Barberán J, Mensa J
Servicio de Enfermedades Infecciosas, Hospital Central de la Defensa "Gómez Ulla" Madrid.
Rev Esp Quimioter. 2009 Sep;22(3):144-50.
Cefditoren is a third-generation oral cephalosporin with good activity against respiratory tract pathogens, including penicillin-intermediate and -resistant strains of S. pneumoniae, and beta-lactamase producing strains of H. influenzae and M. catarrhalis. Its bacterial activity, measured by minimum inhibitory concentration (MIC), is similar or superior to that of many other commonly used antibiotics (penicillins, cephalosporins and fluoroquinolones). Considering the target attainment of T > MIC of >or= 40% a more reliable predictor of clinical and microbiologic outcomes, cefditoren covers strains of S. pneumoniae with MIC values <or= 0.5 microg/mL and <or= 1 microg/mL in the case of doses of 200 mg and 400 mg, respectively, and all strains of H. influenzae. Cefditoren has been associated with high rates of bacteriologic response among the main causative pathogens in lower respiratory tract infection ( approximately 85% against H. influenzae and approximately 90% against S. pneumoniae, including penicillin-intermediate and penicillin-resistant strains). It is a reliable option for switch therapy in case of treatment with third-generation intravenous cephalosporin. Cefditoren is currently approved in Spain for the treatment of adults and adolescents with acute exacerbations of chronic bronchitis (AECB) and community-acquired pneumonia (CAP), two of the lower respiratory tract infections most commonly encountered in clinical practice.
头孢妥仑是一种第三代口服头孢菌素,对呼吸道病原体具有良好的活性,包括肺炎链球菌的青霉素中介和耐药菌株,以及产β-内酰胺酶的流感嗜血杆菌和卡他莫拉菌菌株。通过最低抑菌浓度(MIC)测定,其细菌活性与许多其他常用抗生素(青霉素、头孢菌素和氟喹诺酮类)相似或更优。考虑到T>MIC≥40%是临床和微生物学结果更可靠的预测指标,头孢妥仑分别在200mg和400mg剂量下可覆盖MIC值≤0.5μg/mL和≤1μg/mL的肺炎链球菌菌株,以及所有流感嗜血杆菌菌株。在治疗下呼吸道感染的主要致病病原体中,头孢妥仑具有较高的细菌学反应率(对流感嗜血杆菌约为85%,对肺炎链球菌约为90%,包括青霉素中介和青霉素耐药菌株)。在使用第三代静脉用头孢菌素治疗的情况下,它是转换治疗的可靠选择。目前在西班牙,头孢妥仑被批准用于治疗患有慢性支气管炎急性加重(AECB)和社区获得性肺炎(CAP)的成人和青少年,这是临床实践中最常见的两种下呼吸道感染。