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[Clinical effects of cefodizime in severe infections complicated with hematological diseases. Hanshin Infection Study
H Teshima1, T Masaoka, A Hiraoka
1Fifth Department of Internal Medicine, Center for Adult Diseases, Osaka.
Insights
Cefodizime (CDZM) shows moderate efficacy in treating severe infections in hematological disease patients, with a 55.4% overall success rate. This antibiotic demonstrated higher effectiveness against Gram-negative bacteria and was generally well-tolerated.
Area of Science:
- Infectious Diseases
- Hematology
- Pharmacology
Background:
- Severe infections frequently complicate hematological diseases, necessitating effective antimicrobial therapy.
- Cefodizime (CDZM) is a cephalosporin antibiotic with broad-spectrum activity.
- Evaluating CDZM's efficacy and safety in this vulnerable patient population is crucial.
Observation:
- A study involved 138 patients with severe infections and hematological diseases treated with intravenous CDZM (2-8 g daily for 3-18 days).
- Clinical efficacy was observed in 68 patients (excellent/good response), with an overall efficacy rate of 55.4%.
- Higher efficacy was noted against Gram-negative bacteria (66.7%) compared to Gram-positive bacteria (28.6%).
Findings:
- The overall clinical efficacy rate for cefodizime was 55.4%.
- Efficacy rates did not significantly differ based on initial neutrophil counts.
- Adverse events were infrequent, including skin eruption (1.5%), hepatic disorders (5.0%), and minor renal or urinary abnormalities.
Implications:
- Cefodizime demonstrates clinical utility as an antibiotic option for severe infections in patients with hematological disorders.
- Its safety profile appears acceptable, with manageable adverse events.
- Further research may explore optimizing CDZM use in specific hematological conditions.
Abstract:
One hundred thirty-eight patients with severe infections accompanying hematological diseases were treated with cefodizime (CDZM). CDZM was administered by intravenous injection at daily doses ranging from 2 g to 8 g for about 3 to 18 days. Clinical efficacies of CDZM were excellent in 30 cases, good in 37 cases, fair in 1 case and poor in 53 cases. The efficacy rate was 55.4%. The efficacy rate was 56.4% in patients from whom causative organisms were not identified. The efficacy rate against Gram-negative bacteria (66.7%) was higher than that against Gram-positive bacteria (28.6%). No significant differences in the efficacy rates were found among groups of patients with different initial neutrophil counts (less than 100, 100-499, and over 500/microliters). Skin eruption caused by CDZM was observed in 2 patients (1.5%). Hepatic disorders, renal dysfunction and urinary test abnormality (protein and urobilinogen) were observed in 7 (5.0%), 1 (0.7%) and 1 (0.7%), respectively. Therefore, CDZM was considered to be a clinically useful antibiotic for severe infections complicated with hematological diseases.