Flomoxef

Description

Flomoxef sodium is a P-lactamase resistant oxacephalosporin. Its spectrum of activity is similar to that of cefazolin and moxalactam, but with better efficacy against Staphylococcus aureus and Bacteroides fragilis. Flomoxef is reported effective in the treatment of post-operative, urinary tract and abdominal cavity infections.

Originator

Shionogi (Japan)

The Uses of Flomoxef

Flomoxef is an oxacephem derived beta-lactam antibiotic that is particularly effective against gram-positive bacteria.

Definition

ChEBI: Flomoxef is a second-generation oxacephem antibiotic in which the oxazine ring is substituted at C-3 with a hydroxyethyl-substituted tetrazolylthiomethyl group and the azetidinone ring carries 7alpha-methoxy and 7beta-{2-[(difluoromethyl)thiomethyl]acetamido} substituents. It has a role as an antibacterial drug. It is a N-acyl-amino acid, an oxacephem and an organonitrogen heterocyclic antibiotic.

brand name

Flumari

Antimicrobial activity

An oxa-cephem which differs from latamoxef in the side chains carried at the 7-amino and C-3 positions, but which retains the 7-methoxy group that confers β-lactamase stability. The methyl group of the methylthiotetrazole side chain of latamoxef has been modified to hydroxymethyl in an attempt to avoid the undesirable side effects, while the side chain at the 7-amino position is F2-CH-S-CH2-.
Activity is similar to that of latamoxef, but activity against Staph. aureus is improved and it is claimed to be a poor inducer of penicillin-binding protein 2′, which is associated with resistance in methicillin-resistant strains.
Intravenous injection of 2 g achieves a peak plasma concentration of around 50 mg/L, falling to 2.6 mg/L after 6 h. The plasma half-life is about 50 min. It appears to be well distributed and penetrates moderately well into lung, mucosal tissue of the middle ear and bone.
Flomoxef does not seem to be prone to the effects on platelet function of latamoxef and it has a less marked effect on vitamin K metabolism. It does not cause a disulfiram-like reaction with alcohol.
It is available in Japan, where it appears safe and effective in a wide range of infections.