Clinical evolution of cefpirome for severe infections in patients with hematological disease: Tokai infection study on hematological disorders

A prospective study was carried out to evaluate the efficacy and safety of cefpirome (CPR) in treating infections associated with hematological diseases. 1) CPR was administered alone to one hundred patients in the study, and 77 of them were evaluated for efficacy. 2) CPR was effective or markedly effective in 45 of the 77 patients (efficacy rates 58.4 %). In septicemia and suspected septicemia, the efficacy rates were 25% (1/4) and 59.7% (37/62), respectively. 3) The efficacy rate depended on the neutrophil count before and after antimicrobial treatment. As the counts increased, the efficacy rates rose. 4) In patients with a neutrophil count under 500/μl before CPR administration and over 500/μl after CPR, the efficacy rates for treatment with CPR alone and in combination with G-CSF were 25% (1/4) and 80.0% (8/10), respectively. The efficacy rates were higher in patients receiving CPR plus G-CSF, suggesting that G-CSF is likely to be of value in the treatment of infections. 5) Adverse effects of CPR in the 100 patients consisted of nausea in one patient (1.0%) and abnormal laboratory values (mainly elevation of GOT, GPT and AL-P) in 11 patients. None of the adverse effects were serious and all resolved after completion of treatment with CPR.