Cefonicid kinetics in subjects with normal and impaired renal function

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Abstract
Cefonicid is a cephalosporin with a longer t1/2 [half-life] than currently available cephalosporins. Cefonicid kinetics after an i.v. dose of 7.5 mg/kg were followed in 4 groups of subjects: group 1, 4 subjects with normal creatinine clearance (Clcr > 80 ml/min); group II, 7 subjects with mild renal insufficiency (Clcr 50-80 ml/min); group III, 5 subjects with moderate to severe renal impairment (Clcr 8-49 ml/min); and group IV, 5 subjects with end-stage renal disease who were receiving maintenance hemodialysis (Clcr < 8 ml/ml). Cefonicid volume of distribution ranged from 6.9-17.6% body wt but was not related to Clcr. Elimination t1/2 was 4.6 .+-. 0.7 h in group 1, 6.0 .+-. 2.7 h in group II, 25.6 .+-. 14.0 h in group III and 65.3 .+-. 43.6 h in group IV. There was a strong correlation between plasma cefonicid clearance and Clcr. Nonrenal clearance did not change with decreasing Clcr. Hemodialysis clearance calculated from plasma concentrations and recovery in dialysate was 2.5 .+-. 0.9 ml/min. These kinetic parameters were used to formulate dosage regimens for patients with renal impairment. [Cefonicid is a new, long-acting parenteral cephalosporin with enhanced activity against most gram-negative pathogens.].

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