The in-vitro activity of cefodizime: a review

For Enterobacteriaceae, MIC50s and MIC90s of cefodizime (mg/l), respectively, were as follows, for naturally non-beta-lactamase-producing species: Escherichia coli 0.12 and 0.5, Salmonella spp. and Shigella spp. 0.25 and 0.5, Proteus mirabilis 0.016 and 0.03; for chromosomal penicillinase-producing species. Klebsiella spp. 0.25 and 64, and for chromosomal cephalosporinase-producing species. Enterobacter cloacae 1 and 64, Citrobacter freundii 1 and 128, Serratia marcescens 2 and 8: indole-positive Proteus spp. 0.06 and 0.5; and Providencia stuartii 0.5 and 1. The activity of cefodizime was not modified by plasmid-mediated penicillinase-producing strains but cefodizime was inactive against cephalosporinase hyper-producing strains and against expanded broad-spectrum beta-lactamase-producing strains. Cefodizime was noticeably less active against Pseudomonas aeruginosa and Acinetobacter baumannii with MICs ranging from 32 to more than 128 mg/l. Haemophilus spp. and Neisseria gonorrhoeae, regardless of beta-lactamase producing status, as well as N. meningitidis, were highly susceptible (MIC50s and MIC90s less than or equal to 0.008 mg/l). Cefodizime was moderately active against methicillin-susceptible staphylococci (MIC50 and MIC90 8 mg/l) but failed to inhibit methicillin-resistant strains. Enterococci were generally resistant: Streptococcus pyogenes and Str. pneumoniae were inhibited by low concentrations (MIC50 and MIC90 0.12 and 0.5 mg/l). A fairly wide range of MICs was found for anaerobes, with lower values for Clostridium perfringens (MIC50 and MIC90 0.5 and 1 mg/l) than for Bacteroides fragilis (8- greater than 128 mg/l). These results show that cefodizime has similar properties to other third generation cephalosporins and suggest that cefodizime would find a role in the management of hospital infections.