Cefprozil is an orally active
cephalosporin which has demonstrated activity against a wide range of organisms in vitro. It is particularly active against the Gram-positive organisms Streptococcus pyogenes, pneumoniae and agalactiae and against
methicillin-susceptible Staphylococcus aureus. Strains of methicillin-resistant S. aureus are not susceptible to
cefprozil.
Cefprozil is also moderately active against Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae, many Enterobacteriaceae and certain anaerobic organisms, and is relatively stable to hydrolysis by a number of
beta-lactamases. In comparative trials, the clinical and bacteriological efficacy of
cefprozil 500mg or 20 mg/kg administered once or twice daily has been comparable with multiple daily dosage regimens of
erythromycin in patients with
tonsillitis or
pharyngitis, with
cefaclor and
amoxicillin/
clavulanate in lower
respiratory tract infections, with
amoxicillin/
clavulanate and
erythromycin in skin and skin-structure
infections and with
cefaclor in acute uncomplicated
urinary tract infections. The clinical efficacy of
cefprozil is similar to that of
cefaclor in patients with
tonsillitis or
pharyngitis but the bacteriological efficacy of
cefprozil is significantly greater than that of
cefaclor.
Cefprozil is clinically more effective than
cefuroxime axetil in the treatment of lower
respiratory tract infections and demonstrated greater efficacy than
cefaclor in one of 2 comparative studies when administered twice daily in patients with skin and skin-structure
infections. In children with acute
otitis media,
cefprozil 15 mg/kg twice daily was as effective as
cefaclor or
amoxicillin/
clavulanate 13.3 mg/kg 3 times daily and was as effective as
cefixime 8 mg/kg once daily. The most frequently reported adverse effects associated with
cefprozil, diarrhoea and
nausea, are usually mild to moderate in severity and discontinuation of treatment is rarely necessary. Thus,
cefprozil with its convenient administration regimen appears to be a suitable alternative to
cefaclor,
cefixime,
amoxicillin/
clavulanate or
erythromycin for the treatment of upper and lower
respiratory tract infections, skin and skin-structure
infections, and
otitis media in children. While
cefprozil has shown similar efficacy to
cefaclor in the treatment of uncomplicated
urinary tract infections, well-controlled clinical trials comparing its efficacy with that of
cotrimoxazole (trimethoprim+sulfamethoxazole) in this indication are required.