Choice of an oral beta-lactam antibiotic for infections due to penicillin-resistant Streptococcus pneumoniae.
The activity, pharmacokinetic and pharmacodynamic parameters of 5 oral beta-lactams have been compared against 400 penicillin-resistant Streptococcus pneumoniae (PRSP) isolated in 9 European countries. All the data have been calculated for the highest recommended oral dosage in France. Amoxicillin was by far the most effective antibiotic when considering its intrinsic activity (96% of the PRSP inhibited at 2 mg/l), the inhibitory quotient (100% of the PRSP > 1 vs 69.2% for cefuroxime) or a time above MIC > 40% which best correlates with clinical results (96% for amoxicillin vs < 25% for the cephalosporins).
Goldstein
F W
FW
Laboratoire de Microbiologie Médicale, Fondation Hôpital Saint-Joseph, Paris, France.
D000284:Administration, Oral; D000658:Amoxicillin / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D002433:Cefaclor / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D020682:Cefixime; D002439:Cefotaxime / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D015296:Ceftizoxime / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D002444:Cefuroxime / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D002511:Cephalosporins / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D010406:Penicillins / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D011485:Protein Binding; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D018440:beta-Lactam Resistance; D000097623:Cefpodoxime
D000658:Amoxicillin; D002433:Cefaclor; D020682:Cefixime; D002439:Cefotaxime; D015296:Ceftizoxime; D002444:Cefuroxime; D002511:Cephalosporins; D010406:Penicillins; D000097623:Cefpodoxime