Pharmacological study of cefoxitin as an alternative antibiotic therapy to carbapenems in treatment of urinary tract infections due to extended-spectrum-β-lactamase-producing Escherichia coli.
Cefoxitin could be an alternative to carbapenems in extended-spectrum-beta-lactamase-producing Escherichia coli (ESBL-EC) infections. However, pharmacological and clinical data regarding cefoxitin are limited. Using a recent pharmacological model and the MICs of ESBL-EC collected from pyelonephritis, we determined the probabilities to reach four pharmacological targets: free cefoxitin concentrations above the MIC during 50% and 100% of the administration interval (T>MIC = 50% and T>MIC = 100%, respectively) and free cefoxitin concentrations above 4× MIC during 50% and 100% of the administration interval (T>4MIC = 50% and T>4MIC = 100%, respectively). Cefoxitin could be used to treat ESBL-EC pyelonephritis, but administration modalities should be optimized according to MICs in order to reach pharmacological targets.
Université Paris Descartes, Paris, France Service de Microbiologie-Hygiène Hospitalière, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France.
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Guet-Revillet
Service de Bactériologie, Virologie, Hygiène, Hôpital Henri-Mondor, AP-HP, Créteil, France Université Paris-Est, Créteil, France.
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Emirian
Service de Microbiologie-Hygiène Hospitalière, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France.
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Groh
Service de Bactériologie, Virologie, Hygiène, Hôpital Henri-Mondor, AP-HP, Créteil, France.
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Nebbad-Lechani
Service de Microbiologie-Hygiène Hospitalière, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France.
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Weiss
Université Paris Descartes, Paris, France Service de Microbiologie-Hygiène Hospitalière, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France.
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Join-Lambert
Université Paris Descartes, Paris, France Service de Microbiologie-Hygiène Hospitalière, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France.
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Bille
Service de Pharmacologie Clinique, Hôpital Européen Georges Pompidou, AP-HP, Paris, France INSERM U1129, Paris Descartes, Paris, France.
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Jullien
Université Paris Descartes, Paris, France Service de Microbiologie-Hygiène Hospitalière, Hôpital Necker-Enfants-Malades, AP-HP, Paris, France JeanRalph.ZAHAR@chu-angers.fr.
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Zahar
D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000494:pharmacology*; D015780:Carbapenems / Q000493:pharmacokinetics / Q000494:pharmacology; D002440:Cefoxitin / Q000493:pharmacokinetics / Q000494:pharmacology*; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D004926:Escherichia coli / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000254:growth & development; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology; D015870:Gene Expression; D006801:Humans; D008826:Microbial Sensitivity Tests; D015233:Models, Statistical; D011704:Pyelonephritis / Q000188:drug therapy / Q000382:microbiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis / Q000235:genetics
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002440:Cefoxitin; D001618:beta-Lactamases