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Treatment of community-acquired pneumonia in the elderly: the role of cefepime, a fourth-generation cephalosporin
- Source :
- The Journal of antimicrobial chemotherapy. 43(4)
- Publication Year :
- 1999
-
Abstract
- In a prospective, multicentre double-blind trial, 151 patients over the age of 65 years were randomly assigned to receive either cefepime 2 g every 12 h for a minimum of 3 days and up to 14 days or ceftriaxone 1 g every 12 h for a minimum of 3 days and up to 14 days. Antibiotics were maintained until 48 h after fever had resolved; no other antibiotics were permitted. The average age in each group exceeded 77 years and significant co-morbidity was found in the majority of patients. The mean total duration of therapy was 5.8 ± 2.4 days for the cefepime group and 6.7 ± 2.7 days for the ceftriaxone group (P = 0.06). The clinical success rate at the end of therapy was 79.1% with cefepime and 75.4% with ceftriaxone (P = 0.62). At the end of follow-up, 91.7% of the cefepime-treated patients and 86.5% of the ceftriaxone patients had a satisfactory clinical response (P = 0.38). In 35 bacteriological evaluable patients, potential pathogens were eradicated in all but one patient receiving cefepime. Seven patients in each group died during the study period but in each case the death was unrelated to study drug. The commonest side-effect was diarrhoea (cefepime, five patients; ceftriaxone, two patients). The clinical and microbiological efficacy of cefepime is similar to that of ceftriaxone in elderly patients with community-acquired pneumonia requiring hospitalization. Cefepime is an appropriate choice for the treatment of community-acquired respiratory tract infections in the elderly.
- Subjects :
- Microbiology (medical)
Male
medicine.medical_specialty
medicine.drug_class
Cefepime
Antibiotics
Community-acquired pneumonia
Double-Blind Method
Internal medicine
medicine
Pneumonia, Bacterial
Humans
Pharmacology (medical)
Prospective Studies
Adverse effect
Antibacterial agent
Aged
Pharmacology
Aged, 80 and over
Respiratory tract infections
business.industry
Ceftriaxone
medicine.disease
Surgery
Cephalosporins
Community-Acquired Infections
Pneumonia
Infectious Diseases
Treatment Outcome
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 03057453
- Volume :
- 43
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The Journal of antimicrobial chemotherapy
- Accession number :
- edsair.doi.dedup.....804c915fe73d06f1d96a0ec18a13ec19