EFFICACY OF CEFPIROME IN THE TREATMENT OF SEPTICEMIA

From a total of 4180 patients entered in 15 phase II-III clinical tria ls involving cefpirome, an analysis was carried out on 378 patients wi th bacteriologically confirmed or suspected septicaemia who were treat ed with cefpirome (n = 282) or comparator drugs (ceftazidime, n = 80; ceftriaxone, n = 15; imipenem/cilastatin, n = 1). Gram-negative organi sms were the causative pathogens in over half of the patients, with Es cherichia coli being the most common species found. The most frequentl y isolated Gram-positive bacterium was Streptococcus pneumoniae. Causa tive organisms were eradicated in over 90% of patients receiving cefpi rome or comparators. Only 4/230 pathogens tested were resistant to cef pirome in vitro. Among patients with bacteriologically confirmed septi caemia, a satisfactory clinical response was documented in 131/176 (74 %) cefpirome vs 34/50 (68%) ceftazidime vs 5/10 (50%) ceftriaxone reci pients, improvement in 39/176 (22%) vs 11/50 (22%) vs 5/10 (50%), and failure in 6/176 (4%) vs 5/50 (10%) vs 0/10 (0%). respectively. Simila r results were achieved in patients with 'suspected' septicaemia. Cefp irome 1 or 2 g twice daily offers an effective treatment option for pa tients with septicaemia. The higher dosage regimen produced superior b acteriological clearance rates and is therefore preferable in patients with severe septicaemia.