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[Pharmacokinetics and clinical effects of cefdinir 10% fine granules in pediatrics]
T Motohiro1, S Handa, S Yamada
1Department of Pediatrics, School of Medicine, Kurume University.
Insights
This study shows that cefdinir (CFDN) is effective in treating pediatric infections. Cefdinir demonstrated good clinical and bacteriological outcomes in children, with no significant adverse effects reported.
Area of Science:
- Pediatric Pharmacology
- Infectious Diseases
- Antimicrobial Agents
Background:
- Cefdinir (CFDN) is a new oral cephalosporin.
- Pediatric pharmacokinetic and efficacy data are essential for its clinical use.
Purpose of the Study:
- To evaluate the pharmacokinetics of cefdinir in children.
- To assess the clinical and bacteriological efficacy of cefdinir in pediatric infections.
- To monitor for adverse effects of cefdinir in children.
Main Methods:
- Cefdinir pharmacokinetics (plasma, urine concentrations, recovery rates) were determined in 8 children.
- Clinical and bacteriological effects were assessed in 9 children with various infections.
- Minimum inhibitory concentrations (MICs) were determined for cefdinir and other antibiotics.
Main Results:
- Cefdinir showed dose-dependent absorption, with higher plasma peak levels when administered before meals.
- Mean urinary recovery rates were 16.6% (before meal) and 13.4% (after meal) over 8 hours.
- 100% efficacy was observed clinically and bacteriologically against common pediatric pathogens.
Conclusions:
- Cefdinir is well-tolerated and effective in treating pediatric bacterial infections.
- Administration timing (before or after meal) influences cefdinir pharmacokinetics in children.
- Cefdinir demonstrates promising efficacy and safety for pediatric use.
Abstract:
Cefdinir (CFDN), a newly developed oral cephalosporin in a 10% fine granular form, was administered to 8 children and concentrations of the drug in plasma and urine and urinary recovery rates of the drug were determined. The subjects were divided into 2 groups of 4 children each; one group received 3 mg/kg of CFDN at 1 hour before meal (in the fasting state), and the other, at 30 minutes after meal. To study clinical and bacteriological effects of this drug, a mean dose of 4.8 mg/kg t.i.d. was administered for 8 days on the average to 9 children with various infections; tonsillitis (3 cases), acute bronchitis (1), pneumonia (1), acute purulent otitis media (1), urinary tract infection (2), and impetigo (1). MICs were determined for 6 drugs including CFDN, cefaclor, cefixime (CFIX), methicillin, cloxacillin, amoxicillin (AMPC) against 4 strains freshly isolated from children receiving CFDN. An inoculum size of 10(6) cfu/ml was used in the MIC-determinations. Adverse reactions and abnormal laboratory findings attributable to this drug were also examined in these children. The results obtained are summarized as follows. 1. Mean plasma peak levels of CFDN were observed at 2 hours after administration in the before-meal group and 4 or 5 hours after administration in the after-meal group mean peak values of 0.88 and 0.50 micrograms/ml, respectively. Mean half-lives were 1.61 hours in the before-meal group and 2.54 hours in the after-meal group, and mean AUCs were 4.24 in the former and 3.59 micrograms.hr/ml in the latter. 2. Mean urinary peak concentrations of CFDN were observed during 2-4 hours after dosing in the before-meal group and during 6-8 hours in the after-meal group with values of 93.3 and 44.8 micrograms/ml, respectively, in cases for which plasma concentrations of drugs were determined. Mean urinary recovery rates during the first 8 hours after administration in the before- and after-meal groups were 16.6 and 13.4%, respectively. 3. Good clinical effects were obtained with an efficacy rate of 100% in 9 patients with 6 diseases due to bacterial infections. 4. Good bacteriological effects were also obtained against 2 strains of Streptococcus pyogenes, 2 strains of Escherichia coli and 1 strain of Haemophilus influenzae with an eradication rate of 100%. In 3 cases of these and another case (normal flora), strains present before the study were replaced by other strains.(ABSTRACT TRUNCATED AT 400 WORDS)