ppharmПедиатрическая фармакологияPediatric pharmacology1727-57762500-3089Издательство «ПедиатрЪ»10.15690/pf.v11i5.1169ppharm-56Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWЦЕФПИРОМ. ОБЗОР ЛИТЕРАТУРЫCEFPIROME. LITERATURE REVIEWДмитриеваН. В.DmitrievaN. V.prof.ndmitrieva@mail.ruРоссийский онкологический научный центр им. Н.Н. Блохина, Москва, Российская ФедерацияРоссияBlokhin Russian Cancer Research Center, Moscow, Russian FederationRussian Federation201401102014115Педиатрическая фармакология7781Copyright © Дмитриева Н.В., 20142014Дмитриева Н.В.Dmitrieva N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pedpharma.ru/jour/article/view/56

Во всем мире ученые констатируют продолжающуюся тенденцию к росту антибиотикорезистентности. В этой связи особенно важно при огромном выборе антибактериальных средств на фармацевтическом рынке применять их с учетом региональной чувствительности, только по четким показаниям и в порядке приоритетности для данного случая. В настоящее время наиболее часто применяют препараты широкого спектра действия, в том числе цефалоспорины 4-го поколения которые активны в отношении грамположительные и грамотрицательные микроорганизмы и большинства анаэробов. Данный обзор посвящен представителю этой группы цефпирому. Показаны преимущественные показания к его применению и представлен сравнительный анализ его эффективности. Цефпиром не уступает в эффективности цефепиму, что очень важно в условиях роста резистентности бактерий к цефалоспоринам 3-го поколения,  его важное преимущество ―  активность в отношении некоторых энтерококков и анаэробов. Цефпиром хорошо проникает в различные ткани организма, создавая там бактерицидные концентрации для большинства клинически значимых микроорганизмов. Исследования показали клиническую эффективность препарата при лечении различных нозокомиальных инфекций, таких как сепис (62-77%), фебрильная нейтропения (53-84%), интраабдоминальные инфекции (83%), осложненные инфекции мочевых путей (100%) и др. Препарат малотоксичен: не превышает таковую у цефепима и цефалоспоринов 3-го поколения, что с учетом широты антибактериального спектра и клинической значимости позволяет применять его в качестве препарата 1-й линии при лечении тяжелых внутрибольничных инфекций.

 

Researchers around the world acknowledge a continuing growth of antibiotic resistance. Thus, it is especially important to select from a wide range of antibacterial agents in the pharmaceutical market the ones appropriate for specific regional sensitivity, only in accordance with clearly defined indications and in order of priority for each specific case. The most frequently used are wide range drugs, including the 4th-generation cephalosporins active against gram-positive and gram-negative microbes and most anaerobes. This review is dedicated to a representative of this group – cefpirome. The authors indicate the primary indications for use thereof and present a comparative effectiveness analysis. Cefpirome is as effective as cefepime, which is important, particularly because of growth of bacterial resistance against the 3rd-generation cephalosporins. Its significant advantage is activity against several enterococci and anaerobes. Cefpirome penetrates various body tissues fairly well and establishes there bactericidal concentrations against most known clinically significant microbes. The trials have demonstrated clinical effectiveness of the drug for various nosocomial infections, such as sepsis (62-77%), febrile neutropenia (53-84%), intra-abdominal infections (83%), complicated urinary infections (100%) etc. The drug features low toxicity: it does not exceed the one in cefepime and the 3rd-generation cephalosporins, which makes it possible to use cefpirome as the drug of the 1st choice for severe hospital-acquired infections given its wide antibacterial range and clinical significance.

 

цефпиромцефепимнозокомиальные инфекциисепсисфебрильная нейтропениярезистентность к антибиотикамлечение грамотрицательных инфекцийцефалоспорины 4-го поколенияcefpiromecefepimenosocomial infectionssepsisfebrile neutropeniaantibiotic resistancetreatment of gram-negative infections4th-generation cephalosporinsReferencesNorrby S. R. I., Geddes A. M., Shah P. M. Randomized comparative trial of cefpirome versus ceftazidime in the empirical treatment of suspected bacteraemia or sepsis. Multicentre Study Group. J Antimicrob Chemother. 1998 Oct; 42 (4): 503–9.Norrby S.R.I., Geddes A.M., Shah P.M. Randomized comparative trial of cefpirome versus ceftazidime in the empirical treatment of suspected bacteraemia or sepsis. Multicentre Study Group. J Antimicrob Chemother. 1998 Oct; 42 (4): 503−9.Lehrnbecher T., Robert P., Sarah A., Alvaro F., Carlesse F., Fisher B., Hakim H., Santolaya M., Castagnola E., Davis B. L., Dupuis L. L., Gibson F., Groll A. H., Gaur A., Gupta A., Kebudi R., Petrilli S., Steinbach W. J., Villarroel M., Zaoutis T., Sung L. Guideline for the Management of Fever and Neutropenia in Children With Cancer and/or Undergoing Hematopoietic Stem-Cell Transplantation. Journal of clinical oncology. Special article. J Clin Oncol. 30. 2012 by American Society of Clinical Oncology. Published Ahead of Print on September 17, 2012 as 10.1200/JCO.2012.42.7161. URL: http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2012.42.7161Lehrnbecher T., Robert P., Sarah A., Alvaro F., Carlesse F., Fisher B., Hakim H., Santolaya M., Castagnola E., Davis B.L., Dupuis L.L., Gibson F., Groll A.H., Gaur A., Gupta A., Kebudi R., Petrilli S., Steinbach W.J., Villarroel M., Zaoutis T., Sung L. Guideline for the Management of Fever and Neutropenia in Children With Cancer and/or Undergoing Hematopoietic Stem-Cell Transplantation. Journal of clinical oncology. Special article. J Clin Oncol. 30. 2012 by American Society of Clinical Oncology. Published Ahead of Print on September 17, 2012 as 10.1200/JCO.2012.42.7161. Available at: http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2012.42.7161Формуляр РОНЦ им. Н. Н. Блохина РАМН. Антимикробные препараты и стандарты лечения инфекционных осложнений у онкологических больных. Под ред. Н. В. Дмитриевой. М.: Практическая медицина. 2011. 270 с.Formulyar RONTs im. N.N. Blokhina RAMN. Antimikrobnye preparaty i standarty lecheniya infektsionnykh oslozhnenii u onkologicheskikh bol'nykh. Pod red. N.V. Dmitrievoi [N.N. Blokhin RCRC Form. Antimicrobials and Standards of Treatment of Infectious Complications in Patients with Cancer. Edited by N.V. Dmitrieva]. Moscow, Prakticheskaya meditsina, 2011. 270 p.Дмитриева Н. В., Петухова И. Н., Григорьевская З. В. Ванкомицин и линезолид при нозокомиальных инфекциях, вызванных метициллинрезистентными стафилококками. Врач. 2012; 2: 39–43.Dmitrieva N.V., Petukhova I.N., Grigor'evskaya Z.V. Vancomycin and linezolid in nosocomial infections caused by methicillin-resistant staphylococci. Vrach = The Doctor. 2012; 2: 39−43.Bergeret M. I., Boutros N., Raymond J. In vitro combined bactericidal activity of cefpirome and glycopeptides against glycopeptides and oxacillin-resistant staphylococci. Int J Antimicrob Agents. 2004 Mar; 23 (3): 247–53.Bergeret M.I., Boutros N., Raymond J. In vitro combined bactericidal activity of cefpirome and glycopeptides against glycopeptides and oxacillin-resistant staphylococci. Int J Antimicrob Agents. 2004 Mar; 23 (3): 247−53.Georges B. I., Roche C., Archambaud M., Decun J. F., Cougot P., Conil J. M., Chaminade B., Andrieu P., Saivin S., Bonnet E., Chaba-non G., Houin G., Samii K., Virenque C. Importance of a cefpirome-van co mycin combination on bactericidal kinetics in severe MRSA infections in intensive care. Pathol Biol (Paris). 2002 Apr; 50 (3): 161–8.Georges B.I., Roche C., Archambaud M., Decun J.F., Cougot P., Conil J.M., Chaminade B., Andrieu P., Saivin S., Bonnet E., Chabanon G., Houin G., Samii K., Virenque C. Importance of a cefpirome-vancomycin combination on bactericidal kinetics in severe MRSA infections in intensive care. Pathol Biol (Paris). 2002 Apr; 50 (3): 161−8.Hafeez S. I., Izhar M., Ahmed A., Zafar A., Naeem M. In vitro antimicrobial activity of Cefpirome: a new fourth-generation cephalosporin against clinically significant bacteria J Pak Med Assoc. 2000 Aug; 50 (8): 250–2.Hafeez S.I., Izhar M., Ahmed A., Zafar A., Naeem M. In vitro antimicrobial activity of Cefpirome: a new fourth-generation cephalosporin against clinically significant bacteria J Pak Med Assoc. 2000 Aug; 50 (8): 250−2.Poiata A., Tuchilus C., Badicut I., Buiuc D. Cefpirome suscep ti bility in staphylococci isolates. Cefpirome susceptibility in staphylococci isolates. Rev Med Chir Soc Med Nat Iasi. 2007; 111 (1): 276–9.Poiata A., Tuchilus C., Badicut I., Buiuc D. Cefpirome susceptibility in staphylococci isolates. Cefpirome susceptibility in staphylococci isolates. Rev Med Chir Soc Med Nat Iasi. 2007; 111 (1): 276−9.Ishii Y. I., Ueda C., Kouyama Y., Tateda K., Yamaguchi K. Evaluation of antimicrobial susceptibility for -lactams against clinical isolates from 51 medical centers in Japan (2008). Diagn Microbiol Infect Dis. 2011 Apr; 69 (4): 443–8.Ishii Y.I., Ueda C., Kouyama Y., Tateda K., Yamaguchi K. Evaluation of antimicrobial susceptibility for β-lactams against clinical isolates from 51 medical centers in Japan (2008). Diagn Microbiol Infect Dis. 2011 Apr; 69 (4): 443−8.Strateva T. I., Ouzounova-Raykova V., Markova B., Todorova A., Marteva-Proevska Y., Mitov I. Problematic clinical isolates of Pseudomonas aeruginosa from the university hospitals in Sofia, Bulgaria: current status of antimicrobial resistance and prevailing resistance mechanisms. J Med Microbiol. 2007 Jul; 56 (Pt. 7): 956–63.Strateva T.I., Ouzounova-Raykova V., Markova B., Todorova A., Marteva-Proevska Y., Mitov I. Problematic clinical isolates of Pseudomonas aeruginosa from the university hospitals in Sofia, Bulgaria: current status of antimicrobial resistance and prevailing resistance mechanisms. J Med Microbiol. 2007 Jul; 56 (Pt. 7): 956−63.Ishii Y. I., Alba J., Kimura S., Shiroto K., Yamaguchi K. Evaluation of antimicrobial activity of beta-lactam antibiotics using Etest against clinical isolates from 60 medical centres in Japan. Int J Antimicrob Agents. 2005 Apr; 25 (4): 296–301.Ishii Y.I., Alba J., Kimura S., Shiroto K., Yamaguchi K. Evaluation of antimicrobial activity of beta-lactam antibiotics using Etest against clinical isolates from 60 medical centres in Japan. Int J Antimicrob Agents. 2005 Apr; 25 (4): 296−301.Tuchilus C. I., Poiata A., Iancu L. S., Badicut I., Ambarus A., Buiuc D. Susceptibility of Klebsiella spp. to cefpirome and cefepime. Rev Med Chir Soc Med Nat Iasi. 2006 Apr-Jun; 110 (2): 465–7.Tuchiluş C.I., Poiată A., Iancu L.S., Bădicuţ I., Ambăruş A., Buiuc D. Susceptibility of Klebsiella spp. to cefpirome and cefepime. Rev Med Chir Soc Med Nat Iasi. 2006 Apr-Jun; 110 (2): 465−7.Huang C. C. I., Wu C. J., Wang L. R., Lee H. C., Chang C. M., Lee N. Y., Chen T. Y., Ko W. C. Antimicrobial susceptibility of bacteremic isolates from cancer patients with or without neutropenia at a medical center in southern Taiwan. J Microbiol Immunol Infect. 2011 Oct; 44 (5): 376–81.Huang C.C.I., Wu C.J., Wang L.R., Lee H.C., Chang C.M., Lee N.Y., Chen T.Y., Ko W.C. Antimicrobial susceptibility of bacteremic isolates from cancer patients with or without neutropenia at a medical center in southern Taiwan. J Microbiol Immunol Infect. 2011 Oct; 44 (5): 376−81.Joukhadar C. I., Klein N., Mayer B. X., Kreischitz N., Delle-Karth G., Palkovits P., Heinz G., Muller M. Plasma and tissue pharmacokinetics of cefpirome in patients with sepsis. Crit Care Med. 2002 Jul; 30 (7): 1478–82.Joukhadar C.I., Klein N., Mayer B.X., Kreischitz N., Delle-Karth G., Palkovits P., Heinz G., Müller M. Plasma and tissue pharmacokinetics of cefpirome in patients with sepsis. Crit Care Med. 2002 Jul; 30 (7): 1478−82.Lindenmann J. I., Kugler S. A., Matzi V., Porubsky C., Maier A., Dittrich P., Graninger W., Smolle-Juttner F. M., Joukhadar C. High extracellular levels of cefpirome in unaffected and infected lung tissue of patients. J Antimicrob Chemother. 2011 Jan; 66 (1): 160–4.Lindenmann J.I., Kugler S.A., Matzi V., Porubsky C., Maier A., Dittrich P., Graninger W., Smolle-Jüttner F.M., Joukhadar C. High extracellular levels of cefpirome in unaffected and infected lung tissue of patients. J Antimicrob Chemother. 2011 Jan; 66 (1): 160−4.Дмитриева Н. В. Фебрильная нейтропения у онкологических больных. Русский медицинский журнал. 2003; 12 (11): 734–736.Dmitrieva N.V. Febrile neutropenia in cancer patients. Russkii meditsinskii zhurnal = Russian Medical Journal. 2003; 12 (11): 734–736.Bauduer F. I., Cousin T., Boulat O., Rigal-Huguet F., Molina L., Fegueux N., Jourdan E., Boiron J. M., Reiffers J. BGMT Collaborative Group. A randomized prospective multicentre trial of cefpirome versus piperacillin/tazobactam in febrile neutropenia. Leuk Lymphoma. 2001 Jul; 42 (3): 379–86.Bauduer F.I., Cousin T., Boulat O., Rigal-Huguet F., Molina L., Fegueux N., Jourdan E., Boiron J.M., Reiffers J. BGMT Collaborative Group. A randomized prospective multicentre trial of cefpirome versus piperacillin/tazobactam in febrile neutropenia. Leuk Lymphoma. 2001 Jul; 42 (3): 379−86.Su Y. C., Sheu Y. T., Peng M. Y., Yeh K. M., Huang C. Y., Wang S. M., Chang Y. F., Chang M. C., Wu M. F., Tsao S. M. An observational study on the empiric use of cefpirome in febrile neutropenia. J Microbiol Immunol Infect. 2007 Feb; 40 (1): 62–7.Su Y.C., Sheu Y.T., Peng M.Y., Yeh K.M., Huang C.Y., Wang S.M., Chang Y.F., Chang M.C., Wu M.F., Tsao S.M. An observational study on the empiric use of cefpirome in febrile neutropenia. J Microbiol Immunol Infect. 2007; 40 (1): 62−7.Timmers G. J., van Vuurden D. G., Swart E. L., Simoons-Smit A. M., Huijgens P. C. Cefpirome as empirical treatment for febrile neutropenia in patients with hematologic malignancies. Haematologica. 2005 Jul; 90 (7): 1005–6.Timmers G.J., van Vuurden D.G., Swart E.L., Simoons-Smit A.M., Huijgens P.C. Cefpirome as empirical treatment for febrile neutropenia in patients with hematologic malignancies. Haematologica. 2005 Jul; 90 (7): 1005−6.Kumamoto Y., Tsukamoto T., Matsukawa M., Kunishima Y., Hirose T., Shigeta S., Yamaguchi O., Ishibashi K., Suzutani T., Yoshida H., Imafuku Y., Murai M., Watanabe K., Kobayashi Y., Uchida H., Matsuda S., Sato S., Fujime M., Fujita K., Igari J., Oguri T., Yamaguchi K., Furuya N., Deguchi T., Ishihara S., Ooe H., Oka T, Kitamura M., Fukuhara Y., Kamidono S., Arakawa S., Kumon H., Monden K., Matsumoto T., Muratani T., Naito S., Egashira T., Konishi T., Kohno S., Hirakata Y., Kondo A., Matsuda J., Nakano M. Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2004). III. Secular changes in susceptibility. Japanise J Antibiot. 2006 Aug; 59 (4): 217–315.Kumamoto Y., Tsukamoto T., Matsukawa M., Kunishima Y., Hirose T., Shigeta S., Yamaguchi O., Ishibashi K., Suzutani T., Yoshida H., Imafuku Y., Murai M., Watanabe K., Kobayashi Y., Uchida H., Matsuda S., Sato S., Fujime M., Fujita K., Igari J., Oguri T., Yamaguchi K., Furuya N., Deguchi T., Ishihara S., Ooe H., Oka T, Kitamura M., Fukuhara Y., Kamidono S., Arakawa S., Kumon H., Monden K., Matsumoto T., Muratani T., Naito S., Egashira T., Konishi T., Kohno S., Hirakata Y., Kondo A., Matsuda J., Nakano M. Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2004). III. Secular changes in susceptibility. Japanise J Antibiot. 2006 Aug; 59 (4): 217−315.Nikolovski M., Kotsev Iu., Panchev P. Treatment with cerom (cefpirom) in severe urulogical infections. Khirurgiia (Sofia). 2004; 60 (4–5): 39–41.Nikolovski M., Kotsev Iu., Panchev P. Treatment with cerom (cefpirom) in severe urulogical infections. Khirurgiia (Sofia). 2004; 60 (4−5): 39−41.Hayashi Y., Yamashita T., Nakata T., Huji T., Kojima T., Katayama H., Ishikawa M. Cefpirome sulphate for gynecological infections and prophilaxis of non-laparatomy surgery in patients with begin disease. Int J Antimicrob Agents. 2002 May; 19 (5): 405–11.Hayashi Y., Yamashita T., Nakata T., Huji T., Kojima T, Katayama H., Ishikawa M. Cefpirome sulphate for gynecological infections and prophilaxis of non-laparatomy surgery in patients with begin disease. Int J Antimicrob Agents. 2002 May; 19 (5): 405−11.Mikamo H. I., Sato Y., Hayasaki Y., Hua Y. X., Tamaya T., Iwasa S., Kawazoe K., Furuta N., Ito M., Nomura M., Tsukahara Y., Furui K., Sakakibara K., Hattori S., Sugiyama M., Ohnishi N., Hirose R., Nakagawa M., Yamada Y., Hashiyama T., Arahori K., Izumi K., Shiraki S., Morishita S., Watanabe K. Clinical efficacy of cefpirome sulfate against Bacteroides species, Prevotella species and Porphyromonas species. Society of Anaerobic Bacterial Infections in the fields of obstetrics and gynecology in Gifu. Japanise J Antibiot. 2000 Jan; 53 (1): 26–45.Mikamo H.I., Sato Y., Hayasaki Y., Hua Y.X., Tamaya T., Iwasa S., Kawazoe K., Furuta N., Ito M., Nomura M., Tsukahara Y., Furui K., Sakakibara K., Hattori S., Sugiyama M., Ohnishi N., Hirose R., Nakagawa M., Yamada Y., Hashiyama T., Arahori K., Izumi K., Shiraki S., Morishita S., Watanabe K. Clinical efficacy of cefpirome sulfate against Bacteroides species, Prevotella species and Porphyromonas species. Society of Anaerobic Bacterial Infections in the fields of obstetrics and gynecology in Gifu. Japanise J Antibiot. 2000 Jan; 53 (1): 26−45.Giamarellou H. Forth generation cephalosporins in the antimicrobial chemotherapy of surgical infections. J Chemotherapy. 1999 Dec; 11 (2): 486–93.Giamarellou H. Forth generation cephalosporins in the antimicrobial chemotherapy of surgical infections. J Chemotherapy. 1999 Dec; 11 (2): 486−93.Cereda R. F. I., Sader H. S., Barth A. L., Segura A., Kage R., Novakonski A., Pignatari A. C. Evaluation of the in vitro Activity of Two Fourth — Generation Cephalosporins Against Bacterial Samples Isolated From Patients in Several Brazilian Hospitals. Braz J Infect Dis. 1999 Oct; 3 (5): 189–196.Cereda R.F.I., Sader H.S., Barth A.L., Segura A., Kage R., Novakonski A., Pignatari A.C. Evaluation of the in vitro Activity of Two Fourth ― Generation Cephalosporins Against Bacterial Samples Isolated From Patients in Several Brazilian Hospitals. Braz J Infect Dis. 1999 Oct; 3 (5): 189−196.Matsuoka S., Takahashi Y., Kuroda Y. Clinica levaluation of Cefpirome in pediatric field. Japanise J Antibiot. 1991; 44 (4): 462–465.Matsuoka S., Takahashi Y., Kuroda Y. Clinica levaluation of Cefpirome in pediatric field. Japanise J Antibiot. 1991; 44 (4): 462−465.Meguro H., Fujii R., Tajima T., Abe T. Clinical evaluation of Cefpirome in Children. Japanise J Antibiot. 1991 Feb; 44 (2): 160–7.Meguro H., Fujii R., Tajima T., Abe T. Clinical evaluation of Cefpirome in Children. Japanise J Antibiot.1991 Feb; 44 (2): 160−7.Furakawa S., Okada T. Clinical evaluation of Cefpirome in pediatrics and a study on the penetration into cerebrospinal fluid. Japanise J Antibiot. 1991; 44 (4): 472–479.Furakawa S., Okada T. Clinical evaluation of Cefpirome in pediatrics and a study on the penetration into cerebrospinal fluid. Japanise J Antibiot. 1991; 44 (4): 472−479.

The authors declare that there are no conflicts of interest present.