Clinical efficacy of cefotiam against community-acquired pneumonia

Abstract

As a part of our survey of guidelines from the Japanese Respiratory Society (JRS) regarding the treatment of community-acquired pneumonia, we assessed the safety, clinical efficacy, and antibacterial activity of cefotiam, a second-generation cephalosporin antimicrobial, in actual clinical treatment of mild to moderate community-acquired pneumonia in Japan. Cases were classified in accordance with JRS guidelines as: bacterial pneumonia in which the causative organism was unknown (type A), bacterial pneumonia in which the causative organism was presumed (type B), or pneumonia in a special environment and condition (type E). Cefotiam was effective in 80.5%(268/333) of the type A cases, 81.7%(49/60) of the type B cases, and 85.7%(12/14) of the type E cases. These levels of efficacy are similar to those obtained 20 years ago when cefotiam was first introduced, and they underscore the continuing usefulness of this drug. The similarity of the results obtained against bacterial pneumonia type A and type B also indicates that the guidelines made it possible to accurately identify bacterial pneumonia even when the causative organism was unknown, supporting the usefulness of these guidelines (in selecting appropriate antibiotic treatment). Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Klebsiella pneumoniae were isolated before treatment in many cases. The efficacy of cefotiam was quite high against all of these organisms (89.8%[44/49], 86.7%[26/30], 80.0%[12/15], and 83.3 %[10/12], respectively), and the eradication rates were also favorable (88.5%[23/26], 87.5%[14/16], 85.7%[6/7], and 100%[6/6], respectively), suggesting that good therapeutic effects can be obtained when these guidelines are used to identify the type of community-acquired pneumonia and to select appropriate antibiotics.