{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:21:30Z","timestamp":1787566890563,"version":"build-2736575974"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      The lack of oral equivalent for third-generation IV cephalosporins challenges sequential cephalosporin therapy for pneumococcal infections. This\n                      <jats:italic>in vitro<\/jats:italic>\n                      study combined the previously reported pharmacokinetics of IV cefotaxime (CTX) and oral cefditoren (CDN) or cefuroxime (CXM) to simulate an intravenous-to-oral switch and explore the pharmacodynamic activity against\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used an\n                      <jats:italic>in vitro<\/jats:italic>\n                      PK\/PD system to expose four\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      strains (serotype\/MIC\n                      <jats:sub>CTX<\/jats:sub>\n                      mg\/L): 1S (23B\/0.25), 2S (6A\/0.5), 3I (35B\/1), and 4I (11A\/1), to free serum concentrations simulating an initial IV dose of 1,000\u00a0mg CTX, followed by two oral doses of 400\u00a0mg CDN bid (CTX-to-CDN) or 500\u00a0mg CXM bid (CTX-to-CXM) over 36\u00a0h. Reference regimens included a single-dose CTX regimen and a full 1,000\u00a0mg bid CTX regimen (CTX-IV). Bacterial growth (K) was used as a control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Against strain 1S, both oral cephalosporins sustained bactericidal activity in the model, similar to the complete CTX-IV regimen. For strain 2S, CTX-to-CDN maintained bactericidal efficacy comparable to CTX-IV, while CTX-to-CXM showed with counts at 36\u00a0h similar to initial inoculum. Against strain 3I, CTX-to-CDN exhibited a bacteriostatic effect, whereas CTX-to-CXM was equivalent to the growth control. Strain 4I was associated with regrowth in both sequential regimens. The CTX-IV regimen was bacteriostatic against strains 3I and 4I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      Overall, despite the limitations of the proposed model in reproducing the antimicrobial activity of agents with high plasma protein binding, such as CDN, greater\n                      <jats:italic>in vitro<\/jats:italic>\n                      pharmacodynamic activity was observed with CDN than with CXM in the simulated sequential regimens against the four strains tested, particularly against CTX-susceptible strains. These findings warrant confirmation in clinical studies before any therapeutic recommendation could be made.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1770715","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T08:34:15Z","timestamp":1787560455000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Simulating an intravenous-to-oral cefotaxime-to-cefditoren\/cefuroxime switch: an in vitro pharmacodynamic approach against selected Streptococcus pneumoniae strains with defined susceptibility profiles"],"prefix":"10.3389","volume":"17","author":[{"given":"Natalia","family":"Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Microbiology Area, Medicine Department, School of Medicine, Universidad Complutense de Madrid","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Manceras Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Microbiology Area, Medicine Department, School of Medicine, Universidad Complutense de Madrid","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Gim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Medicine, Health and Sport, Universidad Europea de Madrid","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Alou","sequence":"additional","affiliation":[{"name":"Microbiology Area, Medicine Department, School of Medicine, Universidad Complutense de Madrid","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Coronel","sequence":"additional","affiliation":[{"name":"Scientific Department, Meiji Pharma Spain","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"G\u00f3mez-Rubio","sequence":"additional","affiliation":[{"name":"Scientific Department, Meiji Pharma Spain","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Luisa","family":"G\u00f3mez-Lus","sequence":"additional","affiliation":[{"name":"Microbiology Area, Medicine Department, School of Medicine, Universidad Complutense de Madrid","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sevillano","sequence":"additional","affiliation":[{"name":"Microbiology Area, Medicine Department, School of Medicine, Universidad Complutense de Madrid","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1159\/000479089","article-title":"Risk factors for community-acquired pneumonia in adults: a systematic review of observational studies","volume":"94","author":"Almirall","year":"2017","journal-title":"Respiration"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1336","DOI":"10.3390\/antibiotics11101336","article-title":"Multidisciplinary collaboration for the optimization of antibiotic prescription: analysis of clinical cases of pneumonia between emergency, internal medicine, and pharmacy services","volume":"11","author":"Arteche-Eguizabal","year":"2022","journal-title":"Antibiotics"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1093\/jac\/dkm078","article-title":"In vitro effect of the presence of human albumin or human serum on the bactericidal activity of daptomycin against strains with the main resistance phenotypes in Gram-positives","volume":"59","author":"Cafini","year":"2007","journal-title":"J. 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