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Antimicrobial Agents and Chemotherapy, July 1998, p. 1718-1721, Vol. 42, No. 7
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Pharmacokinetic Study of an Oral Cephalosporin, Cefdinir, in Hemodialysis Patients

Akira Hishida,1,* Kazuhisa Ohishi,1 Satoru Nagashima,2 Mitsutaka Kanamaru,2 Masao Obara,3 and Ayako Kitada3

First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-31,1 Sanpoukai Shitoro Clinic, Hamamatsu 432,2 and Post-Marketing Surveillance I, Fujisawa Pharmaceutical Co., Ltd., Osaka 532,3 Japan

Received 28 August 1997/Returned for modification 21 February 1998/Accepted 30 April 1998

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 µg/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 µg · 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.


* Corresponding author. Mailing address: First Department of Medicine, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu 431-31, Japan. Phone: 81-53-435-2261. Fax: 81-53-434-9447. E-mail: ahishida{at}hama-med.ac.jp.


Antimicrobial Agents and Chemotherapy, July 1998, p. 1718-1721, Vol. 42, No. 7
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.