What is Ceftibuten?

From the Guidelines

Ceftibuten is a third-generation oral cephalosporin antibiotic.

Key Characteristics

• It has unique side chains that make cross-reaction rates with penicillin and other cephalosporins exceedingly rare 1.
• Ceftibuten is not suitable for the treatment of acute bacterial sinusitis due to its poor activity against S pneumoniae, especially penicillin-resistant strains 1.
• It has been compared to fluoroquinolones in the treatment of pyelonephritis, with fluoroquinolones showing superior efficacy 1.

Usage and Efficacy

• Ceftibuten is administered orally, typically at a dose of 200 mg twice daily 1.
• It is less effective than fluoroquinolones, such as norfloxacin, in the treatment of pyelonephritis, with higher bacterial relapse rates 1.
• Ceftibuten may be considered as an alternative therapy in certain cases, but its use should be guided by local resistance patterns and susceptibility testing 1.

From the Research

Definition and Classification of Ceftibuten

• Ceftibuten is an orally active third-generation cephalosporin antibiotic 2, 3, 4, 5, 6
• It has a broad spectrum of in vitro antibacterial activity, encompassing the majority of Gram-negative pathogens and streptococci 2, 3, 4, 5, 6

Mechanism of Action and Stability

• Ceftibuten shows greater stability than several other cephalosporins against bacteria producing extended-spectrum beta-lactamases 2
• It has demonstrated bactericidal activity against susceptible pathogens, has high affinity for several lethal penicillin-binding proteins, and possesses stability to common plasmid- or chromosomal-mediated beta-lactamases 3, 4, 5
• Ceftibuten is stable to hydrolysis by many common beta-lactamases, including those enzymes that hydrolyze parenteral third-generation cephalosporins 3, 5, 6

Spectrum of Activity

• Ceftibuten is active against a wide range of bacterial organisms, including:
  • Gram-negative pathogens such as Enterobacteriaceae, Haemophilus influenzae, Moraxella catarrhalis, and Neisseria spp. 2, 3, 4, 5, 6
  • Streptococci, including Streptococcus pneumoniae and Streptococcus pyogenes 2, 3, 4, 5, 6
  • Some fastidious Gram-negative species causing respiratory tract or genital infections 3
• However, ceftibuten is generally resistant to Staphylococci, enterococci, Pseudomonas species, and Gram-negative anaerobic bacteria 3, 5

Clinical Efficacy and Tolerability

• Ceftibuten has been shown to be effective in the treatment of various infections, including:
  • Acute uncomplicated or complicated urinary tract infections 2
  • Acute or chronic lower respiratory tract infections 2
  • Acute otitis media 2, 6
  • Streptococcal pharyngitis or scarlet fever caused by Group A beta-haemolytic streptococci 2
• Ceftibuten is well tolerated in most patients, with adverse events (mostly mild to moderate gastrointestinal disturbances) generally occurring in 5 to 10% of patients 2, 6