Nakazawa S, Sato H, Narita A, Nakazawa S, Suzuki H, Matsumoto K, Chikaoka H, Kamigaki M, Koido R, Niino K
Jpn J Antibiot. 1986 Apr;39(4):1020-34.
A newly developed cephalosporin, cefixime (CFIX), was evaluated clinically in 35 pediatric patients. A pharmacokinetic study was also performed with 11 patients. CFIX was administered as granules. The pharmacokinetic study was conducted in 11 patients, each of 6 patients was given CFIX at a dose of 3 mg/kg and each of the remaining patients was given CFIX at 6 mg/kg. Serum concentrations of CFIX were measured at 2, 4, 6, 8 and 12 hours after dosing. Urinary concentrations of CFIX were measured for periods of 0-6 and 6-12 hours after dosing. CFIX was assayed by the disk method using E. coli ATCC 39188 as the test organism. The clinical evaluation was conducted in 35 children including 5 patients of acute tonsillitis, 10 of acute lacunar tonsillitis, 1 of purulent lymphadenitis, 1 of scarlet fever, 8 of acute bronchitis, 5 of pneumonia, 3 of urinary tract infections and 1 of paratyphoid B. One additional patient was included only in the evaluation of safety since he was suffering from Mycoplasma pneumonia. the patients were from 4 months to 8 years 2 months old and 11 of them were inpatients. Daily doses were from 6.0 to 13.5 mg/kg. After CFIX administration in doses of 3 mg/kg and 6 mg/kg, peak serum concentrations were 1.75 and 3.36 micrograms/ml, half-lives were 2.65 and 2.86 hours and urinary excretions rates up to 12 hours after dosing were 16.1 and 12.4%, respectively. Serum concentrations were dose dependent and the half-life was fairly long compared with other known oral cephalosporins. Clinical efficacies of CFIX in 34 patients were "excellent" in 25 children, "good" in 8 and "poor" in 1 with effectiveness rate of 97.1%. Twenty-two strains of causative organisms, including 6 strains of S. aureus, 3 of S. pyogenes, 2 of S. pneumoniae, 3 of E. coli, 5 of H. influenzae, 2 of H. parainfluenzae and 1 of S. paratyphi B, were isolated. After treatment all strains except 2 strains of S. aureus (one was unknown and the other was decreased), 1 strain of S. pneumoniae (unknown) and 1 strain of H. influenzae (unknown) were successfully eradicated but S. paratyphi B was proved again in feces 9 days after treatment. No adverse reaction was observed. Among 18 children who went through laboratory test, however, an elevation of eosinophile and elevations of GOT and GPT were observed in 2 children and 1 child, respectively.
一种新开发的头孢菌素——头孢克肟(CFIX),在35例儿科患者中进行了临床评估。还对11例患者进行了药代动力学研究。CFIX以颗粒剂形式给药。药代动力学研究在11例患者中进行,其中6例患者每例给予3mg/kg剂量的CFIX,其余患者每例给予6mg/kg剂量的CFIX。给药后2、4、6、8和12小时测量血清中CFIX浓度。给药后0 - 6小时和6 - 12小时测量尿液中CFIX浓度。使用大肠杆菌ATCC 39188作为测试菌株,通过纸片法测定CFIX。临床评估在35名儿童中进行,包括5例急性扁桃体炎患者、10例急性陷窝性扁桃体炎患者、1例脓性淋巴结炎患者、1例猩红热患者、8例急性支气管炎患者、5例肺炎患者、3例尿路感染患者和1例副伤寒乙患者。另有1例患者仅纳入安全性评估,因为他患有支原体肺炎。患者年龄从4个月至8岁2个月,其中11例为住院患者。每日剂量为6.0至13.5mg/kg。给予3mg/kg和6mg/kg剂量的CFIX后,血清峰值浓度分别为1.75和3.36μg/ml,半衰期分别为2.65和2.86小时,给药后12小时内的尿排泄率分别为16.1%和12.4%。血清浓度呈剂量依赖性,与其他已知口服头孢菌素相比,半衰期相当长。CFIX对34例患者的临床疗效为:25例儿童“优秀”,8例“良好”,1例“差”,有效率为97.1%。分离出22株致病微生物,包括6株金黄色葡萄球菌、3株化脓性链球菌、2株肺炎链球菌、3株大肠杆菌、5株流感嗜血杆菌、2株副流感嗜血杆菌和1株副伤寒乙杆菌。治疗后,除2株金黄色葡萄球菌(1株情况不明,另1株数量减少)、1株肺炎链球菌(情况不明)和1株流感嗜血杆菌(情况不明)外,所有菌株均被成功根除,但治疗9天后粪便中再次检出副伤寒乙杆菌。未观察到不良反应。然而,在18名接受实验室检查的儿童中,分别有2名儿童嗜酸性粒细胞升高,1名儿童谷草转氨酶和谷丙转氨酶升高。