Comparative efficacy of ceftazidime vs. carbenicillin and amikacin for treatment of neonatal septicemia

C. M. Odio, M. A. Umana, A. Saenz, J. L. Salas, G. H. McCracken

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

The efficacy and safety of ceftazidime were compared with those of carbenicillin and amikacin in 60 neonates with proved invasive bacterial infections. The two treatment groups of patients were comparable with regard to sex, gestational and chronologic ages, associated risk factors, clinical condition on enrollment, focus of infection and bacteriology. Escherichia coli was isolated from blood cultures of 31%, Pseudomonas aeruginosa from cultures of 25%, Klebsiella sp. from cultures of 13% and other Gram-negative enteric bacilli from cultures of 17% of the patients. Staphylococcus aureus was isolated from 20% (12 of 60), and coagulase-negative staphylococci from 8% (5 of 60) of the patients. All Gram-negative coliform bacilli were susceptible to ceftazidime whereas 10, 56 and 77% were resistant to amikacin, carbenicillin and ampicillin, respectively. Serum bactericidal activity against the offending pathogen was as much as 5-fold greater in ceftazidime-treated compared with conventionally treated patients. Seven patients with infections caused by organisms resistant to the study drugs were excluded from analysis. Case-fatality rates were 6.4% (2 of 31) and 21% (6 of 28) in the ceftazidime- and amikacin/carbenicillin-treated patients, respectively. Total failure rates, including deaths, were significantly higher in patients treated with amikacin/carbenicillin (8 of 28, 28.5%) compared with that of ceftazidime-treated patients (2 of 31, 6.4%). Thirteen percent (5 of 31) and 3% (1 of 28) of the ceftazidime- and amikacin/carbenicillin-treated patients, respectively, developed invasive Candida albicans superinfection while receiving treatment. In this study results of treatment with ceftazidime were superior to results of treatment with amikacin/carbenicillin for invasive bacterial infections of newborn infants. This difference was principally attributed to superior efficacy of ceftazidime for treatment of Pseudomonas infections.

Original languageEnglish (US)
Pages (from-to)371-377
Number of pages7
JournalPediatric Infectious Disease Journal
Volume6
Issue number4
StatePublished - 1987

Fingerprint

Carbenicillin
Ceftazidime
Amikacin
Sepsis
Therapeutics
Bacterial Infections
Newborn Infant
Pseudomonas Infections
Superinfection
Bacteriology
Klebsiella
Mortality
Coagulase
Enterobacteriaceae
Ampicillin
Infection
Candida albicans
Staphylococcus
Pseudomonas aeruginosa
Bacillus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Comparative efficacy of ceftazidime vs. carbenicillin and amikacin for treatment of neonatal septicemia. / Odio, C. M.; Umana, M. A.; Saenz, A.; Salas, J. L.; McCracken, G. H.

In: Pediatric Infectious Disease Journal, Vol. 6, No. 4, 1987, p. 371-377.

Research output: Contribution to journalArticle

@article{0bfbb6b9558c4352a96e40b5f667a05a,
title = "Comparative efficacy of ceftazidime vs. carbenicillin and amikacin for treatment of neonatal septicemia",
abstract = "The efficacy and safety of ceftazidime were compared with those of carbenicillin and amikacin in 60 neonates with proved invasive bacterial infections. The two treatment groups of patients were comparable with regard to sex, gestational and chronologic ages, associated risk factors, clinical condition on enrollment, focus of infection and bacteriology. Escherichia coli was isolated from blood cultures of 31{\%}, Pseudomonas aeruginosa from cultures of 25{\%}, Klebsiella sp. from cultures of 13{\%} and other Gram-negative enteric bacilli from cultures of 17{\%} of the patients. Staphylococcus aureus was isolated from 20{\%} (12 of 60), and coagulase-negative staphylococci from 8{\%} (5 of 60) of the patients. All Gram-negative coliform bacilli were susceptible to ceftazidime whereas 10, 56 and 77{\%} were resistant to amikacin, carbenicillin and ampicillin, respectively. Serum bactericidal activity against the offending pathogen was as much as 5-fold greater in ceftazidime-treated compared with conventionally treated patients. Seven patients with infections caused by organisms resistant to the study drugs were excluded from analysis. Case-fatality rates were 6.4{\%} (2 of 31) and 21{\%} (6 of 28) in the ceftazidime- and amikacin/carbenicillin-treated patients, respectively. Total failure rates, including deaths, were significantly higher in patients treated with amikacin/carbenicillin (8 of 28, 28.5{\%}) compared with that of ceftazidime-treated patients (2 of 31, 6.4{\%}). Thirteen percent (5 of 31) and 3{\%} (1 of 28) of the ceftazidime- and amikacin/carbenicillin-treated patients, respectively, developed invasive Candida albicans superinfection while receiving treatment. In this study results of treatment with ceftazidime were superior to results of treatment with amikacin/carbenicillin for invasive bacterial infections of newborn infants. This difference was principally attributed to superior efficacy of ceftazidime for treatment of Pseudomonas infections.",
author = "Odio, {C. M.} and Umana, {M. A.} and A. Saenz and Salas, {J. L.} and McCracken, {G. H.}",
year = "1987",
language = "English (US)",
volume = "6",
pages = "371--377",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Comparative efficacy of ceftazidime vs. carbenicillin and amikacin for treatment of neonatal septicemia

AU - Odio, C. M.

AU - Umana, M. A.

AU - Saenz, A.

AU - Salas, J. L.

AU - McCracken, G. H.

PY - 1987

Y1 - 1987

N2 - The efficacy and safety of ceftazidime were compared with those of carbenicillin and amikacin in 60 neonates with proved invasive bacterial infections. The two treatment groups of patients were comparable with regard to sex, gestational and chronologic ages, associated risk factors, clinical condition on enrollment, focus of infection and bacteriology. Escherichia coli was isolated from blood cultures of 31%, Pseudomonas aeruginosa from cultures of 25%, Klebsiella sp. from cultures of 13% and other Gram-negative enteric bacilli from cultures of 17% of the patients. Staphylococcus aureus was isolated from 20% (12 of 60), and coagulase-negative staphylococci from 8% (5 of 60) of the patients. All Gram-negative coliform bacilli were susceptible to ceftazidime whereas 10, 56 and 77% were resistant to amikacin, carbenicillin and ampicillin, respectively. Serum bactericidal activity against the offending pathogen was as much as 5-fold greater in ceftazidime-treated compared with conventionally treated patients. Seven patients with infections caused by organisms resistant to the study drugs were excluded from analysis. Case-fatality rates were 6.4% (2 of 31) and 21% (6 of 28) in the ceftazidime- and amikacin/carbenicillin-treated patients, respectively. Total failure rates, including deaths, were significantly higher in patients treated with amikacin/carbenicillin (8 of 28, 28.5%) compared with that of ceftazidime-treated patients (2 of 31, 6.4%). Thirteen percent (5 of 31) and 3% (1 of 28) of the ceftazidime- and amikacin/carbenicillin-treated patients, respectively, developed invasive Candida albicans superinfection while receiving treatment. In this study results of treatment with ceftazidime were superior to results of treatment with amikacin/carbenicillin for invasive bacterial infections of newborn infants. This difference was principally attributed to superior efficacy of ceftazidime for treatment of Pseudomonas infections.

AB - The efficacy and safety of ceftazidime were compared with those of carbenicillin and amikacin in 60 neonates with proved invasive bacterial infections. The two treatment groups of patients were comparable with regard to sex, gestational and chronologic ages, associated risk factors, clinical condition on enrollment, focus of infection and bacteriology. Escherichia coli was isolated from blood cultures of 31%, Pseudomonas aeruginosa from cultures of 25%, Klebsiella sp. from cultures of 13% and other Gram-negative enteric bacilli from cultures of 17% of the patients. Staphylococcus aureus was isolated from 20% (12 of 60), and coagulase-negative staphylococci from 8% (5 of 60) of the patients. All Gram-negative coliform bacilli were susceptible to ceftazidime whereas 10, 56 and 77% were resistant to amikacin, carbenicillin and ampicillin, respectively. Serum bactericidal activity against the offending pathogen was as much as 5-fold greater in ceftazidime-treated compared with conventionally treated patients. Seven patients with infections caused by organisms resistant to the study drugs were excluded from analysis. Case-fatality rates were 6.4% (2 of 31) and 21% (6 of 28) in the ceftazidime- and amikacin/carbenicillin-treated patients, respectively. Total failure rates, including deaths, were significantly higher in patients treated with amikacin/carbenicillin (8 of 28, 28.5%) compared with that of ceftazidime-treated patients (2 of 31, 6.4%). Thirteen percent (5 of 31) and 3% (1 of 28) of the ceftazidime- and amikacin/carbenicillin-treated patients, respectively, developed invasive Candida albicans superinfection while receiving treatment. In this study results of treatment with ceftazidime were superior to results of treatment with amikacin/carbenicillin for invasive bacterial infections of newborn infants. This difference was principally attributed to superior efficacy of ceftazidime for treatment of Pseudomonas infections.

UR - http://www.scopus.com/inward/record.url?scp=0023253653&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023253653&partnerID=8YFLogxK

M3 - Article

VL - 6

SP - 371

EP - 377

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 4

ER -