Latamoxef

Latamoxef belongs to the pharmacological class of Third-generation cephalosporin antibiotics.

Latamoxef has been approved to relieve symptoms and also for the treatment and maintenance of Lower respiratory tract infections, such as pneumonia and bronchitis; urinary tract infections; gynecologic conditions, such as endometritis and pelvic inflammatory disease; intra-abdominal infections, such as peritonitis and cholecystitis, Skin and skin structure infections, such as cellulitis and wound infections, bone and joint infections, such as osteomyelitis and septic arthritis, Septicemia, Meningitis, Surgical prophylaxis to prevent infections during surgery.

Latamoxef's pharmacokinetic properties include a rapid onset of action, with therapeutic concentrations reached within 30 minutes to 1 hour after administration. The drug has a short half-life of approximately 1 hour in patients with normal renal function, which may be prolonged in patients with renal impairment. Latamoxef is primarily eliminated via renal excretion, with approximately 70% of the drug excreted unchanged in the urine within 6 hours after administration. The drug is extensively distributed throughout the body, including into the respiratory tract, where it achieves high concentrations in bronchial secretions.

The common side effects involved in using Latamoxef are Diarrhea, Nausea, Vomiting, Abdominal pain, Headache, Dizziness, Rash, Itching, Elevated liver enzymes

Latamoxef is available in the form of Intramuscular and Intravenous Solutions

Latamoxef is approved in Germany, Japan, Malaysia, India, U.K.,U.S, and China.

Latamoxef belongs to the pharmacological class of Third-generation cephalosporin antibiotics.

Penicillins work by acylating the penicillin-binding protein, which is the penicillin-sensitive transpeptidase C-terminal domain. This process involves opening the lactam ring, which inactivates the enzyme and prevents the formation of a cross-link of two linear peptidoglycan strands. This inhibition ultimately hinders the third and final stage of bacterial cell wall synthesis, leading to cell lysis. In addition, amoxicillin may also interfere with an autolysin inhibitor, which can further contribute to cell lysis through the action of bacterial cell wall autolytic enzymes such as autolysins.

Latamoxef has been approved to relieve symptoms and also for the treatment and maintenance of Lower respiratory tract infections, such as pneumonia and bronchitis, Urinary tract infections, Gynecologic infections, such as endometritis and pelvic inflammatory disease, Intra-abdominal infections, such as peritonitis and cholecystitis, Skin and skin structure infections, such as cellulitis and wound infections, bone and joint infections, such as osteomyelitis and septic arthritis, Septicemia, Meningitis , Surgical prophylaxis to prevent infections during surgery.

The time to reach maximum concentration (Tmax) of Latamoxef is approximately 30 minutes to 1 hour after intravenous administration.The onset of action of Latamoxef is rapid, with therapeutic concentrations reached within 30 minutes to 1 hour after administration.

The duration of action of Latamoxef is approximately 6 to 8 hours after intravenous administration, depending on the dose and severity of the infection.The half-life of Latamoxef is approximately 1 hour in patients with normal renal function.

Latamoxef is found to be available in the form of Intramuscular and Intravenous Solutions.

Latamoxef can be used in the following treatment:

• Lower respiratory tract infections, such as pneumonia and bronchitis
• Urinary tract infections
• Gynecologic infections, such as endometritis and pelvic inflammatory disease
• Intra-abdominal infections, such as peritonitis and cholecystitis
• Skin and skin structure infections, such as cellulitis and wound infections
• Bone and joint infections, such as osteomyelitis and septic arthritis
• Septicemia
• Meningitis
• Surgical prophylaxis to prevent infections during surgery.

Latamoxef can help to relieve symptoms and also for the treatment and maintenance of Lower respiratory tract infections, such as pneumonia and bronchitis, Urinary tract infections, Gynecologic infections, such as endometritis and pelvic inflammatory disease, Intra-abdominal infections, such as peritonitis and cholecystitis, Skin and skin structure infections, such as cellulitis and wound infections, bone and joint infections, such as osteomyelitis and septic arthritis, Septicemia, Meningitis , Surgical prophylaxis to prevent infections during surgery.

Latamoxef is approved for use in the following clinical indications:

• Lower respiratory tract infections, such as pneumonia and bronchitis
• Urinary tract infections
• Gynecologic infections, such as endometritis and pelvic inflammatory disease
• Intra-abdominal infections, such as peritonitis and cholecystitis
• Skin and skin structure infections, such as cellulitis and wound infections
• Bone and joint infections, such as osteomyelitis and septic arthritis
• Septicemia
• Meningitis
• Surgical prophylaxis to prevent infections during surgery.

Lower Respiratory Tract Infections:

For the treatment of lower respiratory tract infections, such as pneumonia and bronchitis, the recommended dose of latamoxef is 1-2 grams every 12 hours, administered by intravenous injection over a period of 30 minutes to 1 hour. The duration of treatment depends on the severity of the infection and the clinical response.

Urinary Tract Infections:

For the treatment of urinary tract infections, the recommended dose of latamoxef is 1 gram every 12 hours, administered by intravenous injection over a period of 30 minutes to 1 hour. The duration of treatment may vary depending on the severity and complexity of the infection.

Gynecologic Infections:

For the treatment of gynecologic infections, such as endometritis and pelvic inflammatory disease, the recommended dose of latamoxef is 1-2 grams every 12 hours, administered by intravenous injection over a period of 30 minutes to 1 hour. The duration of treatment depends on the severity of the infection and the clinical response.

Intra-abdominal Infections:

For the treatment of intra-abdominal infections, such as peritonitis and cholecystitis, the recommended dose of latamoxef is 1-2 grams every 12 hours, administered by intravenous injection over a period of 30 minutes to 1 hour. The duration of treatment may vary depending on the severity and complexity of the infection.

Skin and Skin Structure Infections:

For the treatment of skin and skin structure infections, such as cellulitis and wound infections, the recommended dose of latamoxef is 1 gram every 12 hours, administered by intravenous injection over a period of 30 minutes to 1 hour. The duration of treatment depends on the severity of the infection and the clinical response.

Bone and Joint Infections:

For the treatment of bone and joint infections, such as osteomyelitis and septic arthritis, the recommended dose of latamoxef is 1-2 grams every 12 hours, administered by intravenous injection over a period of 30 minutes to 1 hour. The duration of treatment may vary depending on the severity and complexity of the infection.

Septicemia and Meningitis:

For the treatment of septicemia and meningitis, the recommended dose of latamoxef is 2 grams every 6-8 hours, administered by intravenous injection over a period of 30 minutes to 1 hour. The duration of treatment depends on the severity of the infection and the clinical response.

Surgical Prophylaxis:

For surgical prophylaxis, the recommended dose of latamoxef is 1 gram administered intravenously within 1 hour prior to surgery. In certain cases, a second dose of 1 gram may be administered within 4 hours after the initial dose.

• Powder for injection: 500 mg, 1 g, and 2 g
• Premixed solution for injection: 1 g and 2 g

Intramuscular and Intravenous Solutions.

• Dosage Adjustments in Kidney Patients:

For patients with CrCl greater than 50 mL/min, the recommended dosage of Latamoxef is 1-2 grams every 6-12 hours. For patients with CrCl between 20-50 mL/min, the recommended dosage is 1 gram every 12 hours, and for patients with CrCl less than 20 mL/min, the recommended dosage is 1 gram every 24 hours.

For patients undergoing hemodialysis, a loading dose of 1 gram of Latamoxef may be given before the start of hemodialysis, followed by a maintenance dose of 500 mg every 24 hours. For patients undergoing continuous ambulatory peritoneal dialysis (CAPD), the recommended dosage of Latamoxef is 1 gram every 24 hours.

• Dosage Adjustments in Pediatric Patients:

For pediatric patients weighing less than 50 kg, the recommended dosage of Latamoxef is 30-50 mg/kg/day given in divided doses every 6-12 hours. For pediatric patients weighing 50 kg or more, the recommended dosage is the same as for adults, which is 1-2 g every 6-12 hours.

There are no specific dietary restrictions related to the use of Latamoxef. However, patients should always follow the instructions provided by their healthcare provider and pharmacist regarding the proper administration of Latamoxef, including any instructions related to food or drink. It is important to note that some foods or beverages may interact with Latamoxef or affect its absorption or efficacy, so patients should always inform their healthcare provider of their dietary habits and any supplements they may be taking.

Latamoxef may be contraindicated under the following conditions:

• In patients with known hypersensitivity to Latamoxef, cephalosporin, penicillin, or any component of the formulation.

The physician should closely monitor the patients and keep pharmacovigilance as follows:

• Hypersensitivity reactions: Latamoxef can cause hypersensitivity reactions, including anaphylaxis. Patients with a history of hypersensitivity to cephalosporins should avoid the use of Latamoxef.
• Clostridium difficile-associated diarrhea (CDAD): CDAD has been reported with the use of Latamoxef and may range from mild diarrhea to fatal colitis. Patients should be monitored for signs and symptoms of CDAD during treatment with Latamoxef.
• Seizures: Latamoxef can lower the seizure threshold and should be used with caution in patients with a history of seizures or who are at risk for seizures.
• Coagulation abnormalities: Latamoxef may potentiate the effects of anticoagulants, leading to an increased risk of bleeding. Patients receiving anticoagulants should be monitored closely for signs of bleeding.
• Pseudomembranous colitis: Pseudomembranous colitis has been reported with the use of Latamoxef and may range from mild to life-threatening. Patients should be monitored for signs and symptoms of pseudomembranous colitis during treatment with Latamoxef.

Patients should avoid consuming alcohol while taking Latamoxef. This is because alcohol can increase the risk of liver toxicity associated with Latamoxef. In addition, alcohol can also impair the immune system, which can make it more difficult for the body to fight infections. Patients should always follow the instructions provided by their healthcare provider and pharmacist regarding the proper administration of Latamoxef and should not consume alcohol while taking this medication.

Latamoxef is excreted in human milk. Women who are breastfeeding should be cautious when using latamoxef, and the drug should only be used if the potential benefit justifies the potential risk to the infant.

Pregnancy Category B

Latamoxef is classified as pregnancy category B, which means that animal studies have not shown any adverse effects on the fetus, but there are no well-controlled studies in pregnant women. Latamoxef should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.

There are no specific food warnings associated with the use of Latamoxef. However, it is recommended to take Latamoxef with food or immediately after a meal to minimize gastrointestinal side effects such as nausea, vomiting, and diarrhea. It is also important to avoid consuming alcohol while taking Latamoxef as it may increase the risk of liver toxicity.

The adverse reactions related to Latamoxef can be categorized as follows:

Common:

• Diarrhea
• Nausea and vomiting
• Skin rash
• Pain or inflammation at the injection site

Less Common:

• Hypersensitivity reactions, including urticaria, pruritus, and anaphylaxis
• Headache
• Dizziness
• Transient elevations of liver enzymes
• Eosinophilia
• Hematologic abnormalities, such as leukopenia and thrombocytopenia

Rare:

• Seizures
• Stevens-Johnson syndrome
• Pseudomembranous colitis
• Clostridium difficile-associated diarrhea (CDAD)
• Hemolytic anemia
• Acute interstitial nephritis

The clinically relevant drug interactions of Latamoxef is briefly summarized here:

Probenecid: Probenecid can decrease the renal clearance of latamoxef, leading to increased plasma concentrations and potential toxicity.

Aminoglycosides: The combination of latamoxef and aminoglycosides can increase the risk of nephrotoxicity.

Anticoagulants: Latamoxef may potentiate the effects of anticoagulants, leading to an increased risk of bleeding.

Oral contraceptives: Latamoxef can decrease the efficacy of oral contraceptives, leading to a potential risk of unintended pregnancy.

Methotrexate: Latamoxef can increase the serum concentrations of methotrexate, leading to potential toxicity.

Live vaccines: Latamoxef may interfere with the efficacy of live vaccines, such as the measles, mumps, and rubella (MMR) vaccine.

Vancomycin: Concurrent use of latamoxef and vancomycin may increase the risk of nephrotoxicity.

The following are the side effects involving Latamoxef:

• Diarrhea
• Nausea
• Vomiting
• Skin rash
• Pain or inflammation at the injection site

Pregnancy:

Pregnancy Category B

Latamoxef is classified as pregnancy category B, which means that animal studies have not shown any adverse effects on the fetus, but there are no well-controlled studies in pregnant women. Latamoxef should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.

Breastfeeding:

Latamoxef is excreted in human milk. Women who are breastfeeding should be cautious when using latamoxef, and the drug should only be used if the potential benefit justifies the potential risk to the infant.

Pediatric use:

The safety and efficacy of latamoxef in pediatric patients have not been well established. The drug should only be used in children if the potential benefit justifies the potential risk.

Geriatric use:

Elderly patients may be more susceptible to the adverse effects of latamoxef, including gastrointestinal symptoms and central nervous system effects such as confusion and seizures. Dose adjustment may be necessary in elderly patients with impaired kidney function.

Physicians should be knowledgeable and vigilant about the treatment and identification of over dosage of Latamoxef.

Over dosage with latamoxef may result in neurological symptoms such as seizures, confusion, and agitation. Gastrointestinal symptoms such as nausea, vomiting, and diarrhea may also occur.

In cases of over dosage, supportive care should be provided, including monitoring of vital signs and maintenance of fluid and electrolyte balance. Hemodialysis and peritoneal dialysis may be used to remove the drug from the body, although the efficacy of these methods has not been well established.

There is no specific antidote for latamoxef overdose, and there is no evidence that activated charcoal or gastric lavage is effective in reducing drug absorption.

In the case of severe allergic reactions, such as anaphylaxis, the standard emergency treatments for anaphylaxis should be administered promptly, including epinephrine, antihistamines, and corticosteroids.

Pharmacodynamics

Latamoxef works by inhibiting bacterial cell wall synthesis through binding to and inactivating the enzymes responsible for cross-linking of the peptidoglycan layer of the bacterial cell wall. This results in disruption of the bacterial cell wall and ultimately leads to bacterial death.

The antibacterial activity of latamoxef is concentration-dependent, meaning that higher concentrations of the drug result in greater bacterial killing. The time above the minimum inhibitory concentration (MIC) of the bacteria is an important pharmacodynamic parameter for latamoxef. The longer the time above the MIC, the more effective the drug is at killing the bacteria.

Latamoxef has a broad spectrum of activity against both gram-positive and gram-negative bacteria, including many strains that are resistant to other beta-lactam antibiotics. It is active against many anaerobic bacteria as well.

Resistance to latamoxef can occur through the production of beta-lactamases, enzymes that inactivate the drug by breaking the beta-lactam ring. Some bacteria may also have decreased permeability to the drug or altered penicillin-binding proteins that reduce the drug's effectiveness.

Pharmacokinetics

• Absorption:

Latamoxef is administered intravenously or intramuscularly. When given intravenously, the drug is rapidly and completely absorbed.

• Distribution:

Latamoxef has a large volume of distribution and penetrates well into most body tissues and fluids, including bone, pleural fluid, and cerebrospinal fluid. It is approximately 70% protein-bound in the plasma.

• Metabolism:

Latamoxef is not extensively metabolized in the body. It is mainly eliminated unchanged through the kidneys.

• Elimination:

The elimination half-life of latamoxef is approximately 1 hour in patients with normal kidney function. Approximately 80% of a dose is eliminated in the urine within 6 hours of administration. In patients with impaired kidney function, the elimination half-life may be prolonged.

1. https://go.drugbank.com/drugs/DB04570
2. https://pubchem.ncbi.nlm.nih.gov/compound/Latamoxef
3. http://www.antimicrobe.org/drugpopup/Moxalactam.htm