cefzil and Respiratory-Tract-Infections

Cefprozil is a novel third generation, broad-spectrum oral cephalosporin with activity against a spectrum of aerobic gram-negative and positive bacteria, as well as certain anaerobes. The beta-lactamase stability of cefprozil may exceed that of other oral cephalosporins for some important pathogens. Cefprozil may be a suitable alternative to several other commonly used beta-lactams and cephalosporins in the treatment of mild to moderate upper and lower respiratory tract infections including sinusitis, otitis media, pharyngitis/tonsillitis, secondary bacterial infection of acute bronchitis, and acute bacterial exacerbations of chronic bronchitis, and skin and skin structure infections in children. Available data indicate the safety of cefprozil in both pediatric and adult population.

Topics: Bronchitis; Cefprozil; Cephalosporins; Humans; Otitis Media; Pharyngitis; Respiratory Tract Infections; Sinusitis; Skin Diseases, Infectious

The oral second generation cephalosporin cefprozil has a broad spectrum microbiologic profile, with good in vitro activity against respiratory pathogens; 90% or more of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis isolates are susceptible to cefprozil. Clinical trials of cefprozil have consistently demonstrated good clinical success rates in upper and lower respiratory tract infections, including otitis media, sinusitis, pharyngitis/ tonsillitis and acute bacterial exacerbations of chronic bronchitis. Most recently cefprozil has demonstrated success in children with recurrent and persistent acute otitis media. Data from clinical trials including more than 4000 children and adults have shown that cefprozil is well-tolerated. The most common adverse events associated with cefprozil are gastrointestinal disturbances (i.e. diarrhea and nausea). In two patient satisfaction surveys (pediatric and adult), cefprozil was cited for having a low incidence of side effects and was rated by children as having a pleasing taste. These data indicate that cefprozil is a practical therapeutic choice for the treatment of upper and lower respiratory tract infections.

Topics: Adult; Bronchitis; Cefprozil; Cephalosporins; Child; Child, Preschool; Drug Tolerance; Humans; Infant; Otitis Media; Patient Satisfaction; Pharyngitis; Respiratory Tract Infections; Sinusitis; Tonsillitis

Cefprozil was evaluated in four multicentre comparative studies in the treatment of acute respiratory tract infections. In two studies, cefprozil 500 mg q. 12 hours was compared to cefaclor 500 mg q. eight hours for ten days of therapy. Randomization was on a 2:1 (cefprozil:cefaclor) basis in the European centres and 1:1 in North America. The clinical efficacy in acute bronchitis was 88% (284 out of 324 patients) for cefprozil and 88% (183 out of 208) for cefaclor, with successful bacteriological eradication of the causative pathogen in 86% and 82% of the patients, respectively. Amongst the patients with acute exacerbations of chronic bronchitis, the clinical response rate of 80% (59 out of 74) for cefprozil appeared superior to that of cefaclor at 62% (p = 0.067), whilst the bacteriological response rates were 62% (36 out of 58) for cefprozil and 74% (20 out of 27) for cefaclor. In pneumonia, the clinical response rates for cefprozil and cefaclor therapy were similar, 82% vs. 79%, although bacteriological eradication rates were better for cefprozil at 82% than for cefaclor at 71%. In the comparison of cefprozil with cefuroxime axetil, a total of 170 patients were evaluable. The clinical and bacteriological response rates for cefprozil of 95% and 100% were better than those for cefuroxime axetil 500 mg q. 12 hours of 84% and 75%, respectively. In the cefprozil vs. amoxicillin-clavulanate, 500 mg q. eight hours comparative study, the two antibiotics displayed no significant difference in clinical or bacteriological responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; Bronchitis; Cefaclor; Cefprozil; Cefuroxime; Cephalosporins; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Male; Multicenter Studies as Topic; Pneumonia; Prodrugs; Randomized Controlled Trials as Topic; Respiratory Tract Infections

Topics: Acute Disease; Adult; Aged; Ambulatory Care; Anti-Bacterial Agents; Cefprozil; Cephalosporins; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Otitis Media; Respiratory Tract Infections; Treatment Outcome

Cefprozil was evaluated in four multicentre comparative studies in the treatment of acute respiratory tract infections. In two studies, cefprozil 500 mg q. 12 hours was compared to cefaclor 500 mg q. eight hours for ten days of therapy. Randomization was on a 2:1 (cefprozil:cefaclor) basis in the European centres and 1:1 in North America. The clinical efficacy in acute bronchitis was 88% (284 out of 324 patients) for cefprozil and 88% (183 out of 208) for cefaclor, with successful bacteriological eradication of the causative pathogen in 86% and 82% of the patients, respectively. Amongst the patients with acute exacerbations of chronic bronchitis, the clinical response rate of 80% (59 out of 74) for cefprozil appeared superior to that of cefaclor at 62% (p = 0.067), whilst the bacteriological response rates were 62% (36 out of 58) for cefprozil and 74% (20 out of 27) for cefaclor. In pneumonia, the clinical response rates for cefprozil and cefaclor therapy were similar, 82% vs. 79%, although bacteriological eradication rates were better for cefprozil at 82% than for cefaclor at 71%. In the comparison of cefprozil with cefuroxime axetil, a total of 170 patients were evaluable. The clinical and bacteriological response rates for cefprozil of 95% and 100% were better than those for cefuroxime axetil 500 mg q. 12 hours of 84% and 75%, respectively. In the cefprozil vs. amoxicillin-clavulanate, 500 mg q. eight hours comparative study, the two antibiotics displayed no significant difference in clinical or bacteriological responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; Bronchitis; Cefaclor; Cefprozil; Cefuroxime; Cephalosporins; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Male; Multicenter Studies as Topic; Pneumonia; Prodrugs; Randomized Controlled Trials as Topic; Respiratory Tract Infections

Cefprozil (CFPZ), a newly developed oral cephalosporin in a fine granular form for pediatric use, was administered to children with bacterial infections. MICs were determined for 6 drugs including CFPZ, cephalexin (CEX), cefaclor (CCL), ampicillin (ABPC), methicillin (DMPPC) and cloxacillin (MCIPC) against the following 84 strains isolated from cases to which CFPZ was administered; 55 strains of Gram-positive cocci (GPC) including 2 strains of Staphylococcus aureus, 49 strains of Streptococcus pyogenes, 4 strains of Streptococcus pneumoniae, and 29 strains of Gram-negative bacilli (GNB) including 10 strains of Haemophilus influenzae, 18 strains of Escherichia coli, and 1 strain of Proteus mirabilis. MIC determination of these strains was done with an inoculum size of 10(6) CFU/ml. In pharmacokinetic studies, serum concentrations, urinary concentrations and urinary recovery rates were investigated using bioassay and high-performance liquid chromatography (HPLC). CFPZ was orally administered 30 minutes before meals to 9 children with ages ranging from 7 years and 1 month to 12 years and 3 months. Three groups of 3 children were tested with doses of 4.0, 7.5 and 15.0 mg/kg, respectively. In addition to the above, clinical and bacteriological studies were performed in a total of 160 cases consisting of children with ages ranging 5 months to 12 years and 5 months. A mean dose of 8.6 mg/kg in 3-4 divided doses (130 cases of t.i.d. and 30 cases of q.i.d.) was administered for an average of 7 days. The 160 cases included 34 cases of pharyngitis, 5 cases of tonsillitis, 8 cases of acute bronchitis, 8 cases of pneumonia, 52 cases of scarlet fever, 4 cases of acute purulent otitis media, 47 cases of urinary tract infection, 1 case of purulent lymphadenitis and 1 case of posthitis. Adverse reactions and abnormal clinical laboratory test results were also examined in 166 cases, including 6 cases excluded from the evaluation of clinical efficacy. The results obtained are summarized as follows: 1. With regard to GPC, MICs of CFPZ against 2 strains of S. aureus were 0.78 or 1.56 micrograms/ml and CFPZ showed the second highest activity to MCIPC. MICs of CFPZ against 49 strains of S. pyogenes were all less than 0.025 micrograms/ml.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Administration, Oral; Age Factors; Bacteria; Bacterial Infections; Cefprozil; Cephalosporins; Child; Child, Preschool; Drug Resistance, Microbial; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

Cefprozil (CFPZ, BMY-28100) is a new oral cephem antibiotic without an ester linkage. Pharmacokinetic and clinical studies using CFPZ 10% fine granules were performed in pediatric patients. 1. Pharmacokinetic investigation Peak serum concentrations of CFPZ after dose of 7.5 mg/kg and 10 mg/kg were, respectively, 3.65 +/- 0.24 micrograms/ml and 6.38 +/- 3.23 micrograms/ml at 1-2 hours. The average half-life with 7.5 mg/kg administration was 0.90 +/- 0.16 hours and that with 10 mg/kg was 1.29 +/- 0.50 hours. The urinary excretion of CFPZ was about 45% (35.3-50.0%) in 6 hours. 2. Clinical investigation Enrolled in the study were 22 patients including 4 with pharyngitis, 3 with tonsillitis, 3 with bronchitis, 5 with pneumonia, 4 with urinary tract infection, and 1 each with pertussis, purulent lymphadenitis and otitis media. Responses were excellent in 14 patients, good in 5 patients and fair in 1 patient. In the assessment of the bacteriological efficacy, 8 out of 17 strains of organism identified previous to the treatment were eradicated, 5 strains were found replaced by other bacteria and 4 strains persisted, hence the eradication rate was 76.5%. 3. No adverse reactions attributable to the drug were observed. From the above results, it has been concluded that CFPZ is a highly effective and safe agent for moderate respiratory and urinary tract infections in children.

Topics: Administration, Oral; Adolescent; Age Factors; Cefprozil; Cephalosporins; Child; Female; Humans; Lymphadenitis; Male; Otitis Media; Respiratory Tract Infections; Urinary Tract Infections

To investigate antimicrobial resistance of common community respiratory pathogens isolated in China, 2002 - 2003.. 779 strains of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Group A beta-haemolytic Streptococci and oxacillin-susceptible Staphylococcus aureus (MSSA) were isolated from patients with community-acquired respiratory tract infections at 5 hospitals in China from April 2002 to 2003. Meanwhile, 185 strains of S. pneumoniae, H. influenzae and M. catarrhalis were isolated from nasopharynx swabs at 2 day-care centers in Beijing. Agar dilution method was used to determine the minimal inhibitory concentration (MICs) of cefprozil and other 9 antibiotics against these strains.. The prevalence of penicillin-intermediate S. pneumoniae (PISP) was 23.9% and that of penicillin-resistant S. pneumoniae (PRSP) was 22.7% at 5 cities in China. The prevalence of PISP were 44.1% in Hangzhou, 26.2% in Wuhan, 21.5% in Shenyang, 20.8% in Shanghai, 18.5% in Beijing, and 12.7% at day-care centers in Beijing;the prevalance of PRSP were 34.9% in day-care centers, 31.9% in Shanghai, 27.9% in Wuhan, 22.1% in Hangzhou, 13.8% in Shenyang and 8.6% in Beijing. The susceptible rate of levofloxacin in S. pneumoniae was 96.3%. 9.5% of H. influenzae and 87.4% of M. catarrhalis produced beta-lactamases. The susceptibility of amoxicillin/clavulanate, cefaclor, cefprozil, cefuroxime, ceftriaxone, azithromycin, and levofloxain in these two species ranged from 96.4% to 100%. The resistance rate of azithromycin in S. pneumoniae was higher than 60%. Cefprozil MICs against PISP, Group A beta-haemolytic Streptococci and MSSA were 4 - 16 fold lower than cefaclor.. Antimicrobial resistance in respiratory pathogens, especially S. pneumoniae is increasing. It brings concerns that high macrolide resistance was found in gram-positive cocci. Cefprozil was more active than cefaclor against respiratory pathogens.

Topics: Anti-Bacterial Agents; Cefprozil; Cephalosporins; Child, Preschool; China; Community-Acquired Infections; Drug Resistance, Bacterial; Haemophilus influenzae; Humans; Levofloxacin; Microbial Sensitivity Tests; Moraxella catarrhalis; Multicenter Studies as Topic; Ofloxacin; Penicillins; Respiratory Tract Infections; Streptococcus pneumoniae

Respiratory tract infections are the leading cause of children's visits to physicians. Antibiotic resistance is increasing among the three most common bacterial respiratory pathogens, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, which cause acute otitis media and sinusitis. Therefore clinicians may need to reexamine their treatment strategies because these infections may cause complications. Antibiotic selection in such infections should take into account local bacterial resistance patterns, anticipated clinical efficacy against S. pneumoniae, H. influenzae and M. catarrhalis, including penicillin-resistant and beta-lactamase-producing strains, as well as the safety profile and compliance-enhancing features of the drug.

Topics: Cefprozil; Cephalosporins; Child; Humans; Respiratory Tract Infections

Cefprozil granule preparation was administered orally to 16 patients (ages ranging 8 months to 9 years and 6 months) with pediatric bacterial infections at daily dose levels between 29.4 and 35.7 mg/kg divided into 3 or 4 doses. The following results were obtained. 1. Sixteen patients including 5 with pharyngitis, 3 with tonsillitis, 3 with lacunar tonsillitis, 2 with pneumonia, 2 with contagious impetigo and 1 with scarlet fever were treated. Clinical effects were excellent in 9 cases and moderate in 7, with an overall efficacy rate of 100%. 2. Organisms suspected as pathogens included 17 strains (10 strains of haemophilus influenzae, 2 of Haemophilus parainfluenzae, 3 of Streptococcus pyogenes and 2 of Staphylococcus aureus). Bacteriologically, eradication of pathogens were observed for 11 strains, but no changes were obtained for 5 (all Haemophilus), and unknown results were obtained for 1, thus the eradication rate was 68.8%. 3. No side effects were observed. Abnormal laboratory test results included 2 cases of increase in platelets, and 2 of increase in eosinophils, but those were not significant. 4. No refusal of the drug occurred due to its taste or odor.

Topics: Administration, Oral; Age Factors; Bacteria; Bacterial Infections; Cefprozil; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male; Respiratory Tract Infections

Cefprozil (CFPZ, BMY-28100), a new oral cephalosporin, was evaluated for its antibacterial activity and clinical efficacy. Thirty-four patients were treated with 7.7-36.2 mg/kg per day of CFPZ divided into 3 times. A total of 33 patients including 3 with acute pneumonia, 2 with acute bronchitis, 17 with acute upper respiratory tract infections, 4 with urinary tract infections, 1 with suppurative lymphadenitis and 6 with other soft tissue infections were evaluated for clinical efficacy except for 1 patient whose general conditions were too serious to continue to be treated with orally medication. Clinical effects were excellent in 8 patients and good in 23 but 2 cases were excluded because they were suspected for viral infections, hence the overall efficacy rate was 100%. Bacteriological responses were confirmed on 6 (66.7%) strains which were eradicated by the treatment out of 9 strains identified. CFPZ showed stronger antibacterial activities than those of cefaclor. Side effects or abnormal laboratory test results were observed in 2 patients; nausea and pallor of face in 1 patient and an increase of eosinophil in 1. The above findings suggest that CFPZ is a safe and useful antibiotics for the treatment of bacterial infections in pediatric patients.

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

1. Serum levels of cefprozil (CFPZ, BMY-28100) after single oral administration of 7.5 mg/kg were 2.9-5.5 micrograms/ml at 1 hour and trace at 6 hours. 2. Urinary excretion rates of CFPZ were 45.7-102.3% within 6 hours (HPLC). 3. CFPZ was administered at doses ranging 19-47.3 mg/kg/day to 17 cases of pediatric infections including 16 cases with respiratory infections and 1 case with external otitis. Good clinical and bacteriological responses were obtained in all cases. 4. As side effect, diarrhea was observed in 1 case. As abnormal laboratory test results, eosinophilia was observed in 5 cases.

Topics: Administration, Oral; Age Factors; Bacteria; Cefprozil; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Male; Otitis Externa; Respiratory Tract Infections

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Cefprozil; Cephalosporins; Clavulanic Acids; Drug Combinations; Drug Resistance, Microbial; Humans; Moraxella catarrhalis; Respiratory Tract Infections