Cefotiam

Cefotiam

Systematic (IUPAC) name
(6R,7R)-7-{[2-(2-amino-1,3-thiazol-4-yl)acetyl] amino}-3-{[1-(2-dimethylaminoethyl)tetrazol-5-yl] sulfanylmethyl}-8-oxo-5-thia-1-azabicyclo[4.2.0] oct-2-ene-2-carboxylic acid
Clinical data
Trade names	Pansporin
AHFS/Drugs.com	International Drug Names
Legal status	℞ (Prescription only)
Routes of administration	Intravenous, intramuscular
Pharmacokinetic data
Bioavailability	60% (intramuscular)
Protein binding	40%
Metabolism	Nil
Biological half-life	Approximately 1 hour
Excretion	Renal
Identifiers
CAS Number	61622-34-2 Y
ATC code	J01DC07
PubChem	CID 43708
DrugBank	DB00229 Y
ChemSpider	39831 Y
UNII	91W6Z2N718 Y
KEGG	D07648 Y
ChEBI	CHEBI:355510 Y
ChEMBL	CHEMBL1296 Y
Chemical data
Formula	C18H23N9O4S3
Molar mass	525.631 g/mol
SMILES CN(C)CCN1N=NN=C1SCC1=C(N2[C@H](SC1)[C@H](NC(=O)CC1=CSC(N)=N1)C2=O)C(O)=O
InChI InChI=1S/C18H23N9O4S3/c1-25(2)3-4-26-18(22-23-24-26)34-7-9-6-32-15-12(14(29)27(15)13(9)16(30)31)21-11(28)5-10-8-33-17(19)20-10/h8,12,15H,3-7H2,1-2H3,(H2,19,20)(H,21,28)(H,30,31)/t12-,15-/m1/s1 Y Key:QYQDKDWGWDOFFU-IUODEOHRSA-N Y
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Cefotiam is a parenteral second-generation cephalosporin antibiotic. It has broad-spectrum activity against Gram-positive and Gram-negative bacteria. As a beta-lactam, its bactericidal activity results from the inhibition of cell wall synthesis via affinity for penicillin-binding proteins.

Cefotiam was launched as Pansporin in February 1981 by Takeda Pharmaceutical of Japan and has been available as a generic since February 1993.

Mechanism of action

Cefotiam inhibits final cross-linking stage of peptidoglycan production, thus inhibiting bacterial cell wall synthesis. It has similar or less activity against Gram-positive staphylococci and streptococci, but is resistant to some beta-lactamases produced by Gram-negative bacteria. It is more active against many of the Enterobacteriaceae including Enterobacter, E. coli, Klebsiella, Salmonella and indole-positive Proteus species.

In clinical use, high concentrations of cefotiam are observed in several tissues (kidney, heart, ear, prostate, and genital tract), as well as in fluids and secretions (bile, ascitic fluid).

Spectrum of bacterial susceptibility

Cefotiam has a broad spectrum of activity and has been used to treat infections caused by a number of enteric bacteria and bacteria responsible for causing skin infections. The following represents MIC susceptibility data for a few medically significant bacteria.

• Bacteroides fragilis: - 16 - >128 μg/ml
• Clostridium difficile: >128 μg/ml
• Staphylococcus aureus: 0.25 - 32 μg/ml

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Indications

This drug is indicated for prophylaxis for surgical infection, postoperative infections, bacterial septicaemia, bone and joint infections, cholangitis, cholecystitis, peritonitis, prostatitis, pyelonephritis, respiratory tract infections, skin and soft tissue infections, cystitis, urethritis, and infections caused by susceptible organisms. It does not have activity against Pseudomonas aeruginosa.

Dosage

For adults, the dose is up to 6 grams daily by intravenous or intramuscular route in divided doses according to severity of infection. In patients with renal impairment a dose reduction may be needed.

Adverse effects

Side effects include nausea and vomiting, diarrhoea, hypersensitivity reactions, nephrotoxicity, convulsions, CNS toxicity, hepatic dysfunction, haematologic disorders, pain at injection site, thrombophloebitis, pseudomembranous colitis, and superinfection with prolonged use.

External links

• Müller R, Böttger C, Wichmann G (2003). "Suitability of cefotiam and cefuroxime axetil for the perioperative short-term prophylaxis in tonsillectomy patients.". Arzneimittelforschung 53 (2): 126–32. doi:10.1055/s-0031-1297083. PMID 12642969. 
• Kolben M, Mandoki E, Ulm K, Freitag K (2001). "Randomized trial of cefotiam prophylaxis in the prevention of postoperative infectious morbidity after elective cesarean section.". Eur J Clin Microbiol Infect Dis 20 (1): 40–2. doi:10.1007/s100960000365. PMID 11245321. 
• Shimizu S, Chen K, Miyakawa S (1996). "Cefotiam-induced contact urticaria syndrome: an occupational condition in Japanese nurses.". Dermatology 192 (2): 174–6. doi:10.1159/000246352. PMID 8829507.