Comparative trial of cefonicid and cefamandole in the therapy of community-acquired pneumonia.

Abstract

Cefonicid (Smith Kline & French Laboratories; D-75073) is a new parenteral cephalosporin with a markedly long half-life, high serum levels, and good in vitro activity against Haemophilus influenzae. Patients with community-acquired pneumonia were randomized 2:1 to receive cefonicid, 1 g daily (21 cases) or cefamandole, 1 g every 6 h (12 cases). The two groups were similar, except that the cefonicid patients were older (mean 42 versus 31 years). Peak serum levels of cefonicid averaged 133 microgram/ml after intravenous and 83 microgram/ml after intramuscular administration compared with 55 microgram/ml with intravenous cefamandole. All 9 patients on intramuscular cefonicid and 8 or 12 patients on intravenous cefonicid had trough serum levels of greater than 2.0 microgram/ml at 24 h. Sputum levels of cefonicid were usually between 2.0 and 4.0 microgram/ml and did not correlate with serum levels. Cefonicid was well tolerated, and all cefonicid patients responded clinically. Sputum cultures for H. influenzae or Streptococcus pneumoniae became negative in 6 of 7 cefamandole patients and 13 or 15 cefonicid patients. In in vitro studies, cefonicid inhibited 90% of beta-lactamase-negative h. influenzae at 0.5 microgram/ml and beta-lactamase-positive strains at 2.0 microgram/ml. Cefonicid inhibited 50% of S. pneumoniae at 1.6 microgram/ml, but required 6.4 microgram/ml to inhibit 90%. Cefonicid once a day appears to be as safe and as effective as cefamandole four times a day for therapy of community-acquired pneumonia.

• Authors: R J Wallace Jr, S L Niefield, S Waters, B Waters, R J Awe, K Wiss, R R Martin, S B Greenberg
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 21 Issue 2 Pg. 231-5 (Feb 1982) ISSN: 0066-4804 [Print] United States
• PMID: 7041813 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Cephalosporins
• Cefamandole
• Cefonicid

Topics

• Adult
• Cefamandole (analogs & derivatives, metabolism, pharmacology, therapeutic use)
• Cefonicid
• Cephalosporins (therapeutic use)
• Clinical Trials as Topic
• Female
• Haemophilus Infections (drug therapy, metabolism)
• Haemophilus influenzae
• Humans
• Male
• Middle Aged
• Pneumococcal Infections (drug therapy, metabolism)
• Pneumonia (drug therapy)
• Random Allocation