cefotetan
Sources réglementaires consultées
Indications approuvées
- Infections sensibles urinaires, respiratoires basses, cutanées, gynécologiques, intra-abdominales, osseuses et articulaires, et prophylaxie chirurgicale.
Contre-indications
Absolues
- Hypersensibilité au céfotétan ou aux céphalosporines.
- Antécédent d’anémie hémolytique associée à une céphalosporine.
Mises en garde cliniques
- Mise en garde majeure · Il peut provoquer une hypersensibilité sévère ou une anaphylaxie. Rechercher tout antécédent de réaction immédiate aux bêta-lactamines avant l’emploi et arrêter en cas de réaction allergique. — FDA, set_id 33b13b93-58ce-44c7-b9a2-af3b3a333f80
- Mise en garde majeure · Il peut provoquer une diarrhée associée à Clostridioides difficile pendant ou après le traitement ; évaluer toute diarrhée importante et éviter les antipéristaltiques si une colite est suspectée. — FDA, set_id 33b13b93-58ce-44c7-b9a2-af3b3a333f80
- Mise en garde majeure · Le groupement N-méthylthiotétrazole peut provoquer une hypoprothrombinémie et une hémorragie. Surveiller le temps de prothrombine/INR chez les patients à risque et administrer de la vitamine K si indiqué. — FDA, set_id 33b13b93-58ce-44c7-b9a2-af3b3a333f80
- Mise en garde majeure · Il peut provoquer une anémie hémolytique immune sévère ou mortelle. Arrêter en cas de signes d’hémolyse et ne pas réexposer. — FDA, set_id 33b13b93-58ce-44c7-b9a2-af3b3a333f80
Interactions médicamenteuses
- SévèreAminosides et autres médicaments néphrotoxiques
Mécanisme: L’association peut augmenter la néphrotoxicité.
Recommandation: Éviter l’association si possible et surveiller la fonction rénale.
FDA, set_id 33b13b93-58ce-44c7-b9a2-af3b3a333f80
- SévèreAlcool
Mécanisme: Une réaction de type disulfirame peut survenir pendant le traitement et jusqu’à 72 heures après.
Recommandation: Éviter les boissons et préparations alcoolisées pendant le traitement et pendant 72 heures après.
FDA, set_id 33b13b93-58ce-44c7-b9a2-af3b3a333f80
Effets indésirables
Communs (≥1%)
Nausées, diarrhée et éruption cutanée
Rares mais graves
Anaphylaxie, colite à C. difficile et cytopénies sévères · Hémorragie par hypoprothrombinémie et anémie hémolytique immune
Grossesse et allaitement
Utiliser pendant la grossesse uniquement en cas d’indication claire. De faibles quantités passent dans le lait ; surveiller diarrhée, candidose ou sensibilisation chez le nourrisson et réévaluer la poursuite selon le produit.
Bibliographie récente (PubMed)
Given concerns for antibiotic resistance, broader spectrum antibiotic agents such as ertapenem are being used for pre-operative prophylaxis. We hypothesize that pre-operative ertapenem prior to laparotomies and colectomies is superior at decreasing surgical site infections (SSIs) compared with other widely used antibiotic agents. Medline, Embase, the Cochrane Library, and Web of Science were queried for studies until February 02, 2025. Studies were excluded if they did not evaluate ertapenem as a pre-operative antibiotic prophylaxis in patients undergoing laparotomy or colectomy, the outcome was not SSIs, or it represented a review of prior publications. Three reviewers independently extracted relevant articles, and two performed risk-of-bias analyses. Of 6,389 abstracts identified, 9 studies remained after full-text review. Seven of the included studies were observational (78%), and two (22%) were randomized controlled trials (RCTs). The median number of patients enrolled was 499 (inter-quartile range 253, 5192). Study populations included colorectal surgery (n = 8) and trauma patients undergoing laparotomy (n = 1). Ertapenem was compared with single-agent second-generation cephalosporins such as cefotetan, cefuroxime, and cefoxitin and to a single-agent penicillin with or without a combined β-lactamase inhibitor (i.e., ampicillin-sulbactam). In total, five (56%) studies showed that ertapenem was superior in preventing SSIs, decreasing SSI rates by as much as 59% (adjusted odds ratio = 0.41 [0.28-0.61]; p < 0.001). Approximately half of the studies (56%) demonstrated that ertapenem was superior to other commonly used antibiotic prophylaxis regimens in decreasing SSI after laparotomies and colectomies. However, most studies were observational. Therefore, RCTs, especially in trauma, are needed.
Gram-negative bacteria are infectious and life-threatening agents after hematopoietic stem cell transplantation (HSCT). So, this study aimed to investigate the prevalence of Pseudomonas aeruginosa and its antibiotic resistance in patients who have received Hematopoietic Stem-Cell Transplantation through a systematic review. The systematic search was done with key words; Pseudomonas aeruginosa, hematopoietic stem cell transplantation from 2000 to the end of July 2023 in Google Scholar and PubMed/Medline, Scopus, and Web of Science. Twelve studies were able to include our study. Quality assessment of studies was done by Appraisal tool for Cross-Sectional Studies. The most of the included studies were conducted as allo-HSCT. Infections such as respiratory infection, urinary infection and bacteremia have occurred. The rate of prevalence with P. aeruginosa has varied between 3 and 100%. The average age of the participants was between 1 and 74 years. The rate of prevalence of P. aeruginosa resistant to several drugs has been reported to be variable, ranging from 20 to 100%. The highest antibiotic resistance was reported against cefotetan (100%), and the lowest was related to tobramycin (1.8%) followed by amikacin, levofloxacin and ciprofloxacin with the prevalence of 16.6%. Our findings showed a high prevalence and antibiotic resistance rate of P. aeruginosa in Hematopoietic stem cell transplantation. Therefore, more serious health measures should be taken in patients after transplantation.
Extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales continue to pose a major threat to human health worldwide. Given the limited therapeutic options available to treat infections caused by these pathogens, identifying additional effective antimicrobials or revisiting existing drugs is important. Ceftriaxone-resistant Escherichia coli and Klebsiella pneumoniae containing CTX-M-type ESBLs or AmpC, in addition to narrow-spectrum OXA and SHV enzymes, were selected from blood culture isolates obtained from the MERINO trial. Isolates had previously undergone whole-genome sequencing (WGS) to identify antimicrobial resistance genes. Cefotetan MICs were determined by broth microdilution (BMD) testing with a concentration range of 0.125 to 64 mg/liter; CLSI breakpoints were used for susceptibility interpretation. BMD was performed using an automated digital antibiotic dispensing platform (Tecan D300e). One hundred ten E. coli and 40 K. pneumoniae isolates were used. CTX-M-15 and CTX-M-27 were the most common beta-lactamases present; only 7 isolates had coexistent ampC genes. Overall, 98.7% of isolates were susceptible, with MIC50s and MIC90s of 0.25 mg/liter and 2 mg/liter (range, ≤0.125 to 64 mg/liter), respectively. MICs appeared higher among isolates with ampC genes present, with an MIC50 of 16 mg/liter, than among those containing CTX-M-15, which had an MIC50 of only 0.5 mg/liter. Isolates with an ampC gene exhibited an overall susceptibility of 85%. Presence of a narrow-spectrum OXA beta-lactamase did not appear to alter the cefotetan MIC distribution. Cefotetan demonstrated favorable in vitro efficacy against ESBL-producing E. coli and K. pneumoniae bloodstream isolates. IMPORTANCE Carbapenem antibiotics remain the treatment of choice for severe infection due to ESBL- and AmpC-producing Enterobacterales. The use of carbapenems is a major driver of the emergence of carbapenem-resistant Gram-negative bacilli, which are often resistant to most available anti