Cefodizime (CAS 69739-16-8,
HR 221) is a new
third-generation cephalosporin with pharmacokinetic properties that make it suitable for once-daily administration in the treatment of lower
respiratory tract infections (LRTI). Ninety-nine adult hospitalized patients (66 males, 33 females, median age 57.5 years) received a once-daily injection of 2 g
cefodizime for LRTI. Median
treatment duration was 8 days. Forty-two patients received
cefodizime intravenously and 57 intramuscularly. Indications for treatment were as follows; primary
lobar pneumonia (n = 36),
bronchopneumonia (n = 14), secondary
pneumonia (n = 3),
aspiration pneumonia (n = 5), acute exacerbation of
chronic bronchitis (n = 21), and of
bronchiectasis (n = 9) and acute purulent
bronchitis (n = 11). General condition was good in 29 patients and poor in 58; 12 patients were
critically ill. The following pathogens were isolated at baseline (source: bronchial secretions, sputum or blood): S. pneumoniae (n = 47), Haemophilus spp. (n = 17), M. catarrhalis (n = 6), Streptococcus spp. (n = 9), Staphylococcus spp. (n = 5), Klebsiella spp. (n = 4), Pseudomonas spp. (n = 1), A. calcoaceticus (n = 1) and anaerobic organisms (n = 7). Fifty-nine patients were evaluable for bacteriological response and 82 for clinical response. Bacteriological outcome was satisfactory in 29/30 patients having LRTI with parenchymal involvement (97%) and in 29/29 patients without parenchymal involvement (100%). Clinical cure was achieved in 41/43 evaluable patients with parenchymal involvement (95%) and in 37/39 patients without parenchymal involvement (95%) in the per-protocol analysis and in 54/58 patients (93%) and 37/41 patients (93%), respectively, in the clinical intention-to-treat analysis. Three of the patients with an unsatisfactory clinical response died of
infection during the study.
Cefodizime was well tolerated. Adverse reactions--all of mild intensity--were
tachycardia, lumbalgia and
dizziness, each occurring in one patient.
Cefodizime 2 g once daily either i.m. or i.v. was effective in the treatment of lower
respiratory tract infections in hospitalized patients.