Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Cefrom (Roussel Uclaf Australia)
vials containing 500 mg, 1 g and 2 g as powder
Indication: specified infections
Cefpirome is another broad spectrum cephalosporin for intravenous use. Its antimicrobial activity is similar to that of cefotaxime.
The reconstituted drug can be injected over 3-5 minutes or given as a 20-30 minute infusion. Clearance is mainly renal so a lower dose is given if creatinine clearance is reduced. The half life is 2 hours, but cefpirome can usually be given twice a day.
Cefpirome is stable to beta lactamases and has activity against staphylococci, streptococci, and Gramnegative organisms including Escherichia coli, Haemophilus influenzae and Moraxella catarrhalis . The drug is active against Pseudomonas aeruginosa, but may be less active than ceftazidime.
The results of clinical trials have led to cefpirome being approved for the treatment of serious or life threatening infections. It can be given for septicaemia, infections of the lower respiratory tract, skin and soft tissues and complicated infections of the urinary tract. Cefpirome can also be used to treat infections in neutropenic patients.
Adverse reactions occurred in over 12% of patients during clinical trials and cefpirome was withdrawn from 5%. These reactions can range from pain at the injection site to pseudomembranous colitis and jaundice. Renal function should be monitored if cefpirome is given with an aminoglycoside or a loop diuretic.
With the addition of cefpirome to the market, cost may become a significant influence on the choice of cephalosporins1 for severe infections.
