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Query: UMLS:C0519030 (Klebsiella)
 21,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The antimicrobial activity of cefpodoxime, the active metabolite of the new cephalosporin ester cefpodoxime proxetil, in comparison to cefixime, cefotiam, cefuroxime, and cefotaxime was determined against a broad spectrum of freshly isolated gram-positive and gram-negative bacterial strains. Cefpodoxime was demonstrated to be inhibitory at concentrations of less than or equal to 1 mg/l against 90% of strains of Moraxella catarrhalis, Haemophilus influenzae, Escherichia coli (beta-lactamase- negative strains), Klebsiella spp., Serratia spp., Proteus mirabilis, Proteus vulgaris, Providencia spp., and Salmonella spp. This antimicrobial activity of cefpodoxime was generally superior to that of cefuroxime and similar to that of cefixime. Cefpodoxime was active at less than or equal to 1 mg/l against 50% of the members of beta-lactamase-producing Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Citrobacter spp., and Morganella morganii. Cefpodoxime proved to be highly inhibitory against group A, B, and G streptococci and Streptococcus pneumoniae (MIC90 less than 0.015 mg/l). The MICs of cefpodoxime and those of the other cephalosporins were less than 2 mg/l for greater than or equal to 90% of the strains of Staphylococcus aureus and Staphylococcus epidermidis, with the exception of cefixime which had no activity with MICs below 8 mg/l against these bacteria. Pseudomonas spp., Acinetobacter spp., and Enterococcus spp. were resistant to cefpodoxime. The antibacterial activity of cefpodoxime was only to a minor degree influenced by different growth conditions with the exception of high inoculum sizes against some beta-lactamase producing strains of gram-negative bacilli.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cefpodoxime: comparative antibacterial activity, influence of growth conditions, and bactericidal activity. 180 Mar 79

The in vitro activity of cefpodoxime, an oral cephalosporin ester, against 792 bacterial isolates representing 36 species was evaluated in comparison to that of ciprofloxacin and trimethoprim/sulfamethoxazole (TMP/SMX). Cefpodoxime inhibited the majority of Streptococcus spp., Haemophilus influenzae and Proteus mirabilis at a concentration of less than or equal to 0.12 microgram/ml. It was also active against Citrobacter diversus, Escherichia coli, Klebsiella spp., Proteus vulgaris, Serratia marcescens and methicillin-susceptible Staphylococcus aureus isolates. Overall, cefpodoxime appeared to be less active than ciprofloxacin and TMP/SMX against many pathogens common in cancer patients.
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PMID:In vitro activity of cefpodoxime against bacterial isolates obtained from patients with cancer. 191 1

The antibacterial activity of cefpodoxime, a new orally active methoxy-imino cephalosporin was evaluated in 470 recent isolates of gram-positive cocci and gram-negative rods from clinical specimens and compared to that of other orally active beta-lactam compounds. Cefpodoxime was highly active against ampicillin-resistant enterobacteria producing the plasmid-mediated TEM-1, TEM-2 or OXA-1 enzymes, as was the case for the other newer compounds. However, it was poorly active against cefuroxime-resistant (MIC greater than or equal to 16 mg/l) E. coli isolates, thus resembling cefetamet and cefixime. It was inactive against isolates exhibiting a production of large amounts of class I beta-lactamase, as was the case with all other compounds studied. Cefpodoxime was highly active against beta-hemolytic streptococci and against Haemophilus influenzae, resembling the related agents. Moreover, its activity against Staphylococcus aureus was comparable to that of cefotaxime and exceeded that of cefetamet and cefixime. Cefpodoxime and the other methoxyimino cephalosporins exhibited a poor affinity to the plasmid-mediated TEM-2 and OXA-1 enzymes. The hydrolysis of cefpodoxime by class I beta-lactamases was barely detectable, whereas it served as a moderate substrate for the enzyme from Klebsiella oxytoca 3951. Cefpodoxime, cefetamet and cefixime were slowly inactivated by the enzyme from Proteus vulgaris 4917 (an enzyme with cefuroximase activity) and much poorer substrates than cefotaxime.
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PMID:Cefpodoxime: comparable evaluation with other orally available cephalosporins. With a note on the role of beta-lactamases. 224 85

A total of 1834 non-copy, general practice or outpatient isolates were collected by 20 hospital laboratories within the British Isles, and identified and tested for susceptibility to nine antimicrobial agents available by oral administration at one centre. Against Enterobacteriaceae cefpodoxime was the most active beta-lactam agent tested, the MIC90s being: for Escherichia coli 1.0 mg/l, for Proteus mirabilis 1.0 mg/l, for Citrobacter spp. 2.0 mg/l, and for Enterobacter spp., Serratia spp., Morganella spp. and Klebsiella spp. 16-64 mg/l. Cefpodoxime also showed a certain amount of activity against staphylococci and high activity against streptococci, the MIC90s being for Staphylococcus aureus 2 mg/l, for coagulase negative staphylococci 8 mg/l, for Streptococcus pyogenes 0.015 mg/l, for Str. pneumoniae 0.06 mg/l and for Str. agalactiae 0.5 mg/l.
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PMID:In-vitro activity of cefpodoxime against 1834 isolates from domiciliary infections at 20 UK centres. 229 33

The aim of our study was to re-evaluate the in vitro activity of cefpodoxime in comparison with other oral beta-lactam antibiotics against bacteria causing respiratory tract infections. The study drugs were cefpodoxime, cefaclor, cefixime, cefuroxime, cefetamet, cefprozil, and the combination of amoxicillin and clavulanic acid (= augmentin). In addition, cefotaxime as the standard agent of parenteral third generation cephalosporins was examined. The organisms tested were Staphylococcus aureus, Streptococcus pyogenes, Streptococcus agalactiae, streptococci of serogroups C and G, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae and Proteus mirabilis. Minimal inhibitory concentrations of the antimicrobials were determined with the agar dilution procedure. Cefpodoxime showed the broadest spectrum and generally also the highest activity of the oral beta-lactam antibiotics examined. The drug was equally active against the major groups of beta-lactamase negative and positive bacteria causing respiratory tract infections. Against penicillin-resistant pneumococci, all beta-lactam agents exhibited reduced activity comparable to the reduced activity of penicillin.
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PMID:In vitro activity of cefpodoxime in comparison with other oral beta-lactam antibiotics. 784 23

Cefpodoxime proxetil is a new orally administered prodrug which is absorbed and de-esterified by the intestinal mucosa to release the third-generation cephalosporin, cefpodoxime, and which is undergoing in vitro and in vivo evaluations. Using the standard agar dilution method, we compared the in vitro activity of this drug with other oral cephalosporins and quinolones against 637 recent clinical isolates from Kaohsiung Veterans General Hospital in Taiwan. Against Escherichia coli and Klebsiella pneumoniae, cefpodoxime showed excellent activity, inhibiting over 90% of these isolates at 1 mg/l. Like other oral drugs of its class, it had little activity against Pseudomonas aeruginosa and Acinetobacter spp. Against Haemophilus influenzae, irrespective of beta-lactamase production, its activity was similar to comparative drugs. Against methicillin-susceptible Staphylococcus aureus, cefpodoxime showed moderate activity, inhibiting 90% of these isolates at 4 mg/l, whereas it was inactive against methicillin-resistant S. aureus. However, all cephalosporins have shown little in vivo activity against methicillin-resistant S. aureus regardless of in vitro results. Cefpodoxime was inactive against Enterococcus spp. Against other streptococci, its activity was similar to other oral cephalosporins and quinolones tested. The results of this in vitro study indicated that oral administration of cefpodoxime should be an ideal agent in the empirical outpatient treatment for community-acquired cutaneous, respiratory and urinary tract infections.
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PMID:Antibacterial activity of cefpodoxime in vitro. 899 37

We used a Vitek custom card to detect cefpodoxime MIC of--2 mg/L as a screen for extended-spectrum beta-lactamase (ESBL) production in E. coli and Klebsiella spp. Of 2873 organisms tested, 60 were screen positive, but only 3 were confirmed to be ESBL producers. Cefpodoxime is believed to be a sensitive screen for ESBL production, but a more specific test is desirable.
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PMID:Cefpodoxime screening of Escherichia coli and Klebsiella spp. by Vitek for detection of organisms producing extended-spectrum beta-lactamases. 1114 52

Antimicrobial resistance is universally recognized as a major problem. A European resistance survey was established to monitor the activity of widely used oral antibiotics against common respiratory tract pathogens. Studies were conducted in Italy, Spain and Austria to monitor resistance patterns among respiratory Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes, Staphylococcus aureus and Klebsiella pneumoniae to amoxicillin, co-amoxiclav, penicillin, cefaclor, cefadroxil, cefalexin, cefprozil, cefuroxime, cefixime, ceftibuten, cefpodoxime, clarithromycin and azithromycin (the antibiotics tested varying slightly from country to country). Minimum inhibitory concentrations were determined using the NCCLS-recommended broth microdilution method. Among the antibiotics tested, cefpodoxime, an oral cephalosporin, was remarkably active against the major respiratory pathogens in all three countries. Cefpodoxime was more potent than cefaclor, cefixime and ceftibuten against pneumococci, especially against strains with decreased sensitivity to penicillin, and more active than cefaclor and cefuroxime against Gram-negative respiratory pathogens. Pneumococci and staphylococci displayed a very high level of in vitro macrolide resistance. These data indicate that cefpodoxime represents an appropriate choice in the treatment of community-acquired respiratory tract infection in the three countries surveyed.
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PMID:Antibacterial activity of oral antibiotics against community-acquired respiratory pathogens from three European countries. 1207 54

Cefpodoxime is one of five antimicrobial agents recommended by the National Committee for Clinical Laboratory Standards for screening isolates of Klebsiella spp. and Escherichia coli for extended-spectrum beta-lactamase (ESBL) production. In a prior study, we noted that among 131 E. coli isolates for which the MIC of at least one extended-spectrum cephalosporin (ESC) or aztreonam was > or =2 micro g/ml (suggesting the presence of ESBL production), there were 59 isolates (45.0%) for which the MIC of cefpodoxime was 2 to 4 micro g/ml (i.e., a positive ESBL screening test), but the MICs of ceftazidime, cefotaxime, and ceftriaxone were < or =1 micro g/ml (below the ESBL screening breakpoint). Thus, the results appeared to be false-positive ESBL screening tests. These 59 isolates were divided into five phenotypic groups based on the susceptibility patterns of the organisms to a variety of beta-lactam agents and further characterized. The first group (32 isolates) all produced a TEM-1 beta-lactamase, and changes in the major outer membrane proteins were detected in representative strains. The second group (18 isolates) lacked bla(TEM) but showed a number of porin changes; some also showed a modest elevation in production of the AmpC chromosomal beta-lactamase. In the third phenotypic group (seven isolates) all expressed an OXA-30 beta-lactamase. Some also harbored altered porins. The two remaining phenotypes each had a distinct pattern of porin changes with or without beta-lactamase production. These data indicate that several factors are associated with decreased susceptibility to cefpodoxime in E. coli, but none of the mechanisms are related to ESBL production. Current screening methods produced false-positive ESBL results for these isolates. Such isolates should not be classified as containing ESBLs, nor should interpretations of ESCs or aztreonam susceptibility be changed to resistant on test reports for these isolates.
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PMID:Mechanisms of decreased susceptibility to cefpodoxime in Escherichia coli. 1243 84

Cefpodoxime is a semi-synthetic, third generation cephalosporin. The drug is available for use as a prodrug-Cefpodoxime proxetil, which is absorbed readily from the gut. It reaches adequate levels exceeding the MIC in most of the body fluids. It is excreted by kidneys, unchanged. Dose needs adjustment in compromised renal function. The drug is active against common gram-positive cocci like staphylococci including penicillinase producing strains, streptococci and gram negative bacteria like Hemophilus, E. coli, Klebsiella, Moraxella, Meningococci, Gonococci etc. The drug is useful in common upper and lower respiratory tract infections, sinusitis, and otitis media. The drug is also used in skin and soft tissue infections, urinary tract infection and respiratory tract infection. Cefpodoxime is being used as a step down from parenteral cephalosporin. The recommended dose is 8-10 mg/kg/d in a single or two doses. Different schedules have been given for different infections. The drug is safe, effective as a short course (5 vs. 10 days). With a low incidence of side effects, and twice a day dosing, it proves to be a useful drug.
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PMID:Cefpodoxime: pharmacokinetics and therapeutic uses. 1278 94


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