Delving into the Latest Updates on Flomoxef Sodium with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

Efmox, FMOX, Flomoxef

+ [8]

Target

PBPs

Mechanism

PBPs inhibitors(Bacterial penicillin-binding protein inhibitors), Cell wall inhibitors

Therapeutic Areas

Infectious Diseases

Active Indication

Bacterial Infections

Inactive Indication-

Originator Organization

Shionogi & Co., Ltd.

Active Organization

Shionogi & Co., Ltd.

Information Systems of Florida, Inc.

Inactive Organization-

Drug Highest PhaseApproved

First Approval Date

JP (29 Mar 1988),

Bacterial Infections

Regulation-

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Structure

Molecular FormulaC15H18F2N6NaO7S2

InChIKeySYHZUFMYQQRMKT-YLCXCWDSSA-N

CAS Registry92823-03-5

View All Structures (2)

In this age of antimicrobial resistance (AMR), improving treatment using existing antibiotics is desirable.Extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (ESBL-E) are high priority AMR pathogens according to the World Health Organization.Cephamycin-class beta- lactams are tolerant to hydrolysis by ESBL activity and have bactericidal effects on ESBL-E.The aim of the present study was to compare the in vitro min. inhibitory concentration (MIC) of cefmetazole (CMZ) and flomoxef (FMOX) among ESBL-E strains.This was a retrospective study using microbiol. laboratory data from Okayama University Hospital (Japan) from Jan. 2014 to June 2022.The MIC was determined by broth microdilution method and the ESBL phenotypes were determined by double-disk method.Antimicrobial use d. (AUD) data for CMZ and FMOX were also gathered.Annual proportions of ESBL-producing organisms in Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae complex were 20.4-30.6%, 3.5-13.7%, and 0-3.1%, resp.The ESBL-producing bacteria with MIC levels ≤1 μg/mL for CMZ and FMOX ranged from 57 to 84% and 97 to 100%, resp., for E. coli, and from 50 to 92% and 80 to 100%, resp., for K. pneumoniae.E. cloacae strains showed MIC levels ≥32 μg/mL for both agents.The AUD ratio for CMZ to FMOX ranged from 5.31 to 12.27, with no apparent upward or downward trend.Proportions of ESBL-producing E. coli and K. pneumoniae strains with MIC ≤1 μg/mL were greater in FMOX than in CMZ.To corroborate the clin. superiority of FMOX in treating ESBL-E infections, a randomized controlled study, as well as pharmacokinetic/pharmacodynamic anal., is required.

01 Jan 2024·IDCases

Bilateral parapneumonic empyema caused by Fusobacterium necrophorum infection in a healthy individual

Article

Author: Aoshiba, Kazutetsu ; Nakamura, Hiroyuki ; Nakajima, Eiji ; Tanaka, Takehiko ; Kufukihara, Taro ; Tamenaga, Rena ; Mizushima, Reimi ; Watanabe, Yusuke ; Takeda, Yukihisa

Pulmonary infection caused by Fusobacterium necrophorum, an obligate anaerobic gram-negative bacterium, most commonly occurs as a part of Lemierre's syndrome, i.e., pharyngotonsillitis complicated by septic thrombophlebitis of the internal jugular vein and secondary lung abscesses. A 51-year-old previously healthy man was admitted to our hospital with pleuritic right-sided chest pain. No sore throat, dysphagia, or neck pain was observed. Chest radiography and computed tomography (CT) revealed massive right pleural effusion and bilateral bronchopneumonia. Right thoracic drainage yielded purulent fluids, from which a pure culture of F. necrophorum was isolated. Blood culture and broad-range polymerase chain reaction for bacterial 16S ribosomal ribonucleic acid on blood samples were negative. CT scan showed no evidence of internal jugular vein thrombosis or peritonsillar abscess. The right thoracic tube was removed after the purulent fluids were no longer drained. Although the antibiotic treatment was continued with intravenous sulbactam/ampicillin, to which F. necrophorum was sensitive, left purulent pleural effusion emerged. The antibiotic was switched to clindamycin, cefazolin, cefotiam, and flomoxef. Although the left pleural effusion gradually decreased, the right purulent pleural fluid was reaccumulated. Thus, the patient underwent right-sided thoracoscopic decortication and debridement, followed by thoracic lavage through a chest tube with saline solution. After the surgery, the patient's condition improved, and no recurrence of pleural effusion was observed. This report presents the case of a previously healthy patient with bilateral parapneumonic empyema caused by F. necrophorum, without manifestations of pharyngotonsillitis, bacteremia, or Lemierre's syndrome. Extensive thoracic drainage, effective antibiotics, and timely surgical interventions are imperative.

19 Sep 2023·Antimicrobial agents and chemotherapy

In vitro efficacy of humanized regimen of flomoxef against extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae.

Article

Author: Takemura, Miki ; Anan, Naomi ; Kasamatsu, Yu ; Yamano, Yoshinori ; Yamashiro, Hidenori

This study compared the efficacy of flomoxef with other β-lactam antibiotics against extended-spectrum β-lactamases (ESBL)-producing bacteria of clinical relevance. First, the prevalence and β-lactamase genotypes of ESBL-producing strains among Escherichia coli and Klebsiella pneumoniae isolates collected in Japan from 2004 to 2018 were investigated. High MIC₉₀ values (>64 µg/mL) of ceftriaxone, cefepime, and ceftazidime and low MIC₉₀ values (≤0.06-2 µg/mL) of flomoxef, cefmetazole, and meropenem against both species were observed. Second, a chemostat model was used to analyze the efficacy of humanized regimens of three oxacephem/cephamycin antibiotics (flomoxef, cefmetazole, cefoxitin) and two other antibiotics (meropenem and piperacillin/tazobactam) in suppressing the growth of five ESBL-producing E. coli and two K. pneumoniae strains. Flomoxef, piperacillin/tazobactam, and meropenem showed good bactericidal effects with >4 log₁₀ CFU/mL reduction without bacterial regrowth at 24 h even when the MIC of test isolates was >MIC₉₀. Cefmetazole and cefoxitin resulted in regrowth of test isolates with MIC ≥MIC₉₀ at 24 h. Cefmetazole, cefoxitin, flomoxef, and meropenem showed increased MICs for regrown samples. A clear relationship between the proportion of time that the free drug concentration exceeded the MIC (%fT_>MIC) and antibiotic efficacy was found for flomoxef, cefoxitin, and cefmetazole, and flomoxef had the highest %fT_>MIC, whereas discrepancies between Clinical and Laboratory Standards Institute breakpoint and bactericidal activity were observed for cefmetazole. Flomoxef was effective in preventing the growth of all ESBL-producing strains, even those with an MIC eight times the MIC₉₀. Thus, flomoxef may be a good alternative to meropenem in context of carbapenems sparing stewardship.

100 Deals associated with Flomoxef Sodium

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External Link

KEGG	Wiki	ATC	Drug Bank
D01473	Flomoxef Sodium	J01DC14	DB11935

R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Bacterial Infections	JP	Shionogi & Co., Ltd.	29 Mar 1988

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT02302092 (FLORUS, CTgov)	Phase 3	Urinary Tract Infections \| Pyelonephritis	13	Flomoxef (Flomoxef)	efweieivfw(omuysgfwnx) = fjrqwftiwt bupxkayyyr (lxihbrnyzo, kspwtpzhzb - lswgxupdfh) View more	-	27 Oct 2017
				Cefepime (Cefepime)	efweieivfw(omuysgfwnx) = ixnjjdwojm bupxkayyyr (lxihbrnyzo, zrxykidhaa - swfstrgavp) View more