Labolatory and clinical studies with cefepime

Koutaro Mitsutake, Yasuhito Higashiyama, Haruko Matsuda, Yoshitsugu Miyazaki, Yuko Yoshitomi, Shigefumi Maesaki, Hiroshi Yamada, Akira Yasuoka, Kazuo Sasayama, Hironobu Koga, Shigeru Kouno, Kohei Hara, Chikako Mochida, Kazuyuki Sugawara, Mitsuo Kaku, Rokushi Oka, Kazuhiro Okuno, Hiroshi Soda, Yoshito Tanaka, Hideo MasumotoNaofumi Suyama, Sadahiro Asai, Masanori Iwamoto, Yuichi Inoue, Toru Ishino, Mikio Oka, Naoko Murayama, Fumiyuki Kuze

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The new developed broad-spectrum cephalosporin, cefepime (CFPM), was evaluated in vitro and in vivo in comparison with ceftazidime (CAZ), cefoperazone (CPZ), cefotaxime (CTX), piperacillin (PIPC) and gentamicin (GM). The results were as follows; 1. Antimicrobial activity : Minimal inhibitory concentration (MICs) against 210 clinical isolates including 7 different species were determined by microbroth dilution method. CFPM showed excellent antimicrobial activity against Gram-positive and -negative bacteria except methicillin-resistant Staphylococcus aureus. MICs of CFPM were the same or greater than those of the other 3rd generation cephems, PIPC and GM even against Pseudomonas aeruginosa. 2. CFPM concentration in serum and sputum : A patient with diffuse panbronchiolitis was given 1 g of CFPM intravenously and its concentration in serum and sputum were measured at intervals using HPLC. A peak serum concentration of 30 μ/ml was achieved at the end of the 60 minutes infusion, and peak sputum level of 2.0 μ/ml was observed 3-4 hours after the infusion. This suggests that CFPM has rapid and good penetration into the lung. 3. Clinical efficacy and adverse reactions : Twenty one patients with respiratory tract infections were treated with CFPM with an overall efficacy rate of 84.2 % (excellent in 3 cases, good in 13, fair in 1, poor in 2, not evaluable in 2). As to side effects, skin eruption in 1 case, ill feeling in 1 and abdominal pain with loosen stool in 1 were observed. Elevation of LDH in 1 case, GPT and ³-GTP in 1, GPT in 1, and decrease of leukocyte, monocyte, platelets and elevation of GOT, LDH, totalbilirubin, urobilinogen in 1 were observed as abnormal laboratory findings. Most of these were mild and improved rapidly after completion of CFPM. However, slight elevation of GPT in 1 case and a positive reaction in the direct Coombs test in another case have not been followed up.

Original languageEnglish
Pages (from-to)180-187
Number of pages8
JournalChemotherapy
Volume39
DOIs
Publication statusPublished - 1991
Externally publishedYes

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases
  • Pharmacology
  • Drug Discovery
  • Oncology

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  • Cite this

    Mitsutake, K., Higashiyama, Y., Matsuda, H., Miyazaki, Y., Yoshitomi, Y., Maesaki, S., Yamada, H., Yasuoka, A., Sasayama, K., Koga, H., Kouno, S., Hara, K., Mochida, C., Sugawara, K., Kaku, M., Oka, R., Okuno, K., Soda, H., Tanaka, Y., ... Kuze, F. (1991). Labolatory and clinical studies with cefepime. Chemotherapy, 39, 180-187. https://doi.org/10.11250/chemotherapy1953.39.Supplement2_180