Wu Guolan, Zheng Yunliang, Zhou Huili, Hu Xingjiang, Liu Jian, Zhai You, Zhu Meixiang, Wu Lihua, Shentu Jianzhong
Research Center for Clinical Pharmacy, State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Drug Des Devel Ther. 2015 Oct 16;9:5687-95. doi: 10.2147/DDDT.S92117. eCollection 2015.
Dicloxacillin, a semisynthetic isoxazolyl penicillin antibiotic, has antimicrobial activity against a wide variety of gram-positive bacteria including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumonia, Streptococcus epidermidis, Streptococcus viridans, Streptococcus agalactiae, and Neisseria meningitidis. The objective of this study was to evaluate the safety and pharmacokinetic profile of dicloxacillin after single and multiple oral dose in healthy Chinese volunteers.
A single-center, open-label, randomized, two-phase study was conducted in 16 subjects. In the single-dose phase, subjects were randomly assigned to receive single doses of 0.25, 0.5, 1.0, and 2.0 g of dicloxacillin sodium capsule in a 4-way crossover design with a 5-day washout period between administrations. In the multiple-dose phase, subjects were assigned to receive 0.25 or 0.5 g every 6 hours for 3 days in a 2-way crossover design. Plasma and urine pharmacokinetic samples were assayed by a validated high-performance liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters were calculated and analyzed statistically. Safety assessments were conducted throughout the study.
Following a single oral dose of 0.25-2.0 g dicloxacillin sodium, the maximum plasma drug concentration (Cmax) and the corresponding values for the area under the concentration- time curve from 0 to 10 hours (AUC0-10 h) increased in a dose-proportional manner. The mean elimination half-life (t1/2) was in the range of 1.38-1.71 hours. Dicloxacillin was excreted in its unchanged form via the kidney, with no tendency of accumulation, and varied from 38.65% to 50.10%. No appreciable accumulation of drug occurred with multiple oral doses of dicloxacillin. No serious adverse events were reported. Adverse events were generally mild.
Dicloxacillin was safe and well tolerated in the volunteers and displayed linear increases in the Cmax and AUC0-10 h values.
双氯西林是一种半合成异恶唑青霉素类抗生素,对多种革兰氏阳性菌具有抗菌活性,包括金黄色葡萄球菌、化脓性链球菌、肺炎链球菌、表皮葡萄球菌、草绿色链球菌、无乳链球菌和脑膜炎奈瑟菌。本研究的目的是评估双氯西林在健康中国志愿者单次和多次口服给药后的安全性和药代动力学特征。
在16名受试者中进行了一项单中心、开放标签、随机、两阶段研究。在单剂量阶段,受试者采用4交叉设计,随机分配接受0.25、0.5、1.0和2.0 g双氯西林钠胶囊的单剂量给药,给药间隔为5天的洗脱期。在多剂量阶段,受试者采用2交叉设计,每6小时接受0.25或0.5 g给药,共3天。血浆和尿液药代动力学样本采用经过验证的高效液相色谱-串联质谱法进行分析。计算药代动力学参数并进行统计学分析。在整个研究过程中进行安全性评估。
单次口服0.25 - 2.0 g双氯西林钠后,最大血浆药物浓度(Cmax)以及0至10小时浓度-时间曲线下面积(AUC0 - 10 h)的相应值呈剂量比例增加。平均消除半衰期(t1/2)在1.38 - 1.71小时范围内。双氯西林以原形经肾脏排泄,无蓄积倾向,排泄率在38.65%至50.10%之间。多次口服双氯西林未出现明显的药物蓄积。未报告严重不良事件。不良事件一般较轻。
双氯西林在志愿者中安全且耐受性良好,Cmax和AUC0 - 10 h值呈线性增加。