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

• Published in: Antimicrobial agents and chemotherapy Vol. 58; no. 8; pp. 4899 - 4901
• Main Authors: GUET-REVILLET, H, EMIRIAN, A, GROH, M, NEBBAD-LECHANI, B, WEISS, E, JOIN-LAMBERT, O, BILLE, E, JULLIEN, V, ZAHAR, J. R
• Format: Journal Article
• Language: English
• Published: Washington, DC American Society for Microbiology 01.08.2014
• Subjects: Anti-Bacterial Agents; Anti-Bacterial Agents - pharmacokinetics; Anti-Bacterial Agents - pharmacology; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Bacterial diseases of the urinary system; beta-Lactam Resistance; beta-Lactamases - biosynthesis; beta-Lactamases - genetics; Biological and medical sciences; Carbapenems - pharmacokinetics; Carbapenems - pharmacology; Cefoxitin; Cefoxitin - pharmacokinetics; Cefoxitin - pharmacology; Drug Administration Schedule; Drug Dosage Calculations; Escherichia coli; Escherichia coli - drug effects; Escherichia coli - enzymology; Escherichia coli - genetics; Escherichia coli - growth & development; Escherichia coli Infections - drug therapy; Escherichia coli Infections - microbiology; Gene Expression; Human bacterial diseases; Humans; Infectious diseases; Medical sciences; Microbial Sensitivity Tests; Models, Statistical; Nephrology. Urinary tract diseases; Pharmacology; Pharmacology. Drug treatments; Pyelonephritis - drug therapy; Pyelonephritis - microbiology; Urinary system involvement in other diseases. Miscellaneous; Urinary Tract Infections - drug therapy; Urinary Tract Infections - microbiology; Urinary tract. Prostate gland; Urinary system disease; β-Lactams; Escherichia coli; Extended-spectrum β-lactamase; Urinary tract disease; Cefoxitin; Cephalosporin derivatives; Antibiotic; Carbapenem derivatives; Urinary tract infection; Treatment; Bacteria; Antibacterial agent; Enterobacteriaceae
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.02509-14

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.