REVIEW Cefcapene pivoxil is an orally-available, third-generation cephalosporin antibacterial that has demonstrated activity against both gram-positive and gram-negative bacteria. Cefcapene pivoxil is an ester prodrug of the active free acid metabolite, cefcapene. The compound has documented antibacterial activity at 90% in vitro inhibition of Staphylococcus aureus A, B, C, F, and G streptococci and Streptococcus pneumoniae isolates at a concentration of less than or equal to 2ug/ml and 0.12ug/ml respectively. In the same study 100% of the isolates of Haemophilus influenzae were inhibited at concentrations equal to or less than 0.06ug/ml. The bactericidal activity of Cefcapene pivoxil results from the inhibition of cell wall synthesis via affinity for penicillin-binding proteins (PBPs). The PBPs are transpeptidases which are vital in peptidoglycan biosynthesis. Therefore, their inhibition prevents this vital cell wall component from being properly synthesized.
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