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Clinical and in vitro evaluation of cephapirin, a new cephalosporin antibiotic
Abstract:
Cephapirin sodium, a cephalosporin for parenteral use, was evaluated in vitro and in 27 patients. Cephapirin had activity equivalent to cephalothin against 25 strains each of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus; 10 strains each of Diplococcus pneumoniae, Pseudomonas species, and Enterobacter species; and 8 strains of Proteus species other than P. mirabilis. All strains of S. aureus and D. pneumoniae and most strains of E. coli, K. pneumoniae, and Proteus species were inhibited by concentrations of cephapirin achieved in the serum. Of 27 patients (20 with pneumonia, 2 with S. aureus empyema, and 5 with miscellaneous infections), 25 responded to cephapirin therapy. The only major toxicity thought to be drug-related occurred in a patient who developed reversible bone marrow depression with leukopenia, neutropenia, and anemia. Although cephapirin was painful on intramuscular injection, phlebitis and pain were absent in patients treated intravenously. In a controlled comparison of intravenously administered cephalothin and cephapirin in four additional patients, the latter caused much less pain than the former and caused no phlebitis.
Insights
Cephapirin sodium demonstrated effectiveness against various bacterial infections in vitro and in patients, with most showing positive responses. Intravenous administration was well-tolerated, with minimal adverse effects reported.
Area of Science:
- Microbiology
- Pharmacology
- Clinical Medicine
Background:
- Cephapirin sodium is a parenteral cephalosporin antibiotic.
- Evaluation of its efficacy and safety is crucial for clinical application.
Purpose of the Study:
- To assess the in vitro activity of cephapirin sodium against common bacterial pathogens.
- To evaluate the clinical efficacy and safety of cephapirin sodium in patients with various infections.
Main Methods:
- In vitro susceptibility testing against multiple bacterial strains including Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus.
- Clinical evaluation in 27 patients with infections such as pneumonia and S. aureus empyema.
- Comparison of intravenous cephapirin sodium with cephalothin in a small cohort.
Main Results:
- Cephapirin sodium exhibited activity comparable to cephalothin against tested bacterial strains.
- 25 out of 27 patients responded favorably to cephapirin therapy.
- Intravenous administration of cephapirin sodium was associated with less pain and no phlebitis compared to intramuscular injection and intravenous cephalothin.
Conclusions:
- Cephapirin sodium is an effective antibiotic for treating susceptible bacterial infections.
- Intravenous administration of cephapirin sodium is preferred due to reduced local adverse effects.
- Reversible bone marrow depression was the primary drug-related toxicity observed.