Cefmetazole (CS-1170), a “new” cephamycin with a decade of clinical experience

Jones, Ronald N.

doi:10.1016/0732-8893(89)90106-5

Cited by 17 publications

(13 citation statements)

References 60 publications

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“…abscessus (1,16,17), although the usual modal MIC for both organisms is 32 pug/ml, which is in the moderately susceptible category (as defined for these organisms) (10,17). Results for cefoxitin from the current study were comparable.…”

supporting

confidence: 66%

“…Although not yet approved by NCCLS, the proposed moderately susceptible breakpoint for cefmetazole is also 32 jig/ml (10 (1,7,9,16,17) and most isolates of M. chelonae subsp. abscessus (1,16,17), although the usual modal MIC for both organisms is 32 pug/ml, which is in the moderately susceptible category (as defined for these organisms) (10,17).…”

mentioning

confidence: 99%

“…Moderately susceptible breakpoints for imipenem (8 jig/ml) and amoxicillin-clavulanic acid (16/8 ,ug/ml) were the moderately susceptible breakpoints of the National Committee for Clinical Laboratory Standards (NCCLS) for aerobic bacteria (13). An MIC of 32 ,ug/ml rather than 16 ,ug/ml (the latter being the NCCLS breakpoint) has been used as the moderately susceptible breakpoint for cefoxitin against the rapidly growing mycobacteria (17,20).Although not yet approved by NCCLS, the proposed moderately susceptible breakpoint for cefmetazole is also 32 jig/ml (10 (1,7,9,16,17) and most isolates of M. chelonae subsp. abscessus (1,16,17), although the usual modal MIC for both organisms is 32 pug/ml, which is in the moderately susceptible category (as defined for these organisms) (10,17).…”

mentioning

confidence: 99%

“…Although not yet approved by NCCLS, the proposed moderately susceptible breakpoint for cefmetazole is also 32 jig/ml (10 Laboratory of the University of Texas between 1987 and 1990 were tested. Identification to the species level was performed by standard methods (14,21), and identification to the subspecies level was by carbohydrate utilization tests and/or drug susceptibility patterns (14,15 (1,7,9,16,17) and most isolates of M. chelonae subsp.…”

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confidence: 99%

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Susceptibilities of Mycobacterium fortuitum biovar. fortuitum and the two subgroups of Mycobacterium chelonae to imipenem, cefmetazole, cefoxitin, and amoxicillin-clavulanic acid

Wallace

Brown

Onyi

1991

Antimicrob Agents Chemother

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MICs of imipenem, cefoxitin, cefmetazole, and amoxicillin-clavulanic acid were determined against 100 strains of Mycobacteriumfortuitum and 200 strains ofMycobacterium chelonae. Imipenem and cefmetazole were more active against M. fortuitum than cefoxitin was, and imipenem (which inhibited 39% of strains at 8 ,ug/ml) was the only beta-lactam active against M. chelonae subsp. chelonae.Rapidly growing mycobacteria cause a variety of infections, the majority of which involve skin and soft tissues (22). Antimicrobial therapy based on in vitro susceptibilities combined with surgical debridement are the indicated therapy for patients with serious cutaneous disease (9, 20). Long-term drug therapy of 3 to 6 months is usually needed (20). Amikacin is the most common drug used for serious disease, often in combination with cefoxitin (8,9,20). Because of toxicity (amikacin) and a relatively short half-life (cefoxitin), there has been continued interest in other potential drugs for therapy.We chose to compare three beta-lactams (cefmetazole, imipenem, and amoxicillin-clavulanic acid) with cefoxitin for their in vitro activities against the common pathogenic species of rapidly growing mycobacteria, Mycobacterium fortuitum and Mycobacterium chelonae, after preliminary studies showed that the drugs have therapeutic potential (5, 17).MICs were determined by using broth microdilutions with cation-supplemented Mueller-Hinton broth as described by Swenson et al. (16). Twofold dilutions of cefoxitin, cefmetazole, imipenem, and amoxicillin-clavulanic acid (2:1 ratio) were prepared and added to 96-well plates by using the Mini-Quick Spense II system (Dynatech Laboratories, Chantilly, Va.). Plates were inoculated with disposable inoculators with a dilution designed to obtain a final well concentration of 104 to 105 CFU/ml. The plates were covered, sealed in plastic bags, and incubated in room air at 30°C for 3 days. Quality control was performed by using Staphylococcus aureus ATCC 29213, Escherichia coli ATCC 25922, E. coli ATCC 35218 (clavulanic acid), and M. fortuitum ATCC 6841. Moderately susceptible breakpoints for imipenem (8 jig/ml) and amoxicillin-clavulanic acid (16/8 ,ug/ml) were the moderately susceptible breakpoints of the National Committee for Clinical Laboratory Standards (NCCLS) for aerobic bacteria (13). An MIC of 32 ,ug/ml rather than 16 ,ug/ml (the latter being the NCCLS breakpoint) has been used as the moderately susceptible breakpoint for cefoxitin against the rapidly growing mycobacteria (17,20).Although not yet approved by NCCLS, the proposed moderately susceptible breakpoint for cefmetazole is also 32 jig/ml (10 (1,7,9,16,17) and most isolates of M. chelonae subsp. abscessus (1,16,17), although the usual modal MIC for both organisms is 32 pug/ml, which is in the moderately susceptible category (as defined for these organisms) (10,17). Results for cefoxitin from the current study were comparable.Cefmetazole, like cefoxitin, is a 7-ot-methoxy cephalosporin or cephamycin, but the former has approximately 20% higher...

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supporting

confidence: 66%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Susceptibilities of Mycobacterium fortuitum biovar. fortuitum and the two subgroups of Mycobacterium chelonae to imipenem, cefmetazole, cefoxitin, and amoxicillin-clavulanic acid

Wallace

Brown

Onyi

1991

Antimicrob Agents Chemother

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“…S. montevideo is relatively sensitive to CMZ, a parenterally administered, second generation cephamycin-group antibiotic that is microbicidal for gram negative (18), gram positive (19) and anaerobic (20) Bacteria. Salmonella montevideo (SH5770) was obtained from P. Helena Makela (Helsinki, Finland).…”

Section: Introductionmentioning

confidence: 99%

Sub-minimal inhibitory concentrations of cefmetazole enhance serum bactericidal activity in vitro by amplifying poly-C9 deposition.

Schweinle

Nishiyasu²

1992

J. Clin. Invest.

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Serum-resistant organisms grown in sub-minimal inhibitory concentrations (subMICs)-of antibiotics in vitro may be rendered sensitive to complement-mediated, serum bactericidal activity. We measured '"I-C3 and 125I1C9 deposition on genetically serum resistant Salmonella montevideo SH5770 (SH5770) that was rendered serum sensitive by growth in subMICs of cefmetazole (CMZ), a parenteral, second generation, cephamycin-group antibiotic. Three times as much C3 and over six times as much C9 bound to SH5770 grown in one-fourth the MIC of CMZ compared to broth-grown bacteria. SDS-PAGE analysis and autoradiography showed that neither the ratio of C3b:iC3b (-1:2.5) nor the nature ofthe C3-bacterial bond was changed by growing the organisms in CMZ. Large amounts of complement membrane attack complexes containing poly-C9 were seen only on CMZ-grown SH5770 by SDS-PAGE and autoradiography. Poly-C9 was also detected only on CMZgrown bacteria by indirect immunofluorescence and ELISA using a murine monoclonal antibody directed against a neoantigen of poly-C9. Bacterial hydrophobicity increased after growth in CMZ, and transmission electron micrographs of CMZ-grown SH5770 showed cell wall disruption and blebbing. These results indicate that growth in subMICs ofCMZ increases bacterial hydrophobic domains available for interacting with the membrane attack complex, C5b-9, allowing formation and stable insertion of bactericidal complexes containing poly-C9.

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Cefmetazole Sodium: Pharmacology, Pharmacokinetics, and Clinical Trials

Schentag

1991

Pharmacotherapy

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Cefmetazole sodium is a semisynthetic cephamycin antibiotic. It has a broad spectrum of activity comparable to that of the second‐generation cephalosporins, covering gram‐positive, gram‐negative, and anaerobic bacteria. Unlike the second‐generation cephalosporins, cephamycins such as cefmetazole are usually active against Bacteroides fragilis. Cefmetazole is also active against β‐lactamase‐producing organisms that are resistant to first‐generation cephalosporins or penicillins. The pharmacokinetics of cefmetazole allow parenteral administration (intravenous or intramuscular) 2–3 times daily for treatment of infection. The drug has been studied in gynecologic, intraabdominal, urinary tract, respiratory tract, and skin and soft tissue infections. Administered preoperatively, it may reduce the frequency of infection in certain clean‐contaminated or potentially contaminated procedures, including cesarean section, abdominal or vaginal hysterectomy, cholecystectomy (high‐risk patients), and colorectal surgery. On the basis of in vitro spectrum, pharmacokinetics, and data from a relatively small number of clinical trials, this agent may be considered when a second‐generation cephalosporin is indicated.

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Cefmetazole (CS-1170), a “new” cephamycin with a decade of clinical experience

Cited by 17 publications

References 60 publications

Susceptibilities of Mycobacterium fortuitum biovar. fortuitum and the two subgroups of Mycobacterium chelonae to imipenem, cefmetazole, cefoxitin, and amoxicillin-clavulanic acid

Susceptibilities of Mycobacterium fortuitum biovar. fortuitum and the two subgroups of Mycobacterium chelonae to imipenem, cefmetazole, cefoxitin, and amoxicillin-clavulanic acid

Sub-minimal inhibitory concentrations of cefmetazole enhance serum bactericidal activity in vitro by amplifying poly-C9 deposition.

Cefmetazole Sodium: Pharmacology, Pharmacokinetics, and Clinical Trials

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