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Journal of Antimicrobial Chemotherapy (1995) 36, 757-771
© 1995 The British Society for Antimicrobial Chemotherapy

review-article

Laboratory assessment of antibacterial activity of zwitterionic 7-methoxyimino cephalosporins

J. C. Pechèrea,*, W. Wilsonb and H. Neuc

aDepartment of Genetics and Microbiology, University of Geneva 9 Ave de Champel, 1211 Geneva 4, Switzerland bDivision of Infectious Diseases, Mayo Clinic Rochester, Minnesota, USA cCollege of Physicians and Surgeons, Columbia University New York, New York State, USA

Received 8 December 1994; returned 14 March 1995; accepted 2 June 1995

*Corresponding author: Tel: +41. (22)-702 5656; Fax: +41-(22)-702 5702

Zwitterionic 7-methoxyimino cephalosporins (cefpirome, cefepime, cefclidin, DQ2556, FKO37 and SCE2787) possess a variable substitution at C3 which contains a quarernary nitrogen. These cephalosporins display low affinities for Class I /7-lactamase and rapid penetration through the outer membrane of Gram-negative bacilli, so that an increased number of periplasmic ß-lactam molecules interact with PBP's per unit of time. As a consequence, the new zitterionic compounds remain active against some, but not all, ceftazidime-resistant Enterobacteriaceae producing high levels of Class Ißlactamase or Bush type 2bßlactamases. Antipseudomonas activities are generally similar to that of ceftazidime except that cefclidin is more active. The new zwitterionic compounds, especially cefpirome and FK037, express greater antistaphylococcal potency than does ceftazidime. A variety of animal models including meningitis and endocarditis have confirmed the potential of these compounds in-vivo. On the basis of structural and antibacterial characteristics, the expression ‘forth generation’ is acceptable to describe the zwitterionic 7-methoxyimino cephalosporins.


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