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Pharmacokinetics of cefixime in children with urinary tract infections after a single oral dose
K Mamzoridi1, N Kasteridou, A Peonides
14th Paediatric Clinic, ACHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Greece.
Insights
This study shows cefixime pharmacokinetics in children with urinary tract infections are similar to adults. Cefixime (a third-generation cephalosporin) levels in plasma and urine remained effective for extended periods.
Area of Science:
- Pharmacology
- Pediatric Infectious Diseases
- Clinical Pharmacy
Background:
- Urinary tract infections (UTIs) are common in children.
- Cefixime is a third-generation cephalosporin antibiotic used for bacterial infections.
- Understanding cefixime pharmacokinetics in pediatric UTIs is crucial for effective treatment.
Purpose of the Study:
- To determine the pharmacokinetics of cefixime in children with UTIs.
- To compare pediatric cefixime pharmacokinetics to adult data.
- To assess the adequacy of cefixime concentrations against common UTI pathogens.
Main Methods:
- Single oral dose (8 mg/kg) of cefixime suspension administered to six pediatric patients (6-13 years).
- Plasma and urine samples collected up to 12 and 24 hours, respectively.
- Cefixime concentrations analyzed via reversed-phase HPLC; pharmacokinetic parameters calculated using model-independent methods.
Main Results:
- Mean peak plasma concentration: 4.04 µg/mL at 3.2 hours.
- Mean elimination half-life: 3.91 hours.
- Approximately 15% of the dose excreted unchanged in urine; concentrations exceeded minimal inhibitory levels for pathogens for 12-24 hours.
Conclusions:
- Cefixime pharmacokinetics in pediatric UTIs are comparable to adults on a mg/kg basis.
- Achieved plasma and urine cefixime concentrations support efficacy against common UTI pathogens.
- Cefixime is a suitable antibiotic option for pediatric urinary tract infections.
Abstract:
The pharmacokinetics of cefixime, a third-generation broad-spectrum cephalosporin, were determined following administration of a 8 mg/kg single oral dose of cefixime suspension to six children with urinary tract infections, ages from 6 to 13 years and weights from 17 to 60 kg. Blood samples for determination of plasma cefixime concentrations were obtained for up to 12 hr and complete urine collections were obtained for urinary excretion of unchanged parent drug for up to 24 hr after administration. Plasma and urine concentrations of cefixime were determined using a reversed phase HPLC assay and pertinent pharmacokinetic parameters were estimated by model-independent standard methods. Mean peak plasma concentration was 4.04 micrograms/ml and was reached after 3.2 hr. The mean area under the plasma concentration-time curve was 33.07 micrograms.hr/ml and the mean elimination half-life was 3.91 hr. The mean apparent total clearance was 4.74 ml/min./kg and about 15% of the dose administered was recovered unchanged in urine. In conclusion, the estimated pharmacokinetic values of cefixime were comparable to those observed in healthy adult subjects based on equivalent mg/ kg doses. Plasma and urine concentrations of the drug were well above the reported minimal plasma and urinary concentrations for most common urinary tract pathogens for up to 12 and 24 hr after administration, respectively.