramide + amikacin (CPM + AMK) was compared in a prospective randomized trial with our standard regimen of piperacillin plus amikacin (PIPC + AMK) as an empiric therapy for fever in 252 episodes of 141 patients with granulocytopenia. Initial profound granulocytopenia (fewer than 100/mm3 mature granulocytes) was present in approximately 69% of the patient trials in both treatment groups. Both groups were equally distributed in regard to age, disease, pretreatment WBC count and duration of antibiotic treatment, although septic shock was more frequently seen in CPM + AMK. Responses to PIPC + AMK and CPM + AMK were similar for microbiologically and clinically documented infection, while the response rate for clinically documented infections treated with PIPC + AMK was superior to CPM + AMK (63% vs. 52%). Patients with persistent granulocytopenia of less than 100/mm3 of mature granulocytes without a rise during therapy responded significantly less in both groups (22% vs. 9%) than those in whom the granulocyte count rose (79% vs. 79%). Toxicities of jaundice or disordered hepatic function test were infrequent in both groups. Disordered renal function test occurred in one case in PIPC + AMK groups.

Topics: Adolescent; Adult; Aged; Agranulocytosis; Amikacin; Bacterial Infections; Cephalosporins; Drug Therapy, Combination; Female; Fever; Humans; Male; Middle Aged; Piperacillin; Prospective Studies

The clinical efficacy and tolerance of cefpiramide were studied in 34 patients at the age of 15 to 79 years with infectious destructive lesions in the lungs. The clinical efficacy amounted to 88.2 per cent. Out of 39 strains of grampositive and gramnegative aerobes and anaerobes 85 per cent were sensitive to cefpiramide. The bacteriological efficacy of cefpiramide amounted to 71.4 per cent. In 11.7 per cent of the patients involved in the trial there were recorded adverse reactions to cefpiramide. The results of the study made it possible to recommend the drug for the treatment of patients with severe and complicated infectious destructive lesions in the lungs.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cephalosporins; Female; Humans; Lung Diseases; Male; Microbial Sensitivity Tests; Middle Aged

Cefpiramide (CPM) 2 g was preoperatively administered to 29 patients by intravenous drip infusion for 20 minutes. Concentrations of CPM in bone marrow blood, peripheral blood, and bone tissue were determined at 30, 60, 120, 180, 240 and 360 minutes after CPM administration. Mean concentrations of CPM in peripheral blood, bone marrow blood were peaked at 60 minutes after injection, those in bone tissues (cortex, cancellous bone) peaked at 30 minutes after injection. The mean ratio of the CPM concentration in bone marrow blood to peripheral blood was 105.5%, that in cortex (/g) to peripheral blood (/ml) was 17.7%, and that in cancellous bone (/g) to peripheral blood was 18.2%. These concentrations were maintained above MIC80 for 6 hours. From the above results, CPM appears useful for the prevention of infection in orthopaedic operation (skeletal surgery).

Topics: Adult; Aged; Aged, 80 and over; Bacterial Infections; Bone and Bones; Bone Marrow; Cephalosporins; Female; Humans; Infusions, Intravenous; Joint Prosthesis; Male; Middle Aged; Premedication

We determined MIC values of cefpiramide (CPM) against clinical isolates from 100 patients who were subjected to total hysterectomy between April 1986 and March 1988. We also investigated the concentrations of CPM in uterine tissue and assessed the clinical efficacy of postoperative prophylaxis. 1. Against bacteria isolated from clinical materials the MIC80 values of CPM were as follows: Staphylococcus epidermidis 1.56 micrograms/ml, Enterococcus faecalis 25 micrograms/ml, and Escherichia coli 6.25 micrograms/ml. 2. Peak concentrations of CPM in various tissues and tissue/serum ratios of AUC were as follows: cervix uteri 35 micrograms/g (39.5%), perimetrium 43 micrograms/g (44.9%), endometrium 39 micrograms/g (51.6%), myometrium 28 micrograms/g (26.8%), oviduct 67 micrograms/g (41.9%), and ovary 27 micrograms/g (45.8%). In all tissues examined CPM concentrations were above 4 micrograms/g after 600 minutes. 3. Serum half-lives were T 1/2(alpha) = 13.2 minutes and T 1/2(beta) = 260.2 minutes. 4. The efficacy rate in postoperative prophylaxis was 97.9%. 5. No serious side effects were observed.

Topics: Bacterial Infections; Cephalosporins; Endometriosis; Enterobacteriaceae; Female; Humans; Ovary; Premedication; Staphylococcus epidermidis; Streptococcus; Uterus

The concentration of cefpiramide (CPM) in serum and myocardial tissues was measured in 24 patients with open heart surgery. The regimen was given in bolus of 2 g intravenously before the commencement of cardiopulmonary bypass. Blood and tissues of the right atrial appendage and pericardium were surveyed for samples at an estimated interval after the administration of CPM. The concentration of CPM in the blood and the myocardial tissues were consistently efficacious for both gram positive and negative bacterium. The duration and dosage of CPM, selected in the study, were both satisfactory for prevention of infection in open heart surgery.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cardiac Surgical Procedures; Cephalosporins; Female; Heart Defects, Congenital; Heart Valve Diseases; Humans; Male; Middle Aged; Myocardium; Postoperative Complications; Premedication; Tissue Distribution

Forty one patients with infections associated with leukemia and related disorders were treated with cefpiramide (CPM). In 26 patients among them, we were able to evaluate the effectiveness of CPM against infections. Fifteen patients were not evaluated, because 6 patients were subjected to additional therapy such as gamma-globulin and other antibiotics, 5 were prophylactically treated, 2 had fever episode which were retrospectively reviewed to be originated from tumor mass, 1 received too short a duration of administration of CPM (2 days) to evaluate its effectiveness, and 1 with whom no precise data were recorded. Excellent responses were observed in 10 patients (38.5%) and good responses in 6 (23.1%) among these 26, with a total efficacy rate of 61.5%. Whereas, we found only one patient who showed an unfavorable side effect out of 31 patients including the 26 and 5 other patients who were prophylactically treated. The side effect observed was a mild bleeding tendency occurred in 77 years old female at 11 days after CPM was administrated. The bleeding tendency was easily diminished with the cessation of CPM treatment and a parenteral use of vitamin K. These results suggest that CPM is an effective and safe antibiotic for the treatment of infections in patients with leukemia and related disorders.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cephalosporins; Female; Humans; Leukemia; Male; Middle Aged

The cefpiramide (CPM) concentration in prostatic tissue of 19 patients with benign prostatic hypertrophy and bladder wall of 2 patients with bladder tumors was measured, after 2 g of CPM was administered intravenously by bolus technique prior to operation. Prostatic tissue level was 28.4 to 131 micrograms/g and tissue to serum ratio 0.15 to 0.63 at 12 min. to 220 min. after administration. The T1/2 of CPM in prostatic tissue was 3.29 hours. The bladder wall level was high at both determinations. CPM level in prostatic tissue and bladder wall covered the minimum inhibitory concentration of many bacteria detected from the infected sites. Therefore, CPM which has a strong antimicrobial activity can be considered as a highly useful antibiotic for the treatment of postoperative infections.

Topics: Aged; Aged, 80 and over; Bacterial Infections; Cephalosporins; Humans; Male; Middle Aged; Postoperative Complications; Prostate; Prostatic Hyperplasia; Tissue Distribution; Urinary Bladder; Urinary Bladder Neoplasms

Cefpiramide (SM-1652, CPM), a new cephem antibiotic was studied for the transfer into intrapelvic tissues and clinical efficacy in the field of obstetrics and gynecology. The results were obtained as follows. Clinical results of 17 patients with obstetrical and gynecological infection were excellent in 10 cases, good in 6, and poor in 1 with the efficacy rate of 94.1%. Following a single intravenous 30 minutes-drip infusion of 1 g dose of CPM, the peak of serum level and intrapelvic tissues were obtained at 30-60 minutes after completion of the administration. No adverse reaction or abnormal laboratory findings were observed.

Topics: Adult; Aged; Bacterial Infections; Cephalosporins; Drug Resistance, Microbial; Endometritis; Escherichia coli; Female; Genital Diseases, Female; Humans; Kinetics; Middle Aged; Pregnancy; Puerperal Infection; Uterus

The in vitro activities of cefpiramide and apalcillin were compared with those of other third-generation cephalosporins and extended-spectrum penicillins against over 1,000 clinical bacterial isolates. The activity of cefpiramide against Pseudomonas aeruginosa was comparable to those of piperacillin and cefoperazone, inhibiting 90% of strains at concentrations less than or equal to 16.0 micrograms/ml. This drug was also active against a broad range of gram-negative organisms but was generally less active than many of the other cephalosporins tested against members of the family Enterobacteriaceae. The activity of cefpiramide against gram-positive organisms was comparable to that of cefoperazone. Apalcillin, along with ceftazidime, was the most active agent tested against P. aeruginosa and Acinetobacter calcoaceticus subsp. anitratus, inhibiting 90% of these strains at concentrations less than or equal to 8 micrograms/ml. Against other gram-negative and gram-positive organisms, its activity was similar to that of piperacillin. The activities of both cefpiramide and apalcillin were significantly reduced by the presence of several plasmid-mediated beta-lactamases in a series of otherwise isogenic strains of P. aeruginosa in comparison with their activities against a parent strain which lacks these enzymes. Many strains of Enterobacter cloacae were synergistically inhibited by the combination of gentamicin with either cefpiramide (5 of 10 strains) or apalcillin (6 of 10 strains). Most strains of P. aeruginosa were synergistically inhibited by the combination of gentamicin with either cefpiramide (8 of 10 strains) or apalcillin (10 of 10 strains). However, cefoxitin antagonized the activity of both cefpiramide and apalcillin against most of these same strains.

Topics: Ampicillin; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Cephalosporins; Drug Synergism; Enterobacteriaceae; Humans; Microbial Sensitivity Tests; Naphthyridines; Pseudomonas aeruginosa

Fundamental and clinical studies on a new cephalosporin antibiotic, cefpiramide (CPM), was carried out under a joint study program, in order to evaluate the usefulness of the drug in treating infection of the female genital organs. The results obtained were as follows: CPM was readily transported to female genital organ tissues, and the concentrations of the drug exceeded 35 micrograms/g in various organ tissues in about 1 hour, following intravenous injection of 1 g. A level of more than 2 micrograms/g was maintained even 14 hours after the injection. The transport of CPM to various tissues was also studied following intravenous drip infusion of 1 g for 1 hour. The concentrations in tissues were slightly low but similar to those following intravenous injection. The peak concentration of the drug in the dead space exudate was 3.1-20.4 micrograms/ml, following intravenous injection and intravenous drip infusion of 1 g. The MIC80 of CPM were 3.13-12.5 micrograms/ml against S. aureus, Klebsiella sp., P. mirabilis and P. aeruginosa. Clinical effects of CPM were analyzed in 158 patients, including 56 cases with intrauterine infection, 37 cases with intrapelvic infection, 22 cases with external genital infection, 31 cases with adnexitis, 6 cases with postoperative wound infection and 6 cases with other infections. Excellent response was seen in 28 cases (17.7%), good response in 120 (75.9%) poor response in 10 (6.3%). The rate of response was calculated as 93.7%. Safety of the drug was analyzed in 258 patients, and side effects occurred in 4 (1.6%). Of these 4 patients, rash was in 1 patient, heat sensation in 1 patient, nausea in 1 patient and rash accompanying edema in 1 patient. Abnormal values in clinical laboratory findings were seen in 7 patients. Elevations of transaminase were seen in 5 patients and decrease of platelet was seen in a patient, and then elevations of transaminase with decrease of platelet was seen in a patient, and no other changes of particular note appeared.

Topics: Adult; Aged; Bacterial Infections; Cephalosporins; Drug Resistance, Microbial; Female; Genital Diseases, Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Infusions, Parenteral; Injections, Intravenous; Kinetics; Middle Aged; Uterus

In vivo transfer and therapeutic efficiency of a new cephalosporin derivative, cefpiramide (CPM) have studied in perinatal and gynecologic field. The following results have been obtained. The level of CPM transferred to uterus and adnexa was higher than its MIC against majority of Gram-negative bacilli, such as E. coli. This drug as demonstrated its efficiency, in treating 3 infection cases refractory to cephalothin, ampicillin and cephalexin, out of which 1 had "excellent" and 2 had "good" results. No side effect was evidenced in any of our patients. In conclusion, this drug has satisfactory tissue transfer as well as sufficient safety and excellent efficiency in treatment of perinatal infection cases.

Topics: Adnexa Uteri; Adult; Bacterial Infections; Cephalosporins; Drug Resistance, Microbial; Female; Fetal Membranes, Premature Rupture; Genital Diseases, Female; Humans; Hysterectomy; Kinetics; Pregnancy; Uterus

Clinical study on cefpiramide (CPM, SM-1652), a new cephalosporin antibiotic, was carried out and the following results were obtained. CPM was intravenously administrated at a daily dose of 2 g to 8 cases including 2 cases with intrauterine infection, 3 cases with adnexitis, 2 cases with intrapelvic infection and 1 case with external genital infection. All cases responded to the drug, and marked response was seen in 2 cases, moderate response in 6 cases. Neither side effects nor abnormal values in clinical laboratory findings attributable to the drug were seen.

Topics: Adult; Aged; Bacterial Infections; Cephalosporins; Drug Resistance, Microbial; Female; Fetal Membranes, Premature Rupture; Genital Diseases, Female; Humans; Hysterectomy; Middle Aged; Pregnancy

Transfer of cefpiramide (SM-1652, CPM) to female genital organs was studied. CPM concentration was determined in the uterine artery, portio vaginalis, myometrium, ovary and oviduct of patients undergoing hysterectomy, and in the pelvic dead space exudate of patients undergoing radical hysterectomy due to uterocervical cancer. Data obtained were analyzed by three-compartment model. The maximum concentration at 1 hour after intravenous drip infusion of CPM in a dose of 1 g were 244.31 micrograms/ml in both the uterine arterial serum and uterine venous serum, 31.41 micrograms/g in the portio vaginalis, 32.99 micrograms/g in the myometrium, 31.67 micrograms/g in the ovary and 31.99 micrograms/g in the oviduct. The concentration in the pelvic dead space exudate reached to the maximum level of 5.32 micrograms/ml at 5.84 hours and thereafter decreased slowly. The clinical effect of CPM was examined in 6 patients with various female genital infections and found to be effective in all cases. Side effects and abnormal laboratory finding values were not observed at all.

Topics: Adnexa Uteri; Adult; Bacterial Infections; Cephalosporins; Drug Resistance, Microbial; Female; Genital Diseases, Female; Gram-Negative Bacteria; Humans; Kinetics; Middle Aged; Pelvis; Uterus

Fundamental and clinical studies of cefpiramide (CPM, SM-1652) a new semisynthetic cephalosporin were carried out in the field of obstetrics and gynecology. The results were obtained as follows: In vitro antibacterial activity of CPM against recent 255 clinical isolates was compared with those of cefazolin (CEZ), cefmetazole (CMZ) and cefoperazone (CPZ). CPM showed strong antibacterial activity against Staphylococcus, K. pneumoniae, Peptococcus and Peptostreptococcus. However the minimum inhibitory concentration of CPM was inferior to those of CEZ, CMZ and CPZ against E. coli. The transfer of CPM to the female genital organs was found to be good. Tissue levels over than 5 micrograms/g were maintained after 5 hours. CPM was administered to 10 patients with obstetrical and gynecological infections. Good responses were obtained in all of the cases. Neither adverse reactions nor abnormal laboratory findings were observed except 1 case with slight elevation of BUN.

Topics: Adult; Bacteria; Bacterial Infections; Cephalosporins; Drug Resistance, Microbial; Female; Genital Diseases, Female; Humans; Kinetics; Uterus

Cefpiramide (CPM) was evaluated for clinical effects in the treatment of obstetrical and gynecological infections. The following results were obtained. CPM was given to 11 cases. Clinical efficacy was good in 8 cases and poor in 3 cases. The poor cases were parametritis and pyometra from those Serratia sp., K. pneumoniae, P. magnus, E. faecalis and B. ovatus were isolated. Other 1 case was external genital abscess with no isolated bacteria. There was a slight transaminase elevation in 1 case but no other appreciable side effects or abnormal laboratory findings were observed.

Topics: Adolescent; Adult; Aged; Bacterial Infections; Cephalosporins; Drug Resistance, Microbial; Female; Genital Diseases, Female; Humans; Middle Aged; Pregnancy; Pregnancy Complications, Infectious

Cefpiramide (CPM, SM-1652), a new cephem antibiotic, was fundamentally and clinically studied. The following results were obtained. Serum and internal genital tissue levels of CPM were measured following intravenous drip infusion of 1 g. High serum levels of 30 micrograms/ml and tissue levels of more than 4 micrograms/g were at least maintained for 8 hours. Favourable transfer of CPM into the pelvic dead space exudate was observed. The exudate level was 7.25 micrograms/ml on average even at 8 hours after intravenous drip infusion. A total of 6 cases comprising 4 with Bartholin's cyst, 1 with pelvic peritonitis and 1 with lymphocyst was treated with CPM at a dose of 0.5-2 g twice daily by intravenous injection or intravenous drip infusion. The clinical response was excellent in 1 case and good in 5 cases. Side effects and abnormal laboratory findings due to the drug were not noted.

Topics: Adult; Bacterial Infections; Body Fluids; Cephalosporins; Drug Resistance, Microbial; Female; Genital Diseases, Female; Humans; Kinetics; Middle Aged; Pelvis; Peptostreptococcus; Staphylococcus epidermidis

Cefpiramide (CPM) was administrated intramuscularly to 27 cases of gynecological infections to evaluate its clinical efficacy and safety and the following results wee obtained. CPM was effective to all the cases of gynecological infections, and excellent was seen in 14 cases and good was seen in 13 cases. CPM eliminated 75% of clinical isolates. Laboratory tests were performed to blood samples and functions of liver and kidney before and after CPM treatment. Elevation of GPT was observed in 2 cases but required no treatment.

Topics: Adolescent; Adult; Bacteria, Anaerobic; Bacterial Infections; Cephalosporins; Drug Evaluation; Drug Resistance, Microbial; Endometritis; Female; Genital Diseases, Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Middle Aged; Pelvic Inflammatory Disease

A new cephalosporin, cefpiramide was administered to 12 patients with gynecological infections and the clinical effects obtained were good in 11 cases and poor in 1 (effective ratio: 91.7%). No side effects were observed except for eruption in 1 case, however, the relationship between the drug and eruption was unknown. No abnormalities were observed in hematological, hepatic and renal tests.

Topics: Adult; Aged; Bacterial Infections; Cephalosporins; Drug Evaluation; Drug Resistance, Microbial; Female; Genital Diseases, Female; Gram-Negative Bacteria; Humans; Injections, Intravenous; Middle Aged

Fundamental and clinical studies were performed on cefpiramide (CPM), a new cephem antibiotic, with following results. Following a single intravenous administration of 1.0 g dose of CPM, the average serum level of CPM was 129.5 micrograms/ml after 1 hour and the half-life in beta-phase was about 5.0 hours. The transfer of CPM to the internal genital organs was found to be good. the transfer of CPM to retroperitoneal fluid was moderate. In clinical trial, CPM was given to 9 patients with obstetrical and gynecological infection. Efficacy was excellent in 1 case and good in 6 cases (effectiveness rate: 77.8%). No side effects were observed. In laboratory findings, a mild elevation of S-GOT was noted in 1 case.

Topics: Adult; Aged; Bacterial Infections; Cephalosporins; Drug Evaluation; Female; Genital Diseases, Female; Genitalia, Female; Humans; Middle Aged; Pelvis

The effectiveness of antibiotics on biliary tract infections should be evaluated strictly by bacteriological findings rather than clinical results. In this report, the bacteria counts and drug excretion in bile were studied in 4 cases with obstructive jaundice. All patients received cefpiramide (CPM) (1.0 g) by the intravenous administration; before and at 1, 2, 4, 8 and 24 hours after injection, bile samples were taken to measure the CPM concentration (by bioassay) and bacteria counts (by plate count and uricult method). Case 1: After Soupault's operation. The highest peak of CPM excretion in bile was seen after 2 hours; bacteria counts (plate count) were decreased and/or abolished after 4 hours. Case 2: On day 25 after PTCD. CPM showed the highest peak after 1 hour, bacteria counts fell between 3 approximately 5 hours. Case 3: 4 months after PTCD. S. faecalis and Streptococcus were gradually diminished but E. cloacae (MIC greater than 100) was almost unchanged. Case 4: Cholangitis with T-tube. No change was seen in A. anitratum though CPM concentration was 830 micrograms/ml. However by the uricult method, bacteria counts decreased from 10(7) to 10(4) on CLED medium, and to 10(3) on MacConkey medium. From these results, the bacteria counts in the bile were correlated to the CPM concentrations 2 hours after it's peak. It was speculated that the decease of bacteria counts reflected the theoretical antibacterial activity.

Topics: Aged; Bacterial Infections; Bacteriological Techniques; Bile; Biliary Tract Diseases; Cephalosporins; Cholestasis; Drug Evaluation; Female; Humans; Infusions, Parenteral; Injections, Intravenous; Male; Middle Aged

Thirty-six febrile patients were administered cefpiramide (CPM) of 20 approximately 75 mg/kg/day for 3 approximately 11 days, and the clinical and side effects were evaluated. Among children with bacterial infections, including pneumonia, urinary tract infection, sepsis, pharyngitis and bronchitis, the results were excellent in 9, good in 13, and fair in 3 patients. Out of 36 patients, adverse reactions were observed in 9 cases, i.e. vascular pain at one shot intravenous injection in 4, diarrhea in 2, eosinophilia in 2, and diarrhea and eosinophilia in 1 case. One shot intravenous administration of CPM of 10 mg/kg to 4 patients yielded mean serum level of 100 micrograms/ml at 15 minutes and mean serum half-life of 2.5 hours, and administration of 20 mg/kg to 3 patients yielded mean serum level of 200 micrograms/ml at 15 minutes and mean serum half-life of 3.5 hours. The half-life in 1 patient with slight liver lesion was 5.36 hours. The rates of urinary recovery within 8 approximately 12 hours were 7.2 to 28.0% in 5 patients, 45.1% in a patient with nephrotic syndrome, and 50.9% in a patient with slight liver lesion.

Topics: Age Factors; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Infusions, Parenteral; Kinetics; Male

Twenty-one pediatric patients with moderate or severe infections were treated with cefpiramide (CPM). The drug was given intravenously in a dose of 10 approximately 52.3 mg per kg at 8 approximately 12 hourly interval. All 7 patients with urinary tract infection, 4 with bacterial enteritis and 4 out of 7 patients with lower respiratory tract infections responded satisfactory, but 2 patients with either Serratia marcescens septicemia or H. influenzae meningitis not responded to treatment. Over all response rate was 71.4 percent. There was no change in test of liver and renal function. CPM appears to be effective and well-tolerated antibiotics for the treatment of pediatric patients with various infections.

Topics: Age Factors; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Enteritis; Female; Humans; Infant; Injections, Intravenous; Male; Respiratory Tract Infections; Urinary Tract Infections

Cefpiramide (CPM) is a newly developed cephalosporin. Clinical studies on this drug were carried out and the results were as follows; Forty-three patients (purulent lymphadenitis 2, cellulitis 2, purulent otitis media 1, purulent tonsillitis 3, acute bronchitis 2, pneumonia 22, bronchiectasis 1, urinary tract infection 10) were treated with CPM, in doses of 20 approximately 82 mg/kg divided 2 approximately 4 times per day for 3 approximately 11 days intravenously. The overall efficacy rate was 83.7%. As to adverse reaction, 4 cases, which includes 3 cases of diarrhea and 1 case of exanthema, were observed. Abnormal laboratory data noted were liver dysfunction in 3 cases (6.8%), and eosinophilia in 2 cases (4.5%).

Topics: Adolescent; Age Factors; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male

Fundamental and clinical studies of cefpiramide (CPM), a newly developed cephem antibiotic with a broad spectrum, were performed and the following results were obtained. The serum levels of CPM after the intravenous injection or the drip infusion of CPM at dose of 10.0 approximately 46.7 mg/kg reached the peak of 75.8 approximately 274.0 micrograms/ml at 30 approximately 60 minutes after infusion and were 3.9 approximately 55.1 micrograms/ml at 8 hours after the infusion. Half-life of CPM in the blood was between 2.4 and 7.0 hours. The excretion rates of CPM into urine up to 24 hours after the infusion were 5.7 approximately 20.4%. Twenty-five patients with acute respiratory tract infection (RTI, 15 cases), urinary tract infection (UTI, 8 cases), cellulitis (1 case) and salmonellosis (1 case) were treated with CPM. The treatment by intravenous injection or drip infusion of 22 approximately 55 mg/kg/day (40 approximately 50 mg/kg/day) for mean 6 days resulted in 100% of good response in 15 cases of RTI and in 88% of good response in 8 cases of UTI. S. aureus, H. influenzae, E. coli, Proteus, Klebsiella and Salmonella group B were isolated from the culture of sputum or urine in the patients, and they were all eradicated by the treatment with CPM. No side effects were observed except eosinophilia in 1 case and the elevation of GOT and GPT in 1 case.

Topics: Adolescent; Age Factors; Bacteria; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Infusions, Parenteral; Injections, Intravenous; Male

Cefpiramide (CPM), a new broad-spectrum cephalosporin antibiotic with good antipseudomonas activities, was evaluated for its safety and efficacy in 20 children with bacterial infections. The diagnoses of the patients included pneumonia (10), acute bronchitis (1), streptococcal pharyngitis (1), purulent cervical lymphadenitis (1), urinary tract infections (2), acute enterocolitis (1), infections in agranulocytosis and acute leukemia (2), and acute purulent meningitis (2). Of the 20 patients, 17 were cured by the CPM therapy. The main etiologic pathogens were H. influenzae, P. aeruginosa, P. fluorescens, S. pneumoniae and E. coli. The serum half-life of CPM was 2.4 to 4.1 hours after an intravenous bolus injection. As an adverse reaction, diarrhea was encountered in 4 cases, and 1 of them experienced severe watery diarrhea with significant fecal colonization of K. oxytoca. The data suggest that CPM is an effective antibiotic when used in children with susceptible bacterial infections. Administrations divided in 2 to 3 dosages will be enough to maintain effective serum levels.

Topics: Age Factors; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male

Cefpiramide (CPM) was given to 4 patients with respiratory tract infection (H. influenzae 3 cases, P. aeruginosa 1 case), 1 patient with enteritis (enteropathogenic E. coli) and 1 patient with sepsis (E. cloacae). Bacteriological eradication was observed in 5 cases (83.3%), and clinical effectiveness was 66.7%. Serum concentration of CPM at a dose of 15 mg/kg after intravenous drip-infusion for 30 minutes was 105 micrograms/ml at the end of infusion and 67 micrograms/ml at 1 hour. Bacteriological eradication by the administration of CPM was rapidly occurred in 3 strains of H. influenzae including 1 strain of beta-lactamase producing ABPC-resistant one, and 1 strain of P. aeruginosa in the sputum. One patient aged 2 years and 5 months with pneumonia was cured by the treatment of CPM as an outpatient. No side effects were observed except 1 case of vascular pain. It was concluded that CPM is a useful drug for the treatment of bacterial infections in children.

Topics: Adult; Age Factors; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Infusions, Parenteral; Male

After the intravenous injection of cefpiramide (CPM) at a dose of 10 mg/kg to 2 children, the average blood levels of CPM were 77.7 micrograms/ml at 15 minutes, 64.6 micrograms/ml at 30 minutes, 41.9 micrograms/ml at 1 hour, 31.9 micrograms/ml at 2 hours, 10.7 micrograms/ml at 4 hours and 3.28 micrograms/ml at 12 hours. The half-lives were 3.0 hours and 5.8 hours. When CPM was given to 22 pediatric patients with mainly acute respiratory tract infection at doses of 20 approximately less than 50 mg/kg/day divided into 2 times by intravenous injection (12 cases) and drip-infusion (10 cases) for 2 approximately 3 days (10 cases) or 4 approximately 6 days (12 cases), the effective rate was 90.9%. No side effects were observed except slight increase of eosinophil in 1 case slight elevation of GOT in 1 case. It was concluded that CPM is a useful drug for the treatment of infection in pediatric field.

Topics: Adolescent; Age Factors; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Infusions, Parenteral; Injections, Intravenous; Male

Fundamental and clinical studies on cefpiramide (CPM), a new semisynthetic cephalosporin, were made and the following results were obtained. The antibacterial activities of CPM against clinical isolates were almost similar to those of conventional cephems except for Pseudomonas aeruginosa. The antibacterial activity of CPM against P. aeruginosa was excellent and superior than those of the others. Ten or twenty mg/kg of CPM was given intravenously at one shot to 11 cases. The mean serum levels of CPM reached 231 micrograms/ml at 15 minutes, 119 micrograms/ml at 30 minutes, 88 micrograms/ml at 1 hour, 65 micrograms/ml at 2 hours and 33 micrograms/ml at 6 hours after administration at a single dose of 10 mg/kg, respectively with the half-life of 3.42 hours. In case of 20 mg/kg, the mean serum levels attained 306 micrograms/ml at 15 minutes, 245 micrograms/ml at 30 minutes, 160 micrograms/ml at 1 hour, 118 micrograms/ml at 2 hours and 66 micrograms/ml at 6 hours respectively after administration with the half-life of 5.20 hours. CPM was given intravenously to 12 patients with various bacterial infections. The clinical effects were excellent in 5 cases, good in 6 cases and poor in 1 case and the effective rate was 92%. No side effect was observed in all cases.

Topics: Adolescent; Age Factors; Bacteria; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Injections, Intravenous; Male

Fundamental and clinical trials were carried out with cefpiramide (CPM) in pediatric infections. Results were as follows. CPM has a broad spectrum of activity against both Gram-positive and -negative microorganisms, including Pseudomonas. Half-lives of CPM were more prolonged than any others that have ever been reported on cephalosporin derivatives. The mean half-lives in the blood after infection were 4.76 hours and 4.14 hours, when the doses were 10 mg/kg and 20 mg/kg, respectively. The average recovery rates in the urine between 0 and 8 hours were 17.1% and 24.7%, when the intravenous doses were 10 mg/kg and 20 mg/kg, respectively. Thirty-two pediatric patients received CPM in doses ranging from 31.9 to 88.2 mg/kg divided mainly 2 times a day. They were respiratory tract infection in 23, urinary tract infection in 8, and SSSS in 1. The rate of satisfactory clinical response was 90.6%. Clinical side effect observed were mild diarrhea in 7 cases. Slight elevation of GOT and GPT were observed in 3 cases. All were considered to be minor.

Topics: Adolescent; Age Factors; Bacteria; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Male; Respiratory Tract Infections; Urinary Tract Infections

Fundamental and clinical studies on cefpiramide (CPM), a new semisynthetic cephalosporin were performed and the following results were obtained. Antibacterial activity The antibacterial activity of CPM was investigated in comparison with those of CTT, CPZ, CEZ, LMOX and CFS. Against clinical isolates of S. aureus, CPM was superior to CTT and LMOX, but almost similar to CPZ and inferior to CEZ. Against E. coli, K. pneumoniae, P. mirabilis and S. marcescens, CPM showed the activity almost similar to that of CEZ, but inferior to those of the others. On the contrary, the activity of CPM against P. aeruginosa was satisfactory and was superior to those of CTT, CPZ and LMOX, but slightly inferior to that of CFS. Blood level and urinary recovery Twenty mg/kg of CPM was given intravenously at one shot to 3 patients. The mean serum levels of CPM were 116.9 micrograms/ml at 30 minutes, 90.5 micrograms/ml at 1 hour, 71.1 micrograms/ml at 2 hours, 55.8 micrograms/ml at 4 hours, 24.9 micrograms/ml at 6 hours, 19.3 micrograms/ml at 9 hours and 12.1 micrograms/ml at 12 hours after administration, respectively. The mean half-life was very long and the value was 3.85 hours. The urinary recovery rates in 2 cases were 18.31 and 21.47% respectively up to 12 hours after administration. Clinical results and side effects CPM was given intravenously to 30 diseases including 11 cases of bronchopneumonia, 3 cases of bronchopneumonia and pleurisy, 2 cases of bronchitis, 4 cases of purulent tonsillitis, 5 cases of pyelonephritis and each one case of pyothorax, parotitis, cellulitis, otitis media and salmonellosis. CPM was effective in 29 out of 30 cases, and the effective rate was 96.7%. As side effects, 2 cases of fever and 1 case of cough were observed, but no abnormality in clinical laboratory findings was observed.

Topics: Adolescent; Age Factors; Bacteria; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male

The authors have carried out the laboratory and clinical studies of cefpiramide (CPM). The results were as follows; The sensitivity was estimated by plate dilution method on 27 strains of S. aureus and P. aeruginosa, 26 strains of E. coli, 25 strains of K. pneumoniae and 13 strains of Proteus sp. isolated from patients. The distribution of S. aureus was 0.78 approximately 6.25 micrograms/ml and the peak of distribution was 1.56 micrograms/ml. The distribution of E. coli was 0.78 approximately 50 micrograms/ml and the peak of distribution was 0.78 and 25 micrograms/ml. The growth of 24% of K. pneumoniae was not inhibited at concentration of more than 50 micrograms/ml. The distribution of Proteus sp. was 6.25 approximately 100 micrograms/ml. The growth of 77.8% of P. aeruginosa was inhibited at concentration of less than 3.13 micrograms/ml. CPM was given by intravenous administration for 5 minutes and drip infusion for 30 minutes at a single dose of 20 mg/kg of CPM to each 2 children respectively. After intravenous administration of CPM, the mean peak serum level was 200.5 +/- 37.5 micrograms/ml at 15 minutes, 44.3 +/- 0.9 micrograms/ml at 6 hours, 19.9 +/- 0.3 micrograms/ml at 12 hours respectively. Half-life time was 4.2 hours. After drip infusion of CPM, the mean peak serum level was 150.5 +/- 14.5 micrograms/ml at end of infusion, 23.6 +/- 3.3 micrograms/ml at 6 hours and 8.2 +/- 2.0 micrograms/ml at 12 hours respectively. Half-life time was 3.8 hours. The mean urinary excretion rate was 23.15%, 28.2% up to 12 hours after intravenous administration and drip infusion respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Age Factors; Bacteria; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Male

Fundamental and clinical studies of cefpiramide (CPM), a new cephem antibiotic, were carried out in the field of pediatrics. 80% MICs of CPM against S. aureus, S. pyogenes, H. influenzae, E. coli, K. pneumoniae and P. aeruginosa were 1.56, 0.05, 0.39, 6.25, 0.78 and 25 micrograms/ml, respectively. Serum concentration of CPM after intravenous injection at a dose of 20 mg/kg to 3 children was 103.7 +/- 9.1 micrograms/ml at 15 minutes and 13.4 +/- 5.0 micrograms/ml at 8 hours, with half-life of 3.11 +/- 0.83 hours. The excretion rate of CPM into urine was 16.40 +/- 7.31% within 8 hours. The transfer of CPM to cerebrospinal fluid was 0.1 approximately 0.2 micrograms/ml at 1 hour after intravenous injection at a dose of 20 mg/kg to patients with Aseptic meningitis, and 0.4 approximately 4.0 micrograms/ml at 1 hour approximately 3 hours 15 minutes after intravenous injection at a dose of 50 mg/kg to patients with purulent meningitis. Clinical effects of CPM on 37 patients with various infections were excellent in 28 cases, good in 6 cases, fair in 2 cases and poor in 1 case. The effective rate (excellent and good) was 91.9%. Bacteriologically, the eradication rate in 23 isolated organisms was 95.5%. No side effects and abnormalities of laboratory findings were noted. It was concluded that CPM has a broad spectrum antibacterial activity both in vitro and in vivo.

Topics: Age Factors; Bacteria; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male

A clinical study was made of cefpiramide (CPM) a new cephem-type antibiotic for injection and the following results were obtained. Blood level of CPM, after 20 mg/kg administration by drip infusion over a period of 1 hour, reached its peak of 86 micrograms/ml at the end of the infusion and declined to 19.8 micrograms/ml at 4th hour after infusion with the half-life value of 3.02 hours. Its urinary recovery rate up to 9 hours was 29.2% and the urine concentration from 0 to the 3rd hour was 820 micrograms/ml and from the 3rd to the 5th hour 650 micrograms/ml. In another case of the same dose with intravenous administration, the blood level at the end of the first 1 hour reached 56 micrograms/ml and by the 4th hour it had fallen to 20.6 micrograms/ml and by the 6th hour to 13.6 micrograms/ml. The half-life value was estimated as 2.44 hours. CPM was administered in 2 or 3 divided doses at a daily dosage ranging from 41.7 to 62.5 mg/kg by intravenous injection or by 1-hour drip infusion to 6 patients (3 cases of pneumonia, 2 cases of urinary tract infections, 1 case of purulent cervical lymphadenitis) and the following clinical results were obtained; "markedly effective" 3 cases, "effective" 2 cases, and "ineffective" 1 case. The overall efficacy rate was 83.3%. No side-effects or abnormal laboratory findings were found in any of the 7 patients including 1 patient who was excluded from the efficacy evaluation because of Kawasaki's disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Age Factors; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Infusions, Parenteral; Male

The authors treated a total of 23 patients (15 were outpatients, 8 were hospitalized), employing an injectable preparation of cefpiramide (CPM) a new antibiotic of the cephems. Included in this total were 10 cases of acute infectious diseases of skin and soft tissues, 5 cases of acute localized peritonitis, 5 cases of acute urinary tract infection and 3 cases of acute and subacute cholecystitis. To 15 cases of outpatients, CPM in a dose of 500 mg were given by intramuscular injection once a day, and to 8 cases of hospitalized patients were given 500 mg of CPM by intramuscular injection twice a day. The duration were 3 to 15 days. The clinical efficacy obtained was excellent in 4 cases, good in 17 cases, and fair in 2 cases. In no case was CPM found to be completely ineffective. Clinical adverse effect was not recognized. Therefore, CPM will be a useful drug when used for chemotherapy of acute or subacute infectious diseases on surgical field following intramuscular administration.

Topics: Acute Disease; Adult; Aged; Bacterial Infections; Cephalosporins; Cholecystitis; Drug Evaluation; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Peritonitis; Postoperative Complications; Skin Diseases, Infectious; Urinary Tract Infections

The in vitro and in vivo activities of Sm-1652 were compared with those of other cephalosporins. SM-1652 possessed a wide antibacterial spectrum which included activity against Pseudomonas aeruginosa. It also exhibited potent antibacterial activities against gram-positive cocci and clinical isolates of glucose nonfermentative bacteria. Most notably, its activity against glucose nonfermentative bacteria was the highest of all of the drugs tested. The bactericidal activity of SM-1652 was compared with that of cefoperazone. The difference between the minimum bactericidal concentration and the minimum inhibitory concentration of SM-1652 was actually smaller than that of cefoperazone for Escherichia coli and clinical isolates of indole-positive Proteus spp. SM-1652 was stable for most cephalosporinases but was hydrolyzed to some extent by penicillinases. The in vivo therapeutic effect of SM-1652 against infections in mice was better than those of cefazolin and cefoxitin. The in vivo antipseudomonal activity of SM-1652 was second to that of cefsulodin.

Topics: Animals; Anti-Bacterial Agents; Bacteria; Bacterial Infections; beta-Lactamases; Cephalosporins; Enterobacteriaceae; Hydrolysis; Male; Mice; Mice, Inbred ICR