cefpiramide and Neutropenia

The therapeutic efficacy of cefpiramide and ciprofloxacin alone and in combination was investigated and compared with that of ticarcillin plus tobramycin against pseudomonal infections in mice made neutropenic by administration of cyclosphosphamide. Therapy with cefpiramide plus ciprofloxacin was significantly more effective than that by either antibiotic alone. These results were consistent with in-vitro synergistic effects. At a higher dose of ciprofloxacin (4 mg/kg) plus cefpiramide (50 mg/kg), the combination therapy protected all neutropenic mice from fatal bacteraemia, and was more protective than ticarcillin (200 mg/kg) plus tobramycin (1 mg/kg). The peak serum concentration of cefpiramide in infected neutropenic mice was 51 mg/l when they were given 50 mg/kg subcutaneously. Ciprofloxacin attained a peak serum concentration of 1.2 mg/l and a serum half-life of 34 min.

Topics: Agranulocytosis; Animals; Cephalosporins; Ciprofloxacin; Cyclophosphamide; Drug Therapy, Combination; Female; Mice; Microbial Sensitivity Tests; Neutropenia; Pseudomonas Infections

Cefpiramide and cefoperazone alone and in combination with gentamicin were compared for therapeutic efficacy against pseudomonal infections in normal mice and in mice made neutropenic by administration of cyclophosphamide. Neutropenic mice were more susceptible to infection with Pseudomonas aeruginosa than normal mice. At all challenge doses, combination therapy with either cefpiramide-gentamicin or cefoperazone-gentamicin was more effective than that with a single agent. Therapy with the cefpiramide-gentamicin combination was significantly more active than that with the cefoperazone-gentamicin combination in protecting mice from fatal bacteremia. Pharmacokinetic studies in mice showed that cefpiramide attained a peak serum concentration of 12 micrograms/ml and a serum half-life of 40 min, which are higher than attained by cefoperazone with values of 4 micrograms/ml and 18 min. These factors may have caused the combined cefpiramide-gentamicin therapy to result in significantly improved survival rates in mice as well as in higher bactericidal titers than the cefoperazone-gentamicin combination. The results show that cefpiramide when combined with gentamicin is effective in treating serious infections with P. aeruginosa in neutropenic mice.

Topics: Animals; Cefoperazone; Cephalosporins; Cyclophosphamide; Drug Combinations; Drug Evaluation, Preclinical; Drug Synergism; Female; Gentamicins; Half-Life; Injections, Intraperitoneal; Injections, Subcutaneous; Kinetics; Lethal Dose 50; Mice; Neutropenia; Pseudomonas Infections