Cefpodoxime Proxetil 50DT,100,200 mg
THE NEED FOR A BETA-LACTAM + BETA LACTAMASE INHIBITOR COMBINATION
Among different antibiotics, beta lactam antibiotics account for approximately 50% of global antibiotic consumption because of their proven efficacy and safety. It is well documented fact that bacterial resistance to this group of antibiotic increased parallely with increasing use of these antibiotics. Strategy for overcoming bacterial resistance with newer cephalosporins has been successfully employed as it was possible to modify structure of a cephalosporin nucleus easily to confer an additional advantage. However, it has become clear that such attempts have been not only short lived but has created an alarming situation that currently available antibiotics are not adequate to control infection due to resistant bacteria.
Reintroduction of currently available penicillins and cephalosporins with other agents such as beta lactamase inhibitors is an attractive preposition for many reasons;
1)Well established safety and efficacy profile
2)Production of beta lactamase is the most common mechanism of resistance to beta lactam antibiotics, especially in gram negative bacteria
3)Convenience of use, and more essentially an understanding that using such combination empirically may help in not only overcome therapeutic failures due to resistant bacteria but will also delay resistance development in susceptible bacteria
4)Minimize use of newer antibacterials so that they remain effective antibacterial for specific use.
ADVANTAGE OF CEFPODOXIME + CLAVULANICACID COMBINATION
Cefpodoxime is a 3rd generation cephalosporin active against many gram positive and gram negative organisms and is beta lactamase stable. It exhibits excellent activity against Streptococcus pneumoniae, methicillin susceptible Staphylococci, Haemophilus influenzae, Moxaxella catarrhalis and Nesseria spp which are the most common community acquired and hospital acquired infections.
However in recent past it observed that due to production of Beta lactamase enzyme MIC values of cefpodooxime has increased for certain micro-organism. As a result, cefpodoxime may be less effective in treating infectiolls.
Reference: Drugs. 1991;42 Suppl 3:6-12.
Protective role of Clavulanic acid:
Clavulanic acid is a naturally derived beta lactamase inhibitor produced by Streptomyces clavuligerus. Clavulanic acid binds to and inactivates them thus preventing the destruction of cefpodoxime that is a substrate for this enzyme.
It has poor intrinsic antimicrobial activity , but it is a ‘suicide’ inhibitor (irreversible binder) of 13- lactamases produced by a wide range of gram positive and gram negative microorganism. Clavulanic acid is well absorbed by mouth.
The combination of Cefpodoxime (3rd generation cephalosporin) and Clavulanic acid (beta-lactamase inhibitor) provides a solution for treatment of bacterial infections caused by beta lactam resistant pathogens.