Faulkner R D, Yacobi A, Barone J S, Kaplan S A, Silber B M
Medical Research Division, American Cyanamid Company, Pearl River, NY.
Pediatr Infect Dis J. 1987 Oct;6(10):963-70. doi: 10.1097/00006454-198710000-00035.
Cefixime is an orally absorbed third generation cephalosporin with a broad spectrum of activity against Gram-positive and Gram-negative bacteria and is highly resistant to beta-lactamase degradation. In general serum and urinary concentrations of cefixime achieved after recommended daily doses are well above the minimal inhibitory concentrations at 90% for indicated microorganisms. The pharmacokinetics of cefixime were determined in adult and pediatric subjects. In general the half-life of the drug is about 3 to 4 hours and is not dependent on dose. The drug is not extensively bound to serum proteins; the free fraction is about 31% and is concentration-independent. The absolute bioavailability, based on comparisons of area under the serum concentration-time curve values after 200-mg intravenous, 200-mg oral solution, and 200- and 400-mg capsule doses, ranged from 40 to 52%, showing a comparable bioavailability for cefixime at single 200- and 400-mg oral doses. In a dose proportionality study, over an oral dose range of 200 to 2000 mg, peak serum concentration (Cmax) and area under the concentration-time values increased linearly but were not directly proportional with dose. Upon multiple dosing for 2 weeks on a 400-mg daily or 200-mg twice a day regimen, serum concentrations and urinary recovery of unchanged drug were similar for each group, and there was no drug accumulation. Peak serum concentration and area under the concentration-time curve values after a 400-mg dose were almost double those after a 200-mg dose. All formulations of cefixime were bioequivalent to an oral reference solution at doses of 200 and 400 mg.(ABSTRACT TRUNCATED AT 250 WORDS)
头孢克肟是一种口服吸收的第三代头孢菌素,对革兰氏阳性菌和革兰氏阴性菌均有广泛的抗菌活性,且对β-内酰胺酶降解具有高度抗性。一般来说,推荐日剂量给药后,头孢克肟在血清和尿液中的浓度远高于指示微生物90%的最低抑菌浓度。头孢克肟的药代动力学已在成人和儿科受试者中确定。一般来说,该药的半衰期约为3至4小时,且不依赖于剂量。该药与血清蛋白结合不广泛;游离分数约为31%,且与浓度无关。基于200mg静脉注射、200mg口服溶液以及200mg和400mg胶囊剂量后的血清浓度-时间曲线下面积值比较,绝对生物利用度范围为40%至52%,表明单次口服200mg和400mg剂量的头孢克肟具有相当的生物利用度。在一项剂量比例研究中,口服剂量范围为200至2000mg时,血清峰浓度(Cmax)和浓度-时间值下面积呈线性增加,但与剂量不成正比。在400mg每日一次或200mg每日两次的方案下多次给药2周后,每组的血清浓度和未改变药物的尿回收率相似,且无药物蓄积。400mg剂量后的血清峰浓度和浓度-时间曲线下面积值几乎是200mg剂量后的两倍。头孢克肟的所有制剂在200mg和400mg剂量时与口服参比溶液生物等效。(摘要截断于250字)