Exploring the pharmacokinetics of second-generation cephalosporin, cefaclor: a systematic review in healthy and diseased populations

Cefaclor is a bactericidal antibiotic recommended for treating diverse types of infections. This review aims to comprehensively assess the pharmacokinetic (PK) data on cefaclor in humans.Google Scholar, PubMed, Cochrane Library, and EBSCO databases were systematically performed to identify all the relevant studies containing at least one reported PK parameter of cefaclor.Cefaclor shows the linear PK profile as the area under the plasma concentration-time curve from 0 to t (AUC0-t) and maximum plasma concentration (Cmax) increase in a dose-dependent manner. The AUC0-t of cefaclor in the rice diet was found to be higher than that of bread food, i.e. 19.9 ± 2.6 ug/ml.hr vs 15.4 ± 4 ug/ml.hr. The AUC in paediatrics during the fed state was significantly higher compared to that in adults. Patients with renal impairments showed a Cmax 2.2 times higher than that of normal subjects. A significant increase in Cmax was depicted among individuals following a vegetarian diet in comparison with the non-vegetarian diet. Moreover, cefaclor exhibits time-dependent killing above the minimum inhibitory concentration (MIC < 2 ug), favouring its use in treating infections caused by specific pathogens.This systematic review summarises all the reported PK parameters of cefaclor in healthy and diseased subjects in the literature. This data can help practitioners in adjusting cefaclor doses among different diseases and populations to avoid drug interactions and adverse effects.

LC-MS/MS method for nine different antibiotics

BACKGROUND AND AIMS

TDM of antibiotics can bring benefits to patients and healthcare systems by providing better treatment and saving healthcare resources. We aimed to develop a multi-analyte method for several diverse antibiotics using LC-MS/MS.

MATERIALS AND METHODS

Sample preparation consisted of protein precipitation with methanol, dilution and online extraction using a Turboflow Cyclone column. Separation was performed on a Synergi 4 µm Max RP column and deuterated forms of three antibiotics were used as internal standards.

RESULTS

We present a LC-MS/MS method for the quantitative determination of nine antibiotics, including five cephalosporins, the carbapenem ertapenem, the fluoroquinolone ciprofloxacin as well as the combination drug trimethoprim-sulfamethoxazole from plasma. Additionally, unbound ertapenem and cefazolin were analyzed in plasma water after ultrafiltration using plasma calibrators. Results from routine TDM show the applicability of the method.

CONCLUSION

The presented method is precise and accurate and was introduced in a university hospital, permitting fast TDM of all nine analytes. It was also used in a clinical study for measuring cefazolin free and total concentrations.

Bio-analytical methods for investigating the effect of age, body mass index and gender on the PK/PD ratio of antibiotics

The effectiveness of antibiotics (ABs) is governed by achieving the adequate pharmacokinetic (PK)/pharmacodynamics (PD) ratio. In this study, fast LC-MS/MS methods were developed and validated for the bioanalysis of cefaclor (CFC), ciprofloxacin (CFC), roxithomycin (RXM) and clindamycin (CLD). Chromatographic separation was performed on a C₁₈ Zorbax-Eclipse Plus (3.5 μm, 100 × 4.6 mm) using isocratic elution. Detection was performed by positive electrospray ionization. The methods were applied for the assessment of PK parameters in volunteers (n = 101, 64 male and 37 female) and the effects of age, body mass index (BMI) and gender were investigated. Good linearity (r² ≥ 0.99), accuracy (>86%), precision (CV% ≤ 11) and extraction recovery (>83%) were observed for CFC, CFX, RXM and CLD. Application to PK studies revealed that age and BMI affected the T_half and the AUC of RXM and CLD (p < 0.023). Gender difference affected the critical PK parameters of the four ABs (T_half (U = 18; P = 0.036) of CFC, the C_max of CFX (U = 30; P = 0.017), the T_half (U = 23; P = 0.009) and AUC (U = 26; P = 0.008) of RXM and CLD), respectively. These results highlight the significance of age and BMI variations for RXM and CLD dosing. Furthermore, it indicates that the gender difference may be considered when adjusting the AB dose.

New ecological method for determination of different β-lactams: application to real human plasma samples

An innovative ecofriendly HPTLC method was established for in vivo analysis of four β-lactam antibiotics with minimal sample pretreatment.