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Lin PP, Wang CJ, Liu YP, Li T, Gao XM, Ma YP, Shi P, Li X, Wang LX, Cao Y. Pharmacokinetics and Bioequivalence of Cefprozil for Suspension and Granule Formulation in Healthy Chinese Volunteers: Two Single-Dose Crossover Studies. Adv Ther 2021; 38:1130-1142. [PMID: 33340343 DOI: 10.1007/s12325-020-01593-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/02/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Cefprozil, an oral second-generation semi-synthetic cephalosporin, possesses a broad spectrum of antimicrobial activity. A granule formulation has been developed to improve medication adherence of the patients. This study was conducted to assess the bioequivalence of the granule formulation to a dry suspension in healthy Chinese volunteers and estimate the pharmacokinetic (PK) profiles of cefprozil. METHODS An open-label, randomized, single-dose, two-period, two-group, crossover study was conducted in 60 healthy Chinese volunteers under fasted or fed conditions (30 volunteers for each condition) to assess the bioequivalence between two formulations of cefprozil. Blood samples were collected at specified time intervals, and the plasma concentrations of cis- and trans-cefprozil were determined by a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. PK and bioavailability parameters were estimated via non-compartmental methods. Adverse events (AEs) were also recorded. RESULTS Under fasted conditions, the mean Cmax was (3534.70 ± 634.67) ng/ml, Tmax was (0.98 ± 0.25) h, t1/2 was (1.37 ± 0.13) h and AUC0-t was (9302.86 ± 1618.39) ng·h/ml, respectively, after a single dose of 125 mg cefprozil for suspension. Under fed conditions, the mean Cmax was (2438.80 ± 493.78) ng/ml, Tmax was (1.66 ± 0.76) h, t1/2 was (1.36 ± 0.24) h and AUC0-t was (9332.36 ± 1373.61) ng·h/ml, respectively. The PK parameters of the granule formulation of cefprozil were similar to those of the suspension. The 90% CI values of the GMRs of Cmax, AUC0-t and AUC0-∞ under both fasted and fed conditions were within the prespecified bioequivalence range (80.00-125.00%). CONCLUSIONS According to the criteria for bioequivalence, the test granule formulations of cefprozil and "Cefprozil for Suspension®" were determined to be bioequivalent whether under fasted or fed conditions by measurement of cis-, trans- and total cefprozil. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT04414254.
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Affiliation(s)
- Ping-Ping Lin
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chen-Jing Wang
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yan-Ping Liu
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ting Li
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiao-Meng Gao
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ya-Ping Ma
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ping Shi
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xin Li
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Le-Xin Wang
- School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
| | - Yu Cao
- Clinical Trial Center, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Population Pharmacokinetics of Cis-, Trans-, and Total Cefprozil in Healthy Male Koreans. Pharmaceutics 2019; 11:pharmaceutics11100531. [PMID: 31614996 PMCID: PMC6836086 DOI: 10.3390/pharmaceutics11100531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/23/2019] [Accepted: 10/12/2019] [Indexed: 12/03/2022] Open
Abstract
Cefprozil, one of cephalosporin antibiotics, has been used extensively in clinics. However, pharmacokinetic (PK) information on cefprozil is still very limited. There have been no reports of population pharmacokinetics (PPKs). A PPK model for cefprozil will be a great advantage for clinical use. Thus, the aim of this study was to develop a PPK model for cefprozil for healthy male Koreans. Clinical PK and demographic data of healthy Korean males receiving cefprozil at a dose of 1000 mg were analyzed using Phoenix® NLME™. A one-compartment model with first-order absorption with lag-time was constructed as a base model. The model was extended to include covariates that influenced between-subject variability. Creatinine clearance significantly influenced systemic clearance of cefprozil. The final PPK model for cis-, trans-, and total cefprozil was established and validated. PPK parameter values of cis- and total cefprozil were similar to each other, but different from those of trans-isomer. Herein, we describe the establishment of accurate PPK models of cis-, trans-, and total cefprozil for healthy male Koreans for the first time. It may be useful as a dosing algorithm for the general population. These results might also contribute to the development of stereoisomeric cefprozil.
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Raymond F, Ouameur AA, Déraspe M, Iqbal N, Gingras H, Dridi B, Leprohon P, Plante PL, Giroux R, Bérubé È, Frenette J, Boudreau DK, Simard JL, Chabot I, Domingo MC, Trottier S, Boissinot M, Huletsky A, Roy PH, Ouellette M, Bergeron MG, Corbeil J. The initial state of the human gut microbiome determines its reshaping by antibiotics. THE ISME JOURNAL 2016; 10:707-20. [PMID: 26359913 PMCID: PMC4817689 DOI: 10.1038/ismej.2015.148] [Citation(s) in RCA: 224] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/09/2015] [Accepted: 07/15/2015] [Indexed: 02/07/2023]
Abstract
Microbiome studies have demonstrated the high inter-individual diversity of the gut microbiota. However, how the initial composition of the microbiome affects the impact of antibiotics on microbial communities is relatively unexplored. To specifically address this question, we administered a second-generation cephalosporin, cefprozil, to healthy volunteers. Stool samples gathered before antibiotic exposure, at the end of the treatment and 3 months later were analysed using shotgun metagenomic sequencing. On average, 15 billion nucleotides were sequenced for each sample. We show that standard antibiotic treatment can alter the gut microbiome in a specific, reproducible and predictable manner. The most consistent effect of the antibiotic was the increase of Lachnoclostridium bolteae in 16 out of the 18 cefprozil-exposed participants. Strikingly, we identified a subgroup of participants who were enriched in the opportunistic pathogen Enterobacter cloacae after exposure to the antibiotic, an effect linked to lower initial microbiome diversity and to a Bacteroides enterotype. Although the resistance gene content of participants' microbiomes was altered by the antibiotic, the impact of cefprozil remained specific to individual participants. Resistance genes that were not detectable prior to treatment were observed after a 7-day course of antibiotic administration. Specifically, point mutations in beta-lactamase blaCfxA-6 were enriched after antibiotic treatment in several participants. This suggests that monitoring the initial composition of the microbiome before treatment could assist in the prevention of some of the adverse effects associated with antibiotics or other treatments.
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Affiliation(s)
- Frédéric Raymond
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Amin A Ouameur
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Maxime Déraspe
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Naeem Iqbal
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Hélène Gingras
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Bédis Dridi
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Philippe Leprohon
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Pier-Luc Plante
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Richard Giroux
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Ève Bérubé
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Johanne Frenette
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Dominique K Boudreau
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Jean-Luc Simard
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Isabelle Chabot
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Marc-Christian Domingo
- Institut National de Santé Publique du Québec, Laboratoire de Santé Publique du Québec, Montréal, Québec, Canada
| | - Sylvie Trottier
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Maurice Boissinot
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Ann Huletsky
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Paul H Roy
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Marc Ouellette
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Michel G Bergeron
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
| | - Jacques Corbeil
- Centre de Recherche en Infectiologie, CHU de Québec–Université Laval, Québec, Canada
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Li X, Wang Z, Liu WP, Wang YG, Li B, Fei Z. Chronokinetic study of cefprozil in postprandial and fasting volunteers. BIOL RHYTHM RES 2013. [DOI: 10.1080/09291016.2011.652862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Tonsillopharyngitis is very common in children, with Group A Streptococci being the most common bacterial etiology. Effective antibacterial treatment is imperative due to risk of rheumatic fever. Cephalosporins have been used successfully for the treatment of Group A beta-hemolytic Streptococcal (GABHS) tonsillopharyngitis. Cefprozil is a novel broad-spectrum oral cephalosporin. Cefprozil is rapidly absorbed from the gastrointestinal tract with high bioavailability. The excellent penetration of cefprozil into tonsillar and adenoidal tissue corresponds well with the clinical outcome. The drug provides excellent coverage against both gram-negative and -positive bacteria that may cause pharyngitis/tonsillitis. The beta-lactamase stability of cefprozil appears to exceed that of other oral cephalosporins for important gram negative pathogens. In clinical trials, cefprozil appears to be at least as effective as commonly used comparison agents such as cefaclor and cefixime. Additionally, cefprozil is better tolerated than the latter, especially with regard to gastrointestinal adverse effects. Thus cefprozil can be considered a safe and reliable drug for the treatment of Streptococcal tonsillopharyngitis in children.
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Affiliation(s)
- Nameet Jerath
- Pediatric Intensivist, Indraprastha Apollo Hospital, New Delhi, India
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Abstract
Cefprozil is a novel third generation, broad-spectrum oral cephalosporin with activity against a spectrum of aerobic gram-negative and positive bacteria, as well as certain anaerobes. The beta-lactamase stability of cefprozil may exceed that of other oral cephalosporins for some important pathogens. Cefprozil may be a suitable alternative to several other commonly used beta-lactams and cephalosporins in the treatment of mild to moderate upper and lower respiratory tract infections including sinusitis, otitis media, pharyngitis/tonsillitis, secondary bacterial infection of acute bronchitis, and acute bacterial exacerbations of chronic bronchitis, and skin and skin structure infections in children. Available data indicate the safety of cefprozil in both pediatric and adult population.
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Affiliation(s)
- Sumit Bhargava
- Department of Paediatrics, All India Insitute of Medical Sciences, Ansari Nagar, New Delhi 110029.
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Wise R, Andrews JM, Da Ros L, Child J, Mortiboy D. A study to determine the pharmacokinetics and inflammatory fluid penetration of two doses of a solid formulation of the hexetil prodrug of a trinem, sanfetrinem (GV 104326). Antimicrob Agents Chemother 1997; 41:1761-4. [PMID: 9257756 PMCID: PMC164000 DOI: 10.1128/aac.41.8.1761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The trinem sanfetrinem (GV 104326) was administered as the oral hexetil prodrug GV 118819X in two dose levels to six healthy volunteers. A single dose equivalent to 125 mg of sanfetrinem was administered, followed 6 weeks later by a single dose equivalent to 500 mg of sanfetrinem. The concentrations of the drug in plasma, cantharidin-induced inflammatory fluid, and urine were measured with a microbiological assay. The stability of sanfetrinem was studied in serum and inflammatory fluid. The mean peak concentrations in plasma of 0.77 and 2.47 microg/ml were attained at 1.1 and 2.0 h after the 125- and 500-mg doses, respectively. Mean peak concentrations in inflammatory exudate of 0.26 and 0.86 microg/ml were attained at 2.80 and 2.67 h after the 125- and 500-mg doses, respectively. The mean terminal elimination half-lives in plasma were 1.33 and 1.97 h for the 125- and 500-mg doses, respectively. The half-lives in the inflammatory fluid were 1.66 and 1.74 h for the 125- and 500-mg doses, respectively. The overall penetration of the drug into the inflammatory fluid was 51.4 and 47.0% for the 125- and 500-mg doses, respectively. Mean urine recovery was greater following 500 mg (24.15%) than after 125 mg (18.4%) of sanfetrinem. Sanfetrinem was relatively unstable in the inflammatory exudate in vitro (half-life, 5.5 h), and this could explain the poor penetration of the drug in the inflammatory exudate observed in this study.
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Affiliation(s)
- R Wise
- Department of Medical Microbiology, City Hospital NHS Trust, Birmingham, United Kingdom
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