Cefetamet pivoxil is an oral
third-generation cephalosporin which is hydrolysed to form the active agent,
cefetamet.
Cefetamet has excellent in vitro activity against the major respiratory pathogens Streptococcus pneumoniae, Haemophilus influenzae, Moraxella (Branhamella) catarrhalis and group A beta-haemolytic streptococci; it is active against
beta-lactamase-producing strains of H. influenzae and M. catarrhalis, but has poor activity against
penicillin-resistant S. pneumoniae.
Cefetamet has marked activity against Neisseria gonorrhoeae and possesses a broad spectrum of activity against Enterobacteriaceae. Both staphylococci and Pseudomonas spp. are resistant to
cefetamet.
Cefetamet pivoxil has been investigated in the treatment of both upper and lower community-acquired
respiratory tract infections and has demonstrated equivalent efficacy to a number of more established agents, namely
cefaclor,
amoxicillin and
cefixime. In patients with group A beta-haemolytic streptococcal pharyngotonsillitis, a 7-day course of
cefetamet pivoxil was as effective as a 10-day course of the standard agent,
phenoxymethylpenicillin, in this indication. In complicated
urinary tract infections,
cefetamet pivoxil showed similar efficacy to
cefadroxil,
cefaclor and
cefuroxime axetil.
Cefetamet pivoxil was effective in the treatment of
otitis media,
pneumonia, pharyngotonsillitis and
urinary tract infections in children. Preliminary data indicate that single dose
cefetamet pivoxil can effectively eradicate N. gonorrhoeae from both men and women.
Cefetamet pivoxil has a tolerability profile similar to that of other oral
cephalosporins, with gastrointestinal effects being the most commonly reported adverse events. To date, no symptoms of
carnitine deficiency have been reported with
cefetamet pivoxil.
Cefetamet pivoxil offers effective alternative oral
therapy for outpatient treatment of community-acquired
respiratory tract infections, with the advantage of improved activity against H. influenzae and increased
beta-lactamase stability. However, its use in areas with a high incidence of
penicillin-resistant S. pneumoniae is likely to be limited.
Cefetamet pivoxil is also effective in the treatment of
urinary tract infections, although further trials are required to define any comparative advantages over other oral agents.