cefditoren and Acute-Disease

Cefditoren pivoxil, an oral third-generation cephalosporin, was approved by the Food and Drug Administration in September 2001. It has been used in Japan for several years. The greatest therapeutic potential of cefditoren appears to be its activity against gram-positive and gram-negative organisms causing respiratory tract infections and skin and skin-structure infections, such as Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Cefditoren is also effective against methicillin-susceptible strains of Staphylococcus aureus. Nevertheless, cefditoren has no activity against atypical pathogens, including Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella sp. Moreover, cefditoren does not inhibit Pseudomonas aeruginosa or Bacteroides fragilis. In virtually all studies, cefditoren has compared favorably against other orally administered antibiotics used against the most commonly isolated respiratory tract pathogens. Its side effect profile includes diarrhea, nausea, vomiting, headache, and dyspepsia. Cefditoren is indicated for treatment of mild-to-moderate acute exacerbations of chronic bronchitis, pharyngitis-tonsillitis, and uncomplicated skin and skin-structure infections caused by susceptible strains of organisms in adults and adolescents (> or = 12 yrs of age). Based on its reported antimicrobial activity, cefditoren has potential for empiric management of most commonly encountered respiratory tract infections. Additional studies will further define its role in clinical practice.

Topics: Acute Disease; Bacterial Infections; Bronchitis, Chronic; Cephalosporins; Clinical Trials as Topic; Community-Acquired Infections; Drug Interactions; Humans; Maxillary Sinusitis; Pharyngitis; Pneumonia, Bacterial; Skin Diseases, Bacterial

Topics: Acute Disease; Adolescent; Adult; Aged; Cephalosporins; Child; Child, Preschool; Community-Acquired Infections; Drug Resistance, Bacterial; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Middle Aged; Otitis Media; Penicillin Resistance; Pneumococcal Infections; Streptococcus pneumoniae; Treatment Outcome

Topics: Acute Disease; Ampicillin Resistance; beta-Lactamases; Cephalosporins; Child; Child, Preschool; Community-Acquired Infections; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Otitis Media; Penicillin Resistance; Pneumococcal Infections; Prospective Studies; Respiratory Tract Infections; Streptococcus pneumoniae; Treatment Outcome

Topics: Acute Disease; Ampicillin; Anti-Bacterial Agents; beta-Lactam Resistance; Carbapenems; Cephalosporins; Child, Preschool; Drug Resistance, Multiple, Bacterial; Fluoroquinolones; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Japan; Microbial Sensitivity Tests; Multilocus Sequence Typing; Naphthyridines; Otitis Media; Pneumococcal Vaccines; Quinolones; Streptococcus pneumoniae; Vaccines, Conjugate

The antibacterial susceptibility to frequently prescribed antibiotics of Streptococcus pneumoniae isolated from the pediatric patients with acute respiratory infectious diseases was investigated in a study of three medical institutions in Korea. Total 143 clinical isolates of S. pneumoniae were available for susceptibility tests between May 2003 and July 2007. Antimicrobial susceptibility data for S. pneumoniae were analyzed by using agents of amoxicillin, cefaclor, cefuroxime, cefdinir, and cefditoren as the test antibiotics. The prevalence of each resistance class, penicillin-resistant S. pneumoniae (PRSP) were high with the proportion of MIC range (susceptible = 8.4%, intermediate resistance = 18.2%, resistance = 73.4%). MIC90 and susceptible (S) rate of antimicrobial agents to the strains tested were amoxicillin (MIC90 = 4 microg/ml, S = 76.2%), cefaclor (MIC90 = 128 microg/ml, S=8.4%), cefuroxime (MIC90 = 16 microg/ml, S = 24.5%), cefdinir (MIC90 = 16 microg/ml, S = 21.8%), and cefditoren (MIC90 = 0.5 microg/ml, S=90.2%) respectively. Against clinical isolates including PRSP, cefditoren demonstrated the strongest antibacterial activity intrinsically among the antibiotics tested. Conclusively, the antimicrobial activity of cefditoren to S. pneumoniae strains isolated from pediatric patients with acute respiratory infection is very high. In South Korea, where the antibiotic resistance ofS. pneumoniae is issued, cefditoren is expected to be used as a primary or secondary antibiotic. Moreover, cefditoren may serve as a useful option for secondary antibiotics after failure of amoxicillin treatment, which is most primarily used for acute respiratory S. pneumoniae infection in children.

Topics: Acute Disease; Amoxicillin; Anti-Bacterial Agents; Cefaclor; Cefdinir; Cefuroxime; Cephalosporins; Child; Child, Preschool; Community-Acquired Infections; Drug Resistance, Bacterial; Humans; Korea; Respiratory Tract Infections; Streptococcus pneumoniae

To study the influence of resistance phenotypes (based on sentinel antibiotics: penicillin and amoxicillin with/without clavulanate) on the cefuroxime versus cefditoren susceptibility of Streptococcus pneumoniae and Haemophilus influenzae recovered from children with acute otitis media.. Middle ear isolates (193 S. pneumoniae and 114 H. influenzae) received in the Spanish Reference Laboratory (Instituto de Salud Carlos III) were tested. Antimicrobial susceptibility to penicillin, amoxicillin with/without clavulanate, cefuroxime and cefditoren was determined by agar dilution using Mueller-Hinton agar supplemented with 5% sheep blood for S. pneumoniae and Haemophilus Test Medium for H. influenzae. Strains were classified according to penicillin susceptibility (S. pneumoniae) or beta-lactamase production (H. influenzae).. The decrease in penicillin susceptibility of S. pneumoniae (from the susceptible to the resistant category) decreased amoxicillin and cefuroxime susceptibility rates from 100% to 34% and 0%, respectively. All pneumococcal strains were inhibited by 0.5 mg/L cefditoren, including those from penicillin-resistant serotypes 14, 23F, 6B and 9V with higher amoxicillin versus penicillin MICs. Susceptibility rates of beta-lactamase-positive H. influenzae strains were 93.8% and 85.4% to amoxicillin/clavulanate and cefuroxime, respectively. Resistance to amoxicillin/clavulanate (MIC>or=8/4 mg/L) was 12.1% (8 out of 66) and 6.3% (3 out of 48) in beta-lactamase-negative and -positive strains, respectively. All H. influenzae strains were inhibited by

Topics: Acute Disease; Anti-Bacterial Agents; beta-Lactam Resistance; beta-Lactamases; Cefuroxime; Cephalosporins; Child; Haemophilus influenzae; Humans; Microbial Sensitivity Tests; Otitis Media; Phenotype; Streptococcus pneumoniae

A total of 2865 strains of the causative organisms isolated from the patients with acute pharyngitis and tonsillitis at the primary medical institutions were used in this study. The MICs of levofloxacin (LVFX) and other oral antimicrobial drugs were determined and evaluated by the NCCLS guideline. LVFX, cefditoren (CDTR) and cefcapene (CFPN) were potently active against 773 isolates of Hemophilus influenzae, the MIC50S of LVFX being < or = 0.06 microgram/mL and also the same as the MIC90S of LVFX. LVFX was the most active against 496 isolates of Enterobacteriaceae. The MIC50S of LVFX were < or = 0.06 microgram/mL and were lower than those of CDTR, cefdinir (CFDN) and cefpodoxime (CPDX) (MIC50S: 0.5 microgram/mL). The MIC90S of these cephems were markedly higher than the respective MIC50S, whereas MIC50 of LVFX was 0.12 microgram/mL, only twice the MIC50. Against the majority of Streptococcus pyogenes (555 isolates) and Streptococcus spp. (495 isolates), CDTR, CFDN, CPDX and CFPN were highly active (MICs: < or = 0.06 microgram/mL), and clarithromycin (CAM) and azithromycin (AZM) were also active against these organisms (MICs: 0.12 to 0.25 microgram/mL). Against S. pneumoniae (92 isolates), CDTR and CFDN were active (MIC50S: 0.12 and 0.25 microgram/mL, respectively). However, the MIC90S of these drugs were 4-8 times the MIC50S. Against Moraxella (Branhamella) catarrhalis (454 isolates), LVFX was potently active, the MIC90 of LVFX being < or = 0.06 microgram/mL and MIC90S of the other cephems being 0.5 microgram/mL or more. When the susceptibility of these strains to LVFX was evaluated by the NCCLS guideline, about 3% of other Streptococcus spp. were resistant to the drug but no test strains resistant to LVFX were detected in H. influenzae, S. pyogenes or Enterobacteriaceae. On the other hand, the percentages of strains susceptible to the cephems tested were 60-90%, which were quite different according to kinds of drugs and species used. Furthermore, the strains of S. pneumoniae resistant to CFDN and CPDX, and those to CAM and AZM were 21-25% and 50% or more, respectively, whereas no LVFX-resistant strains were detected. The major pathogens isolated from patients with pharyngitis and tonsillitis in the primary institutions were highly susceptible to LVFX. These results suggest that LVFX is a useful drug which is potently active against the strains resistant to oral cephem and macrolide antibiotics.

Topics: Acute Disease; Ampicillin; Anti-Infective Agents; Azithromycin; Cefdinir; Cefpodoxime; Ceftizoxime; Cephalosporins; Clarithromycin; Enterobacteriaceae; Haemophilus influenzae; Humans; Levofloxacin; Ofloxacin; Penicillin G; Pharyngitis; Streptococcus pneumoniae; Streptococcus pyogenes; Tonsillitis

Topics: Acute Disease; Amoxicillin; Cephalosporins; Child, Preschool; Community-Acquired Infections; Humans; Infant; Middle Ear Ventilation; Otitis Media; Penicillin Resistance; Pneumococcal Infections; Recurrence; Retrospective Studies; Streptococcus pneumoniae; Treatment Outcome

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; beta-Lactams; Cephalosporins; Chronic Disease; Clarithromycin; Community-Acquired Infections; Drug Therapy, Combination; Female; Humans; Lactams; Male; Middle Aged; Ofloxacin; Pneumococcal Infections; Respiratory Tract Infections; Streptococcus pneumoniae; Time Factors

Topics: Acute Disease; Cephalosporins; Child; Child, Preschool; Community-Acquired Infections; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Nasopharynx; Otitis Media; Penicillin Resistance; Pneumococcal Infections; Pulse Therapy, Drug; Retrospective Studies; Severity of Illness Index; Streptococcus pneumoniae; Treatment Outcome

Topics: Acute Disease; Ampicillin Resistance; beta-Lactamases; Cephalosporins; Child; Child, Preschool; Community-Acquired Infections; Drug Resistance, Bacterial; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Otitis Media; Penicillin Resistance; Pneumococcal Infections; Respiratory Tract Infections; Streptococcus pneumoniae