cefamyciner

Cephamyciner, also spelled cephamycins in some languages, are a subgroup of beta-lactam antibiotics within the cephalosporin class. They are characterized by a 7-alpha methoxy group that increases stability to certain beta-lactamases and enhances activity against anaerobic bacteria. This structural feature gives cephamyciner a different activity profile compared with many other cephalosporins.

The antimicrobial spectrum of cephamyciner includes many Enterobacterales and a strong activity against anaerobes such as Bacteroides fragilis. They typically have limited activity against gram-positive cocci and are less effective against Pseudomonas aeruginosa. Because of their anaerobic coverage, cephamyciner have been used for intra-abdominal infections, gynecologic infections, and as part of surgical prophylaxis in certain settings. The exact spectrum varies by agent.

Common representatives include cefoxitin, cefotetan, cefmetazole, cefminox, flu or latamoxef, and flomoxef. Most cephamyciner are given by injection, and pharmacokinetics vary by compound but generally involve renal excretion with dose adjustments needed in renal impairment.

Adverse effects are similar to other beta-lactams and can include hypersensitivity reactions. Cefotetan, in particular, is associated with a risk of hypoprothrombinemia and a disulfiram-like reaction with alcohol. Cross-reactivity with penicillin allergy exists but is generally low to moderate.

Resistance can arise through beta-lactamase production (including ESBLs and AmpC) and other mechanisms; cephamyciner are not reliable against many resistant pathogens and are not active against MRSA. Use is guided by local susceptibility patterns and infection type.

See also: cephalosporins, beta-lactam antibiotics.