Cephalosporins
Thomas T. Yoshikawa, Shobita Rajagopalan in Antibiotic Therapy for Geriatric Patients, 2005
Cefoxitin has Gram-negative activity that is similar to cefuroxime. However, compared with other first- and second-generation cephalosporins, its activity against streptococci and MSSA is significantly reduced (15). It is the most active cephalosporin against B.fragilis, although its activity against the other Bacteroides spp., such as B. thetaiotaomicron or B ovatus, is less. It is highly active against N. gonorrhoeae, and is used in empirical therapy for pelvic inflammatory disease. Cefotetan is similar to cefoxitin except for a long half-life that permits twice-daily dosing, and less activity against the non-fragilis Bacteroides spp.(16). Unlike cefoxitin, it has an jV-methylthiotetrazole (NMTT) group, which has been associated with hypopro-thrombinemia and bleeding. Most hospital pharmacies consider cefoxitin and cefotetan interchangeable, and may have only one on their formulary. The cephamycins are effective in the treatment of mixed aerobic-anaerobic infections, such as pelvic, abdominal, or diabetic foot infections. However, metronidazole and clindamycin have superior activity against Bacteroides spp. The cephamycins should not be used as monotherapy for nosocomial infections and serious nursing-home infections, or when reliable coverage against MSSA is needed. They are used for antimicrobial prophylaxis of colorectal surgery or for appendectomy, which would have clinical relevance to the elderly.
Fungi and Water
Chuong Pham-Huy, Bruno Pham Huy in Food and Lifestyle in Health and Disease, 2022
Here are some examples of the antimicrobial activity of some cephalosporins. Cefadroxil, cephradine, cefaclor, and cephalexin are used orally for the therapy of both acute and chronic upper and lower respiratory tract infections associated with Haemophilus influenzae, Streptococcus pyogenes, Klebsiella, Streptococcus pneumoniae, and S. aureus (144). Cefoxitin is more potent against the Bacteroides fragilis species and many Gram-negative and Gram-positive bacteria. Cefoxitin is also used in the treatment of pelvic and intraabdominal infections and is frequently employed as a preventive agent in patients subjected to pelvic or colorectal surgery (144).
Prevention, Screening, and Treatment of Sexually Transmitted Infections
James M. Rippe in Lifestyle Medicine, 2019
Most cases of PID are considered polymicrobial.22 As an inpatient, Cefoxitin 2 grams IV every six hours with doxycycline 100 mg orally, twice daily for 14 days is recommended. Cefotetan plus doxycycline or clindamycin plus gentamicin may also be used. There are alternative regimens available if a patient has known allergies. As an outpatient, a single dose of ceftriaxone 250 mg intramuscularly, as well as doxycycline 100 mg orally, twice daily for 14 days, plus or minus Metronidazole 500 mg orally, twice daily for 14 days is recommended.
Evaluation of institutional guideline adherence for carbapenem use at a large academic medical center
Published in Infectious Diseases, 2018
Derek Michalski, Riane J. Ghamrawi, Constantine Tsigrelis
A rising incidence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae has led to an increased consumption of carbapenems, with a subsequent increase of carbapenemase-producing Enterobacteriaceae. We read with interest an article in the present journal, in which cefoxitin was used as a carbapenem-sparing antibiotic for infections caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae [1]. The clinical outcome was favorable in 30 of 33 patients in the first 48 hours after the start of cefoxitin therapy. This study was performed in France and as stated by the authors, cefoxitin is currently recommended by French guidelines for urinary tract infections caused by ESBL-producing E. coli. We here focus on a concern that needs to be handled in this highly problematic situation, namely a failure to adapt to institutional guidelines for appropriate carbapenem use.
The use of cefepime as a carbapenem-sparing antibiotic for treating uncomplicated acute pyelonephritis caused by extended-spectrum β-lactamase producing Escherichia coli
Published in Infectious Diseases, 2018
Jin Woong Suh, Kyung Sook Yang, Sun Bean Kim, Jong Hun Kim, Jang Wook Sohn, Min Ja Kim, Young Kyung Yoon
Carbapenems are traditionally considered the first choice of treatment for serious infections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. The emergence of ESBL-producing Enterobacteriaceae has caused an increased use of carbapenems and spread of carbapenem-resistant strains. Among studies aiming to find suitable alternative antibiotics, a recent report in the present journal showed cefoxitin to be useful as a carbapenem-sparing drug for infections caused by ESBL-producing Escherichia coli (E. coli) and Klebsiella pneumoniae [1]. An alternative for this purpose is cefepime. Clinical data evaluating the efficacy of cefepime in the treatment of acute pyelonephritis (APN) due to ESBL-producing E. coli are limited and controversial [2–5]. Our aim was to compare the clinical efficacy of cefepime and ertapenem in the treatment of adult patients with APN caused by ESBL-producing E. coli.
Clinical efficacy and safety of cefepime–tazobactam in hospitalized patients in South India
Published in Infectious Diseases, 2018
Nitin Bansal, Kalpesh S Sukhwani, Suresh Kumar D, P. Senthur Nambi, Ram Gopalakrishnan, V Ramasubramanian
Due to a threatening increase of carbapenem resistance, there is an urgent need of a general decrease in carbapenem use and to find alternatives. In a recent French report in the present journal, cefoxitin was found useful for infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae [1]. Moreover, beta lactam-beta lactamase inhibitors can be successfully used as carbapenem sparers for treatment of ESBL-producing Gram-negative organisms [2]. We here report our experience on clinical and microbiological outcomes and safety when cefepime–tazobactam was used in a variety of infections in hospitalized patients
Related Knowledge Centers
- Antibiotic
- Cephalosporin
- Cephamycin
- Imipenem
- Generic Drug
- Beta-Lactamase
- Meca
- Methicillin-Resistant Staphylococcus Aureus
- Gram-Negative Bacteria
- Gram-Positive Bacteria