Microbiology: Like other β-lactam antibiotics, cefpodoxime exerts its inhibitory effect by interfering with bacterial cell wall synthesis. This interference is primarily due to its covalently binding to the penicillin-binding proteins (PBPs) (i.e. transpeptidase and/or carboxypeptidase), which are essential for synthesis of the bacterial cell wall. Therefore, cefpodoxime is bactericidal. Cefpodoxime is stable in the presence of many common β-lactamase enzymes. As a result, many organisms resistant to other β-lactam antibiotics (penicillins and some cephalosporins) due to the production of β-lactamases may be susceptible to cefpodoxime.
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Cefpodoxime has a broad spectrum of clinically useful antibacterial activity that includes staphylococci, streptococci, and Gram-negative species (including Pasteurella, Escherichia, and Proteus). The compound is not active against most obligate anaerobes, Pseudomonas spp., or enterococci. The minimum inhibitory concentrations (MICs) for cefpodoxime against Gram-positive and Gram-negative pathogens isolated from canine skin infections (wounds and abscesses) in a 2002 U.S. field study are presented in Table 5. All MICs were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS). Appropriate quality control (QC) ranges for in vitro susceptibility testing are presented in Table 6.
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Table 5. Cefpodoxime Minimum Inhibitory Concentration Values (mcg/mL) from a 2002 Field Study Evaluating Skin Infections (wounds and abscesses) of Canines in the United States Organism*# of IsolatesMIC50MIC90Range * Veterinary specific interpretive criteria have not been established for the above listed canine pathogens by the NCCLS at this time. † No Range, all isolates yielded the same value. Staphylococcus pseudintermedius1180.120.500.12->32.0 Streptococcus canis (group G, β hemolytic)33≤0.03≤0.03≤0.03† Escherichia coli410.250.500.12->32.0 Pasteurella multocida32≤0.03≤0.03≤0.03-0.12 Proteus mirabilis14≤0.030.06≤0.03-0.06 Staphylococcus aureus192.02.00.12-2.0 Table 6. Acceptable Quality Control Ranges for Cefpodoxime QC ATCC strainKB Disk Diffusion MethodBroth Micro-dilution Method Drug concentrationZone diameterMIC * These ranges are for quality control strains used to monitor accuracy of minimum inhibitory concentrations (MICs) of non-fastidious organisms using cation-adjusted Mueller-Hinton agar or broth medium. The dilution range should encompass the QC ranges of these strains in the broth micro-dilution method. † These ranges are for quality control strains used to monitor accuracy of minimum inhibitory concentrations (MICs) of fastidious organisms. When susceptibility testing is performed for Streptococcus canis (group G, β hemolytic), Streptococcus pneumoniae ATCC 49619 should be included as a QC strain in the presence of 5% lysed sheep blood (KB disk diffusion method) or 2.5% lysed horse blood (broth micro-dilution method). Escherichia coli 2592210 mcg23-28 mm*0.25-1 mcg/mL* Staphylococcus aureus 2592310 mcg19-25 mm* Staphylococcus aureus 292131-8 mcg/mL* Staphylococcus pneumoniae 4961910 mcg28-34 mm†0.03-0.12 mcg/mL†
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