cefpiramide and Pseudomonas-Infections

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

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

The therapeutic efficacy of cefpiramide and apalcillin was evaluated and compared with that of six other antipseudomonal beta-lactam antibiotics in an experimental mouse burn infection due to Pseudomonas aeruginosa. Both cefpiramide and apalcillin were as potent as cefsulodin and more potent than carbenicillin, cefotaxime, cefoperazone, piperacillin and gentamicin in protecting the infected mice from fatal bacteraemia and in eradicating Ps. aeruginosa from the infected site.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Burns; Cephalosporins; Female; Mice; Naphthyridines; Pseudomonas Infections; Wound Infection

The in vivo therapeutic efficacy of cefpiramide was investigated and compared with that of cefoperazone. Cefpiramide was more potent than cefoperazone against infections produced by both beta-lactamase-producing and non-beta-lactamase-producing S. aureus. The protective activity of cefpiramide against experimental infections with selected members of Enterobacteriaceae was lower than that of cefoperazone. Against carbenicillin-resistant P. aeruginosa infections, cefpiramide was as active as gentamicin and aztreonam and three times more potent than cefoperazone, cefotaxime and piperacillin. The pharmacokinetic properties of cefpiramide in mice and rats were superior to those of cefotaxime and cefoperazone. The peak serum concentrations of cefpiramide, administered subcutaneously at a dose of 50 mg/kg, were 76 micrograms/ml in mice and 174 micrograms/ml in rats and the corresponding serum half-lives of cefpiramide were 87 min and 49 min in mice and rats respectively.

Topics: Animals; Anti-Bacterial Agents; Cephalosporins; Female; Kinetics; Male; Mice; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections; Rats; Rats, Inbred Strains; Staphylococcal Infections

Topics: Cephalosporins; Child; Diarrhea; Feces; Humans; Pseudomonas Infections