Efficacy and Safety of Twice Daily Administration of Cefpirome in the Empiric Treatment of Sepsis
PANPIT SUWANGOOL, M.D.', CHUREERATANA BOWONWATANUWONG, M.D. SANG-A-ROON KULPRADIST, M.D., Ph.D.5, PANTIP CHAYAKUL, M.D.7, SOMBAT LEELASUPASRI, M.D.9, CHUANPIT SUTTINONT, M.D.2, ADUL RAJANUWONG, M.D. VISITH DUSITNANOND, M.D.6, PLOENCHAN CHETCHOTISAKD,M.D.8, NALINEE ASWAPOKEE, M.D., M.M.Sc. 10
Affiliation : 1 Department of Medicine, Faculty of Medicine, Chulalongkom Hospital, Bangkok 10330, 2 Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima 30000, 3 Department of Internal Medicine, Chonburi Regional Hospital, Chonburi 20000, 4 Department of Medicine, Sappasittiprasong Hospital, Ubonratchathani 34000, s Infectious Unit, Department of Medicine, Vajira Hospital Medical School, Bangkok I 0300, 6 Infectious Diseases Division, Bhurnibol Adulyadej Hospital, Bangkok 10900, 7 Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Y ai, Songkhla 90110, 8 Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, 9 Infectious Diseases Division, Department of Medicine, Pramongkutklao Hospital, Bangkok 10400, 10 Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Cefpirome is a fourth-generation ceJ>!l~lo~_rin with good activity against both gram-posi- tive and gram-negative bacteria. A multicentre trial was performed to study the efficacy and safety of cefpirome 2 g twice daily in the treatment of sepsis. Sixty-three cases were recruited from 10 hospitals from April 1996 to January 1998. Fifty seven cases could be evaluated according to the protocol. The APACHE II score was used to measure severity of illness, with 46.9 per cent of patients having APACHE II score more than 10 and two patients more than 20; both were cured. The most common pathogens were gram-negative bacteria with E. coli predominating 16/40 ( 40.0% ), followed by Klebsiella 8/40 (20.0% ). The overall clinical success rates were 54 out of 57 patients (94. 7% ). In patients with positive blood culture, the clinical cures were achieved for 20/22 (90.9%). Cefpirome showed good efficacy and safety in the empirical treatment of suspected bacteremia or sepsis.
Keywords : Cefpirome, Sepsis, Efficacy, Safety
