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[Laboratory and clinical evaluation of cefoxitin in children (author's transl)]
Insights
Cefoxitin, an injectable cephalosporin antibiotic, demonstrates favorable plasma levels and rapid excretion in children. This new antibiotic achieved significant clinical and bacterial response rates in patients with various infections.
Area of Science:
- Pharmacology
- Infectious Diseases
Context:
- Cefoxitin is a novel injectable semisynthetic cephamycin antibiotic.
- Understanding its pharmacokinetic profile is crucial for optimizing therapeutic use.
Purpose:
- To evaluate the pharmacokinetics of cefoxitin in pediatric patients.
- To assess cefoxitin's efficacy and safety in treating various infections.
Summary:
- Cefoxitin administration resulted in favorable plasma concentrations and rapid urinary excretion, with half-lives around 15.9-27.5 minutes.
- The drug showed high clinical effectiveness (84%) and bacterial response (87%) in patients with infections.
- Cerebrospinal and thoracic fluid levels were explored, with thoracic fluid levels higher than CSF levels.
Impact:
- Provides essential pharmacokinetic data for cefoxitin in pediatric populations.
- Supports the clinical utility of cefoxitin as an effective antibiotic for diverse infections.
- Highlights the need for further research into cefoxitin's penetration into cerebrospinal fluid.
Abstract:
Pharmacokinetics of cefoxitin, a new injectable semisynthetic-cephamycin, was studied in 12 healthy children and also was studied cerebrospinal fluid levels in 1 patient with bacterial meningitis received 44.5 mg/kg of cefoxitin and thoracic fluid levels in 2 patients were measured. Cefoxitin was administered intravenously to 50 patients with various types of infections an average dose of 130 mg/kg/day for an average of 9 days. The results were as follows: 1. Favorable plasma levels were obtained comparing with those off conventional injectable cephalosporins after 15 mg/kg and 25 mg/kg of cefoxitin for one shot intravenous injection. The half lives of cefoxitin in the plasma were about 15.9 minutes up to 1 hour and 25.5 minutes up to 2 hours after an intravenous administration of cefoxitin at a dose of 15 mg/kg, and while, those were 15.9 minutes and 27.5 minutes after an intravenous administration of cefoxitin at a dose of 25 mg/kg, respectively. 2. Cefoxitin was excreted with high concentration up to 2 hours after the administration and thereafter, urinary concentration of cefoxitin declined rapidly with the lapse of time. The time course urinary concentration reflected those of plasma levels. Approximately 94.7% and 90.6% of dosed cefoxitin were recovered in the urine for 6 hours after the administration at the dose of 15 mg/kg and 25 mg/kg, respectively. 3. The cerebrospinal fluid levels of cefoxitin were only determined in a patient of bacterial meningitis. Therefore, further study should be performed. 4. The thoracic fluid levels with 2 patients were higher than cerebrospinal fluid levels. 5. Among the 50 patients with various infections, cefoxitin was clinically effective in 84% and bacterial response in 87%. 6. As adverse reactions, in total 79 patients included exclusive 29 patients, diarrhea occurred in 1 patient, sweating and cough in 1 patient, rash with fever in 4 patients, vascular pain in 2 patients, and leukopenia was observed in 1 patient, eosinophilia in 1 patient, and increase of GOT and LDH were observed in each 2 patients. The other adverse reactions were not experienced.