The efficacy of cefditoren pivoxil in the treatment of lower respiratory tract infections, with a focus on the per-pathogen bacteriologic response in infections caused by Streptococcus pneumoniae and Haemophilus influenzae: A pooled analysis of seven clinical trials

Granizo, Juan José; Giménez, Marı́a José; Barberán, José; Coronel, Pilar; Gimeno, Mercedes; Aguilar, Lorenzo

doi:10.1016/j.clinthera.2006.12.010

Cited by 26 publications

(29 citation statements)

References 28 publications

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“…[11][12][13][14][15][16][17][18][19][20][24][25][26][30][31][32][33] The values of MiC 50 and MiC 90 found in the present study are, after one year of commercialization of cefditoren in italy, almost one dilution lower than those reported in the multicenter study in italy in 2008. 26 S. pneumoniae susceptibilities to oral cephalosporins have been extremely variable in Europe over the last 3 years.…”

Section: Discussioncontrasting

confidence: 68%

“…and M. catarrhalis) bacteria, 10,[12][13]15 and thus indicated in the treatment of acute pharyngotonsillitis, acute maxillary sinusitis, acute exacerbations of chronic bronchitis, and slight to moderate CAP, is of particular interest. [15][16][17][18][19][20] Cefditoren's antimicrobial mechanism of action, common to all cephalosporins, consists in its inhibition of cell-wall synthesis thanks to its affinity for PBPs. However, its unique structure at the C-3 side chain of its cephem skeleton has been correlated with higher intrinsic activity against S. pneumoniae, both susceptible and resistant to penicillin (PssP and PRsP).…”

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confidence: 99%

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Antibiotic Susceptibility of Respiratory Pathogens Recently Isolated in Italy: Focus on Cefditoren

Tempera

Furneri²,

Carlone³

et al. 2010

Journal of Chemotherapy

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The aim of this study was to evaluate the in vitro antibiotic susceptibility of respiratory pathogens recently isolated in Italy to commonly used antibiotics including cefditoren. Six clinical microbiological laboratories collected, between January and September 2009, a total of 2,510 respiratory pathogens from subjects with community-acquired respiratory tract infections (CARTI). Ceftditoren, out of all the beta-lactams studied, had the lowest MIC(90 )against 965 strains of Streptococcus pneumoniae examined, followed by cefotaxime and ceftriaxone (2% resistance in penicillin-resistant S. pneumoniae (PRSP)). Against 470 Haemophilus influenzae , independently of their production of beta-lactamases or ampicillin resistance, cefditoren was the oral cephalosporin with the best in vitro activity, comparable to that of the injectable cephalosporins and levofloxacin. Higher MIC(90)s were found for the macrolides (4 - 16 mg/l) and cefaclor (4 - 32 mg/l). As was foreseeable, Streptococcus pyogenes (225 strains) was uniformly sensitive to all the beta-lactam antibiotics, but the elevated MIC(90 )values reduced (<75%) susceptibility of this pathogen to macrolides. Beta-lactamase-negative Moraxella catarrhalis (100 strains) had reduced susceptibility only to the macrolides, while the 250 beta-lactamase-producing strains also had reduced susceptibility to cefuroxime. Levofloxacin showed the lowest MIC(50)/MIC(90 )values in the producing strains, whereas cefditoren, cefotaxime and ceftriaxone in the non-producers. As regards the enterobacteriaceae, cefditoren and levofloxacin had the lowest MIC(90)s against Klebsiella pneumoniae. Cefditoren and the third-generation injectable cephalosporins had the lowest MIC(90)s against Escherichia coli (100% susceptibility) while levofloxacin was less active (86% susceptibility).In conclusion, cefditoren's wide spectrum and high intrinsic activity, as well as its capacity to overcome most of the resistance that has become consolidated in some classes of antibiotics widely used as empiric therapy for CARTI, allows us to suggest that cefditoren might be included in the european guidelines as one of the first-choice antibiotics in the treatment of CARTI.

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Section: Discussioncontrasting

confidence: 68%

mentioning

confidence: 99%

Antibiotic Susceptibility of Respiratory Pathogens Recently Isolated in Italy: Focus on Cefditoren

Tempera

Furneri²,

Carlone³

et al. 2010

Journal of Chemotherapy

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“…Comparators were amoxicillin/clavulanic acid or cefpodoxime in CAP studies, and cefuroxime or clarithromycin in AECB studies. Pooled data from CAP studies revealed no significant differences in response rates between cefditoren and comparators, percentages of responders ranging from 89.2% to 91.8% at the end of therapy and from 85.9% to 90.4% at the end of follow-up 62. Pooled data from the AECB studies resulted in response rates ranging from 85.8% to 91.3% at the end of therapy and from 81.2% to 83.3% at the end of follow-up, without significant differences between groups 62…”

Section: Efficacy Clinical Studies With Cefditoren In the Treatment Omentioning

confidence: 90%

“…A pooled analysis of data was performed including a total of 4159 randomized patients 62. Comparators were amoxicillin/clavulanic acid or cefpodoxime in CAP studies, and cefuroxime or clarithromycin in AECB studies.…”

Section: Efficacy Clinical Studies With Cefditoren In the Treatment Omentioning

confidence: 99%

“…Globally, the bacteriologically evaluable population consisted of 1910 patients with 1223 target pathogens isolated prior to treatment initiation, including 406 S. pneumoniae isolates (56 of them nonsusceptible to oral penicillin) and 595 H. influenzae isolates 62. No significant differences were found in the rate of bacteriological responders for S. pneumoniae , percentages ranging from 88.5% to 92.0%.…”

Section: Efficacy Clinical Studies With Cefditoren In the Treatment Omentioning

confidence: 99%

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Cefditoren in upper and lower community-acquired respiratory tract infections

Soriano¹,

Giménez²,

Aguilar³

2011

DDDT

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This article reviews and updates published data on cefditoren in the evolving scenario of resistance among the most prevalent isolates from respiratory tract infections in the community (Streptococcus pyogenes, Haemophilus influenzae, and Streptococcus pneumoniae). By relating the in vitro activity of cefditoren (in national and multinational surveillance and against isolates with emerging resistant genotypes/phenotypes) to its pharmacokinetics, the cefditoren pharmacodynamic activity predicting efficacy (in humans, animal models, and in vitro simulations) is analyzed prior to reviewing clinical studies (tonsillopharyngitis, sinusitis, acute exacerbations of chronic bronchitis, and community-acquired pneumonia) and the relationship between bacterial eradication and clinical efficacy. The high in vitro activity of cefditoren against the most prevalent respiratory isolates in the community, together with its pharmacokinetics (enabling a twice daily regimen) leading to adequate pharmacodynamic indexes covering all S. pyogenes, H. influenzae, and at least 95% S. pneumoniae isolates, makes cefditoren an antibiotic that will play a significant role in the treatment of respiratory tract infections in the community. In the clinical setting, studies carried out with cefditoren showed that treatments with the 400 mg twice daily regimen were associated with high rates of bacteriological response, even against penicillin-nonsusceptible S. pneumoniae, with good correlation between bacteriological efficacy/response and clinical outcome.

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Antimicrobial activity of cefditoren tested against contemporary (2004–2006) isolates of Haemophilus influenzae and Moraxella catarrhalis responsible for community-acquired respiratory tract infections in the United States

Biedenbach

Jones

Fritsche

2008

Diagnostic Microbiology and Infectious Disease

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The efficacy of cefditoren pivoxil in the treatment of lower respiratory tract infections, with a focus on the per-pathogen bacteriologic response in infections caused by Streptococcus pneumoniae and Haemophilus influenzae: A pooled analysis of seven clinical trials

Cited by 26 publications

References 28 publications

Antibiotic Susceptibility of Respiratory Pathogens Recently Isolated in Italy: Focus on Cefditoren

Antibiotic Susceptibility of Respiratory Pathogens Recently Isolated in Italy: Focus on Cefditoren

Cefditoren in upper and lower community-acquired respiratory tract infections

Antimicrobial activity of cefditoren tested against contemporary (2004–2006) isolates of Haemophilus influenzae and Moraxella catarrhalis responsible for community-acquired respiratory tract infections in the United States

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