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头孢洛林酯在特定人群中的一系列药代动力学研究:正常受试者、健康老年受试者以及有肾功能损害或需要血液透析的终末期肾病受试者。

A series of pharmacokinetic studies of ceftaroline fosamil in select populations: normal subjects, healthy elderly subjects, and subjects with renal impairment or end-stage renal disease requiring hemodialysis.

作者信息

Riccobene Todd, Jakate Abhijeet, Rank Doug

机构信息

Forest Research Institute, Inc., Jersey City, NJ, USA.

出版信息

J Clin Pharmacol. 2014 Jul;54(7):742-52. doi: 10.1002/jcph.265. Epub 2014 Jan 22.

Abstract

Ceftaroline fosamil is a parenteral cephalosporin indicated for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. Ceftaroline, the active component of ceftaroline fosamil, exhibits broad-spectrum bactericidal activity against gram-positive organisms, including methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae, as well as common gram-negative pathogens. The objective of the studies presented herein was to establish the pharmacokinetic profile of ceftaroline in healthy subjects and special populations of interest, such as elderly subjects, subjects with renal impairment, or subjects with end-stage renal disease on intermittent hemodialysis. The mean half-life of ceftaroline in healthy subjects was approximately 2.6 hours, and urinary excretion was the primary route of elimination. Ceftaroline Cmax and AUC values increased in proportion to dose increases within the range of 50-1000 mg, demonstrating an approximately linear pharmacokinetic profile following intravenous infusion. The pharmacokinetic parameters of ceftaroline were modestly altered in elderly subjects compared with younger adults, which was attributed to decreased renal function in elderly subjects. Ceftaroline pharmacokinetic parameters varied with different degrees of renal impairment, resulting in recommended dosage adjustments for patients with moderate to severe impairment. Ceftaroline fosamil was generally well tolerated regardless of age or severity of renal impairment.

摘要

头孢洛林酯是一种胃肠外给药的头孢菌素,用于治疗急性细菌性皮肤及皮肤结构感染和社区获得性细菌性肺炎。头孢洛林是头孢洛林酯的活性成分,对革兰氏阳性菌具有广谱杀菌活性,包括耐甲氧西林金黄色葡萄球菌和肺炎链球菌,以及常见的革兰氏阴性病原体。本文所呈现研究的目的是确定头孢洛林在健康受试者以及特定感兴趣人群(如老年受试者、肾功能损害受试者或接受间歇性血液透析的终末期肾病受试者)中的药代动力学特征。头孢洛林在健康受试者中的平均半衰期约为2.6小时,尿液排泄是主要的消除途径。在50 - 1000mg范围内,头孢洛林的Cmax和AUC值随剂量增加成比例增加,静脉输注后呈现近似线性的药代动力学特征。与年轻成年人相比,老年受试者中头孢洛林的药代动力学参数有适度改变,这归因于老年受试者肾功能下降。头孢洛林的药代动力学参数随肾功能损害程度不同而变化,导致对中度至重度肾功能损害患者推荐调整剂量。无论年龄或肾功能损害严重程度如何,头孢洛林酯总体耐受性良好。

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