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Retrospective evaluation of the effectiveness of flomoxef against infections with extended-spectrum β-lactamase-producing Enterobacterales.

Created on 24 Jun 2026

Authors

Ryuji Koizumi, Yukihiro Hamada, Kazuhisa Mezaki, Norio Ohmagari, Kayoko Hayakawa

Published in

GHM open. Volume 6. Issue 1. Pages 1-8. Jun 30, 2026.

Abstract

This retrospective, observational study evaluated the effectiveness and optimal dosage of flomoxef (FMOX) against infections with extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBLPE) by performing pharmacokinetic/pharmacodynamic analysis. Patients with ESBLPE infections treated using FMOX for ≥ 4 days were included. The time above the minimum inhibitory concentration (MIC) (TAM) was calculated using the FMOX MIC for ESBLPE and simulated FMOX concentration. Ten patients including six women (median age: 76 years, interquartile range: 6191) were included. Most ESBLPE infections were urinary tract infections (UTIs, 60%). Among the ESBLPE isolates, eight were of Escherichia coli, one was of Klebsiella pneumoniae, and one was of Proteus mirabilis. Four patients had bacteremia secondary to ESBLPE infection. The most frequent MIC for FMOX was ≤ 0.12 mg/L (50%), followed by 0.25 mg/L and 0.5 mg/L. Clinical effectiveness was noted in 77.8% of cases. Regarding UTIs, effectiveness was noted in all five cases. Regarding non-UTIs, only 50% of cases showed clinical effectiveness. Regarding microbiological effectiveness, both cases in which evaluation was possible showed effectiveness. Despite the use of different doses, TAM was 100% in most cases. FMOX may be a potentially effective option for UTIs caused by ESBLPE, though larger studies are needed. FMOX effectiveness in non-UTI cases needs further evaluation.

PMID:
42339163
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.

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