Cefditoren

Mechanism :

Cefditoren is a cephalosporin with antibacterial activity against gram-positive and gram-negative pathogens. The bactericidal activity of cefditoren results from the inhibition of cell wall synthesis via affinity for penicillin-binding proteins (PBPs). Cefditoren is stable in the presence of a variety of b-lactamases, including penicillinases and some cephalosporinases.

Indication :

• Community acquired pneumonia
• Pharyngitis/Tonsillitis
• Uncomplicated skin and soft tissue infections

Contraindications :

Contraindicated in patients with known allergy to the cephalosporin class of antibiotics or any of its components, in patients with carnitine deficiency or inborn errors of metabolism that may result in clinically significant carnitine deficiency, because use of cefditoren causes renal excretion of carnitine. Patients with milk protein hypersensitivity (not lactose intolerance) should not be administered cefditoren.

Dosing :

Adverse Effect :

Abnormal dreams, allergic reaction, anorexia, asthenia, asthma, increased coagulation time, constipation, dizziness, dry mouth, facial edema, fever, flatulence, hyperglycemia, increased appetite, insomnia, leukopenia, abnormal liver function test, myalgia, diarrhea, pseudomembranous colitis, pruritus, rash, thrombocythemia, urticaria.

Interaction :

Oral Contraceptives: Multiple doses of cefditoren pivoxil had no effect on the pharmacokinetics of ethinyl estradiol, the estrogenic component in most oral contraceptives.
Antacids: Co-administration of a single dose of an antacid which contained both magnesium (800 mg) and aluminium (900 mg) hydroxides reduced the oral absorption of a single 400 mg dose of cefditoren pivoxil administered following a meal.
H2-Receptor Antagonists: Co-administration of a single dose of intravenously administered famotidine (20 mg) reduced the oral absorption of a single 400 mg dose of cefditoren pivoxil administered following a meal. Although the clinical significance is not known, it is not recommended that cefditoren pivoxil be taken concomitantly with H2 receptor antagonists.
Probenecid: As with other b-lactam antibiotics, co-administration of probenecid with cefditoren pivoxil resulted in an increase in the plasma exposure of cefditoren.
Drug/Laboratory Test Interactions: Cephalosporins are known to occasionally induce a positive direct Coombs test. A false-positive reaction for glucose in the urine may occur with copper reduction tests (Benedict’s or Fehling’s solution) but not with enzyme-based tests for glycosuria. As a false-negative result may occur in the ferricyanide test, it is recommended that either the glucose oxidase or hexokinase method be used to determine blood/plasma glucose levels in patients receiving cefditoren pivoxil.

Hepatic Dose :