A randomized clinical trial of ceftizoxime and cefamandole in the treatment of serious lower respiratory tract infections

Rodríguez, J. Rayego; Vázquez, Guillermo J.; Bermúdez, Ramon H.; Luina, Alejo; Ronda, C H Ramírez

doi:10.1093/jac/10.suppl_c.209

Journal of Antimicrobial Chemotherapy

1982

DOI: 10.1093/jac/10.suppl_c.209

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A randomized clinical trial of ceftizoxime and cefamandole in the treatment of serious lower respiratory tract infections

J. Rayego Rodríguez¹,

Guillermo J. Vázquez²,

Ramon H. Bermúdez³

et al.

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1984

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Cited by 6 publications

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“…This difference may reflect the fact that antibiotic trials, including ours, often exclude patients with immunosuppression or neutropenia or those who are severely ill and unable to give informed consent. Our overall response rate of 88% is similar to that reported in previous trials that used cefamandole alone for the treatment of lower respiratory tract infections (26,41,42,44,53) or in comparison with cefotiam (6), ceftizoxime (25,35,39,58), cefonicid (24,65), ceftazidime (16,31), or cefoperazone (20).…”

supporting

confidence: 84%

“…Several other antibiotic trials of patients hospitalized with communityacquired respiratory infections have reported mortality rates ranging from 4 to 11% and have noted that most deaths resulted from the patients' underlying disorders (10,20,22,25,26,31,53,58). The mortality rate for our patients is lower than the 8 to 24% reported for patients hospitalized with community-acquired pneumonia but not specifically entered in a therapeutic trial (14,15,21,40,46,61,66).…”

mentioning

confidence: 54%

“…Previous antibiotic trials have demonstrated that cefamandole is as efficacious as penicillin for pneumococcal pneumonia (54,55) and as efficacious as ampicillin for lower respiratory infection due to H. influenzae (10). Further, broad-spectrum cephalosporins have not been shown to be more efficacious than cefamandole for communityacquired pneumonia (6,16,20,24,25,31,35,39,58,65). Thus, cost considerations appear to favor the empiric use of ampicillin over cefamandole for the majority of patients hospitalized with presumed bacterial pneumonia of uncertain etiology.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Ampicillin versus cefamandole as initial therapy for community-acquired pneumonia

Weber¹,

Calderwood²,

Karchmer³

et al. 1987

Antimicrob Agents Chemother

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supporting

confidence: 84%

mentioning

confidence: 54%

mentioning

confidence: 99%

See 1 more Smart Citation

Ampicillin versus cefamandole as initial therapy for community-acquired pneumonia

Weber¹,

Calderwood²,

Karchmer³

et al. 1987

Antimicrob Agents Chemother

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“…including some caused by gram-negative bacilli. These studies have demonstrated variable effectiveness with cefotaxime (20), ceftizoxime (23), moxalactam (4), cefoperazone (6), piperacillin (9), and mezlocillin (22,26).…”

mentioning

confidence: 99%

Efficacy and safety of aztreonam-clindamycin versus tobramycin-clindamycin in the treatment of lower respiratory tract infections caused by aerobic gram-negative bacilli

Rodríguez¹,

Ramírez-Ronda²,

Nevarez³

1985

Antimicrob Agents Chemother

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A total of 80 patients were randomized to receive either aztreonam or tobramycin for the treatment of lower respiratory tract infections caused by gram-negative bacilli; all these patients received clindamycin concomitantly. A total of 53 patients were randomized to receive aztreonam-clindamycin; of these, 46 were clinically evaluable and 39 were bacteriologically evaluable. Of the 46 clinically evaluable patients, 41 were considered cured, 3 failed to be cured, and 2 died during the study period of unrelated causes. Of the 39 bacteriologically evaluable patients, 36 were considered cured, and 3 failed to be cured. There were 26 clinically evaluable patients in the group randomized to receive tobramycin-clindamycin. Of them, 22 patients were considered cured, 3 failed to be cured, and 1 died of unrelated causes during the study period. There were 18 bacteriologically evaluable patients in the tobramycin-clindamycin group; 17 were cured, and 1 failed to be cured. The most common pathogens isolated from the patients were Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. All of the isolated organisms were susceptible to both tested antibiotics, except for a strain of Pseudomonas cepacia resistant to both tested antimicrobial agents and a strain of Enterobacter aerogenes and one of P. aeruginosa that were resistant to aztreonam. Very few adverse reactions related to the antibiotics were seen. These effects, when present, were transient and comparable in both studied groups, except for renal-function tests, which were altered in 7.7% of the patients randomized to receive tobramycin-clindamycin and in none of the patients randomized to receive aztreonam-clindamycin. Aztreonam-clindamycin is safe and effective for the treatment of lower respiratory tract infections caused by aerobic gram-negative bacilli when the organisms are susceptible.

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Ceftizoxime: A Beta‐Lactamase‐Stable, Broad‐Spectrum Cephalosporin

Neu

1984

Pharmacotherapy

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Ceftizoxime is an iminomethoxy aminothiazolyl cephalosporin that inhibits a wide variety of aerobic, anaerobic gram-positive and gram-negative bacteria. The majority of Enterobacteriaceae are inhibited by less than or equal to 1 microgram/ml as are streptococcal species with the exception of Streptococcus faecalis. Staphylococcus aureus are inhibited by 3-8 micrograms/ml, while methicillin-resistant. aureus are resistant. Bacteroides fragilis are inhibited by 16-64 micrograms/ml. It inhibits Pseudomonas aeruginosa at usually achievable concentrations. Ceftizoxime is overall similar in antibacterial activity to cefotaxime and moxalactam. Ceftizoxime is not hydrolyzed by common plasmid and chromosomal beta-lactamases. Serum levels of ceftizoxime after intramuscular and intravenous injection are similar to those of cefotaxime and moxalactam. The half-life is 1.6 to 1.9 hours in normal individuals. The compound is not metabolized and is cleared from the body by glomerular filtration. Ceftizoxime enters most body fluids, including the cerebrospinal fluid, to produce therapeutic concentrations against clinically important bacteria. Ceftizoxime accumulates in the presence of renal failure, but it is removed from the body by hemodialysis and peritoneal dialysis. Ceftizoxime has proved to be an effective chemotherapeutic agent when used as treatment for pneumonia, urinary tract infections, osteomyelitis, septic arthritis, meningitis, peritonitis, gonorrhea, including penicillinase-producing isolates, and gynecological infections. No major adverse reactions have been associated with the use of ceftizoxime and it has produced neither disulfram -like reactions nor bleeding.

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A randomized clinical trial of ceftizoxime and cefamandole in the treatment of serious lower respiratory tract infections

Cited by 6 publications

References 0 publications

Ampicillin versus cefamandole as initial therapy for community-acquired pneumonia

Ampicillin versus cefamandole as initial therapy for community-acquired pneumonia

Efficacy and safety of aztreonam-clindamycin versus tobramycin-clindamycin in the treatment of lower respiratory tract infections caused by aerobic gram-negative bacilli

Ceftizoxime: A Beta‐Lactamase‐Stable, Broad‐Spectrum Cephalosporin

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