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Drug Investigation

, Volume 7, Issue 3, pp 117–126 | Cite as

A Randomised Comparative Trial of Aztreonam Plus Cefazolin versus Ceftazidime for the Treatment of Nosocomial Pneumonia

  • Thomas Fekete
  • Michael Castellano
  • Julio Ramirez
  • Allan Siefkin
  • Marcel Martin
  • John J. Redington
  • Donald North
  • Peter Krumpe
  • Shahrokh Javaheri
  • Robert Jones
  • Suzanne Gagnon
Original Research Article

Summary

A multicentre prospective randomised open-label controlled trial was conducted to compare the efficacy and safety of aztreonam (1 to 2g every 8 hours) plus cefazolin (1g every 8 hours) with that of ceftazidime (1 to 2g every 8 hours) in patients with nosocomial pneumonia. 66 adults were enrolled who had a presumptive diagnosis of pneumonia made at least 48 hours after hospitalisation. Patients exhibited the classic clinical picture of pneumonia and/or fever and/or leucocytosis and a newly developed or expanding infiltrate on chest x-ray.

Among 48 evaluable patients treated, clinical cure or improvement was reported in 18 of 20 (90%) aztreonam patients as compared with 24 of 28 (85.7%) patients treated with ceftazidime. Bacteriological eradication or presumptive eradication was reported in 11 of 13 (84.6%) aztreonam patients and 15 of 19 (78.9%) ceftazidime recipients. Five patients with positive blood cultures prior to therapy (2 aztreonam, 3 ceftazidime) had negative blood cultures at study completion.

Superinfection was reported in 2 patients randomised to aztreonam (both Staphylococcus aureus) and in 3 ceftazidime patients (2 with Pseudomonas aeruginosa and 1 with β-haemolytic Streptococcus). Colonisation was observed following ceftazidime (n = 4) and aztreonam (n = 2) therapy. Six aztreonam and 3 ceftazidime recipients experienced adverse events, which were possibly related to study therapy.

Aztreonam plus cefazolin appears to be as effective as ceftazidime for the treatment of adults with nosocomial pneumonia.

Keywords

Chronic Obstructive Pulmonary Disease Ceftazidime Cefazolin Drug Invest Lower Respiratory Tract Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • Thomas Fekete
    • 1
  • Michael Castellano
    • 2
  • Julio Ramirez
    • 3
  • Allan Siefkin
    • 4
  • Marcel Martin
    • 5
  • John J. Redington
    • 6
  • Donald North
    • 6
  • Peter Krumpe
    • 7
  • Shahrokh Javaheri
    • 8
  • Robert Jones
    • 1
  • Suzanne Gagnon
    • 9
  1. 1.Temple University HospitalPhiladelphiaUSA
  2. 2.Staten Island University HospitalStaten IslandUSA
  3. 3.Veterans Administration Medical CenterLouisvilleUSA
  4. 4.University of California Davis Medical CenterSacramentoUSA
  5. 5.University of Florida Health Science CenterJacksonvilleUSA
  6. 6.Veterans Administration Medical CenterDenverUSA
  7. 7.Veterans Administration Medical CenterRenoUSA
  8. 8.Veterans Administration Medical CenterCincinnatiUSA
  9. 9.St Francis Regional Medical CenterWichitaUSA

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