A series of pharmacokinetic studies of ceftaroline fosamil in select populations: normal subjects, healthy elderly subjects, and subjects with renal impairment or end-stage renal disease requiring hemodialysis

• Published in: Journal of clinical pharmacology Vol. 54; no. 7; p. 742
• Main Authors: Riccobene, Todd, Jakate, Abhijeet, Rank, Doug
• Format: Journal Article
• Language: English
• Published: England 01.07.2014
• Subjects: Adolescent; Adult; Aged; Aging; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - blood; Anti-Bacterial Agents - pharmacokinetics; Ceftaroline; Cephalosporins - administration & dosage; Cephalosporins - adverse effects; Cephalosporins - analysis; Cephalosporins - pharmacokinetics; Cohort Studies; Dose-Response Relationship, Drug; Double-Blind Method; Female; Half-Life; Humans; Infusions, Intravenous; Kidney - drug effects; Kidney - metabolism; Kidney - physiopathology; Kidney Failure, Chronic - metabolism; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Male; Prodrugs - administration & dosage; Prodrugs - adverse effects; Prodrugs - analysis; Prodrugs - pharmacokinetics; Renal Dialysis; Renal Elimination; Renal Insufficiency - blood; Renal Insufficiency - metabolism; Renal Insufficiency - physiopathology; Renal Insufficiency - urine; Severity of Illness Index; Young Adult; ceftaroline fosamil; pharmacokinetic; cephalosporin; Staphylococcus aureus; Streptococcus pneumoniae
• ISSN: 1552-4604
• DOI: 10.1002/jcph.265

Ceftaroline fosamil is a parenteral cephalosporin indicated for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. Ceftaroline, the active component of ceftaroline fosamil, exhibits broad-spectrum bactericidal activity against gram-positive organisms, including methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae, as well as common gram-negative pathogens. The objective of the studies presented herein was to establish the pharmacokinetic profile of ceftaroline in healthy subjects and special populations of interest, such as elderly subjects, subjects with renal impairment, or subjects with end-stage renal disease on intermittent hemodialysis. The mean half-life of ceftaroline in healthy subjects was approximately 2.6 hours, and urinary excretion was the primary route of elimination. Ceftaroline Cmax and AUC values increased in proportion to dose increases within the range of 50-1000 mg, demonstrating an approximately linear pharmacokinetic profile following intravenous infusion. The pharmacokinetic parameters of ceftaroline were modestly altered in elderly subjects compared with younger adults, which was attributed to decreased renal function in elderly subjects. Ceftaroline pharmacokinetic parameters varied with different degrees of renal impairment, resulting in recommended dosage adjustments for patients with moderate to severe impairment. Ceftaroline fosamil was generally well tolerated regardless of age or severity of renal impairment.