Cefotetan is a new
cephamycin antibiotic characterised by excellent B-lactamase stability and anti-anaerobe activity, coupled with a long half life of 3-4 h which permits twice daily dosage. A clinical trial of
cefotetan in the treatment of severe oro-facial
infections is presented, together with a detailed analysis of the causative organisms and their sensitivities to eight
antibiotics. 50/50 patients achieved clinical cure with a treatment regime comprising
cefotetan therapy and incision and drainage, with patients being transferred to oral
cephradine for the final phase of
therapy. Side effects were minimal and there were no instances of relapse. Significant resistance among alpha-haemolytic streptococci and bacteroides organisms to
penicillin was observed. The streptococci were resistant due to mechanisms other than
beta-lactamase production. In the light of these findings and the reports of other workers it is suggested that
penicillin V may no longer be the most appropriate
drug for
endocarditis prophylaxis, despite the most recent recommendations of the American Heart Association. Furthermore, if
penicillin V is used for this purpose, a
penicillin free interval of 6-8 weeks may be inadequate before this
drug is used.
Cefotetan is not suitable for prophylaxis against
endocarditis.