van Dijkman, SC;
Kamble, P;
Kowalski, JA;
Della Pasqua, Oscar;
(2025)
Cefuroxime axetil dosing regimens and probability of target attainment in adults and children.
British Journal of Clinical Pharmacology
, 19
(11)
pp. 3213-3224.
10.1002/bcp.70158.
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Abstract
Aims: Cefuroxime axetil exists in several dosage forms for oral administration, and isindicated for treatment of respiratory, genitourinary, skin and soft tissue infections.Evolving patterns of bacterial susceptibility, expressed as increasing minimum inhibi-tory concentrations (MICs), warrant monitoring of antibiotic efficacy. Herewe investigate the performance of different cefuroxime axetil doses required to yieldthe desired target exposure against the predominant pathogens for each indication.Methods: The pharmacokinetics of cefuroxime in plasma/serum and urine was char-acterized after oral, intravenous and intramuscular administration. Covariatesincluded the effect of weight on clearance and volume of distribution, and formula-tion on absorption parameters. Subsequently, systemic cefuroxime concentrationsover time were simulated to assess the time above the MIC (T > MIC) and the proba-bility of target attainment (PTA) for different dosing regimens in adults and children.Results: Tablet doses of 250 and 500 mg twice daily achieved the target T > MIC(40%) and PTA (≥90%) for MICs up to 0.25 and 0.5 mg/L, respectively, thereby cov-ering most European Committee on Antimicrobial Susceptibility Testing breakpointsfor key pathogens. Due to its absorption profile, the oral suspension covers evenhigher MICs, up to 1.0 mg/L. As cefuroxime is mostly excreted unchanged in urine,cefuroxime axetil doses of 250 mg twice daily for urinary tract infection yield a PTAof 100% for MIC values up to 8 mg/L.Conclusions: Our analysis provides insight into the performance of different dosesand dosing regimens for cefuroxime axetil for key pathogens. As resistance patternsevolve, and differ between countries or regions, cefuroxime doses may requireadjustments considering local bacterial susceptibility.
| Type: | Article |
|---|---|
| Title: | Cefuroxime axetil dosing regimens and probability of target attainment in adults and children |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/bcp.70158 |
| Publisher version: | https://doi.org/10.1002/bcp.70158 |
| Language: | English |
| Additional information: | © 2025 The Author(s). British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | bacterial infections, bacterial susceptibility, cefuroxime, dose rationale, probability of target attainment |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Pharmacology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10209402 |
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