Oral cephalosporins in the treatment of respiratory tract infections

Abstract

Over the past 40 years, many cephalosporins have been developed; of these, several orally absorbable molecules have been used mainly in community-acquired infections. Recently, newer oral cephalosporins with an increased stability to β-lactamases and an extended spectrum of antibacterial activities have become available; one of these is cefodoxime proxetil, an esterified compound that exhibits an improved intestinal absorption and increased bioavailability compared with previously developed oral cephalosporins. Moreover, as a third-generation cephalosporin, cefpodoxime proxetil possesses a methoxyiminoaminothiazolyl group at position 7, which confers upon the drug a high stability in the presence of common enzymes of types TEM, OXA, SHV. Favorable pharmacokinetic parameters, such as low serum protein binding (20%), long elimination half-life (2.3h), and good tissue distribution, have been demonstrated. These characteristics have resulted in favorable clinical experience with cefpodoxime proxetil in community-acquired respiratory tract infections, in urinary tract infections, and in mild skin and soft tissue infections.