Fundamental and clinical evaluation of Cefpodoxime proxetil in the treatment of oral infections

—Especially, effects on Peptostreptococcus—

Abstract

Cefpodoxime proxetil (CPDX-PR) was orally administered twice a day at doses of 100 or 200mg to patients with closed abscess due to periodontitis (group I) and osteitis of the jaw (group III) in the treatment of infections in Dentistry and Oral Surgery, and the results were as follows:
1) The overall clinical efficacy, determined according to the standards established by the committee, was 91.4%. The efficacy by disease was 88.9% in group I and 93.0% in group III, and that by daily doses was 93.8% in the 200mg group and 90.2% in the 400mg group. The overall efficacy assessed by the doctors in charge was as high as 94.7%.
2) In the cases of which Peptostreptococcus was isolated, the clinical efficacy judged by the committee was 94.1%. The efficacy by disease was 91.7% in group I and 95.5% in group III, and that by daily doses was as high as 92.3% in the 200mg group and 95.2% in the 400 mg group.
3) As for the bacteriological effect, eradication rate by the committee was 94.9% in all cases and 97.1% in the cases of which Peptostreptococcus was isolated.
4) The MIC₅₀ and MIC₉₀ of CPDX against 265 clinically isolated strains were 0.39 and 0.78μg/ml, respectively, and those against 52 strains of Peptostreptococcus were 0.2 and 0.78μg/ml, respectively.
5) As for evaluation of the safety, rash, vomiting, constipation, and nausea were observed as side effects in 4 of 99 cases (4.0%) . None of those side effects were serious. Abnormal changes in laboratory tests, assessed by the doctors in charge, were observed in 5 cases (5.7%), including increases in GOT, GPT, BUN, eosinophilia, and monocytosis in 1 cases each. As for the committee's evaluation, 2 additional cases, including one each of leukopenia and urinary protein abnormality, were adopted, but none of thoese laboratory abnormalities were serious.
6) As for evaluation of the utility by the doctors in charge, the usefulness rate, including useful and better cases, was 92.6%.
From the above results, CPDX-PR was considered to be useful in the treatment of infections in Dentistry and Oral Surgery. Moreover, it was found that this drug is also very useful for infections caused by anaerobes, particularly Peptostreptococcus.