Cefuroxime, a Beta-Lactamase-Resistant Cephalosporin with a Broad Spectrum of Gram-Positive and -Negative Activity

Abstract

The in vitro activity of cefuroxime, a cephalosporin antibiotic, was investigated against 604 isolates and compared with the activity of other β-lactam compounds. Cefuroxime had activity comparable to that of other cephalosporins, including cefamandole and cefoxitin, against streptococcal and staphylococcal species; most streptococci were inhibited by 0.1 μg or less per ml, and staphylococci were inhibited by 1.6 μg or less per ml. Enterococci were relatively resistant. Cefuroxime inhibited β-lactamase-producing Neisseria gonorrhoeae and Haemophilus influenzae . Cefuroxime had excellent activity against members of the Enterobacteriaceae; 83% of β-lactamase-producing Escherichea coli , 100% of Salmonella , 100% of Klebsiella , 90% of Proteus mirabilis , 95% of Citrobacter , 56% of Enterobacter , and 58% of Shigella were inhibited by 12.5 μg/ml. Cefuroxime had activity comparable to that of cefamandole and cefoxitin; it inhibited isolates of E. coli and Klebsiella resistant to cefamandole and inhibited Enterobacter and Citrobacter resistant to cefoxitin. Many isolates of Serratia , some indole-positive strains of Proteus , and Bacteroides fragilis were resistant to cefuroxime. Resistance of cefuroxime to hydrolysis by β-lactamases played a major role in its activity against both gram-positive and gram-negative organisms.