Maesen F P, Davies B I, van den Bergh J J, Gubbelmans H L, Meek J C, Geraedts W H
Department of Respiratory Diseases, De Wever Ziekenhuis, Heerlen, The Netherlands.
J Antimicrob Chemother. 1990 Mar;25(3):413-22. doi: 10.1093/jac/25.3.413.
In a double-blind prospective study, 180 patients admitted to hospital with acute purulent exacerbations of chronic bronchitis were treated for seven days with twice daily 1 g intramuscular injections of either cefodizime or cefotaxime. Sputum cultures performed before, during and immediately after treatment showed complete eradication of the infection in 89/90 given cefodizime and 86/90 receiving cefotaxime. Some symptomatic Pseudomonas aeruginosa superinfections occurred with each agent. During the follow-up week, recurrences or reinfections after apparent clearance occurred in 15 patients given cefodizime and in 21 receiving cefotaxime. Pharmacokinetic studies in blood showed mean Cmax values of 50.8 mg/l for cefodizime and 36.5 mg/l for cefotaxime, corresponding values in the sputum being 1.61 and 0.62 mg/l. Mean AUC values in both blood and sputum were 2 1/2- to 3-fold higher for cefodizime. Some features suggested better performance by cefodizime than by cefotaxime, but the clinical results were not statistically significantly different.
在一项双盲前瞻性研究中，180例因慢性支气管炎急性化脓性加重而入院的患者，接受了为期7天的治疗，每天两次肌肉注射1g头孢地嗪或头孢噻肟。治疗前、治疗期间及治疗后立即进行的痰培养显示，接受头孢地嗪治疗的90例患者中有89例感染被完全清除，接受头孢噻肟治疗的90例患者中有86例感染被完全清除。两种药物均出现了一些有症状的铜绿假单胞菌二重感染。在随访周期间，接受头孢地嗪治疗的15例患者以及接受头孢噻肟治疗的21例患者在表面清除后出现复发或再感染。血液中的药代动力学研究显示，头孢地嗪的平均Cmax值为50.8mg/l，头孢噻肟为36.5mg/l，痰中的相应值分别为1.61mg/l和0.62mg/l。头孢地嗪在血液和痰中的平均AUC值均高出2.5至3倍。一些特征表明头孢地嗪的表现优于头孢噻肟，但临床结果在统计学上无显著差异。
