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In vitro activity and cross resistance studies with cefpodoxime
1Institute for Medical Microbiology and Clin. Chemistry (Laboratory Dr. Gaertner), Weingarten.
Zentralblatt Fur Bakteriologie : International Journal of Medical Microbiology
|December 1, 1991
Summary
Cefpodoxime exhibits significant cross-resistance with other cephalosporins, including cefuroxime axetil and cefixime. While generally effective, cefpodoxime showed varying degrees of superiority and inferiority compared to these agents in pathogen susceptibility testing.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Diseases
Background:
- Cephalosporins are a crucial class of antibiotics used to treat bacterial infections.
- Understanding cross-resistance patterns among different cephalosporins is vital for effective antimicrobial stewardship.
- Cefpodoxime, cefuroxime axetil, cefotiam hexetil, cefixime, and cefotaxime are commonly prescribed cephalosporins.
Purpose of the Study:
- To evaluate the in vitro cross-resistance between cefpodoxime and other oral cephalosporins.
- To determine the comparative efficacy of cefpodoxime against cefuroxime axetil, cefotiam hexetil, cefixime, and cefotaxime.
Main Methods:
- Minimum Inhibitory Concentration (MIC) determinations were performed on 370 pathogens.
- MIC breakpoints were utilized to assess susceptibility and cross-resistance.
- Comparative analysis of cefpodoxime's activity against other cephalosporins was conducted.
Main Results:
- Complete cross-resistance between cefpodoxime and cefuroxime axetil, cefotiam hexetil, cefixime, and cefotaxime was observed in 69.7%, 80.3%, 92.2%, and 87% of strains, respectively.
- Cefpodoxime demonstrated superior activity against cefuroxime axetil (28.7%), cefotiam hexetil (17.6%), and cefixime (7%).
- Cefpodoxime was found to be inferior to these cephalosporins in 1.6% to 13% of cases, with no inferiority noted against cefotaxime.
Conclusions:
- Significant cross-resistance exists between cefpodoxime and other oral cephalosporins, impacting treatment choices.
- Cefpodoxime exhibits variable comparative efficacy, highlighting the need for susceptibility testing.
- These findings underscore the importance of considering individual pathogen resistance profiles when selecting cephalosporin therapy.