Basic and clinical studies on cefpirome in complicated urinary tract infections

We studied the antibacterial activity, pharmacokinetics and clinical efficacy of cefpirome (CPR), a new injectable cephalos porin, in the urological field. The results were as follows. 1. Antibacterial activity We determined the MICs of CPR against clinical isolates (213 strains of 14 species) from urinary tract infections, and compared them with those of cefoperazone (CPZ), latamoxef (LMOX) and ceftazidime (CAZ). CPR had strong antibacterial activity against Escherichia coli, Klebsiella, Enterobacter cloacae, Serratia, Proteus mirabihs, Proteus vulgaris and Morganella morganii. Although the activity of CPR against Pseudomonas aerugmosa was not strong, CPR had stronger activity against Staphylococcus epidcrmidis and Enterococcus faecalis than did CPZ, LMOX and CAZ. 2. Pharmacokinetics The pharmacokinetics of CPR were studied in four healthy volunteers. After three single administrations of CPR 1 g, CPR 0.5 g and CAZ 1.0 g, the peak blood concentrations were 53.0 μg/ml, 24.3 μg/ml and 53.7 μg/ml. The serum half-lives were 1.69 h, 1.69 h, 1.71 h and the urinary recovery rates up to 9 h were 63.3%, 69.1%, 76.8%. 3. Clinical efficacy Of 29 cases of complicated urinary tract infection, 21 were evaluated according to the criteria of the Japanese UTI Committee. The overall clinical efficacy rate was 76.2% and 28/32 (87.5%) strains were eradicated bacteriologically. No side effects were observed, but mild elevation of transaminase was noted in one case.