Fourtillan J B
Rev Med Interne. 1986 Mar;7(2):185-95. doi: 10.1016/s0248-8663(86)80113-8.
The pharmacokinetic profile of pefloxacin is one of the major assets of this new antibiotic of the quinolone family. Digestive absorption is rapid and complete after oral administration. The pharmacokinetic pattern is the same with both routes. The high apparent volume of distribution (AVD = 117 +/- 6 litres) reflects good diffusion in extravascular compartments. Pefloxacin can therefore be used not only for the treatment of systemic infections, but also for that of extravascular infections, whatever the perfusion rate of the infected organ. The predominant route of excretion of pefloxacin is extrarenal, after hepatic degradation; it is responsible for prolonged elimination half-life in patients with hepatic insufficiency. Since renal excretion of the unchanged drug is less important, there is no need to modify the dosage in case of renal impairment. When pefloxacin is eliminated by biotransformation, it is excreted slowly, and plasma or tissue levels of its unchanged form remain much higher. In subjects with normal liver function, the mean elimination half-life is almost 12 h, which makes it possible to administer pefloxacin twice a day. During treatment with 400 mg doses, the steady state is reached within 48 h; mean peak plasma concentrations then are 10 micrograms X ml-1 and mean trough concentrations 4 micrograms X ml-1. The pharmacokinetic properties of pefloxacin give this antibiotic an unquestionable advantage over third-generation cephalosporins and aminoglycosides.
培氟沙星的药代动力学特性是喹诺酮类新型抗生素的主要优势之一。口服给药后,消化道吸收迅速且完全。两种给药途径的药代动力学模式相同。高表观分布容积(AVD = 117 ± 6升)反映了其在血管外腔室中的良好扩散。因此,无论感染器官的灌注率如何,培氟沙星不仅可用于治疗全身感染,还可用于治疗血管外感染。培氟沙星的主要排泄途径是经肝脏降解后的肾外排泄;这导致肝功能不全患者的消除半衰期延长。由于原形药物的肾排泄不太重要,肾功能损害时无需调整剂量。当培氟沙星通过生物转化消除时,排泄缓慢,其原形的血浆或组织水平仍保持较高。在肝功能正常的受试者中,平均消除半衰期约为12小时,这使得培氟沙星可以一天给药两次。在使用400毫克剂量治疗期间,48小时内达到稳态;此时血浆平均峰浓度为10微克/毫升,平均谷浓度为4微克/毫升。培氟沙星的药代动力学特性使其在与第三代头孢菌素和氨基糖苷类药物相比时具有无可争议的优势。