Distribution of Fourth Generation Cephalosporin Antibiotics, Cefepime and Cefpirome, with Concomitant Effect of Bromhexine to Infected Lung

Abstract

The efficacy of treating infected lung is determined by the proper selection of antibiotics that are indicated for the causative strain of bacteria, and the penetration of drug to the broncho-alveolar system. In this study, we investigated the transfer of intravenously injected fourth generation cephalosporin antibiotics, cefepime (CFPM) and cefpirome (CPR) to broncho-alveolar system, using broncho-alveolar lavage fluid (BALF). Moreover, we administered bromhexine, which is a medication considered to have a promoting effect on antibiotic transfer, and investigated its effectiveness. Subjects were 20 cases of pneumonic patients evaluated in similar degree of disease. Study methods were an investigation of drug concentrations in serum and BALF from either CFPM or CPR antibiotics single use group (Group A) and bromhexine concomitant use group (Group B), and comparative study using aforementioned data and previous reports. CFPM concentration in BALF was average 1.706 ± 0.337 μg/ml in Group A, and average 2.459 ± 0.549 μg/ml in Group B. CPR concentration was the average 1.558 ± 0.308 μg/ml in Group A, and average 2.138 ± 0.461 μg/ml in Group B. As a conclusion, better penetration of antibiotics to infected lung was observed, compared to the reports made on animal experiments and healthy lung. Furthermore, enhanced penetration of CFPM and CPR to broncho-alveolar system was observed when bromhexine was administered concomitantly.