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Clinical trials on pediatric lower-respiratory-tract infection: results and comments with cefetamet pivoxil
J Paupe1, M Sarbeji, P Scheinmann
1Enfants-Malades, Hôpital Necker, Paris, France.
Insights
This study found that cefetamet pivoxil at 10 or 20 mg/kg twice daily was as effective as cefaclor for treating pediatric lower-respiratory-tract infections, with similar clinical outcomes and safety profiles.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology and Therapeutics
- Respiratory Medicine
Background:
- Lower-respiratory-tract infections (LRTI) are common in children.
- Antibiotic resistance necessitates evaluation of alternative treatments.
- Cefetamet pivoxil is a third-generation cephalosporin with broad-spectrum activity.
Purpose of the Study:
- To compare the efficacy and safety of two doses of cefetamet pivoxil against cefaclor in pediatric LRTI.
- To evaluate clinical and radiological outcomes.
- To assess adverse events associated with the treatments.
Main Methods:
- Open-label, randomized study involving 30 pediatric patients.
- Three arms: cefetamet pivoxil (10 or 20 mg/kg b.i.d.) and cefaclor (10 mg/kg t.i.d.) for 7-12 days.
- Demographic, clinical, radiological, and adverse event data were collected.
Main Results:
- Overall cure rates were high and comparable across groups (9/10, 8/10, 9/10).
- Significant improvement in signs, symptoms, vital signs, and radiological findings observed in all groups.
- Adverse events, primarily mild gastrointestinal upset and transient thrombocytopenia, were infrequent and similar across treatments.
Conclusions:
- Cefetamet pivoxil, at both tested doses, demonstrates comparable efficacy and safety to cefaclor for pediatric LRTI.
- Cefetamet pivoxil represents a viable therapeutic option for pediatric lower-respiratory-tract infections.
- Further research could explore optimal dosing and long-term outcomes.
Abstract:
A total of 30 pediatric patients suffering from lower-respiratory-tract infections were admitted to a three-arm, open, randomized study comparing two different doses of cefetamet pivoxil (either 10 or 20 mg/kg b.i.d.; groups A and B, respectively) with the standard cefaclor treatment (10 mg/kg t.i.d.; group C) for 7-12 days. The 30 cases were randomly assigned to the three treatment arms which were comparable with regard to demographics as well as to diagnosis on admission and concomitant medication. The children ranged from 1.08 to 12 years in age, and comprised 18 males and 12 females, with a weight range of 11-42 kg. As is to be expected in these patients, bacteriology was mostly not assessable. The overall clinical outcome was cure in 9, 8 and 9 cases, respectively, and improvement in 1, 2 and 0 cases, respectively. In the cefaclor group 1 patient failed to respond. Signs and symptoms of disease improved significantly in the three treatment groups; there were no intergroup differences. Vital signs (morning and evening temperature and pulse rate) improved in parallel. Radiological results had improved by the end of treatment in 9/10 patients in group A, in 10/10 patients in group B, and in 9/10 evaluable patients in group C. Mild to moderate nausea or vomiting were each reported in 1 patient in group A. Platelet increase was reported as a mild adverse event in 2 patients in each of the cefetamet pivoxil groups and in 4 patients given cefaclor.(ABSTRACT TRUNCATED AT 250 WORDS)