@article{3153819,
    title = "Cefditoren: Comparative efficacy with other antimicrobials and risk
factors for resistance in clinical isolates causing UTIs in outpatients",
    author = "Hatzaki, Despina and Poulakou, Garyphallia and Katsarolis, Ioannis and and Lambri, Niki and Souli, Maria and Deliolanis, Ioannis and Nikolopoulos, and Georgios K. and Lebessi, Evangelia and Giamarellou, Helen",
    journal = "BMC Infectious Diseases",
    year = "2012",
    volume = "12",
    publisher = "BMC",
    issn = "1471-2334",
    doi = "10.1186/1471-2334-12-228",
    keywords = "Urinary tract infections; Acute uncomplicated cystitis; Cephalosporins;
Antimicrobial resistance; Empirical treatment",
    abstract = "Background: To investigate a possible role of Cefditoren, a recently
marketed in Greece third-generation oral cephalosporin in urinary
infections of outpatients.
Methods: During a multicenter survey of Enterobacteriaceae causing UTIs
in outpatients during 2005-2007, Cefditoren MICs were determined by agar
dilution method in a randomly selected sample of uropathogens.
Susceptibility against 18 other oral/parenteral antimicrobials was
determined according to Clinical and Laboratory Standards Institute
methodology.
Results: A total of 563 isolates (330 Escherichia coli, 142 Proteus
mirabilis and 91 Klebsiella spp) was studied; MIC50/MIC90 of Cefditoren
was 0.25/0.5 mg/L respectively, with 97.1% of the isolates being
inhibited at 1 mg/L. All 12 strains producing ESBLs or AmpC enzymes were
resistant to cefditoren. Susceptibility rates (%) for
amoxicillin/clavulanic acid, cefuroxime axetil, cefotaxime,
ciprofloxacin, trimethoprim/sulfamethoxazole and fosfomycin were
93.1-94.1-96.8-93.1-71.9 and 92.8% respectively. Cefditoren MIC was
significantly higher in nalidixic/ciprofloxacin non-susceptible strains;
resistance to cefditoren was not associated with resistance to
mecillinam, fosfomycin nitrofurantoin and aminoglycosides. Multivariate
analysis demonstrated history of urinary infection in the last two weeks
or three months as risk factors for cefditoren resistance.
Conclusions: Cefditoren exhibited enhanced in vitro activity against the
most common uropathogens in the outpatient setting, representing an
alternative oral treatment option in patients with risk factors for
resistance to first-line antibiotics."
}