BACTERIOSTATIC AND BACTERICIDAL ACTIVITY OF CEFPIROM ON PNEUMOCOCCI -REVIEWING PUBLICATIONS

Cefpirom (Cefrom (R) - Roussel Uclaf) is an injectable cephalosporin, the major characteristic of which, compared to cefotaxim, is its posit ive action on cephalosporinase producing enterobacteriaceae, its exten ded spectrum on Pseudomonas aeruginosa, and aerobic Gram positive cocc i. Its distinctive activity on these last species lead us to review li terature on Streptococcus pneumoniae. For bacteriostasis, cefpirom wou ld be the most active third generation cephalosporin on Peni-I or Peni -R pneumococci. Some scarce studies on bactericidal kinetics described cefpirom as having a bactericidal activity comparable to that of cefo taxim, as well as being synergistic with vancomycin, rifampicin, and f osfomycin. This activity was confirmed in vivo on experimental meningi tis model in rabbits. Cefpirom level in the CFS is higher than MBC for penicillin resistant pneumococci responsible for meningitis. The emer gence of pneumococci resistant to third generation cephalosporins lead s us to consider antibiotic combinations, especially for meningitis. I n this prospect, combination with fosfomycin, vancomycin, or rifampici n should be considered.