A Comparative Study between cefpirome (CPR) and ceftazidime (CAZ) in Respiratory Tract Infections

• Published in: Kansenshogaku Zasshi Vol. 65; no. 4; pp. 400 - 422
• Main Authors: OKIMOTO, Niro, YAMAGUCHI, Etsuro, KIKUIRI, Tsuyoshi, SHINOHARA, Masahide, SATO, Mitsuo, SEKINE, Kyuichiro, YASUDA, Shinya, KOROKU, Tetsuji, ITO, Susumu, ONODERA, Sokichi, OTA, Takafumi, SAKAI, Eiichi, SHIMIZU, Tetsuo, FUJIKANE, Toshiaki, TAMURA, Toyokazu, ENDO, Katsumi, MURABAYASHI, Hideya, KONISHI, Kazuki, YOSHIDA, Taiji, BANDO, Takeshi, SATO, Nobuhisa, UNOURA, Tetsuro, TANNO, Yasuo, ISHII, Munehiko, SUGIYAMA, Masaharu, NAGAI, Kosaku, SATO, Kazuo, SHIDA, Kuniharu, SHINDO, Satoshi, YOSHIDA, Masaki, SAITO, Atsushi, HORI, Seiji, SAKAI, Osamu, KOBAYASHI, Hiroyuki, OSHITANI, Hiroshi, MIURA, Hiroshi, INOUE, Takashi, GOTO, Hajime, SANO, Yasuyuki, NAKAMORI, Yoshitaka, NARUI, Koji, NOGUCHI, Masayuki, NAKATANI, Tatsuo, NAKATA, Koichiro, ODAGIRI, Shigeki, MATSUMURA, Masanori, SUZUKI, Kaneo, WADA, Koichi, SATAKE, Tatsuo, SUZUKI, Ryujiro, TANAKA, Hitoshi, IMAI, Masatoshi, HAYASHI, Yoshimitsu, YAMAMOTO, Kazuhide, YAMADA, Yasuo, CHIBA, Masaru, NAGAI, Hitoshi, EBISUI, Osamu, IWASAKI, Hironobu, BANDO, Kenji, NISHIMURA, Takashi, ISHIDA, Sunao, OHSHIMA, Shunsaku, MIKI, Fumio, TSUBURA, Eiro, ISHIKAWA, Seiko, HASHIMOTO, Yoshihiro, SAWAKI, Masayoshi, KIMURA, Makoto, KURIMURA, Tadasu, FUKUHARA, Hirofumi, SUGIMOTO, Yuji, SAWAE, Yoshiro, TAKAGI, Koji, SHIGEMATSU, Nobuaki, HAYASHI, Shinichiro, ONUKI, Keisuke, TOHARA, Shinichi, OKUDAIRA, Katsumi, SAKAUE, Akihiko, ICHIKAWA, Yoichiro, KAWAHARA, Masashi, YAMAGUCHI, Keizo, KONO, Shigeru, KOGA, Hironobu, KAKU, Mitsuo, DOTSU, Yasumasa, YAMADA, Hiroshi, FUKUSHIMA, Kiyoyasu, SUYAMA, Naofumi, HAYASHI, Toshiaki, NAGATAKE, Tsuyoshi, AKIYAMA, Moritoshi, SHIMA, Kiyoshi, NASU, Masaru, GOTO, Jun, NAGAI, Hiroyuki, AKASHI, Mitsunobu, KITSUKAWA, Keizo, OGAWA, Nobuya
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Japanese Association for Infectious Diseases 01.04.1991
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cefpirome; cefpirome sulfate; ceftazidime; Ceftazidime - therapeutic use; Cephalosporins - therapeutic use; comparative study; CPR; Female; Humans; Male; Middle Aged; respiratory tract infection; Respiratory Tract Infections - drug therapy
• ISSN: 0387-5911; 1884-569X
• DOI: 10.11150/kansenshogakuzasshi1970.65.400

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. 4. Bacteriological efficacy was judged by bacterial eradication rates, which were 86.6%(58 strains out of 67 strains) for the CPR 0.5 g group, 87.9% (58 strains out of 66 strains) for the CPR 1.0 g group, and 93.0% (66 strains out of 71 strains) for the CAZ group. No statistically significant difference was observed among the 3 groups. 5. Adverse events occurred in 3 (2.1%) of the CPR 0.5 g group patients, 8 (5.6%) of the CPR 1.0 g group patients, and 9 (6.4%) of the CAZ group patients. No statistically significant difference was observed among the 3 groups. The incidences of abnormal laboratory findings were 21.3%(29/136) for the CPR 0.5 g group, 35.7%(46/129) for the CPR 1.0 g group and 24.8%(32/129) for the CAZ group and there was significant difference among the incidences of the 3 groups. Multiple comparison demonstrated that neither the CPR 0.5 g group nor the CPR 1.0 group was significantly different from the CAZ group in the incidence but the CPR 1.0 g group showed a significantly higher incidence of abnormal laboratory findings than the CPR 0.5 g group (p<0.05). 6. Utility rates determined by the efficacy evaluation committee were 81.1%(107/132) for the CPR 0.5 g group, 79.5%(105/132) for the CPR 1.0 g group, and 79.2%(103/130) for the CAZ group. No statistically significant difference was observed among the 3 groups. Utility rates for pneumonia and chronic respiratory tract infection were not significantly different among the 3 groups.