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[Clinical studies of cefixime granules in pediatrics]
Insights
Cefixime (CFIX) demonstrated a 97.1% effectiveness rate in treating pediatric infections, with no observed adverse reactions. This new oral cephalosporin shows promising results for common childhood bacterial infections.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Cefixime (CFIX) is a newly developed oral cephalosporin antibiotic.
- Pediatric infections require effective and safe treatment options.
Purpose of the Study:
- To evaluate the clinical efficacy and safety of cefixime (CFIX) in pediatric patients.
- To conduct a pharmacokinetic study of CFIX in children.
Main Methods:
- Clinical evaluation in 35 pediatric patients with various infections.
- Pharmacokinetic study in 11 pediatric patients receiving CFIX at 3 mg/kg or 6 mg/kg.
- Serum and urine concentrations of CFIX were measured; bacterial eradication was assessed.
Main Results:
- CFIX showed a 97.1% clinical efficacy rate (25 excellent, 8 good).
- Peak serum concentrations were dose-dependent (1.75 µg/ml at 3 mg/kg, 3.36 µg/ml at 6 mg/kg).
- No adverse reactions were reported, though minor laboratory abnormalities were noted in some patients.
Conclusions:
- Cefixime (CFIX) is effective and well-tolerated for treating common pediatric infections.
- The pharmacokinetic profile suggests favorable absorption and a relatively long half-life for an oral cephalosporin.
- CFIX represents a valuable therapeutic option for pediatric bacterial infections.
Abstract:
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.