Paulfeuerborn W, Müller H J, Borner K, Koeppe P, Lode H
Department for Chest and Infectious Diseases, City-Hospital Zehlendorf, Germany.
Antimicrob Agents Chemother. 1993 Sep;37(9):1835-41. doi: 10.1128/AAC.37.9.1835.
Ceftazidime and the new SCE-2787 are parenteral cephalosporins with a broad antimicrobial spectrum. Pharmacokinetics, serum bactericidal activities, and side effects were investigated in a randomized crossover study. A total of 12 healthy volunteers received a 20-min infusion of 1.5 g of SCE-2787 or 2.0 g of ceftazidime. Serum and urine concentrations were determined by the bioassay method and by high-pressure liquid chromatography (HPLC). The mean (+/- standard deviation) drug concentrations in serum at the end of infusion of SCE-2787 and ceftazidime were 124.4 +/- 23.8 and 233.1 +/- 54.1 mg/liter, respectively. The urine recovery of SCE-2787 was 87.8% +/- 5.5% of dose in 24 h and for ceftazidime was 85.8% +/- 6.3% of dose in 24 h. Metabolites of SCE-2787 could not be detected by HPLC in serum or urine. Pharmacokinetic parameters were calculated both with a noncompartmental analysis and on the basis of an open two-compartment model (drugs are administered into and eliminated from a central compartment only. However, reversible drug distribution from the central space occurs simultaneously into one peripheral space). The area under the concentration time curve from 0 h to infinity of SCE-2787 was 197.9 +/- 25.4 mg.h/liter, and that of ceftazidime was 334.2 +/- 40.0 mg.h/liter. SCE-2787 had a mean terminal half-life in the elimination phase of 109.0 +/- 15.3 min, while that of ceftazidime was 99.0 +/- 13.4 min. The volume of distribution at steady state of SCE-2787 was 17.1 +/- 1.6 liters/70 kg, and that of ceftazidime was 122.9 +/- 1.3 liters/70 kg. The mean residence time of SCE-2787 was 136.4 +/- 15.4 min, and that of ceftazidime was 122.9 +/- 12.7 min. The renal clearance per. 1.73 m2 of SCE-2787 was 103.1 +/- 12.3 ml/min, and that of ceftazidime was 80.6 +/- 13.2 ml/min. The serum bactericidal activities were measured with the microdilution method of Stratton and Reller (L. B. Reller and C. W. Stratton, J. Infect. Dis. 136:196-204, 1977) against 40 clinically isolated strains. One hour after administration, we measured mean reciprocal bactericidal titers of SCE-2787 and ceftazidime, respectively, against Escherichia coli of 388 and 243, against Klebsiella pneumoniae of 395 and 138, against Pseudomonas aeruginosa of 13.0 and 12.7, and against Staphylococcus aureus of 32.2 and 4.0. No severe side effects were observed in this single drug administration.
头孢他啶和新型SCE - 2787是具有广谱抗菌活性的胃肠外头孢菌素。在一项随机交叉研究中对其药代动力学、血清杀菌活性及副作用进行了研究。共有12名健康志愿者接受了20分钟的静脉输注,其中1.5克SCE - 2787或2.0克头孢他啶。血清和尿液浓度通过生物测定法和高压液相色谱法(HPLC)测定。SCE - 2787和头孢他啶输注结束时血清中的平均(±标准差)药物浓度分别为124.4±23.8毫克/升和233.1±54.1毫克/升。SCE - 2787在24小时内尿液回收率为剂量的87.8%±5.5%,头孢他啶在24小时内尿液回收率为剂量的85.8%±6.3%。通过HPLC在血清或尿液中未检测到SCE - 2787的代谢产物。药代动力学参数通过非房室分析和基于开放二室模型进行计算(药物仅注入中央室并从中央室消除。然而,药物从中央空间向一个外周空间的可逆分布同时发生)。SCE - 2787从0小时到无穷大的浓度时间曲线下面积为197.9±25.4毫克·小时/升,头孢他啶为334.2±40.0毫克·小时/升。SCE - 2787在消除相平均终末半衰期为109.0±15.3分钟,而头孢他啶为99.0±13.4分钟。SCE - 2787稳态分布容积为17.1±1.6升/7(]千克,头孢他啶为122.9±1.3升/70千克。SCE - 2787平均驻留时间为136.4±15.4分钟,头孢他啶为122.9±12.7分钟。每1.73平方米体表面积SCE - 2787的肾清除率为103.1±12.3毫升/分钟,头孢他啶为80.6±13.2毫升/分钟。采用Stratton和Reller的微量稀释法(L. B. Reller和C. W. Stratton,《传染病杂志》136:196 - 204,1977)测定血清杀菌活性,针对40株临床分离菌株。给药1小时后,分别测定SCE - 2787和头孢他啶针对大肠杆菌的平均杀菌效价倒数为388和243,针对肺炎克雷伯菌为395和138,针对铜绿假单胞菌为13.0和12.7,针对金黄色葡萄球菌为32.2和4.0。在此次单剂量给药中未观察到严重副作用。