Azanza Perea J R, Sádaba Díaz de Rada B
José Ramón Azanza Perea, Clinical Pharmacology Department. Clínica Universidad de Navarra (University of Navarra Clinic). Avenida Pio XII 36. Pamplona 31008, Spain.
Rev Esp Quimioter. 2019 Sep;32 Suppl 3(Suppl 3):11-16.
Ceftobiprole shows many similar pharmacokinetic properties to other cephalosporins, except for not being orally bioactive, and that it is administered by IV infusion as the prodrug ceftobiprole medocaril, which is subsequently hydrolyzed in the blood into the active molecule. Distribution focus in extracellular fluid and active antibiotic concentration has been proven in different corporal tissues using dosing regimen of 500 mg intravenous infusion over 2 h every 8 h. Ceftobiprole is eliminated exclusively into the urine, thus the reason why dose adjustment is required for patients with moderate or severe renal impairment, or increased creatinine clearance. However, there is no need for dose adjustments related with other comorbidities and patients' conditions such as age, body weight. Although considering distribution features, molecular weight and dose fraction, increase dosing regimen might be necessary in patients using renal replacement therapy. The half-life of ceftobiprole is more than 3 h, allowing to easily reach optimal PK/PD parameters with the infusion time of 2 h, using the usual dosing regimen.
头孢比普与其他头孢菌素具有许多相似的药代动力学特性,不同之处在于它没有口服生物活性,是以头孢比普甲磺酸盐前体药物通过静脉输注给药,随后在血液中水解为活性分子。使用每8小时静脉输注500毫克、持续2小时的给药方案,已在不同身体组织中证实其分布集中于细胞外液且有活性抗生素浓度。头孢比普仅经尿液排泄,因此中度或重度肾功能损害患者或肌酐清除率增加时需要调整剂量。然而,对于其他合并症和患者状况(如年龄、体重)无需调整剂量。尽管考虑到分布特征、分子量和剂量分数,接受肾脏替代治疗的患者可能需要增加给药方案。头孢比普的半衰期超过3小时,采用常规给药方案,2小时的输注时间可轻松达到最佳药代动力学/药效学参数。