PHARMACOKINETICS AND CLINICAL EFFECT OF CEFCLIDIN IN SURGICAL INFECTIONS

• Published in: CHEMOTHERAPY Vol. 40; no. Supplement4; pp. 541 - 549
• Main Author: Tanimura, Hiroshi
• Format: Journal Article
• Language: English; Japanese
• Published: Japanese Society of Chemotherapy 1992
• Subjects: Cefclidin
• ISSN: 0009-3165; 1884-5894
• DOI: 10.11250/chemotherapy1953.40.Supplement4_541

Pharmacokinetics and clinical effects on surgical infections of cefclidin (CFCL), a potent antipseudomonal injectable cephalosporin, were evaluated in 36 patients. 1) After 30 minutes intravenous drip infusion of CFCL lg to 8 patients for gastrectomy and 1 patient for pancreatoduodenectomy, the serum level was 49.3 ± 2.2 and 9.5 ± 1.5μg/ml after 1 and 5 hours, respectively. The tissue levels of CFCL after 1 to 4 hours were 13.4 in the gallbladder, 5.01-5.49 in the abdominal skin, 1.33-18.3 in the pariental peritoneum, and 0.96-12.3μg/g in the omental fatty tissue. After pancreatoduodenectomy, the peak level in bile was 7.86 after 2 hours and 6.97μg/ml after 1 hour in pancreatic fluid. 2) After 30 minutes intravenous drip infusion of CFCL 1g to 5 total gastrectomized patients, the serum level was 35.5 ±2.4 in 4 cases on the 3rd administration, and good penetration to ascitic fluid was noted at 23.8-29.0μg/ml on the 1st administration. After the simultaneous administration of CFCL and cefotiam (CTM) 3 times daily, peak.serum levels of CFCL and CTM were 26.7 and 63.0μg/ml on the 3rd adminisatration, respectively. Ascitic levels of CFCL and CTM were almost the same. 3) Based on the analysis of the serum level after daily 2 and 3 times administration of CFCL 1g, AUC0-24 after daily 3 times administration of CFCL was maintained over the 4 MIC80, against Pseudomonas aeruginosa. 4) CFCL was administered at doses of 1g 2-3 times daily for 3-18 days to 15 patients including 4 with biliary tract infections, 1 with hepatic abscess, 3 with wound infections, 4 with intra-abdominal abscess, 2 with peritonitis and 1 with thoracic empyema. The total clinical efficacy rate was 53.8%. The efficacy rate in pseudomonas infections was 66.7% and in particular, a daily 3 times regimen of CFCL 1g showed good response in 3 of 4 cases. It might be concluded that CFCL is useful in the management of severe surgical pseudomonas infections.