[In-vitro activity of cefuroxime-axetil against pathogens of bacterial infections of the respiratory tract]

Abstract

Cefuroxime-Axetil is an ester of cefuroxime, which can be used as an oral antimicrobial agent. The prodrug is hydrolysed by esterases of the gut mucosa, setting free the active cefuroxime. This second generation cephalosporin is well known since more than a decade as a cephalosporin possessing high stability against gram positive and gram negative beta-lactamases. Due to its pharmacokinetic properties and its wide spectrum of activity, cefuroxime-axetil was recommended to be used as an oral agent in bacterial infections of the respiratory tract. This paper describes the in vitro activity of cefuroxime against respiratory tract pathogens and compares it with that of ampicillin and amoxicillin, amoxicillin/clavulanic acid, cefaclor, chloramphenicol, tetracycline, erythromycin and trimethoprim/sulphamethoxazole. Cefuroxime had good activity against beta-lactamase-producing and beta-lactamase-negative H. influenzae and M. catarrhalis. As expected, the aminopenicillins showed reduced activity against beta-lactamase-producing strains of these organisms. Amoxicillin/clavulanic acid and, to a lesser degree, cefaclor also showed good activity against these bacteria. Cefuroxime was highly active against penicillin-susceptible pneumococci, but showed impaired activity against penicillin-resistant strains. Therefore, this drug should not be used in infections caused by penicillin-resistant pneumococci. Resistance to penicillin in pneumococci isolated in Switzerland is not a problem at the present time. For many years, such strains were isolated only sporadically. Cefuroxime showed also a high in vitro activity against streptococci of serogroups A, B, C and G, which are encountered as respiratory tract pathogens. Against beta-lactamase-positive and -negative staphylococci, cefuroxime showed good activity. The drug was inactive, however, against methicillin-resistant strains.