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The in vitro activity of FK041, a new orally active cephem antibiotic, against a wide variety of clinical isolates of bacteria was investigated and compared with those of cefdinir (CFDN) and cefditoren (CDTR). FK041 exhibited broad spectrum activity against reference strains of Gram-positive and Gram-negative aerobes and anaerobes. FK041 was active against clinical isolates of Gram-positive organisms except Enterococcus faecalis with MIC90s less than 1.56 microg/ml. FK041 was more active than CFDN and CDTR against Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus agalactiae and was comparable to CFDN and CDTR against Streptococcus pyogenes and Streptococcus pneumoniae. FK041 had no activity against methicillin-resistant staphylococci, like CFDN and CDTR. FK041 showed moderate activity against penicillin-resistant S. pneumoniae with an MIC range of 0.05 approximately 3.13 microg/ml, and was superior to CFDN but inferior to CDTR. Against clinical isolates of many Gram-negative organisms such as Neisseria gonorrhoeae, Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis, FK041 had good activity comparable or superior to those of CFDN and CDTR. However, it was inferior to CDTR in activity against Moraxella catarrhalis, Haemophilus influenzae, Morganella morganii, and Serratia marcescens, and was inactive against Pseudomonas aeruginosa. With FK041 a small difference between MIC and MBC against S. aureus, E. coli, K. pneumoniae, and H. influenzae was found, indicating that its action is bactericidal against these species. FK041 was stable to group 2beta-lactamase hydrolysis but was unstable to group 1beta-lactamase hydrolysis. The stability of FK041 to these enzymes was similar to those of CFDN and CDTR. FK041 showed high affinity for the main penicillin-binding proteins (PBPs) of S. aureus (PBP 3, 2, and 1) and E. coli (PBP 3, 4, lbs, 2, and 1a).

Cefclidin (E1040), which has an aminothiadiazolyl group in the 7 beta-side chain, showed about four-fold higher activity against Pseudomonas aeruginosa than its aminothiazolyl counterpart. Cefclidin had lower affinity and a higher Vmax value for the chromosomal type I beta-lactamase (cephalosporinase) from P. aeruginosa than its aminothiazolyl counterpart. No differences between the affinities of both compounds for the most of the sensitive essential PBPs were observed. Hydrophilicity of cefclidin was higher than that of its counterpart. The antipseudomonal activity of cefclidin, which was increased by the introduction of the aminothiadiazolyl group, was suggested to have resulted mainly from higher resistance to cephalosporinase hydrolysis at pharmacologically relevant low concentrations due to its low affinity for cephalosporinase, and secondarily from good penetration of cefclidin through the outer membrane due to increased hydrophilicity.

The beta-lactamase stability and inhibitory activity of 1-oxa cephalosporin, (6R,7R)-7-[[carboxy(4-hydroxyphenyl)acetyl]amino]-7-methoxy-3-[[(1-methyl-1H-tetrazol-5-yl)thio]methyl]-8-oxo-5-oxa-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid, was investigated and compared to that of cefoxitin and cefotaxime. There was no detectable beta-lactamase hydrolysis of 1-oxa cephalosporin, cefotaxime and cefoxitin when incubated with beta-lactamases of plasmid or chromosomal origin which were primarily cephalosporinases or enzymes which hydrolyzed both penicillins and cephalosporins. The beta-lactamase inhibitory activity of 1-oxa cephalosporin was comparable to that of cefoxitin and cefotaxime. At equal molar concentration of substrate and inhibitor, cefoxitin, cefotaxime and 1-oxa cephalosporin effectively inhibited cephalosporinase hydrolysis of cephaloridine. Cefoxitin and cefotaxime were more effective inhibitors than the 1-oxa cephalosporin against a Providencia enzyme, whereas cefotaxime and 1-oxa cephalosporin were more effective inhibitors of a Citrobacter cephalosporinase.

Ro 13-9904/001 is a novel parenteral cephalosporin antibiotic with potent in vitro activity against a wide range of beta-lactamase-producing and non-producing pathogens. In addition, Ro 13-9904/001 proved to possess a very long plasma half-life and, as a consequence, high prophylactic in vivo effectiveness.

FK 749 is a distinctive new parenteral cephalosporin antibiotic with a broad antibacterial spectrum which is more potently active against a wide variety of Gram-negative bacilli, including the opportunistic pathogens such as Citrobacter and Enterobacter species and Serratia marcescens, than SCE 963, T 1551 and cefmetazole. The activity of FK 749 against Escherichia coli, Klebsiella pneumoniae, pyogenes was by far superior to that of the three other antibiotics. These test organisms were not resistant to FK 749. The antibacterial activity of FK 749 against Pseudomonas aeruginosa was almost the same as that of ticarcillin but was inferior to that of gentamicin and T 1551. The bactericidal activity of FK 749 against E. coli, K. pneumoniae and Proteus mirabilis was more potent than that of the three other antibiotics. FK 749, like cefmetazole, was extremely stable to beta-lactamases. In studies in mice, the therapeutic effect of subcutaneous injection of FK 749 against various infections due to Gram-negative bacilli was by far superior to that of SCE 963, T 1551 and cefmetazole, was almost the same as that of SCE 963 and cefmetazole against Staphylococcus aureus infection and that of ticarcillin against P. aeruginosa infection.

SQ 14,359 is a new cephamycin-type (7alpha-OCH3) antibiotic belonging to a series containing a 7alpha-ureidoacetyl substituent. The compound is the most potent extended spectrum derivative of this type yet reported, surpassing CS-1170 and cefoxitin by a wide margin. This activity in vitro which extends throughout the Enterobacteriaceae is particularly prominent against Gram-negative organisms that are producers of "cephalosporinase-type" beta-lactamases such as Enterobacter, Serratia, Citrobacter and indole-positive Proteus species. Superior activity also is demonstrated in vitro against streptococci, beta-lactamase-producing staphylococci, Haemophilus influenzae, Neisseria gonorrhoeae, and many Gram-negative pathogens resistant to aminoglycoside antibiotics. Experimental chemotherapeutic studies have confirmed these observations in wound and selected systemic infections in mice as well as acute pyelonephritis and meningitis in rats. The pharmacokinetics for each drug including antibiotic bound to serum was similar in both mice and rats. The pharmacokinetic profile in blood and cerebrospinal fluid favored SQ 14,359.

Biological beta-lactam antibiotic-inactivating activities were detected in bacteriuria and suppurating pleural fluids. Clinical specimens were sterilized with membrane filters and the amounts of ampicillin and/or cephalothin which were being inactivated by 1 ml of each filtrate were determined. In general, filtrates which originally yielded Klebsiella sp. tended to show activity against ampicillin; whereas those yielding Enterobacter sp. and Pseudomonas aeruginosa showed activity against cephalothin.

The susceptibility of 80 Bacteroides fragilis group strains isolated from clinical specimens to beta-lactam antibiotics was investigated by agar dilution method. Twenty strains showed high resistance to the antibiotics. The resistance level of the isolates to cephaloridine was related to the amount of beta-lactamase activity (cephalosporinase; CSase) produced. B. fragilis GN-11477, B. thetaiotaomicron GN11478 and B. vulgatus GN11479 were selected from among the CSase producing strains, and the enzymes were purified about 300-fold by affinity chromatography employed ampicillin as ligand bound to activated CH Sepharose 4B. The enzyme preparations gave a single protein band on polyacrylamide gel electrophoresis. The molecular weights of the three enzymes were estimated to be approximately 32,000 and their isoelectric points were 5.2, 4.9 and 4.5, respectively. The optimal pH and the optimal temperature of the enzymes were 7.2 and 37 degrees C, respectively. The enzyme activities were inhibited by iodine, some divalent ions, p-chloromercuribenzoate, clavulanic acid, cephamycin derivatives and cloxacillin. The enzymes showed hydrolytic activity against cephaloridine, cephalothin, cefazolin, cefuroxime and also newly introduced cephalosporins such as cefotaxime, cefoperazone and cefmenoxime. Each mouse antisera obtained against the purified enzymes showed cross-reactions with its each enzyme and others in neutralization test.

A simplified method to determine minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of beta-lactam antibiotics on agar plates is described. MIC values were determined on agar plates for benzylpenicillin, methicillin and cephalothin using Staphylococcus aureus and Klebsiella pneumoniae. A beta-lactamase solution was then sprayed onto the plates to inactivate the drug(s). After further incubation at 37 degrees C overnight, the minimal concentration at which no test bacteria were visible on the plates was defined as MBC. Both MIC and MBC values decreased with decreased inoculum size. The two values were almost coincidental when high dilutions were used as the inocula. These values were compared with those obtained by the conventional broth dilution method. In this study, MIC as well as MBC values determined by the simplified method were generally smaller than the values determined by the broth dilution technique.

The cephalosporin beta-lactamase (cephalosporinase) produced by Acinetobacter was studied. The enzyme was partially purified by means of column chromatography and its properties were investigated. The enzyme was induced by benzylpenicillin, 6-aminopenicillanic acid and cephaloridine. Its molecular weight is 30,000 its optimal temperature 40C, and its optimal pH 7.25 similar to 7.50. Substrate specificity studies using various cephalosporins and penicillins, showed that the enzyme functioned as a cephalosporinase rather than penicillinase.

Diastereomeric 7-(alpha-ureido-2-amino-4-thiazolylacetyl)cephalosporins are broad-spectrum antimicrobial agents with activity mainly against Gram-negative bacteria. The L-isomers were more potent than the D-isomers. All compounds showed some degree of stability to beta-lactamases. The compounds reached high serum and tissue fluid levels and were excreted unchanged mainly in urine.

The synthesis of a series of 7-acylamido cephalosporins having a substituted furyl moiety in the side chain is described. These new cephalosporins were examined in vitro for antibacterial activity and evaluated for resistance to inactivation by beta-lactamases.

FR10612, like cephalexin, is a broad-spectrum oral cephalosporin derivative. The antimicrobial activity of FR10612 against clinical isolates was similar to cephalexin; however, at a low inoculum size its activity was greater than cephalexin against Klebsiella pneumonia and Proteus mirabilis strains. Like cephalexin, the in vitro bactericidal activity of FR10612 was more influenced by the duration of contact with the test organism than by drug concentration. The bactericidal activity of FR10612 against E. coli 317 was greater than that of cephalexin in an in vitro model system which simulated the serum levels of FR10612 and cephalexin achieved in healthy volunteers after a single oral dose. The protein binding of FR10612 to human and animal serum was extremely low. FR10612 was resistant to beta-lactamases from gram-negative bacilli. It showed resistance similar to cephalexin, but was more resistant to beta-lactamases than were cephaloridine, cephalothin and cefazolin. The protective effect of FR10612 in mice infected with various pathogens was greater than cephalexin. The serum levels of FR10612 in rats were higher and more prolonged than those of cephalexin. Tissue levels of FR10612 in rats also persisted for a long time period reflecting the serum levels. In healthy volunteers, rabbits and monkeys the serum levels of FR10612 were initially lower than those of cephalexin but persisted for a longer time period. The total 24-hour urinary excretion of FR10612 in healthy volunteers after oral administration was almost the same as that of cephalexin, but the excretion rate of FR10612 was slower, and the urinary levels were more persistent than those of cephalexin.

Cefoxitin resistance, an unique property found in clinical isolates of Escherichia coli was investigated. Cefoxitin resistant strains, 255 and GN206, produced cephalosporinase constitutively. The cephalosporinase was located in the periplasm, and its production was considered to be mediated by chromosomal gene(s). Cephalosporinase-less mutants from both strains were susceptible to cefoxitin as well as other beta-lactam antibiotics, suggesting that the cephalosporinase was responsible for the resistance to beta-lactam antibiotics including cefoxitin. The cephalosporinases from the E. coli strains were partially purified and their enzymological properties were compared with those of cephalosporinases of Citrobacter freundii and Proteus morganii. Although the cephalosporinases of E. coli, as well as other cephalosporinases, showed little activity for cefoxitin-hydrolysis, the E. coli cephalosporinases exhibited a significantly higher affinity for cefoxitin than other cephalosporinases. It was assumed that the E. coli enzyme located around the targets of cefoxitin protected the targets from the antibiotic by its high affinity for the antibiotic.

The emergence of beta-lactamase-producing strains of Neisseria gonorrhoeae has led to a reexamination of the role of the disc agar diffusion method in susceptibility testing of gonococci. Our data show that the disc agar diffusion test can be used to screen for beta-lactamase production by these organisms. The disc tests were done on GC Agar Base supplemented with 1% IsoVitaleX. An inoculum of 10(8) colony forming units/ml and either a 10-unit-penicillin or a 10-microgram-ampicillin disc were used. A zone diameter of less than or equal to 19 mm was indicative of beta-lactamase production. These results were compared with results of chemical tests for beta-lactamase and with minimal inhibitory concentrations. Recommondations were also made for a disc test with tetracycline and spectinomycin, but these methods must remain tentative because of the lack of resistant strains.

Three cephalosporins with 7-(2-hydroxyiminophenylacetamido) side chains (SK&F 79433, 80000 and 80303), differing in their 3-substituents, exhibited similar broad-spectrum antibacterial activity in vitro against strains of Staphylococcus aureus, Streptococcus faecalis and various Gram-negative bacilli. All three were active in vivo (s.c., mouse) against S. aureus, Escherichia coli or Klebsiella pneumoniae, but they differed significantly in serum pharmacokinetic profiles. SK&F 80303 produced high and extremely prolonged serum levels and protected mice when administered up to 24 hours prior to challenge with beta-lactamase-producing S. aureus or K. pneumoniae. It was resistant to hydrolysis by beta-lactamases from S. aureus, and variably so to beta-lactamases from E. coli strains. SK&F 80303 was bacteriolytic to logarithmically growing S. aureus, E. coli, Proteus mirabilis, K. pneumoniae and Enterobacter cloacae (partially). SK&F 80303 illustrates further the effect of the 3-sulfoalkyltetrazole substituent on the pharmacokinetic properties of cephalosporins. Its combined biological properties make it a possible candidate for therapeutic and long-term prophylactic use.

The synthesis and in vitro structure-activity relationship of 7-ureidoacetyl cephalosporins carrying various substituents in the 3-position, compounds that showed an enhanced broad spectrum of antibacterial activity, has been outlined. Contrary to most of the previous observations with diastereomeric isomers of cephalosporins, it has been found that the L-side chain isomers also are very potent antibiotics and are even more active inhibitors of certain beta-lactamase-producing Gram-negative bacteria than the corresponding D-side chain isomers. SQ 69,613, 7beta-[[L-[(aminocarbonyl)amino]-2-furanylacetyl]amino]-3-[[(1-methyl-1H-tetrazol-5-yl) thio]methyl]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid, sodium salt, the most active compound tested, except for activity against staphylococci, was as active in vitro as cefamandole.

The cephalosporin beta-lactamase (cephalosporinase) was purified from a strain of Proteus morganii which showed resistance to cephalosporins. The optimal pH was about 8.5, and the optimal temperature was 40 degrees C. The isoelectric point was 8.7 and the molecular weight was estimated to be about 41,000 from sodium dodecyl sulfate-acrylamide gel electrophoresis. The enzyme activity was inhibited by cloxacillin, ampicillin, carbenicillin, cefuroxime, cefotaxime, ceftizoxime (FK749), cefmenoxime (SCE-1365), cefoxitin, cefmetazole, YM09330 and moxalactam (6059-S), but not by clavulanic acid or CP-45899. The beta-lactamase also hydrolyzed cephaloridine, cefazolin, cephalothin, cephalexin, cefotiam, cefamandole and benzylpenicillin. These results suggest the possibility that the properties of beta-lactamases may be characterized by measuring the kinetic parameters of the enzyme toward newly-introduced beta-lactam antibiotics and beta-lactamase inhibitors.

Cefuroxime is a new broad spectrum cephalosporin antibiotic for administration by injection. It is stable to most beta-lactamases. It is active against gram-positive organisms, including penicillinase-producing staphylococci, and has wide activity against gram-negative bacilli including Enterobacter and many strains of indole-positive Proteus spp. The substance is also highly active against Haemophilus influenzae and Neisseria gonorrhoeae. Studies on human volunteers showed that it produced high, long-lasting blood levels with virtually complete recovery of unchanged antibiotic in the urine. No evidence of toxicity due to cefuroxime was found. Slight, short-lived pain followed intramuscular injection, and the compound was well tolerated intravenously.