Microbiology: Kalfoxim is a 3rd generation cephalosporin with activity against gram-negative organisms eg, E. coli, H. influenzae (especially ampicillin-resistant strains), Klebsiella, Proteus (both indole-positive and indole-negative), Enterobacter, Neisseria (especially β-lactamase-producing strains of N. gonorrhoeae), Shigella, Providencia, Serratia, Citrobacter, Pseudomonas (some strains are less sensitive) and Bacteroides (some strains of B. fragilis are resistant). It has similar activity to older cephalosporin generations against gram-positive bacteria eg, Staphylococci (especially penicillinase-producing strains), Streptococci (S. pyogenes, S. viridans, S. pneumoniae), Clostridium. Many strains of Enterococci (S. faecalis) are relatively resistant.
Combinations with aminoglycosides eg, gentamicin produce synergistic effects against some species of gram-negative bacteria including some strains of Pseudomonas.
Pharmacokinetics: Kalfoxim is widely distributed in various tissues, including the cerebrospinal fluid in which levels above the MIC of common sensitive pathogens are attained when the meninges are inflamed. It is excreted mainly through the kidneys in the active form.