hr-810 and Cross-Infection

The efficacy of cefpirome was estimated in the treatment of 12 patients with severe hospital infection in the Municipal Hospital No. 7. The positive clinical effect at the background of the cefpirome use was recorded in 11 patients. The eradication of the primary pathogens was stated in 10 patients. 116 isolates were tested for their susceptibility to cefpirome. 92 per cent of the isolates from outpatients and 79 per cent of the isolates from inpatients proved to be susceptible to the antibiotic. The results of the cefpirome use in the treatment of patients with various infections in 6 hospitals of Moscow were analyzed. The positive clinical effect was observed in 103 out of 111 patients (93 per cent). The eradication of the primary pathogens was recorded in 90 out of 102 patients (88 per cent). In the treatment of the lower respiratory tract infection, urinary tract infection and surgical infection the positive clinical results were stated in 91, 95 and 96 per cent of the cases respectively. Insignificant or moderate side effects of the drug were observed in 17 patients. Discontinuation of the drug use because of the side effects was required in 2 of them. The results showed that the use of cefpirome in the monotherapy of various severe hospital infections was efficient and safe.

Topics: Adult; Cefpirome; Cephalosporins; Cross Infection; Hospitals, Municipal; Humans; Microbial Sensitivity Tests; Russia; Treatment Outcome

Two hundred and seventy-six hospitalized patients with severe infection (complicated UTI, pneumonia, skin and soft tissue infection or septicaemia) were randomly allocated to receive either 1g or 2g cefpirome bd. Two hundred and seventy-four patients were evaluable for tolerance, 210 for bacteriological efficacy. The two groups were similar in terms of underlying disease, age, sex, and general condition on admission. The overall clinical and bacteriological response rates were 97/103 (94%) and 68/76 (90%) respectively in the 1g group, compared with 102/107 (95%) and 67/71 (94%) in the 2g group. There was no significant difference between the treatment groups. Eighteen adverse events, possibly or probably drug related, were reported (7 in the 1g group, 11 in the 2g group). This resulted in discontinuation of therapy in four cases (two in each group). Fourteen of the adverse events were local (five receiving 1g, nine receiving 2g), mainly phlebitis or pain at the injection site. Thirteen patients died during the study period (up to 14 days after the last dose) but in no case was death attributed to cefpirome. A review of routine laboratory parameters revealed no abnormalities which could definitely be attributed to cefpirome although in four cases a relationship was considered possible; these included two increases in serum creatinine, one increase in SGPT, and one episode of neutropenia. Cefpirome administered as 1 or 2g twice daily was a well tolerated, effective agent for the treatment of severe sepsis in hospitalized patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial Infections; Cefpirome; Cephalosporins; Cross Infection; Dose-Response Relationship, Drug; Drug Evaluation; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Prospective Studies

A Pseudomonas aeruginosa isolate recovered in Belgium produced a novel extended-spectrum ss-lactamase, BEL-2, differing from BEL-1 by a single Leu162Phe substitution. That modification significantly altered the kinetic properties of the enzyme, increasing its affinity for expanded-spectrum cephalosporins. The bla(BEL-2) gene was identified from a P. aeruginosa isolate clonally related to another bla(BEL-1)-positive isolate.

Topics: Belgium; beta-Lactamases; Cephalosporinase; Cephalosporins; Cross Infection; Escherichia coli; Genes, Bacterial; Humans; Kinetics; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections

Infections caused by coagulase-negative staphylococci are becoming increasingly important, particularly those of nosocomial origin, as the organisms are frequently multi-resistant. New antimicrobial strategies are needed. The bactericidal activity of a combination of cefpirome with either vancomycin or teicoplanin against 12 strains of methicillin-resistant staphylococci with a decreased susceptibility to teicoplanin was determined in vitro by a time killing method. Strains Mu3 and Mu50 of Staphylococcus aureus were also studied. Cefpirome (0.125-0.5 x MIC) combined with vancomycin (0.25-1 x MIC) or teicoplanin (0.125-1 x MIC) acted synergically against 12 isolates over 18 h in most cases. A synergistic killing effect was also observed with the Mu3 and Mu50 strains of glycopeptide-intermediate S. aureus but over a longer period.

Topics: Anti-Bacterial Agents; Cefpirome; Cephalosporins; Cross Infection; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Glycopeptides; Humans; In Vitro Techniques; Oxacillin; Staphylococcal Infections; Staphylococcus aureus; Staphylococcus epidermidis; Staphylococcus haemolyticus

The in vitro activities of new expanded spectrum of fourth-generation cephalosporins, cefepime and cefpirome, were compared with those of three third-generation cephalosporins, cefoperazone, ceftazidime, and ceftriaxone, that are commonly used in the treatment of serious infections caused by aerobic gram-negative bacteria. The agar dilution method described by the US National Committee for Clinical Laboratory Standards was used to determine the minimum inhibitory concentrations of antibiotics tested. 302 clinical isolates, representing a cross-section of Klebsiella and Enterobacter species and Pseudomonas aeruginosa were tested. Cefepime was considerably more active than other antibiotics tested, against Klebsiella species and Enterobacter species, and demonstrated activity similar to ceftazidime against Pseudomonas aeruginosa. Ceftazidime was active against Pseudomonas aeruginosa but was less potent against Enterobacter species. Cefoperazone and ceftriaxone were less active than ceftazidime against Pseudomonas aeruginosa. Cefepime had slightly greater activity than cefpirome against the gram-negative bacteria tested. However, cefepime and cefpirome were found to be highly active against many resistant organisms that traditionally have been difficult to treat.

Topics: Cefepime; Cefpirome; Cephalosporins; Cross Infection; Drug Resistance, Bacterial; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Microbial Sensitivity Tests

The novel 4(th) generation cephalosporin FK037 was in vitro compared to cefepime and cefpirome on 563 multiresistant nosocomial isolates including methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA). Their time-kill effect was studied on MSSA, Escherichia coli, Klebsiella pneumoniae, and isolates of Enterobacter cross-resistant to cefotaxime, ceftriaxone, and to ceftazidime, their interaction with amikacin being also evaluated on the latter isolates. Results revealed that FK037 possessed a superior antistaphylococcal activity on MSSA isolates to both other compounds being however equal active to cefepime and cefpirome on multiresistant enterobacteriaceae. Synergy was documented between 4(th) generation cephalosporins and amikacin on K. pneumoniae and on Enterobacter spp. cross-resistant to 3(rd) generation cephalosporins. In the latter species 4(th) generation cephalosporins remained inactive. The presented results support the need of clinical studies with FK037 as monotherapy for nosocomial infections based on the local surveillance data of the level of antimicrobial resistance of each hospital.

Topics: Acinetobacter; Cefepime; Cefpirome; Ceftizoxime; Cephalosporins; Cross Infection; Enterobacteriaceae; Gram-Negative Bacteria; Humans; Methicillin Resistance; Microbial Sensitivity Tests; Pseudomonas; Staphylococcus aureus; Stenotrophomonas

Topics: Cefpirome; Cephalosporins; Cross Infection; Hemofiltration; Humans

Topics: Bacterial Infections; Cefpirome; Cephalosporins; Cross Infection; Data Collection; Gram-Negative Bacteria; Gram-Positive Bacteria; Hematology; Hospital Units; Humans; Intensive Care Units; Microbial Sensitivity Tests; Netherlands; Species Specificity

In vitro activities of cefepime and cefpirome against 96 isolates of Chryseobacterium indologenes and 21 of C. meningosepticum were determined by the agar dilution method. Overall, cefepime was more active than cefpirome against C. indologenes (MIC at which 50% of the isolates were inhibited [MIC50] and MIC90, 4 and 16 microg/ml, respectively, for cefepime and 8 and 128 microg/ml, respectively, for cefpirome). Both agents had poor potency against C. meningosepticum (MIC50 and MIC90, 64 and >256 microg/ml, respectively, for cefepime and 128 and >256 microg/ml, respectively, for cefpirome).

Topics: Cefepime; Cefpirome; Cephalosporins; Cross Infection; Drug Resistance, Microbial; Flavobacterium; Gram-Negative Bacterial Infections; Humans; In Vitro Techniques; Microbial Sensitivity Tests

A multicenter in-vitro study was conducted in 13 countries between May and November, 1992 to determine both the current bacterial epidemiology in Intensive Care and Hematology/Oncology units and the susceptibility of the organisms to cefpirome and other commonly used antibacterials. Eighty-nine hospitals each collected 100 consecutive nonduplicate aerobic clinical isolates from patients in either an Intensive Care (81%) or Hematology/Oncology (19%) unit. The major sources of isolates were respiratory, skin/wound, blood and urine. The MIC of eight different antibiotics was determined using a custom microdilution plate. Predominant bacteria accounting for 80% of the 8625 isolates included: staphylococci (26%); Escherichia coli (17%); Pseudomonas aeruginosa (12%); Klebsiella spp. (10%); Enterobacter spp. (8%) and enterococci (7%). Gram-positive isolates accounted for more than 35% of all isolates. Based on the susceptibility results to the predominant pathogens, the activity of the drugs tested could be categorized into three groups. Cefpirome and imipenem had the most potent in-vitro activity, followed by the third generation cephalosporins cefotaxime, ceftazidime and ceftriaxone, and then piperacillin. The large percentage of Gram-positive bacterial isolates in this patient population indicates the utility of antimicrobial agents that are equally effective against both Gram-positive and Gram-negative organisms.

Topics: Anti-Bacterial Agents; Bacterial Infections; Cefpirome; Cephalosporins; Cross Infection; Drug Resistance, Microbial; Europe; Gram-Negative Bacteria; Gram-Positive Bacteria; Hospital Units; Humans; Intensive Care Units; Microbial Sensitivity Tests; Prevalence

A multi-centre in-vitro study (8625 isolates) was conducted in 13 countries between May and November, 1992 to determine both the current bacterial epidemiology in intensive care and haematology/oncology units and the cross-susceptibility of the organisms to cefpirome, ceftazidime, ceftriaxone, imipenem and piperacillin. Bacterial species with 20 or more isolates resistant to one of the six antibiotics were examined for their susceptibility to the beta-lactams. Cefpirome and imipenem had the smallest total numbers of isolates. Bacteria resistant to ceftazidime or ceftriaxone were often susceptible (> 50%) to cefpirome. Conversely, cefpirome resistant isolates were frequently resistant (> 90%) to ceftazidime and ceftriaxone. P. aeruginosa was an exception, exhibiting cross-resistance to all cephalosporins. beta-lactamase producing Enterobacter, Citrobacter and Klebsiella spp. were especially resistant to piperacillin and ceftazidime but not cefpirome or imipenem. Two-thirds or more of coagulase-negative staphylococci resistant to any single agent, including imipenem, maintained their susceptibility to cefpirome. Cross-class resistance was not exhibited by imipenem and cefpirome against ciprofloxacin resistant isolates but was more evident for piperacillin, ceftazidime and ceftriaxone. Cefpirome was more active than ceftazidime against bacteria resistant to both piperacillin and gentamicin, especially coagulase-negative staphylococci (76% vs. 6%) and Enterobacter spp. (56% vs. 21%). Many coagulase-negative staphylococci and Enterobacter spp. susceptible to cefpirome (50-89%). These results suggest that cefpirome has a potential clinical advantage against gram-positive and gram-negative bacteria resistant to other beta-lactams, including imipenem.

Topics: Anti-Bacterial Agents; Bacterial Infections; Cefpirome; Ceftazidime; Ceftriaxone; Cephalosporins; Cross Infection; Drug Resistance, Microbial; Europe; Gram-Negative Bacteria; Gram-Positive Bacteria; Hospital Units; Humans; Imipenem; Intensive Care Units; Microbial Sensitivity Tests; Piperacillin; Prevalence

The activity of cefpirome (HR 810) was evaluated against 247 strains isolated from patients developing their infections while in a hospital in Buenos Aires. Its activity against Gram negative bacilli was compared with ceftriaxone, ceftazidime, cephalotin, piperacillin, amikacin, gentamicin and norfloxacin. In terms of MIC50 and MIC90 (mg/l) it was as follows: Klebsiella pneumoniae: less than 0.125, less than 2.0; Pseudomonas aeruginosa: less than 8, less than 16; Escherichia coli: less than 0.016, less than 0.063; Serratia marcescens: less than 0.063, less than 1.0; Enterobacter cloacae: less than 0.125, less than 1.0. Cefpirome was more active than the other cephalosporins against P. aeruginosa: at 16 mg/l, this drug inhibited 95% of strains versus 60% for ceftazidime and 32% for ceftriaxone. Activity of norfloxacine against Gram negative bacilli was similar to cefpirome, while piperacillin and the aminoglycosides were less active. Cefpirome was more active than cepahallotin against Streptococcus faecalis (2.0, 32) although less active than ampicillin, piperacillin, rifampicin and vancomycin. Against methicillin-susceptible Staphylococcus aureus (less than 0.25, less than 1.0) it was more active than cephalotin and the other drugs evaluated (piperacillin, erythromycin, chloranphenicol, aminogycosides). Like cephalotin, the activity of cefpirome against methicillin-resistant strains was variable (1.0, 32).

Topics: Anti-Bacterial Agents; Cefpirome; Cephalosporins; Cross Infection; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Microbial Sensitivity Tests

The activity of three new antimicrobial agents [cefpirome (HR 810), BMY 28142, WIN 49375], and imipenem was compared to that of four currently available agents, ceftazidime, aztreonam, timentin and piperacillin, against 253 bacterial isolates from cancer patients. The activity of all four agents not yet in clinical use at our institution was significantly greater than that of the four antibiotics already in use.

Topics: Anti-Bacterial Agents; Cefepime; Cefpirome; Cephalosporins; Ciprofloxacin; Cross Infection; Fluoroquinolones; Gram-Negative Bacteria; Humans; Imipenem; Microbial Sensitivity Tests; Neoplasms; Quinolines; Thienamycins