Ronald N. Jones
Jul 1, 1995
Citations
1
Influential Citations
28
Citations
Quality indicators
Journal
The Pediatric Infectious Disease Journal
Abstract
Ceftibuten is a new, orally administered cephalosporin with exceptional beta-lactamase stability and potency against commonly isolated Gram-negative pathogens. More than 90% of recent Enterobacteriaceae clinical isolates were inhibited by ≤8 μg/ml of ceftibuten. In only five enteric species (Citrobacter freundii, Enter-obacter aerogenes, Enterobacter cloacae, Morganella morganii, Serratia marcescens) were more than 15% of strains resistant (minimal inhibitory concentrations (MIC, with percent of strains inhibited in subscript numbers) >16 μg/ml) to ceftibuten. Enteritis-producing bacteria such as Salmonella, Shigella, Escherichia coli and Yersinia were very ceftibuten-susceptible (MIC50 ≤0.13 μg/ml). Fastidious Gram-negative species causing respiratory tract or genital infections had very low ceftibuten MICs, including beta-lactamase-positive Haemophilus influenzae (MIC90 0.06 to 2 μg/ml), Moraxella catarrhalis (MIC90 0.25 to 4 μg/ml), and Neisseria gonorrhoeae (MIC90 0.015 to 0.5 μg/ml). Beta-hemolytic streptococci and penicillin-susceptible pneumococci were also inhibited by ceftibuten. Staphylococci, enterococci, Pseudomonas species and Gram-negative anaerobic bacteria were generally resistant to ceftibuten. Ceftibuten has demonstrated bactericidal activity against susceptible pathogens, has high affinity for several lethal penicillin-binding proteins and possesses stability to common plasmid- or chromosomal-mediated beta-lactamases, including those enzymes that hydrolyze parenteral third generation ceph- alosporins. The microbiologic features for ceftibuten indicate its clinical potential as chemotherapy for community-acquired respiratory tract infections.