The chemistry, microbiology, pharmacokinetics, adverse reactions, and clinical indications for cefsulodin are reviewed and compared to ceftazidime and cefoperazone. Cefsulodin is a narrow-spectrum, third-generation cephalosporin with activity virtually restricted to Pseudomonas aeruginosa. Cefsulodin is eliminated renally and has a serum half-life similar to ceftazidime and cefoperazone. Cefsulodin appears to be well tolerated and relatively free of any significant toxicity except for nausea and vomiting, which appear to be related to the infusion rate. Cefsulodin may be beneficial in those rare clinical situations where an infection is caused by a sensitive isolate of P. aeruginosa known to be resistant to the other antipseudomonal cephalosporins, and/or the avoidance of an aminoglycoside antibiotic is desired. However, its empiric use is to be discouraged.
NeuHC. The new beta-lactamase-stable cephalosporins. Ann Intern Med1982; 97: 408–19.
2.
MandellGL. Cephalosporins. In: MandellGLDouglasRGBennettJE, eds. Principles and practice of infectious diseases. New York: John Wiley and Sons, 1985: 180–7.
3.
SandersCCSandersWE. Emergence of resistance during therapy with the newer beta-lactam antibiotics: role of inducible beta-lactamases and implications for the future. Rev Infect Dis1983; 5 (4): 639–48.
TsuchiyaKKondoM. Comparative in-vitro activities of SCE-129, sulbenicillin, gentamicin, and dibekacin against pseudomonas. Antimicrob Agents Chemother1978; 13: 536–9.
6.
KingAShannonKPhillipsI. In-vitro antibacterial activity and susceptibility of cefsulodin, an antipseudomonal cephalosporin, to beta-lactamases. Antimicrob Agents Chemother1980; 17: 165–9.
7.
NeuHFuKP. In-vitro antibacterial activity and beta-lactamase stability of SCE-129, a new cephalosporin. Antimicrob Agents Chemother1979; 15: 646–50.
8.
BarryALJonesRNThornsberryC. Cefsulodin: antibacterial activity and tentative interpretive zone standards for the disk susceptibility test. Antimicrob Agents Chemother1981; 20: 525–9.
9.
SmithBR. Cefsulodin and ceftazidime, two antipseudomonal cephalosporins. Clin Pharm1984; 3: 373–85.
10.
NeuHLabthavikulP. Antibacterial activity and beta-lactamase stability of ceftazidime, an aminothiazolyl cephalosporin potentially active against Pseudomonas aeruginosa. Antimicrob Agents Chemother1982; 21: 11–8.
11.
JonesRNBarryALThornsberryCCeftazidime, a pseudomonas-active cephalosporin: in-vitro antimicrobial activity evaluation including recommendations for disc diffusion susceptibility tests. J Antimicrob Chemother1981; 8 (suppl B): 187–11.
12.
PhillipsIWarrenCShannonKKingAHansloD. Ceftazidime: in-vitro antibacterial activity and susceptibility to betalactamases compared with that of cefotaxime, moxalactam, and other beta-lactam antibiotics. J Antimicrob Chemother1981; 8 (suppl B): 23–31.
MastellaGAgostiniMBarloccoGAlternative antibiotics for the treatment of pseudomonas infections in cystic fibrosis. J Antimicrob Chemother1983; 12 (suppl A): 297–311.
15.
LivermoreDMWilliamsRJWilliamsJD. In-vitro activity of ceftazidime against Pseudomonas aeruginosa: and its stability to pseudomonal beta-lactamases. J Antimicrob Chemother1981; 8 (suppl B): 163–7.
16.
BauernfeindA. An evaluation of the activity of cephalosporins against Pseudomonas aeruginosa. J Antimicrob Chemother1981; 8 (suppl B): 111–7.
17.
KnotheHDetteA. The in-vitro activity of ceftazidime against clinically important pathogens. J Antimicrob Chemother1981; 9 (suppl B): 33–41.
18.
Van KlingerenB. An in-vitro comparison of new cephalosporins with special reference to Pseudomonas aeruginosa. J Antimicrob Chemother1981; 8 (suppl B): 97–105.
19.
ThabutADurosoirJLSaliouP. Comparison of the in-vitro activities of ceftazidime and new cephalosporins against 107 strains of Pseudomonas aeruginosa and 249 strains of cefazolin-resistant Enterobacteriaceae. J Antimicrob Chemother1981; 8 (suppl B): 123–5.
20.
PhilliponAPaulGNevotP. Comparative in-vitro activity of cefsulodin and ceftazidime against ticarcillin-resistant Pseudomonas aeruginosa. J Antimicrob Chemother1981; 8 (suppl B): 119–22.
21.
SchassanHHFredderJ. Activity of ceftazidime and newer antibiotics against gram-negative bacilli. J Antimicrob Chemother1981; 8 (suppl B): 79–82.
22.
WattBBrownFV. The comparative activity of cefsulodin against anaerobic bacteria of clinical interest: synergy with cefoxitin. J Antimicrob Chemother1981; 7: 269–78.
23.
GrannemanGRSennelloLTSondersRCWynneBThomasEW. Cefsulodin kinetics in healthy subjects after intramuscular and intravenous injection. Clin Pharmacol Ther1982; 31: 95–103.
WittkeRRAdamD. Diffusion of cefsulodin (CGP 7174/E) in human tissues. In: NelsonJGrassiG, eds. Current chemotherapy and infectious disease. Washington DC: American Society for Microbiology, 1980: 197–9.
26.
Bergogne-BerezinEBerthelotGEvenPKafeH. Penetration of cefsulodin into bronchial secretions. Chemotherapy1984; 30: 205–10.
27.
FindlayCDWiseRAllockJEDurhamSR. The tissue penetration, as measured by a blister technique, and pharmacokinetics of cefsulodin compared with carbenicillin and ticarcillin. J Antimicrob Chemother1981; 7: 637–42.
28.
DaschnerFDMetzBSpillnerGBuzelloWSchlosserV. Concentrations of cefamandole and cefsulodin in serum, heart valves, subcutaneous tissue, and muscle of patients undergoing open-heart surgery. J Infect Dis1980; 142: 290.
29.
LecaillonJBRouanMCBinswangerUGuibertJSchoellerJP. Pharmacokinetics of cefotiam and cefsulodin after simultaneous administration to patients with impaired renal function. Antimicrob Agents Chemother1984; 26: 368–72.
30.
MatzkeGRKeaneWF. Cefsulodin pharmacokinetics in patients with various degrees of renal function. Antimicrob Agents Chemother1983; 23: 369–73.
31.
SchoellerJPFillastreJPHumbertGPharmacokinetics of cefsulodin in patients with renal insufficiency. In: PeritiPGrassiG, eds. Current chemotherapy and immunotherapy. Washington, DC: American Society for Microbiology, 1982: 526–37.
32.
MichalsenHBerganT. Effects of cystic fibrosis on the pharmacokinetics of cefsulodin. In: PeritiPGrassiG, eds. Current chemotherapy and immunotherapy. Washington, DC: American Society for Microbiology, 1982: 529–30.
33.
ReedMDSternRCYamashitaTSAckersIMyersCMBlumerJL. Single-dose pharmacokinetics of cefsulodin in patients with cystic fibrosis. Antimicrob Agents Chemother1984; 25: 579–81.
34.
ArvidssonAAlvanGStrandvikB. Difference in renal handling of cefsulodin between patients with cystic fibrosis and normal subjects. Acta Pediatr Scand1983; 72: 293–4.
35.
JuskoWJMosovichLLGerbrachtMSMatterMEYaffeSJ. Enhanced renal excretion of dicloxacillin in patients with cystic fibrosis. Pedatrics1975; 56: 1038–44.
36.
YaffeSJGerbrachtLMMousovichLLMatterMEDanishMJuskoWJ. Pharmacokinetics of methicillin in patients with cystic fibrosis. J Infect Dis1977; 135: 828–31.
MollerNEKochCVesterhaugeSJensenK. Treatment of pulmonary Pseudomonas aeruginosa infection in cystic fibrosis with cefsulodin. Scand J Infect Dis1982; 14: 207–11.
39.
ScullyBPrinceAOresCNeuHC. Cefsulodin therapy of Pseudomonas aeruginosa infections: pulmonary and osteomyelitis (abstract). 22nd Interscience Conference on Antimicrobial Agents and Chemotherapy. Miami: Oct. 4–6, 1982.
40.
DiakosGKGiamarellouHDispirakiKHadjipolydorouKKoumaditisA. Clinical, bacteriological, and pharmacokinetic study of cefsulodin in serious Pseudomonas aeruginosa infections. In: NelsonJGrassiC, eds. Current chemotherapy and infectious diseases. Washington, DC: American Society for Microbiology, 1980: 202–4.
41.
NicholsLCMakiDGGudmundssonS. Cefsulodin for therapy of major Pseudomonas aeruginosa infection (abstract). 23rd Interscience Conference on Antimicrobial Agents and Chemotherapy. Las Vegas, NV: Oct. 24–26, 1983.
42.
GraningerWSpitzyKHPichlerHCefsulodin (CGP 7174/E) in the treatment of Pseudomonas infections in intensive care patients. In: NelsonJGrassiC, eds. Current chemotherapy and infectious diseases. Washington, DC: American Society for Microbiology, 1980: 200–2.
43.
MashimoKHaraKYuraJ. Clinical study of cefsulodin in respiratory tract infections and soft tissue infections due to Pseudomonas aeruginosa. In: PeritiPGrassiG, eds. Current chemotherapy and immunotherapy. Washington, DC: American Society for Microbiology, 1982: 535.
44.
MendelsonMHHubbardRCMeyersBRHirschmanST. Treatment of malignant external otitis with cefsulodin sodium (Abbott-46811) (abstract). 22nd Interscience Conference on Antimicrobial Agents and Chemotherapy. Miami: Oct. 4–6, 1982.
45.
GuibertJKitzisMAcarJ. Clinical evaluation of cefsulodin (CGP 7174/E) in urinary tract infections caused by Pseudomonas aeruginosa. In: NelsonJGrassi, eds. Current chemotherapy and infectious diseases. Washington, DC: American Society for Microbiology, 1980: 199–200.
46.
AhrensT. Treatment of pseudomonas infections with cefsulodin: results of a multicenter clinical trial in Europe. In: PeritiPGrassiG, eds. Current chemotherapy and immunotherapy. Washington, DC: American Society for Microbiology, 1982: 528–9.
47.
GiamarellouHKoumaditisADispiankiKTherapeutic effectiveness and pharmacokinetics of cefsulodin in multiresistant Pseudomonas aeruginosa infections. Drugs Exp Clin Res1981; 7: 219–26.
48.
BrucknerOFreissDSchaffDCure of pseudomonal meningitis dependent on levels of cefsulodin in cerebrospinal fluid. Drugs Exp Clin Res1981; 7: 291–7.
