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Updated: Aug 16, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
[Surveillance of susceptibility of clinical isolates to cefpodoxime between 2000 and 2003]
Tomomi Abe1, Tetsufumi Koga, Yuki Sato
1Biological Research Laboratories, Sankyo Co., Ltd.
Abstract:
For the post-marketing surveillance of cefpodoxime proxetil (CPDX-PR, Banan), MICs of oral cephem antibacterials including CPDX against clinical isolates from 15 medical institutions all over Japan are measured yearly and the incidence rates of resistance in various species are also evaluated. In the first surveillance from June 2000 to March 2001, 1,091 isolates of 22 species were tested, 993 isolates of the same 22 species were tested in the second surveillance from April 2001 to March 2002, and 1,115 isolates of the same 22 species were tested in the third surveillance from April 2002 to March 2003. No remarkable changes in the activity of CPDX were observed against most of the species in these surveillances spanning three years and in comparison with that in the studies conducted before Banan was launched. In the study, CPDX as well as other cephem antibacterials showed a gradual decrease in activity against all the strains of Streptococcus pneumoniae and Haemophilus influenzae in proportion to the increase in the incidence rates of penicillin-resistant S. pneumoniae (PRSP) and beta-lactamase-negative ampicillin-resistant H. influenzae (BLNAR). A small percentage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, which are high-resistant strains, were isolated. The findings of this surveillance indicate that it is necessary to pay careful attention to the trends of resistant bacteria such as PRSP, BLNAR, and ESBL-producing strains.
Insights
Post-marketing surveillance of cefpodoxime proxetil (CPDX-PR) in Japan revealed stable activity against most bacteria over three years. However, decreased effectiveness was noted against resistant Streptococcus pneumoniae and Haemophilus influenzae strains.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Diseases
Background:
- Cefpodoxime proxetil (CPDX-PR) is an oral cephem antibacterial agent.
- Post-marketing surveillance is crucial for monitoring antimicrobial activity and resistance trends.
Purpose of the Study:
- To evaluate the in vitro activity of CPDX-PR and other oral cephem antibacterials against clinical isolates in Japan.
- To assess the incidence rates of resistance in various bacterial species over a three-year period.
Main Methods:
- Yearly measurement of Minimum Inhibitory Concentrations (MICs) of oral cephem antibacterials, including CPDX.
- Testing against clinical isolates from 22 species across 15 medical institutions in Japan.
- Surveillance conducted from June 2000 to March 2003.
Main Results:
- CPDX-PR demonstrated no remarkable changes in activity against most species over the three-year surveillance period.
- A gradual decrease in CPDX activity was observed against Streptococcus pneumoniae and Haemophilus influenzae, correlating with increased resistance rates (PRSP and BLNAR).
- A small percentage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae were isolated.
Conclusions:
- Continued monitoring of cefpodoxime proxetil activity is necessary.
- Emergence and trends of resistant bacteria, including penicillin-resistant Streptococcus pneumoniae (PRSP), beta-lactamase-negative ampicillin-resistant Haemophilus influenzae (BLNAR), and ESBL-producing strains, require careful attention.
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