Document Detail

Treatment of community-acquired pneumonia in the elderly: the role of cefepime, a fourth-generation cephalosporin.
MedLine Citation:
PMID:  10350385     Owner:  NLM     Status:  MEDLINE    
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.
R F Grossman; D A Campbell; S J Landis; G E Garber; G Murray; H G Stiver; R Saginur; R A McIvor; J Laforge; C Rotstein; J Dubois; M Rivard; F Boulerice
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of antimicrobial chemotherapy     Volume:  43     ISSN:  0305-7453     ISO Abbreviation:  J. Antimicrob. Chemother.     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-10-12     Completed Date:  1999-10-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7513617     Medline TA:  J Antimicrob Chemother     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  549-54     Citation Subset:  IM    
Mount Sinai Hospital, Toronto, Ontario, Canada.
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MeSH Terms
Aged, 80 and over
Ceftriaxone / adverse effects,  therapeutic use*
Cephalosporins / adverse effects,  therapeutic use*
Community-Acquired Infections / drug therapy,  microbiology
Double-Blind Method
Pneumonia, Bacterial / drug therapy*
Prospective Studies
Treatment Outcome
Reg. No./Substance:
0/Cephalosporins; 73384-59-5/Ceftriaxone; 88040-23-7/cefepime

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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