Disease relevance of cefotetan

• Cefotetan and hypoprothrombinemia [1].
• Cefbuperazone and cefotetan were equally active against Bacteroides fragilis, with 8% of the organisms tested found to be resistant to 32 micrograms of either drug per ml [2].
• Six Escherichia coli and 12 Klebsiella pneumoniae isolates from a single hospital expressed a common beta-lactamase with a pI of approximately 9.0 and were resistant to cefoxitin and cefotetan (MIC ranges, 64 to > 128 and 16 to > 128 micrograms/ml, respectively) [3].
• In vitro activity of cefotetan compared with that of other antimicrobial agents against anaerobic bacteria [4].
• Cefotetan is particularly active against Enterobacteriaceae but has little activity against Pseudomonas aeruginosa [5].

Psychiatry related information on cefotetan

• Cefotetan inhibited beta-lactamases of the type Ia and Id, but it also induced these beta-lactamases in P. aeruginosa, E. cloacae and C. freundii [6].

High impact information on cefotetan

• Clinical pharmacokinetics of cefotetan [7].
• A long serum half-life and resistance to beta-lactamase hydrolysis have made cefotetan an attractive chemotherapeutic agent, and the results of clinical trials worldwide have demonstrated its efficacy in a wide variety of clinical situations [7].
• Cefotetan concentrations are likely to be active against susceptible bacteria in most tissues and body fluids [7].
• Pharmacokinetics and tissue penetration of single-dose cefotetan used for antimicrobial prophylaxis in patients undergoing colorectal surgery [8].
• Of note were the high and prolonged concentrations of ticarcillin and cefotetan in blister fluid, despite high-level serum protein binding [9].

Chemical compound and disease context of cefotetan

• Activities of cefoxitin and cefotetan against Mycobacterium fortuitum infections in mice [10].
• In vitro activity of cefmetazole, cefotetan, amoxicillin-clavulanic acid, and other antimicrobial agents against anaerobic bacteria from endometrial cultures of women with pelvic infections [11].
• However, cefotetan was hydrolysed at measurable rates by the beta-lactamase of Enterobacter cloacae P99, in contrast to temocillin which was completely stable to this enzyme [12].
• Peptostreptococcus isolates were susceptible to piperacillin, cefotaxime, and imipenem, while 7.4% were resistant to penicillin G, cefotetan, and metronidazole, and 25.9% were resistant to clindamycin [13].
• About half the number of Enterobacter aerogenes and Enterobacter cloacae strains resistant to cefotetan were resistant also to cefotaxime [14].

Biological context of cefotetan

• A slight but statistically significant increase in prothrombin time also was observed with cefotetan [15].
• Cefotetan was bactericidal without significant inoculum effect and was highly resistant to hydrolysis by Richmond-Sykes types I, III, and IV beta-lactamases [16].
• Cefotetan has shown good clinical efficacy in intra-abdominal, obstetric and gynaecological infections, postoperative wound infections, and infections in immunocompromised patients - all of which are often complicated due to their polymicrobial nature or by the presence of anaerobic pathogens [5].
• Bactericidal levels of cefotetan were maintained in plasma in the immediate postpartum period [17].
• Pharmacokinetics and tissue kinetics of 1 gm cefotetan prophylaxis in abdominal or vaginal hysterectomy [18].

Anatomical context of cefotetan

• Like other cephalosporins, cefotetan is effective in treating patients with complicated urinary tract infections and lower respiratory tract infections [5].
• At the time of incision (33 +/- 16 min after the injection), cefotetan concentrations were 14.2 +/- 7 micrograms/g in abdominal-wall fat, 16.4 +/- 1 micrograms/g in epiploic fat, and 163 +/- 62 mg/liter in serum [8].
• The pharmacokinetics of cefotetan excretion in the unobstructed biliary tree [19].
• Persistence of cefotetan on red blood cells [20].
• Concentrations of cefotetan in bile from the common bile ducts and functioning gall bladders were greater than the plasma concentrations at all times [19].

Associations of cefotetan with other chemical compounds

• No changes in prothrombin time or in the formation of abnormal prothrombin were seen either during or following the cefoxitin or cefotetan phase [21].
• The half-life (3 h) of cefotetan was longer than that of cefazolin [22].
• The minimal inhibitory concentrations that inhibited 90% of the 7 alpha-methoxy cephalosporins, cefoxitin, cefmetazole, moxalactam, and cefotetan, against the isolates were 4, 8, 8, and 16 micrograms/ml, respectively, and these antibiotics were entirely resistant to hydrolysis by beta-lactamases (0.10 mumol/h per mg of protein) of the isolates [23].
• In vitro activity of cefotetan, a new cephamycin derivative, compared with that of other beta-lactam compounds [24].
• The discrepancy between in vitro NMTT production (cefmetazole greater than cefotetan greater than cefoperazone) and the amount of NMTT formed in vivo and excreted unchanged (cefoperazone greater than cefotetan greater than cefmetazole) suggests that in vivo production of NMTT is dependent on the disposition of the parent cephalosporin [25].

Gene context of cefotetan

• Cefotetan MICs of >/= 8 microg/ml were obtained for seven of eight producers of AmpC beta-lactamase and no ESBL producers [26].
• In the presence of temperature-sensitive ampD, induction by cefotetan was similar to that by cefoxitin at 30 degrees C but greater than that by cefoxitin at 42 degrees C. These results suggest that ampD encodes a protein involved in induction of AmpC beta-lactamase in E. cloacae [27].
• Upon closure of the abdomen (216 +/- 76 min), cefotetan concentrations were 6.3 +/- 3 micrograms/g in abdominal-wall fat, 6.1 +/- 4 micrograms/g in epiploic fat, and 64 +/- 38 mg/liter in serum [8].
• Meropenem and imipenem were highly resistant to the hydrolytic activity of all the TEM and SHV related beta-lactamases, and to the OXA enzymes, as were the cephamycins: cefoxitin and cefotetan [28].
• Drug-independent antibodies (i.e., those reacting without any drug being present) were detected in 33 to 44 percent of patients' sera containing cefotetan antibodies, depending on the sensitivity of the method used [29].

Analytical, diagnostic and therapeutic context of cefotetan

• Concentrations of cefotetan and cefotetan tautomer in plasma and urine were determined by high-performance liquid chromatography [30].
• The mean plasma cefotetan concentration at the end of the intravenous infusion did not vary with renal function and ranged between 122 and 126 micrograms/ml [30].
• At the time of surgical anastomosis (151 +/- 54 min), cefotetan concentrations were 33.3 +/- 6 micrograms/g in the colonic wall and 73 +/- 34 mg/liter in serum [8].
• The intraperitoneal penetration of cefotetan was studied after a 1-g intravenous injection in 25 patients undergoing elective gastrointestinal surgery [31].
• Cefazolin is inferior to cefotetan as single-dose prophylaxis for women undergoing elective total abdominal hysterectomy [32].

References