| Autor: |
Deguchi, Takashi, Yasuda, Mitsuru, Yokoi, Shigeaki, Ishida, Ken-Ichiro, Ito, Masayasu, Ishihara, Satoshi, Minamidate, Ken, Harada, Yoshimasa, Tei, Kanhin, Kojima, Kentaro, Tamaki, Masayoshi, Maeda, Shin-Ichi |
| Zdroj: |
Journal of Infection and Chemotherapy; January 2003, Vol. 9 Issue: 1 p35-39, 5p |
| Abstrakt: |
The efficacy of antimicrobial regimens for the treatment of uncomplicated gonococcal urethritis depends partially upon the period of time (therapeutic time) during which the drug concentration in the blood after the concentration peak is greater than four times the minimum inhibitory concentration for 90% of clinical isolates of Neisseria gonorrhoeae(MIC90). A therapeutic time of at least 10h is suggested as an important determinant for elimination of 95% or more of the infection. In this study, therapeutic times for a single 400-mg dose of cefixime at various MIC90s were calculated, and pharmacokinetic profiles of double-dosing of 200mg cefixime at various intervals were simulated. Subsequently, a dosing interval of 6h was tested in 6 healthy Japanese men, and then 93 Japanese men with gonococcal urethritis were treated with a regimen of two 200-mg doses of cefixime given at a 6-h interval. For a single dose of 400mg cefixime, therapeutic times were calculated to be 12.8, 9.1, 5.4, and 1.7h for MIC90s of 0.06, 0.125, 0.25, and 0.5μg/ml, respectively. In the simulation study of double-dosing of 200mg cefixime at a 6-h interval, the therapeutic times for the MIC90s of ≤0.125μg/ml were longer than 10h. Of the 93 patients, 68 were evaluated for microbiological outcome, and N. gonorrhoeaewas eradicated in 60 (88.2%). The MIC90of cefixime for the 61 isolates tested was 0.125μg/ml. All strains with MICs of ≤0.06μg/ml were eradicated, whereas 8 of 16 strains with MICs of ≥0.125μg/ml persisted after treatment. This regimen would not be effective against infection by strains exhibiting cefixime MIC90s of ≥0.125μg/ml. For such strains, a different regimen with a higher dose of cefixime would be required. |
| Databáze: |
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