Comparative in-vitro activity of cefpirome against isolates from intensive care and haematology/oncology units

The susceptibility of 389 Enterobacteriaceae, 231 other Gram-negative bacilli (including 150 Pseudomonas aeruginosa) and 233 Gram-positive organisms was determined by the NCCLS reference microdilution technique against cefpirome and other antibiotics. Cefpirome and cefepime were the most active compounds against Enterobacteriaceae, including potentially beta-lactamase-inducible species. The MIC90 of cefpirome against potentially inducible and noninducible species of Enterobacteriaceae was 2 mg/L and 0.5 mg/L, respectively. Ceftazidime, cefpirome and cefepime had similar activity against P. aeruginosa, with MIC(90)s of 64 mg/L, 64 mg/L and 32 mg/L, respectively. Cefpirome and cefepime had similar activity against Grampositive cocci, with MIC(90)s of 1 mg/L and 2 mg/L, respectively, against oxacillin-susceptible Staphylococcus aureus and 64 mg/L and 128 mg/L, respectively, against Enterococcus spp.; both had an MIC90 of 1 mg/L against Streptococcus pneumoniae. This study shows that fourth-generation cephalosporins, such as cefpirome, could be useful in haematology/oncology units and, in particular, ICUs where high resistance rates are observed.