Bradley John S, Flanagan Shawn D, Arrieta Antonio C, Jacobs Richard, Capparelli Edmund, Prokocimer Philippe
From the *Department of Pediatrics, University of California, San Diego, California; †Rady Children's Hospital, San Diego, California; ‡Clinical Development Merck & Co., Inc., Kenilworth, New Jersey; §Division of Infectious Diseases Children's Hospital of Orange County, Orange California; and ¶Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas.
Pediatr Infect Dis J. 2016 Jun;35(6):628-33. doi: 10.1097/INF.0000000000001096.
Tedizolid is a novel oxazolidinone antibacterial US FDA approved for treatment of acute bacterial skin and skin structure infections in adults. This study assessed the pharmacokinetics, safety and tolerability of tedizolid phosphate in adolescents (12-17 years old) after administration of a single intravenous (IV) or oral dose.
In this multicenter, open-label study, a single IV infusion (N = 10) or oral dose (N = 10) of 200 mg tedizolid phosphate was administered to adolescents already receiving antibacterial treatment for presumed or documented infection. Blood and urine samples were collected predose and over 24 hours.
Tedizolid pharmacokinetics was generally similar after IV or oral administration of 200 mg tedizolid phosphate. Mean (standard deviation) half-life values were similar for oral and IV routes, 8.3 (2.0) and 6.6 (0.7) hours, respectively. Absolute oral bioavailability of tedizolid (90% confidence interval) was 88.8% (70.4%-112.1%). Geometric mean ratio (90% confidence interval) of area under the concentration-time curve values for adolescents relative to values previously reported for adults after 200 mg of single-dose IV or oral administration were 0.847 (0.736-0.975). Tedizolid was well tolerated.
Overall pharmacokinetics of tedizolid was similar after administration of a single oral or IV 200 mg dose, and bioavailability was high. Exposure profiles were similar to those in adults. With clinical outcomes based on area under the concentration-time curve/minimum inhibitory concentration and current susceptibility of Gram-positive pathogens, results suggest that the 200 mg daily regimen of tedizolid phosphate can be extended to adolescents for clinical trials, and that dose adjustment may not be required when switching routes.
特地唑胺是一种新型恶唑烷酮类抗菌药物,已获美国食品药品监督管理局批准用于治疗成人急性细菌性皮肤及皮肤结构感染。本研究评估了青少年(12 - 17岁)单次静脉注射或口服磷酸特地唑胺后的药代动力学、安全性及耐受性。
在这项多中心、开放标签研究中,对已因疑似或确诊感染接受抗菌治疗的青少年单次静脉输注(N = 10)或口服(N = 10)200 mg磷酸特地唑胺。在给药前及给药后24小时采集血样和尿样。
静脉注射或口服200 mg磷酸特地唑胺后,特地唑胺的药代动力学总体相似。口服和静脉给药途径的平均(标准差)半衰期值相似,分别为8.3(2.0)小时和6.6(0.7)小时。特地唑胺的绝对口服生物利用度(90%置信区间)为88.8%(70.4% - 112.1%)。青少年单次静脉注射或口服200 mg后,浓度 - 时间曲线下面积值相对于先前报道的成人值的几何平均比值(90%置信区间)为0.847(0.736 - 0.975)。特地唑胺耐受性良好。
单次口服或静脉注射200 mg剂量后,特地唑胺的总体药代动力学相似,且生物利用度高。暴露情况与成人相似。基于浓度 - 时间曲线下面积/最低抑菌浓度以及革兰氏阳性病原体的当前敏感性的临床结果表明,200 mg每日剂量的磷酸特地唑胺可扩展至青少年进行临床试验,且转换给药途径时可能无需调整剂量。