As the post-marketing surveillance of cefpodoxime proxetil (Banan
®), MICs of cefpodoxime (CPDX, an active form of Banan
®) against 1090 clinical isolates of 22 species from 15 medical institutions all over Japan from June 2000 to March 2001 were measured using the broth microdilution method approved by the Japanese Society of Chemotherapy and compared with those of oral cephem antibacterials, cefaclor, cefdinir, cefditoren, and cefcapene.
In this study, remarkable change in the activity of CPDX was observed in
Streptococcus pneumoniae and
Haemophilus influenzae compared with the susceptibility in the studies before Banan
® was launched. This cause is considered to be the increase in the incidence of the following resistant strains: penicillin-intermediate
S. pneumoniae (47.3%), penicillin-resistant
S. pneumoniae (PRSP, 15.1%), and β-lactarnase-negative ampicillin-resistant (BLNAR)
H. influenzae (24.0%), which were scarcely isolated in 1989 when Banan
®was launched. Other tested drugs also exhibited low activity against these resistant strains. However, CPDX showed comparatively good activity with MIC
90 of 2μg/mL against PRSP. Against methicillin-susceptible
Staphylococcus spp.,
Streptococcus pyogenes,
Streptococcus agalactiae, and
Moraxella catarrhalis, CPDX also showed comparatively good activity with MIC
90 of ≤4μg/mL, which was almost equal to that in the studies before its marketing. Against quinolones-resistant
Neisseria gonorrhoeae, CPDX showed excellent activity with MIC
90 of 0.5μg/mL. Against members of the family Enterobacteriaceae except for
Citrobacter freundii,
Enterobacter spp.,
Proteus vulgaris, and
Morganella morganii, CPDX showed good activity. However, in
Escherichia coli,
Klebsiella spp.
Proteus spp., and
Providencia spp., there are some high-resistant strains to all tested drugs including CPDX. Against
Peptostreptococcus spp., MIC
90 of CPDX was 8μg/mL and its MIC range was widely distributed from 0.03 to 32μg/mL, which were similar to those in the studies before its marketing. In this study, CPDX showed the decrease in the activity against several species as did other drugs tested, but against most of species tested, CPDX maintained good activity. Furthermore, it is necessary to pay much attention to the trend of resistant strains.
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