title: Pharmacokinetic study of an oral cephalosporin, cefdinir, in hemodialysis patients.
abstract: The pharmacokinetics of cefdinir were investigated in six hemodialysis patients. For the present study, two tests were carried out, one with 4 h of hemodialysis and the other without hemodialysis. Cefdinir was given orally to each patient in a dose of 100 mg, and blood was collected serially for 48 h after dosing in the test without dialysis and for 72 h in the test with dialysis. In the test without dialysis, the maximum plasma concentration (Cmax) was 2.36 +/- 0.53 micrograms/ml (mean +/- standard deviation) and the time to Cmax was 9.00 +/- 2.45 h. The terminal elimination half-life (t1/2) and area under the concentration-time curve (AUC) were 16.95 +/- 1.20 h and 69.05 +/- 14.84 micrograms.h/ml, respectively. In the test with dialysis, t1/2 during hemodialysis decreased approximately to one-sixth of that obtained in the test without dialysis, although t1/2 in the latter elimination phase did not differ from that in the nondialysis test. AUC was reduced to 43% of that in the test without dialysis. The fractional removal of cefdinir by hemodialysis was 61%. These findings indicate that clearance of cefdinir is prolonged in patients with renal failure, and cefdinir is well removed by introduction of hemodialysis, although t1/2 (during hemodialysis) and AUC were two and eight times higher than the data previously reported for healthy volunteers, respectively. The pharmacokinetic data suggest that 100 mg of oral cefdinir once a day would result in a sufficient concentration in plasma in hemodialysis patients, but this remains to be confirmed by multiple-dose studies.
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan. ahishida@hama-med.ac.jp
authors.forename: A
authors.initials: A
authors.lastname: Hishida
authors.forename: K
authors.initials: K
authors.lastname: Ohishi
authors.forename: S
authors.initials: S
authors.lastname: Nagashima
authors.forename: M
authors.initials: M
authors.lastname: Kanamaru
authors.forename: M
authors.initials: M
authors.lastname: Obara
authors.forename: A
authors.initials: A
authors.lastname: Kitada
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000077525:Cefdinir; D002511:Cephalosporins / Q000097:blood / Q000493:pharmacokinetics*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
chemical_list: D002511:Cephalosporins; D000077525:Cefdinir