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[Pharmacokinetic and clinical studies of cefpirome in pediatric field]
Insights
Cefpirome (CPR) demonstrated favorable pharmacokinetics and achieved a 100% efficacy rate in pediatric patients with various infections. This cephalosporin antibiotic showed good plasma and cerebrospinal fluid concentrations, with minimal side effects like rash.
Area of Science:
- Pediatric Pharmacology
- Infectious Diseases
- Antibiotic Therapy
Background:
- Cefpirome (CPR) is a cephalosporin antibiotic.
- Understanding its pharmacokinetics and clinical efficacy in children is crucial for effective treatment.
Purpose of the Study:
- To evaluate the pharmacokinetics of cefpirome (CPR) in a pediatric patient.
- To assess the clinical application and efficacy of CPR in children with diverse bacterial infections.
- To compare CPR with cefotaxime (CTX) in a case of pediatric suppurative meningitis.
Main Methods:
- Pharmacokinetic analysis of a single intravenous dose of CPR in an infant.
- Measurement of plasma and cerebrospinal fluid concentrations of CPR and cefotaxime (CTX) in a pediatric meningitis patient.
- Clinical evaluation of CPR in 18 pediatric patients with infections caused by Gram-positive and Gram-negative bacteria.
Main Results:
- In an infant, CPR exhibited a plasma half-life of 2.36 hours.
- In a meningitis case, CPR achieved 12.5% penetration into cerebrospinal fluid.
- CPR demonstrated 100% efficacy in treating 18 pediatric patients with infections including septicemia, pneumonia, and urinary tract infections.
Conclusions:
- Cefpirome (CPR) possesses favorable pharmacokinetic properties in children.
- CPR is highly effective in treating a range of pediatric bacterial infections.
- The observed side effect (rash) was transient and resolved upon discontinuation.
Abstract:
We conducted a study on the pharmacokinetics and clinical application of cefpirome (CPR) in children. 1. A single intravenous injection of 20 mg/kg of CPR was given to a two-month-old boy, and the concentration of the drug in the blood was measured. Fifteen minutes after administration, the concentration was 53.3 micrograms/ml, and it gradually decreased thereafter, reaching a level of 5.18 micrograms/ml after 8 hours with a half-life in the plasma of 2.36 hours. 2. A single intravenous injection of 700 mg (50 mg/kg) of CPR and that of cefotaxime (CTX) were given to a girl with suppurative meningitis (3 years old, 14 kg, causative bacteria, Haemophilus influenzae), and concentrations of the drugs in plasma and cerebrospinal fluid after 1 hour were measured. On the second day of illness, the concentration of CTX in the plasma was 39.4 micrograms/ml and the concentration of desacetyl-CTX (D-CTX) was 25.2 micrograms/ml, while concentrations in the cerebrospinal fluid were 6.22 micrograms/ml (15.8%) for CTX and 3.94 micrograms/ml (15.6%) for D-CTX. On the third day of illness, concentration of CPR in the plasma was 59.3 micrograms/ml, while its concentration in the cerebrospinal fluid was 7.44 micrograms/ml (12.5%). 3. CPR was intravenously administered in daily dosages of 37.7-75.0 mg/kg in 2-3 portions for periods of 4-15 days to 2 patients with septicemia (causative bacteria, Klebsiella pneumoniae in 1 case and Escherichia coli in the other), 1 patient with bronchitis (K. pneumoniae), 9 patients with pneumonia (1 case of Staphylococcus aureus, 3 cases of H. influenzae, 2 cases of Haemophilus parainfluenzae, 1 case of K. pneumoniae + Pseudomonas cepacia, 2 cases of H. influenzae + Branhamella catarrhalis), 2 patients with cellulitis (1 case of S. aureus, 1 case, causative agent unknown), 1 patient with suppurative lymphadenitis (causative agent, unknown), 1 patient with staphylococcal scalded skin syndrome, 1 patient with renal abscess (causative agent, unknown), and 1 patient with a urinary tract infection (E. coli), for a total of 18 patients, with excellent results in 9 cases and good results in 9 cases, hence an efficacy rate of 100% was obtained. 4. As an accompanying side-effect, eruption was observed in 1 of the 18 patients, but when administration was discontinued, the symptom gradually receded, and it disappeared by the 4th day.(ABSTRACT TRUNCATED AT 400 WORDS)