The in vitro activity of FK-037, 5-amino-2-[[(6R, 7R)-7-[[(Z)-2-(2-amino-4-thiazolyl)-2-(methoxyimino) acetyl] aminol-2-carboxy-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-3-yllmethyl1-1-(2-hydroxyethyl)-lH-pyrazolium hydroxide, inner salt, sulfate (1:1), a new parenteral cephem, was compared with those of cefepime, ceftazidime, imipenem, and ciprofloxacin. FK-037 inhibited methicillin-susceptible staphylococci at c4 jig/ml. Of 98 isolates of homogenous methicillin-resistant Staphylococcus aureus, 55 (56.1%) were inhibited by 8 jig of FK-037 per ml, compared to 3.1% for cefepime. Imipenem was the most active 13-lactam tested against staphylococci. The MIC of FK-037 for 90o of the strains tested (MIC90) was 0.06 ,ug/ml for hemolytic streptococci, Streptococcus pneumoniae, viridans group streptococci, and Streptococcus bovis. The MIC90 for many of the members of the family Enterobacteriaceae was 1 ji.g/ml, similar to that of cefepime and lower than those of ceftazidime and imipenem. The MIC,0 for KiebsieUla pneumonwiae and Enterobacter cloacae was 8 jug/ml, similar to that for cefepime, but all isolates were inhibited by 2 ,ig of imipenem per ml. K. pneumoniae isolates with cefotaxime and ceftazidime MICs of >32 jig/ml with Bush type 2b' 13-lactamases were inhibited by 4 jig of FK-037 per ml. E. cloacae, Citrobacterfreundii, and S. aureus stably resistant to FK-037 could be selected by repeated transfer in the presence of FK-037. The FK-037 MIC90 for Pseudomonas aeruginosa was 4 ,Ig/ml, compared to 32 jug/ml for cefepime and ceftazidime and 8 pg/ml for imipenem. Xanthomonas maltophilia, Pseudomonas cepacia, Acinetobacter anitratus, and Bacteroides species were resistant to FK-037 (MIC, >32 ,ig/ml). MBCs were identical to or within twofold of the MICs except for a 32-fold greater MBC for P. aeruginosa. Inoculum size and acid environment did not lower the activity of FK-037. FK-037 was not appreciably hydrolyzed by Bush group 1, 2a, 2b, and 2e 1-lactamases but was hydrolyzed by 2b' and 2d enzymes at rates comparable to that of ceftazidime. Nonetheless, FK-037 inhibited bacteria possessing TEM-3, -5, and -7 and SHV-5 at <8 ,ug/ml. Overall, FK-037 has lower MICs against staphylococci and P. aeruginosa than the currently available iminomethoxy aminothiazolyl cephalosporins and has activity against members of the family Enterobacteriaceae comparable to that of cefepime.Although a number of parenteral cephalosporins have been synthesized during the past 2 decades, there has been continued interest in finding new cephalosporins with improved activity against gram-positive bacteria, particularly for methicillin-resistant staphylococci, and which retain the excellent activity of the aminothiazolyl cephalosporins against gram-negative organisms. FK-037, an oxime-type cephem, contains a 1-hydroxyethyl-5-amino pyra-zoliomethyl moiety at position 3 of the cephem ring. Preliminary studies showed FK-037 to have a broad spectrum of antibacterial activity against gram-negative and gram-positive bacteria, including methicillin-resistan...