1
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Mechanism and implication of cephalosporin penetration into oropharyngeal mucosa. J Infect Chemother 2009; 15:70-4. [DOI: 10.1007/s10156-008-0666-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Accepted: 12/26/2008] [Indexed: 10/20/2022]
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2
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Affiliation(s)
- William M Stauffer
- Infectious Diseases, Department of Internal Medicine, University of Minnesota, St. Paul, MN, USA
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3
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Shenep JL, Flynn PM, Baker DK, Hetherington SV, Hudson MM, Hughes WT, Patrick CC, Roberson PK, Sandlund JT, Santana VM, Sixbey JW, Slobod KS. Oral cefixime is similar to continued intravenous antibiotics in the empirical treatment of febrile neutropenic children with cancer. Clin Infect Dis 2001; 32:36-43. [PMID: 11112678 DOI: 10.1086/317552] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/1999] [Revised: 05/24/2000] [Indexed: 01/09/2023] Open
Abstract
Empiric oral antibiotic therapy for febrile neutropenic cancer patients has been suggested as a means to decrease hospitalization, but the safety of this approach has not been adequately studied in children. We compared continued iv antibiotic therapy with switching treatment to orally administered cefixime in a group of selected febrile neutropenic children for whom blood cultures were sterile after 48 h of incubation. Two hundred episodes of febrile neutropenia were studied (156 patients), and 100 episodes were randomized to receive each treatment. Failure to respond to therapy was defined by documented or suspected bacterial infection, recurrent fever, or discontinuation of assigned therapy for any reason before neutropenia resolved. Rates of treatment failure were similar in the oral cefixime group (28%) and in the iv antibiotic group (27%; P=1.0). Results support the safety of oral cefixime therapy for low-risk febrile neutropenic children, a therapeutic approach that would facilitate earlier outpatient management and decrease the costs of treatment.
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Affiliation(s)
- J L Shenep
- Department of Infectious Diseases, St. Jude Children's Research Hospital, University of Tennessee Health Sciences Center, Memphis, TN 38105, USA.
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4
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Barry AL, Fuchs PC. Methods for predicting susceptibility of Streptococcus pneumoniae to cefixime. J Clin Microbiol 1995; 33:1031-3. [PMID: 7790431 PMCID: PMC228095 DOI: 10.1128/jcm.33.4.1031-1033.1995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Among 698 Streptococcus pneumoniae isolates, 475 were penicillin susceptible and > 99% of those were susceptible to 0.5 microgram of cefixime per ml; other pneumococci were tentatively assumed to be resistant to cefixime. A 1-microgram oxacillin disk was more reliable than a 5-micrograms cefixime disk for predicting susceptibility to cefixime.
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Affiliation(s)
- A L Barry
- Clinical Microbiology Institute, Tualatin, Oregon 97062, USA
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5
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Low DE, Scriver SR. Evaluation of the in vitro activity of cefixime for its use in switch therapy. Curr Ther Res Clin Exp 1994. [DOI: 10.1016/s0011-393x(05)80725-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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6
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7
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Lehtonen L, Huovinen P. Susceptibility of respiratory tract pathogens in Finland to cefixime and nine other antimicrobial agents. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1993; 25:373-8. [PMID: 8362234 DOI: 10.3109/00365549309008513] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The in vitro activity of cefixime and 9 other orally used antimicrobial agents against 545 selected clinical respiratory tract pathogens was tested using the plate-dilution method. Of the strains tested, 144 were Haemophilus influenzae strains, 151 group A streptococci, 105 pneumococci and 145 Moraxella catarrhalis isolates. Ciprofloxacin was the most active drug, with a minimal inhibitory concentration (MIC) of < 0.06 mg/l for more than 87% of the isolates. With cefixime, a MIC of 0.06 mg/l inhibited 55% of the strains tested and a MIC of 1.0 mg/l inhibited all except one of the 545 strains. One pneumococcal strain was resistant to cefixime. Beta-lactamase producing H. influenzae and M. catarrhalis strains were clearly more susceptible to cefixime than to other oral cephalosporins (cephalexin, cefaclor, cefuroxime). However, penicillin, ampicillin and cefuroxime were more effective against beta-hemolytic streptococci and pneumococci than was cefixime. The new third generation cephalosporin, cefixime, showed markedly better in vitro activity against certain major respiratory tract pathogens than the other peroral antimicrobials commonly used against respiratory tract infections.
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Affiliation(s)
- L Lehtonen
- Orion Pharmaceutica, Research Center, Espoo, Finland
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8
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Cefixime in the Treatment of Acute Lower Respiratory Tract and Urinary Tract Infections. Clin Drug Investig 1992. [DOI: 10.1007/bf03258376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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9
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Nash DR, Flanagan C, Steele LC, Wallace RJ. Comparison of the activity of cefixime and activities of other oral antibiotics against adult clinical isolates of Moraxella (Branhamella) catarrhalis containing BRO-1 and BRO-2 and Haemophilus influenzae. Antimicrob Agents Chemother 1991; 35:192-4. [PMID: 1901696 PMCID: PMC244967 DOI: 10.1128/aac.35.1.192] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
MICs of 10 oral antibiotics were determined for 105 Moraxella catarrhalis and 96 Haemophilus influenzae isolates from adults. A two- to fourfold increase in MICs of oral cephalosporins was seen in the presence of BRO-1 but not with TEM-1 or BRO-2. The MICs of cefixime for 90% of strains of H. influenzae (0.125 microgram/ml) and M. catarrhalis (0.25 microgram/ml) were 8- to 64-fold lower than those of other oral cephalosporins.
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Affiliation(s)
- D R Nash
- Department of Microbiology, University of Texas Health Center, Tyler 75710
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10
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Bauernfeind A. Comparative antimicrobial spectrum and activity of ceftibuten against clinical isolates from West Germany. Diagn Microbiol Infect Dis 1991; 14:63-74. [PMID: 2013211 DOI: 10.1016/0732-8893(91)90091-s] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The in vitro activity of a new oral cephalosporin, ceftibuten, was determined against 837 clinical isolates by agar dilution technique and compared with that of the oral cephalosporins, cefaclor, cefuroxime, cefixime, cefpodoxime, and cefprozil. Against Enterobacteriaceae, ceftibuten was the most active of the compounds. Ceftibuten MIC90s were less than or equal to 0.25 micrograms/ml for most members of the family Enterobacteriaceae, 0.13 microgram/ml for Haemophilus influenzae, 4 micrograms/ml for Moraxella catarrhalis, and 0.5 microgram/ml for Neisseria gonorrhoeae. Ceftibuten also was active against beta-haemolytic streptococci (serogroups A, C, and G) and penicillin-susceptible strains of Streptococcus pneumoniae (MIC90, 4 micrograms/ml), but was not active against Staphylococcus spp. or the anaerobic bacteria studied. Cefpodoxime and cefuroxime were the most active of the cephalosporins against nonenteric streptococci; cefprozil and cefuroxime were the most active against staphylococci, and cefaclor demonstrated the greatest activity against some Bacteroides spp. Most strains of Acinetobacter baumanii, Pseudomonas spp., and methicillin-resistant staphylococci, as well as all strains of Clostridium difficile, were resistant to each of the cephalosporins tested.
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Affiliation(s)
- A Bauernfeind
- Max von Pettenkofer Institute, Munich, Federal Republic of Germany
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11
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Singh KV, Reves RR, Pickering LK, Murray BE. Comparative in vitro activities of amoxicillin-clavulanic acid, cefuroxime, cephalexin, and cephalothin against trimethoprim-resistant Escherichia coli isolated from stools of children attending day-care centers. Antimicrob Agents Chemother 1990; 34:2047-9. [PMID: 2073095 PMCID: PMC171996 DOI: 10.1128/aac.34.11.2047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A high prevalence of fecal colonization with trimethoprim-resistant Escherichia coli was found in diapered children attending day-care centers in Houston, Tex. In the present study, 100 isolates of E. coli resistant to multiple antibiotics, including trimethoprim (100%), sulfisoxazole (100%), streptomycin (94%), and ampicillin (87%), were obtained over a 5-month period from stool samples of diapered children attending four day-care centers and tested for their susceptibilities to amoxicillin-clavulanic acid, cefuroxime, cephalexin, and cephalothin. The MICs for 50 and 90% of strains tested were 16 and 32 micrograms/ml, respectively, for amoxicillin-clavulanic acid, 4 and 16 micrograms/ml, respectively, for cefuroxime, 4 and 64 micrograms/ml, respectively, for cephalexin, and 32 and greater than 64 micrograms/ml, respectively, for cephalothin. Although all three oral beta-lactams tested were generally active at concentrations likely to be achieved in urine, cefuroxime and cephalexin were more potent and are thus more likely to be inhibitory at the concentrations needed for systemic infections.
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Affiliation(s)
- K V Singh
- Department of Medicine, University of Texas Medical School, Houston 77030
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12
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Mortensen JE, Himes SL. Comparative in vitro activity of cefixime against Haemophilus influenzae isolates, including ampicillin-resistant, non-beta-lactamase-producing isolates, from pediatric patients. Antimicrob Agents Chemother 1990; 34:1456-8. [PMID: 2386375 PMCID: PMC176002 DOI: 10.1128/aac.34.7.1456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The in vitro activity of cefixime was comparatively tested against 232 non-type b and 102 type b isolates of Haemophilus influenzae derived from clinical specimens of pediatric patients, including 10 non-type b strains that did not produce beta-lactamase and demonstrated resistance to ampicillin. Cefixime was active against the ampicillin-susceptible and ampicillin-resistant, beta-lactamase-producing isolates; however, its activity against some non-beta-lactamase-producing, ampicillin-resistant isolates appeared to be limited.
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Affiliation(s)
- J E Mortensen
- St. Christopher's Hospital for Children, Philadelphia, Pennsylvania 19134
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13
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Sanders CC. beta-Lactamase stability and in vitro activity of oral cephalosporins against strains possessing well-characterized mechanisms of resistance. Antimicrob Agents Chemother 1989; 33:1313-7. [PMID: 2802558 PMCID: PMC172646 DOI: 10.1128/aac.33.8.1313] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The in vitro activity of four oral cephalosporins was assessed in dilution tests with 50 isolates of the family Enterobacteriaceae possessing well-characterized mechanisms of resistance to beta-lactam antibiotics. The interaction of the drugs with a broad array of beta-lactamases was also determined in spectrophotometric assays and tests for enzyme induction. Overall, the percentages of strains susceptible to each of the study drugs were 82% for cefixime, 62% for cefuroxime, 58% for cephalexin, and 44% for cefaclor. The poor activity of the older cephalosporins was due to a high degree of susceptibility to hydrolysis by both plasmid-mediated and chromosomally mediated beta-lactamases. For cefaclor, higher MICs were associated with higher levels of plasmid-mediated beta-lactamases in the strains. Resistance to cefuroxime was seen primarily among strains expressing high levels of class I or IV beta-lactamase. Resistance to cefixime was seen only among strains expressing high levels of class I enzymes. Neither cefixime nor cefuroxime was a strong inducer of class I beta-lactamases, although enzyme induction did appear to play a role in cefuroxime resistance in a strain of Serratia marcescens. The consistently greater activity of cefixime over cefuroxime was found not to be due to greater drug permeation into the cell. Rather, it appeared to result from the high affinity of the drug for target enzymes.
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Affiliation(s)
- C C Sanders
- Department of Medical Microbiology, Creighton University School of Medicine, Omaha, Nebraska 68178
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14
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Kuhlwein A, Nies BA. Efficacy and safety of a single 400 mg oral dose of cefixime in the treatment of uncomplicated gonorrhea. Eur J Clin Microbiol Infect Dis 1989; 8:261-2. [PMID: 2496996 DOI: 10.1007/bf01965274] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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15
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Faulkner RD, Sia LL, Barone JS, Forbes SJ, Silber BM. Bioequivalency of oral suspension formulations of cefixime. Biopharm Drug Dispos 1989; 10:205-11. [PMID: 2706319 DOI: 10.1002/bdd.2510100209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A study was performed in 24 healthy male subjects to establish that two suspension formulations of cefixime were bioequivalent to each other and to a reference oral solution. A single 400 mg oral dose of the drug was given in a randomized three-way crossover design as two suspensions (a research suspension (RS) used during clinical trials and a suspension intended for marketing (MS] and a reference oral solution (SOL). Each dose was separated from the other by a 3-day washout period. Mean peak serum concentrations (Cmax) were 4.67, 4.10, and 4.27 micrograms ml-1 after the MS, RS, and SOL, respectively. Although comparison (ANOVA) of the mean pharmacokinetic parameters for cefixime found significant differences (p less than 0.05) in Cmax, the time to Cmax, and area under the serum concentration time curve (AUC 0----infinity) values among the three formulations, the mean differences were less than 20 per cent. No significant differences (p greater than 0.05) were found in either the elimination half-life or renal clearance of unchanged drug. Overall, with a 98 per cent power to detect a 20 per cent difference in AUC0----infinity or urinary recovery values between the formulations tested, the results show that the MS was bioequivalent to the RS and that both suspensions were bioequivalent to the SOL.
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Affiliation(s)
- R D Faulkner
- Medical Research Division, American Cyanamid Company Pearl River, New York 10965
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16
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Jones RN, Barry AL. Ceftibuten (7432-S, SCH 39720): comparative antimicrobial activity against 4735 clinical isolates, beta-lactamase stability and broth microdilution quality control guidelines. Eur J Clin Microbiol Infect Dis 1988; 7:802-7. [PMID: 3145869 DOI: 10.1007/bf01975055] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The antimicrobial activity of ceftibuten, a new oral cephalosporin, was evaluated using 4735 clinical bacterial isolates processed at four medical centers. Ceftibuten inhibited nearly 92% of all Enterobacteriaceae (less than or equal to 8.0 micrograms/ml), thereby being markedly superior to cefixime which inhibited 78.7% at less than or equal to 1.0 microgram/ml and cefuroxime which inhibited 45.1% at less than or equal to 2.0 micrograms/ml. Pseudomonads and staphylococci were not within the spectrum of activity of ceftibuten. Ceftibuten was found to be very stable in the presence of five commonly occurring beta-lactamases of both the chromosomal-mediated (P99, K1) and plasmid-mediated (CARB-2, OXA-1, TEM-1) types. Only Type Ia (P99) beta-lactamase was significantly inhibited by ceftibuten. On the basis of results of a ceftibuten MIC quality control study conducted in five laboratories, a quality control range of 0.12 to 0.5 microgram/ml is recommended for the Escherichia coli ATCC 25922 strain.
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Affiliation(s)
- R N Jones
- Clinical Microbiology Institute, Tualatin, Oregon 97062
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17
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Abstract
MDL 19,592, a semisynthetic oral cephalosporin, has an antimicrobial spectrum principally directed against Gram-positive cocci (MIC50, 0.25-4 micrograms/ml), Branhamella catarrhalis (MIC50, 1-2 micrograms/ml), and pathogenic Neisseria spp. such as meningococci (MIC50, 4 micrograms/ml). Enterobacteriaceae, enterococci, Pseudomonas spp., Corynebacterium jeikeium, and Acinetobacter calcoaceticus strains had MDL 19,592 MIC50 of greater than or equal to 32 micrograms/ml. Although MDL 19,592 generally had a spectrum most similar to cefadroxil, it could not be represented by the cephalothin susceptibility test because of low predictive values and MIC correlations.
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Affiliation(s)
- R N Jones
- Clinical Microbiology Institute, Tualatin, Oregon 97062
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18
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Faulkner RD, Fernandez P, Lawrence G, Sia LL, Falkowski AJ, Weiss AI, Yacobi A, Silber BM. Absolute bioavailability of cefixime in man. J Clin Pharmacol 1988; 28:700-6. [PMID: 3216036 DOI: 10.1002/j.1552-4604.1988.tb03203.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In a four-way cross-over study, the absolute bioavailability of cefixime was determined in 16 healthy volunteers. Each subject received a single 200-mg dose as an intravenous (IV) and oral solution, and 200-mg and 400-mg capsule doses of the drug. Blood and urine samples were collected for 24 hours after each dose. Cefixime was well tolerated after IV and oral doses of the drug and no serious drug-related adverse effects were observed. The maximal serum concentration (Cmax) of cefixime following the 200-mg oral solution and 200-mg and 400-mg capsule doses were 3.22, 2.92, and 4.84 micrograms/mL, respectively. Mean area under the serum concentration time curves (AUC) following the IV, 200-mg oral solution, and 200-mg and 400-mg capsule doses were 47.0, 26.0, 23.6, and 39.4 micrograms.hr/mL, respectively. Mean elimination half-life values of the drug were comparable after oral and IV doses, ranging from 3.2 to 3.5 hours. Based on serum AUC values, the absolute bioavailability of cefixime was 52.3%, 47.9%, and 40.2% after the 200-mg oral solution, 200-mg capsule and 400-mg capsule doses, respectively. Respective ratios based on 24-hour urinary recovery data were 44.7%, 41.7%, and 40.5%. Therefore, the results show that the percent of cefixime adsorbed after 200-mg and 400-mg oral doses was similar.
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Affiliation(s)
- R D Faulkner
- Medical Research Division, American Cyanamid Co., Pearl River, New York
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19
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Jones RN, Barry AL. BMY-28100, a new oral cephalosporin: antimicrobial activity against nearly 7,000 recent clinical isolates, comparative potency with other oral agents, and activity against beta-lactamase producing isolates. Diagn Microbiol Infect Dis 1988; 9:11-26. [PMID: 3259489 DOI: 10.1016/0732-8893(88)90056-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The antimicrobial activity of BMY-28100 was tested against approximately 7,000 bacterial pathogens in a multicenter, multiphased collaborative investigation. The BMY-28100 spectrum and antimicrobial potency was most similar to that of cefaclor and superior to that of cephalexin among currently available cephalosporins. Species that had greater than or equal to 90% of clinical strains inhibited by BMY-28100 (less than or equal to 8.0 micrograms/ml) were: Citrobacter diversus, Escherichia coli, Klebsiella spp., Proteus mirabilis, Salmonella spp., Branhamella catarrhalis, Haemophilus influenzae, Neisseria gonorrhoeae, N. meningitidis, methicillin-susceptible Staphylococcus supp., Streptococcus pneumoniae, S. pyogenes, S. agalactiae, S. bovis, serogroup C and G streptococci, Listeria monocytogenes and gm-positive anaerobes. BMY-28100 inhibited 9% more of the 6286 fresh clinical isolates at less than or equal to 8.0 micrograms/ml than cefaclor at the same concentration. BMY-28100 was generally bactericidal, but MICs for some species were markedly increased when an inoculum concentration of 10(7) CFU/ml was used. Strains producing plasmid-mediated beta-lactamases (TEM, OXA, SHV, HMS) were susceptible to BMY-28100, cefaclor, and cefuroxime. BMY-28100 was less active against strains producing chromosomal-mediated beta-lactamases (Types I and IV). BMY-28100 was not hydrolyzed significantly by the tested plasmid-mediated beta-lactamases, but was destroyed by Type I cephalosporinases and Klebsiella K1 enzymes.
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Affiliation(s)
- R N Jones
- Clinical Microbiology Institute, Tualatin, OR
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20
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Antimicrobial activity, spectrum and pharmacokinetics of old and new orally administered cephems. ACTA ACUST UNITED AC 1988. [DOI: 10.1016/0738-1751(88)90015-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Mulligan ME. In vitro activity of cefixime and six other agents against nosocomial pathogens of the Enterobacteriaceae family. INFECTION CONTROL : IC 1987; 8:241-4. [PMID: 3498702 DOI: 10.1017/s019594170006611x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Cefixime, a broad-spectrum, orally active cephalosporin, was more active in vitro than ampicillin, cefaclor, cephalothin, and trimethoprim/sulfamethoxazole against 194 nosocomial pathogens of the family Enterobacteriaceae. Activity was especially good against Klebsiella spp, Proteus spp, Serratia spp, and Providencia stuartii. Although gentamicin had equivalent or better activity against Citrobacter spp, Enterobacter spp, Escherichia coli, and Morganella morganii, all 23 of the gentamicin-resistant strains studied were susceptible to cefixime. Isolates tested were from urinary tract infections, abdominal infections, wounds, vascular infections, and respiratory infections; they were sequentially collected nosocomial pathogens from a single institution. This orally active cephalosporin should be considered for therapy of a variety of nosocomial infections involving gram-negative bacillary pathogens.
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Affiliation(s)
- M E Mulligan
- Medical Service, Veterans Administration, West Los Angeles Medical Center, California 90073
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Jones RN, Fuchs PC, Barry AL, Ayers LW, Gerlach EH, Gavan TL. Antimicrobial activity of Ro 19-5247 (T-2525), a new oral cephalosporin, tested against 7,745 recent clinical isolates. Diagn Microbiol Infect Dis 1987; 6:193-8. [PMID: 3568594 DOI: 10.1016/0732-8893(87)90012-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The susceptibility testing of 7,745 recent clinical isolates from four medical centers showed Ro 19-5247 to be eight- to greater than 64-fold more active than cephalexin against the Enterobacteriaceae. Ro 19-5247 was comparable with cephalexin in anti-staphylococcal activity (MIC50, 4.0 micrograms/ml) and fourfold more active than cefixime. None of the oral cephalosporins were effective (MIC50, greater than 32 micrograms/ml) against enterococci, Pseudomonas aeruginosa and P. maltophilia. beta-lactamase hydrolysis experiments failed to demonstrate significant Ro 19-5247 inactivation by ten commonly encountered chromosomal- or plasmid-mediated enzymes (P99, K1, K14, TEM, CARB, OXA).
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Abstract
A total of 583 bacterial isolates was tested for susceptibility to cefixime by broth microdilution and by disk agar diffusion with 5-, 10-, and 30-microgram disks. At MIC breakpoints of less than or equal to 1.0 and greater than or equal to 4 micrograms/ml for susceptible and resistant, respectively, the 5-microgram disk showed slightly better discrimination. The 5-microgram cefixime disk is recommended with proposed interpretive breakpoint criteria of: less than or equal to 17 mm, resistant; 18 to 20 mm, intermediate; and greater than or equal to 21 mm, susceptible.
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