0
Articles |

Sequential Therapy With Cefuroxime Followed by Cefuroxime Axetil in Community-Acquired Pneumonia

Paul Van den Brande; Vladimir Vondra; Friedrich Vogel; Francisc Schlaeffer; Heather Staley; Catherine Holmes
Author and Funding Information

Affiliations: From the Pulmonary Division, Hospital St. Norbertus Duffel and Pulmonary Division, University Hospital, Katholieke Universiteit Leuven, Belgium,  From the Faculty Hospital of Charles University, Prague, Czech Republic,  From Medizinische Klinik III, Frankfurt, Germany,  From Internal `H' Department, Soroka Hospital, Beer-Sheva, Israel,  From Glaxo Wellcome Research and Development Ltd, Middlesex, United Kingdom

Affiliations: From the Pulmonary Division, Hospital St. Norbertus Duffel and Pulmonary Division, University Hospital, Katholieke Universiteit Leuven, Belgium,  From the Faculty Hospital of Charles University, Prague, Czech Republic,  From Medizinische Klinik III, Frankfurt, Germany,  From Internal `H' Department, Soroka Hospital, Beer-Sheva, Israel,  From Glaxo Wellcome Research and Development Ltd, Middlesex, United Kingdom

Affiliations: From the Pulmonary Division, Hospital St. Norbertus Duffel and Pulmonary Division, University Hospital, Katholieke Universiteit Leuven, Belgium,  From the Faculty Hospital of Charles University, Prague, Czech Republic,  From Medizinische Klinik III, Frankfurt, Germany,  From Internal `H' Department, Soroka Hospital, Beer-Sheva, Israel,  From Glaxo Wellcome Research and Development Ltd, Middlesex, United Kingdom

Affiliations: From the Pulmonary Division, Hospital St. Norbertus Duffel and Pulmonary Division, University Hospital, Katholieke Universiteit Leuven, Belgium,  From the Faculty Hospital of Charles University, Prague, Czech Republic,  From Medizinische Klinik III, Frankfurt, Germany,  From Internal `H' Department, Soroka Hospital, Beer-Sheva, Israel,  From Glaxo Wellcome Research and Development Ltd, Middlesex, United Kingdom

Affiliations: From the Pulmonary Division, Hospital St. Norbertus Duffel and Pulmonary Division, University Hospital, Katholieke Universiteit Leuven, Belgium,  From the Faculty Hospital of Charles University, Prague, Czech Republic,  From Medizinische Klinik III, Frankfurt, Germany,  From Internal `H' Department, Soroka Hospital, Beer-Sheva, Israel,  From Glaxo Wellcome Research and Development Ltd, Middlesex, United Kingdom


1997 by the American College of Chest Physicians


Chest. 1997;112(2):406-415. doi:10.1378/chest.112.2.406
Text Size: A A A
Published online

Abstract

Study objectives: To compare the efficacy of two sequential therapy regimens of IV cefuroxime followed by oral cefuroxime axetil for the treatment of community-acquired pneumonia (CAP).

Design: Prospective, multicenter, randomized, open-label, parallel-group study.

Setting: Sixty-six centers in 11 countries (Belgium, Canada, Czech Republic, Germany, Hungary, Ireland, Israel, Poland, Portugal, South Africa, and the United Kingdom).

Patients: Six hundred thirty-six adults with CAP requiring hospitalization and initial IV antibiotic treatment.

Interventions: Cefuroxime, 1.5 g IV tid or bid for 48 to 72 h followed by oral cefuroxime axetil, 500 mg bid for 7 days.

Measurements and results: For clinically evaluable patients, the clinical response rates were equivalent for cefuroxime tid and bid groups posttreatment (cure/improvement, 79% and 84%, respectively) and at follow-up (maintained cure, 87% and 82%, respectively). All signs and symptoms of pneumonia showed improvement at the time of switch from IV to oral therapy. A total of 111 pathogens were isolated, the most common being Streptococcus pneumoniae (23%), Haemophilus influenzae (18%), and Enterobacteriaceae (15%). Bacteriologic clearance was obtained posttreatment in 47 of 49 and 36 of 42 of bacteriologically evaluable patients in the cefuroxime tid and bid groups, respectively. Both regimens were well tolerated with a low incidence of drug-related adverse events, the most common being GI.

Conclusions: Twice daily IV cefuroxime followed by oral cefuroxime axetil is a simple and effective sequential therapy regimen for the treatment of CAP. It offers potential cost savings and can replace the current tid regimen in this indication.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Cost-Effectiveness of IV-to-Oral Switch Therapy*: Azithromycin vs Cefuroxime With or Without Erythromycin for the Treatment of Community-Acquired Pneumonia
Factors Influencing In-hospital Mortality in Community-Acquired Pneumonia*: A Prospective Study of Patients Not Initially Admitted to the ICU
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543