New Antibiotic

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http://www.medscape.com/viewarticle/442871

Cefditoren, a New Aminothiazolyl Cephalosporin

Ebrahim A. Balbisi, Pharm.D.

Pharmacotherapy 22(10):1278-1293, 2002. Abstract and Introduction

Abstract

Cefditoren pivoxil, an oral third-generation cephalosporin, was approved

by the Food and Drug Administration in September 2001. It has been used

in Japan for several years. The greatest therapeutic potential of

cefditoren appears to be its activity against gram-positive and

gram-negative organisms causing respiratory tract infections and skin

and skin-structure infections, such as Haemophilus influenzae,

Streptococcus pneumoniae, and Moraxella catarrhalis. Cefditoren is also

effective against methicillin-susceptible strains of Staphylococcus

aureus. Nevertheless, cefditoren has no activity against atypical

pathogens, including Chlamydia pneumoniae, Mycoplasma pneumoniae, and

Legionella sp. Moreover, cefditoren does not inhibit Pseudomonas

aeruginosa or Bacteroides fragilis. In virtually all studies, cefditoren

has compared favorably against other orally administered antibiotics

used against the most commonly isolated respiratory tract pathogens. Its

side effect profile includes diarrhea, nausea, vomiting, headache, and

dyspepsia. Cefditoren is indicated for treatment of mild-to-moderate

acute exacerbations of chronic bronchitis, pharyngitis-tonsillitis, and

uncomplicated skin and skin-structure infections caused by susceptible

strains of organisms in adults and adolescents (>/= 12 yrs of age).

Based on its reported antimicrobial activity, cefditoren has potential

for empiric management of most commonly encountered respiratory tract

infections. Additional studies will further define its role in clinical

practice.

Introduction

The management of respiratory infections is an increasing concern,

especially with the rapidly growing menace of bacterial resistance to

commonly prescribed antibiotics. Newer antimicrobials have been

developed to overcome such resistance while providing enhanced

antimicrobial activity.

Cephalosporins have been available since the 1940s and continue to be

among the most widely prescribed antibiotics. Cefditoren (Spectracef;

TAP Pharmaceutical, Inc., Lake Forest, IL) is the latest cephalosporin

to receive approval by the Food and Drug Administration (FDA). The

tablets contain cefditoren pivoxil, a semisynthetic cephalosporin

antibiotic.

Cefditoren is a third-generation aminothiazolyl cephalosporin,

formulated as an ester for oral administration. Its spectrum of activity

includes both gram-positive and gram-negative species, particularly

Haemophilus influenzae and Streptococcus pneumoniae.[1, 2] Oral

cefditoren has been studied in clinical trials of community-acquired

pneumonia, acute exacerbation of chronic bronchitis,

pharyngitis-tonsillitis, uncomplicated skin and skin-structure

infections, and acute maxillary sinusitis. Its clinical efficacy,

safety, and tolerability have been examined in more than 4299 adult and

adolescent patients.[3] In view of these studies and their findings,

cefditoren provides an alternative for the management of respiratory

tract infections and uncomplicated skin and skin-structure infections.

Becki

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