Comparison of cefprozil, cefpodoxime proxetil, loracarbef, cefixime, and ceftibuten.
OBJECTIVE
To discuss the pharmacokinetics, spectrum of activity, clinical trials, and adverse effects of cefprozil, cefpodoxime proxetil, loracarbef, cefixime, and ceftibuten, an investigational cephalosporin.


METHODS
Literature was identified by a MEDLINE search from 1986 to January 1995.


METHODS
Randomized, controlled studies were selected for evaluation; however, uncontrolled studies were included when data were limited for indications approved by the Food and Drug Administration.


METHODS
Data were evaluated with respect to in vitro activity, study design, clinical and microbiologic outcomes, and adverse drug reactions.


RESULTS
Cefprozil, cefpodoxime proxetil, loracarbef, cefixime, and cefributen are active in vitro against organisms frequently involved in community-acquired infections such as Streptococcus pneumoniae, Escherichia coli, beta-lactamase-positive or -negative Haemophilus influenzae, and Moraxella catarrhalis. Except for cefixime and ceflibuten, they all are active against methicillin-susceptible Staphylococcus aureus. Even though there were problems in study design (discussed within the text), clinical data demonstrate that these new oral beta-lactam compounds are as efficacious as conventional therapies for a variety of community-acquired infections.


CONCLUSIONS
Cefprozil, cefpodoxime, cefixime, loracarbef, and ceftibuten demonstrate in vitro activity against the major organisms that cause community-acquired infections. Clinical trials confirm that these agents are as effective as traditional therapies for the management of acute otitis media, pharyngitis/tonsillitis, sinusitis, bronchitis, pneumonia, urinary tract infections, and skin and skin-structure infections. In addition, cefixime and cefpodoxime are effective therapies for uncomplicated gonococcal infections. Selection of a specific agent will be influenced by susceptibility data and safety, as well as issues of compliance and cost.
Schatz
B S
BS
College of Pharmacy, Michael Reese Hospital and Medical Center, Chicago, IL, USA.
Karavokiros
K T
KT
Taeubel
M A
MA
Itokazu
G S
GS
D001424:Bacterial Infections / Q000188:drug therapy*; D020682:Cefixime; D002439:Cefotaxime / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077722:Ceftibuten; D015296:Ceftizoxime / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000627:therapeutic use; D002511:Cephalosporins / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D006801:Humans; D008826:Microbial Sensitivity Tests; D011355:Prodrugs / Q000009:adverse effects / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000097627:Cefpodoxime Proxetil; D000097670:Cefprozil
D020682:Cefixime; D002439:Cefotaxime; D000077722:Ceftibuten; D015296:Ceftizoxime; D002511:Cephalosporins; D011355:Prodrugs; D000097627:Cefpodoxime Proxetil; D000097670:Cefprozil; C054920:loracarbef