Loracarbef (
LY163892), a carbacephem, is the first of a new class of
beta-lactam compounds. A 14-day, double-blind, randomized, parallel treatment study compared
loracarbef (400 mg b.i.d.; n = 169) and
amoxicillin (500 mg t.i.d.; n = 167) in the treatment of
lobar pneumonia and
bronchopneumonia. Forty-four patients in the
loracarbef group and 40 patients in the
amoxicillin group were evaluable for efficacy analysis. Streptococcus pneumoniae and Haemophilus influenzae were isolated from pure or mixed cultures in 45.5% of the evaluable patients, with S. pneumoniae being isolated most frequently. Favourable clinical responses (cure or improvement) in the
loracarbef-treated group (42/44; 95.5%) were similar to those in the
amoxicillin-treated group (38/40; 95%). A favourable bacteriological response was observed for 36/44 (81.8%)
loracarbef-treated patients compared with 28/40 (70%)
amoxicillin-treated patients (p = 0.2). Adverse events were similar in both groups. Withdrawal of treatment was required in three patients in each group due to gastrointestinal events or
rash/allergic
exanthema. These data support the conclusion that
loracarbef and
amoxicillin have comparable efficacy and safety in the treatment of
bronchopneumonia and
lobar pneumonia caused by susceptible pathogens. However,
loracarbef can be administered twice daily, offering the advantage of improved patient compliance. It is also active against
beta-lactamase producing organisms.