hr-810 and Respiratory-Tract-Infections

The author reviews the comparative and non-comparative studies of cefepime and cefpirome, from which it is evident that both cephalosporins are extremely effective both clinically and bacteriologically. Success rates of about 90% have been reported for both drugs as therapy for complicated urinary tract infections, lower respiratory tract infections of the community as well as of nosocomial origin, including a large number of penicillin-resistant Streptococcus pneumoniae infections, skin and soft-tissue infections, surgical infections, as well as therapy for infections in neutropenic hosts. Cure rates are similar to or better than those obtained with ceftazidime, cefotaxime and ceftriaxone. The author also points out the various precautions necessary in utilizing these two antimicrobial agents.

Topics: Bacterial Infections; Cefepime; Cefpirome; Cephalosporins; Clinical Trials as Topic; Humans; Respiratory Tract Infections; Urinary Tract Infections

This study evaluated the sputum penetration of cefpirome following slow intravenous infusion of 0.5 and 1.0 g using a comparative cross-over design to reduce variability. Five patients with chronic respiratory tract infections were randomized to receive either 0.5 g followed by 1.0 g, or by 1.0 g followed by 0.5 g cefpirome, by slow intravenous infusion over 1 h, with a 24-h wash-out period between each treatment. With the exception of one patient, sputum concentration correlated well with plasma concentration. Higher sputum levels of cefpirome were achieved following the higher dose.

Topics: Adult; Aged; Cefpirome; Cephalosporins; Chronic Disease; Dose-Response Relationship, Drug; Female; Humans; Infusions, Intravenous; Male; Middle Aged; Respiratory Tract Infections; Sputum

The efficacy and safety of cefpirome was reviewed from the documentation of comparative pivotal trials in patients with urinary tract or lower respiratory tract infections UTIs and LRTIs, respectively). A majority of patients with UTIs had pyelonephritis and/or complicated UTIs. Most patients with LRTIs had community acquired pneumonia. Studies of UTI included 865 patients treated with cefpirome 1 g bid and 443 patients allocated to ceftazidime 1 g bid. Satisfactory clinical outcome was reported in 87% and 83%, respectively. Eradication of organisms causing bacteriuria was achieved in 87% and 86%, respectively. In the LRTI trials 199 patients received cefpirome 1 g bid and in 653 patients it was dosed 2 g bid. Comparators were ceftazidime 2 g bid (N = 197) or 2 g tid (N = 296) or ceftriaxone 1 g bid (N = 77). With all treatments unsatisfactory clinical or bacteriological outcome was recorded in < 15% of the patients. The safety of cefpirome and comparators was evaluated in pivotal phase II and III studies and deaths were analysed in all clinical trials for which data were available by June 30th 1991. Cefpirome did not differ from comparators in terms of frequencies or distribution within body systems of adverse events. Death rates were 3.9% in 9189 patients receiving cefpirome and 5.1% in 3162 receiving a comparator. The deaths were in an absolute majority of cases not considered related to study drug given. The most common cause of death was infection, indicating that the trial samples were selected from populations of patients with serious infections. Cefpirome was as safe and efficaceous as its comparators and is a new injectable cephalosporin with broader spectrum than ceftazidime. It should be a suitable alternative for empiric treatment of serious infections in hospitalised patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cefpirome; Cephalosporins; Double-Blind Method; Female; Humans; Male; Middle Aged; Respiratory Tract Infections; Single-Blind Method; Urinary Tract Infections

In order to determine the optimal dose of cefpirome sulfate (HR810, CPR) against respiratory tract infections (RTI), an optimal dose-finding study was conducted on cases of chronic RTI, and the clinical properties of the drug were compared with those of ceftazidime (CAZ). Inpatients with chronic RTI were randomly assigned to 3 groups: an HR 0.5 g group, receiving 0.5 g X 2/day of CPR an HR 1.0 g group, receiving 1.0 X 2/day of CPR and a CAZ group, receiving 1.0 g X 2/day of CAZ. As a rule, the drugs were administered by intravenous drip infusion for 14 days, after which period clinical efficacy, bacteriological response, safety, and utility were investigated. Of the total 121 cases, 106 were subject to analysis of clinical efficacy, including 38 cases in the HR 0.5 g group, 32 in the HR 1.0 g group, and 36 in the CAZ group. Efficacy rates in the assessment by the committee were 84.2% for the HR 0.5 g group, 75.0% for the HR 1.0 g group, and 86.1% for the CAZ group, without any significant difference between the 3 groups. The bacterial elimination rates were 73.9%, 75.0% m and 88.5%, respectively, without any significant difference between the 3 groups. Associated reactions were noted in 2 of 36 cases in the HR 1.0 g group (eruption and diarrhea), but not in the other 2 groups. The incidence of abnormal clinical laboratory findings was 23.1% in the HR 0.5 g group, 22.2% in the HR 1.0 g group, and 22.5% in the CAZ group, without any significant difference between the 3 groups. Utility rates were 84.2% for the HR 0.5 g group, 74.2% for the HR 1.0 g group, and 86.1% for the CAZ group, without any significant difference between the 3 groups. The HR 0.5 g and 1.0 groups showed no difference in clinical efficacy, bacteriological response, safety, and utility against RTI, and the results of both groups were about equal to those of the CAZ group.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cefpirome; Ceftazidime; Cephalosporins; Chi-Square Distribution; Chronic Disease; Drug Evaluation; Female; Humans; Male; Middle Aged; Random Allocation; Respiratory Tract Infections

Efficacy and safety of a new injectable cephem antibiotic, cefpirome sulfate (hereafter, CPR), against respiratory tract infections were examined and compared with those of a control drug, ceftazidime (hereafter, CAZ). As a rule, CPR 0.5 g twice a day, 1.0 g twice a day, or CAZ 1.0 g twice a day (hereafter CPR 0.5 g group, CPR 1.0 g group, and CAZ group) was administered for 14 days and the following results were obtained. 1. The total number of cases was 470 (155 cases in the CPR 0.5 g group, 160 cases in the CPR 1.0 g group, and 155 cases in the CAZ group). Among them 390 cases were subjected to analyses of clinical efficacy by the efficacy evaluation committee (131 cases in the CPR 0.5 g group, 131 cases in the CPR 1.0 g group and 128 cases in the CAZ group). 2. Efficacy rates determined by the efficacy evaluation committee were 82.4% (108/131) for the CPR 0.5 g group, 81.7% (107/131) for the CPR 1.0 g group, and 83.6% (107/128) for the CAZ group. Efficacy rates determined by the physician in charge were 82.0% (105/128) for the CPR 0.5 g group, 80.5% (99/123) for the CPR 1.0 g group, and 88.5% (108/122) for the CAZ group. No statistically significant difference was observed among the 3 groups. In evaluation of equivalency, clinical efficacy for the CPR 0.5 g group and the CPR 1.0 g group determined by the clinical efficacy evaluation committee was proved to be statistically equivalent to that for the CAZ group. 3. In patients with pneumonia, efficacy rates determined by the efficacy evaluation committee were 87.1% (61/70) for the CPR 0.5 g group, 80.7% (71/88) for the CPR 1.0 g group, and 78.9% (56/71) for the CAZ group. Efficacy rates determined by the physician in charge were 85.3% (58/68) for the CPR 0.5 g group, 80.7% (67/83) for the CPR 1.0 g group, and 86.2% (56/65) for the CAZ group and no statistically significant difference was observed among the 3 groups. In patients with chronic respiratory tract infection, efficacy rates determined by the efficacy evaluation committee were 77.0% (47/61) for the CPR 0.5 g group, 83.7% (36/43) for the CPR 1.0 g group, and 89.5% (51/57) for the CAZ group. Efficacy rates determined by the physician in charge were 78.3% (47/60) for the CPR 0.5 g group, 80.0% (32/40) for the CPR 1.0 g group, and 91.2% (52/57) for the CAZ group. No statistically significant difference was observed among the 3 groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cefpirome; Ceftazidime; Cephalosporins; Female; Humans; Male; Middle Aged; Respiratory Tract Infections

Antibiotics not only support to alleviate the infections but also facilitate to avert the multiplication of microbes. Due to the irrational use of antibiotics, the resistance of antibiotics has been augmented which results may increase in morbidity and mortality with the span of time. World renowned regulatory bodies like Food and Drug Administration (FDA), Center of Disease Control and Prevention (CDC), and World Health Organization (WHO) vigorously advocate the surveillance of the resistance of antibiotics. During the present study by Kirby-Bauer disk diffusion method 141 clinical isolates of Staphylococcus aureus (n=47, 33.34%), Escherichia coli (n=54, 38.3%), Proteus species (n=26, 18.4%), and Klebsiella pneumoniae (n=14, 9.92%) are evaluated against cefepime and cefpirome which comes of fourth generation cephalosporin. It has been found that cefpirome has better bactericidal activity than cefepime against E. coli and K. pneumoniae while cefepime has been possessed better antibacterial activity against S. aureus and Proteus species which were isolated from respiratory tract infections, blood stream infection, intra-abdominal and urinary tract infections, and skin and soft tissue infections. K. pneumoniae, E. coli, Proteus species, and S. aureus were 34.8%, 26.3%, 11.3%, and 37.7% resistance against cefepime respectively. S. aureus, E. coli, K. pneumoniae, Proteus species has shown 41.4%, 21.7%, 17.6%, and 8.9% resistance against cefpirome correspondingly.

Topics: Anti-Bacterial Agents; Bacteremia; Cefepime; Cefpirome; Cephalosporins; Drug Resistance, Bacterial; Escherichia coli; Escherichia coli Infections; Humans; In Vitro Techniques; Intraabdominal Infections; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Pakistan; Proteus; Proteus Infections; Respiratory Tract Infections; Skin Diseases, Bacterial; Soft Tissue Infections; Staphylococcal Infections; Staphylococcus aureus; Urinary Tract Infections

The in-vitro activity of cefpirome, a new injectable cephalosporin, was compared with that of several other antibiotics against bacterial isolates from hospitalized patients with lower respiratory tract infections, urinary tract infections and wound infections. Minimum inhibitory concentrations were determined for 874 strains against 16 antibiotics using a microtitration technique. Cefpirome showed a very broad spectrum of activity against most pathogens tested. The spectrum included organisms such as Staphylococcus spp., enterococci, Enterobacter spp., and Pseudomonas spp. which are frequently resistant to third generation cephalosporins.

Topics: Anti-Bacterial Agents; Cefpirome; Cephalosporins; Enterobacteriaceae; Humans; Microbial Sensitivity Tests; Pseudomonas; Respiratory Tract Infections; Staphylococcus aureus; Urinary Tract Infections; Wound Infection

The concentrations of cefpirome, a new semi-synthetic cephalosporin, in the bronchial mucosa and serum were assessed after a single 1 g intravenous dose in 37 patients. Bronchoalveolar lavage allowed epithelial lining fluid (ELF) concentrations to be measured in eight subjects. The mean concentration for serum was 34.5 mg/L (S.E.M. 3.3), for bronchial mucosa 19.3 mg/kg (S.E.M. 1.9) and for ELF 7.2 mg/L (S.E.M. 1.1). The progressive reduction in cefpirome concentration in serum compared to that in bronchial mucosa and ELF is consistent with the permeability characteristics of beta-lactam antimicrobials and the barriers to movement of antimicrobial agents present in the lung.

Topics: Adult; Aged; Aged, 80 and over; Bronchoalveolar Lavage Fluid; Cefpirome; Cephalosporins; Epithelium; Female; Humans; Lung; Male; Middle Aged; Mucous Membrane; Respiratory Tract Infections

Cefpirome (CPR, HR 810) was clinically evaluated for its efficacy and safety in 11 patients with ages from 4 months to 11 years with bacterial infection. The results obtained are summarized as follows. 1. CPR was administered to 6 patients with bronchopneumonia, a patient with pneumonia, a patient with tonsillitis, 2 patients with acute pharyngitis and a patient with suppurative parotitis at daily dosage levels ranging 55.5-91.7 mg/kg, divided into 3 using intravenous bolus injection or 30 minutes drip infusion. Clinical responses of the 11 patients were as follows: excellent; 8 patients, good; 2 patients, poor; 1 patient, hence the efficacy rate was 90.9%. 2. Neither clinical adverse reaction nor abnormal laboratory test value was observed except slight elevation of GOT and GPT in a patient and leukopenia in another. 3. MICs of CPR against 18 beta-lactamase producing strains isolated from patients were as follows. MIC against a strain of Staphylococcus aureus was 1.56 micrograms/ml, MICs against 3 strains of Klebsiella pneumoniae were less than 0.025 microgram/ml, those against 3 out of 5 strains of Enterobacter cloacae were less than 0.025 microgram/ml and those against the remaining 2 strains were 0.05 and 0.20 micrograms/ml. MICs against 2 out of 3 strains Acinetobacter lwoffi were 1.56 micrograms/ml, and that of the remaining 1 strain was 0.39 microgram/ml. MICs against 2 strains of Pseudomonas cepacia were 1.56 micrograms/ml. MICs against a strain of Pseudomonas putida and a strain of Citrobacter diversus were 0.78 and less than 0.025 microgram/ml, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Age Factors; Bacteria; Cefpirome; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Female; Humans; Infant; Infusions, Intravenous; Injections, Intravenous; Male; Respiratory Tract Infections

We have carried out laboratory and clinical studies on cefpirome (CPR, HR 810). The results are summarized as follows. CPR was given by 30-minute drip infusion to 3 children at a single dose of 20 mg/kg. After the 30-minute drip infusion, the mean peak serum level of CPR was 65.7 +/- 2.2 micrograms/ml at the end of infusion, and the mean half-life was 1.49 +/- 0.046 hours. The mean urinary excretion rate of CPR was 57.0 +/- 25.8% in the first 8 hours after the 30-minute drip infusion of 20 mg/kg. Treatment with CPR was made in 9 cases of pediatric bacterial infections; 1 case each of tonsillitis, pharyngitis, and bronchopneumonia, 4 cases of pneumonia, 2 cases of urinary tract infection. Results obtained were excellent in 6 cases, good in 3 cases. No significant side effects due to the drug were observed except one case of elevated GOT and GPT, and 3 cases of eosinophilia.

Topics: Adolescent; Age Factors; Bacteria; Cefpirome; Cephalosporins; Child; Child, Preschool; Humans; Infant; Infusions, Intravenous; Injections, Intravenous; Respiratory Tract Infections; Urinary Tract Infections

Cefpirome (CPR), a new synthetic cephalosporin antibiotic, was administered to 10 patients with infectious diseases. The patients included 5 boys and 5 girls from 1 month to 5 years of age. They were given the drug intravenously at dosages ranging 53-100 mg/kg/day for 4 to 10 days. Clinical efficacy was evaluated in 9 patients: excellent in 2 patients, good in 6 patients and fair in 1 patient. The overall efficacy rate was 88.9%. No adverse effects were observed except in one patient who showed a slight increase of serum GOT and GPT.

Topics: Acute Disease; Age Factors; Cefpirome; Cephalosporins; Child, Preschool; Colitis; Drug Evaluation; Female; Humans; Infant; Injections, Intravenous; Male; Respiratory Tract Infections

Pharmacokinetics and clinical effects of cefpirome (CPR, HR 810) in children were studied. When 20 mg/kg and 40 mg/kg doses of CPR were administered to 4 children through 30 minutes' drip infusion, half-lives were 1.23 +/- 0.23 (mean +/- S.D.) hours and 1.37 +/- 0.35 (mean +/- S.D.) hours, respectively for the 2 dose levels, and recovery rates in urine in the first 6 hours after administration were 74.8% and 56.1%, respectively. CPR was administered to 15 cases (3 tonsillitis, 3 bronchitis, 5 bronchopneumonia, 1 acute cystitis, 1 coxoiliatitis, 1 otitis media, 1 otitis externa). The efficacy rate was 86.7%. Seven strains of bacteria were isolated and identified 4 Haemophilus influenzae, 3 Staphylococcus aureus, 1 Pseudomonas sp. from these cases. These bacteria in children were followed after administration of CPR. Six strains were eradicated and one was reduced in number. No adverse effects of CPR were observed except in 2 cases, one of which showed transient eosinophilia and the other showed a transient increase of transaminase. These results suggest that CPR may be an effective and safe drug to use on children clinically.

Topics: Absorption; Adolescent; Bacterial Infections; Cefpirome; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Haemophilus Infections; Haemophilus influenzae; Half-Life; Humans; Infant; Male; Respiratory Tract Infections; Staphylococcal Infections

Pharmacokinetic and clinical studies of cefpirome (CPR) in children were carried out, and the following results were obtained. 1. Peak serum levels were obtained at the end of drip infusion of 20.0, 17.5 and 6.8 mg/kg for 30 minutes and the half-lives were 1.93, 1.91 and 0.48 hours, respectively. 2. Urinary excretion rates in 6 hours were 40.0-96.2%. 3. Thirty-two patients including 17 with respiratory infections, 7 with urinary tract infections and 8 with skin and soft tissue infections were treated with CPR at 52.2-92 mg/kg per day by intravenous administration. Clinical effects were excellent in 12 cases, good in 13 cases, fair in 3 cases and unknown in 4 cases, and the overall efficacy rate was 89.3% (25 cases/28 cases). 4. Bacterial eradication rate was 93.8% (15 strains/16 strains). 5. Rash and diarrhea were found in 1 case each, and abnormal laboratory test values were found in 7 cases.

Topics: Adolescent; Bacterial Infections; Cefpirome; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Half-Life; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections

This study describes the pharmacokinetic characteristics and clinical usefulness of cefpirome (CPR) in children. Mean half-lives of 20 mg/kg and 40 mg/kg of CPR injected intravenously in one shot were 1.18 and 1.34 hours, respectively, and their mean recovery rates into urine were 69.8 and 72.2%, respectively. Minimum inhibitory concentrations of CPR against Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli and Haemophilus influenzae were the same as or lower than those of ceftazidime. CPR was clinically effective in 14/15 of patients with bacterial infections; 8/9 of pneumonia, 2/2 of bronchitis, 1/1 of pharyngitis, 1/1 of tonsillitis, 1/1 of osteomyelitis, 1/1 of urinary tract infection. No clinically overt side effects of CPR were found, while an increase of eosinophils in blood was observed in 2 cases, and an increase of platelet in blood in 1 case and an elevation of serum GPT activity in 1 case were also observed. These findings indicate that CPR is useful for the treatment of bacterial infections in children.

Topics: Adolescent; Bacteria; Bacterial Infections; Cefpirome; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Half-Life; Humans; Infant; Male; Microbial Sensitivity Tests; Respiratory Tract Infections

The clinical efficacy and the pharmacokinetics of cefpirome (CPR, HR 810), a new semisynthetic cephalosporin derivative, were investigated in children with various infectious diseases. CPR showed high blood peak levels, relatively long half-life and high levels in urine. Excellent clinical efficacy was obtained in 2/3 cases with pneumonia, 3/4 cases with upper respiratory infection, 2/2 cases with cutaneous and soft tissue infection and 1/1 case with urinary tract infection. The overall efficacy rate was 80%. No clinical adverse effects were observed while slightly elevated GPT and GOT, decreased platelet were detected in 4 cases without clinical problems. CPR should be an useful and safe drug in treating infectious diseases in children.

Topics: Adolescent; Bacterial Infections; Cefpirome; Cephalosporins; Child; Child, Preschool; Drug Evaluation; Female; Humans; Infant; Male; Respiratory Tract Infections; Urinary Tract Infections