Ko H, Novak E, Peters G R, Bothwell W M, Hosley J D, Closson S K, Adams W J
Pharmaceutical Research and Development, Upjohn Company, Kalamazoo, Michigan 49001.
Antimicrob Agents Chemother. 1989 Apr;33(4):508-12. doi: 10.1128/AAC.33.4.508.
The tolerance and pharmacokinetics of cefmetazole were studied in healthy male volunteers who received a placebo (sterile saline) or a single dose of cefmetazole sodium intramuscularly. Drug-treated volunteers received one of four doses, 0.375, 0.750, 1, or 2 g. The drug was well tolerated, with no adverse medical events or laboratory changes observed during the study that could affect the pharmacokinetic interpretation of the data. Cefmetazole concentrations were determined by using a specific high-performance liquid chromatographic method. Serum cefmetazole concentrations were well described by a one-compartment open model with first-order absorption and elimination. Cefmetazole was rapidly absorbed in most volunteers, with a mean time to maximum concentration in serum of 1.24 +/- 0.12 h (+/- standard error of the mean), and the mean maximum concentration in serum increased from 17.0 +/- 1.6 to 74.2 +/- 9.5 micrograms/ml over the 0.375- to 2-g dose range. Maximum concentrations in serum, areas under serum concentration-time curve, and urinary excretion of intact drug increased in proportion to cefmetazole sodium dose. Times at which maximum concentrations in serum occurred, apparent volumes of distribution, steady-state volumes of distribution, absorption and elimination half-lives, and systemic clearances did not change significantly (P greater than 0.05) with drug dose. Although absorption and elimination half-lives were not significantly different in 10 of 40 volunteers (P greater than 0.05), in a majority of subjects elimination half-lives were approximately 10 times longer than absorption half-lives. The mean recovery of intact drug in urine ranged from 68.8 to 86.0% over the dose range studied, with a mean recovery over all doses of 77.1 +/- 2.4%. Rental clearances were significantly lower (P < 0.05) for the two lowest doses (93.0 and 84.3 versus 115.0 and 118.0 ml/min); these differences are not considered clinically important. The results of this study indicate that cefmetazole pharmacokinetics are linear after administration of single intramuscular doses ranging from 0.375 to 2 g, that clinically relevant concentrations of cefmetazole in serum (1 to 2 micrograms/ml) persist in a majority of volunteers for more than 8 h after administration of 0.750-g or higher doses, and that clinically relevant concentrations of cefmetazole continue to be excreted in urine 8 to 12 h after administration of 0.375- to 2-g doses.
在接受安慰剂(无菌生理盐水)或单次肌内注射头孢美唑钠的健康男性志愿者中研究了头孢美唑的耐受性和药代动力学。接受药物治疗的志愿者接受了四种剂量之一,即0.375、0.750、1或2克。该药物耐受性良好,在研究期间未观察到可能影响数据药代动力学解释的不良医学事件或实验室变化。采用特定的高效液相色谱法测定头孢美唑浓度。血清头孢美唑浓度可用具有一级吸收和消除的一室开放模型很好地描述。大多数志愿者中头孢美唑吸收迅速,血清中达到最大浓度的平均时间为1.24±0.12小时(±平均标准误差),在0.375至2克剂量范围内,血清中平均最大浓度从17.0±1.6微克/毫升增加到74.2±9.5微克/毫升。血清中的最大浓度、血清浓度-时间曲线下面积以及完整药物的尿排泄量与头孢美唑钠剂量成比例增加。血清中出现最大浓度的时间、表观分布容积、稳态分布容积、吸收和消除半衰期以及全身清除率随药物剂量未发生显著变化(P>0.05)。虽然40名志愿者中有10名的吸收和消除半衰期无显著差异(P>0.05),但在大多数受试者中,消除半衰期约为吸收半衰期的10倍。在所研究的剂量范围内,尿中完整药物的平均回收率为68.8%至86.0%,所有剂量的平均回收率为77.1±2.4%。最低的两个剂量(93.0和84.3对比115.0和118.0毫升/分钟)的肾清除率显著较低(P<0.05);这些差异在临床上不被认为重要。本研究结果表明,单次肌内注射0.375至2克剂量的头孢美唑后,其药代动力学呈线性,在0.750克或更高剂量给药后,大多数志愿者血清中头孢美唑的临床相关浓度(1至2微克/毫升)持续超过8小时,并且在0.375至2克剂量给药后8至12小时,头孢美唑的临床相关浓度继续从尿中排泄。