Evaluation of cefuroxime axetil and cefadroxil suspensions for treatment of pediatric skin infections

Abstract

A randomized, single-blind, multicenter study was conducted to evaluate the safety and efficacy of cefuroxime axetil and cefadroxil suspensions for the treatment of skin or skin structure infections in 287 children. Each drug was given at a dosage of 30 mg/kg of body weight per day in two divided doses. Staphylococcus aureus and Streptococcus pyogenes, or a combination of the two, were the primary pathogens isolated from infected skin lesions. A satisfactory bacteriological response (cure or presumed cure) was obtained in 97.1 and 94.3% of children in the cefuroxime axetil and cefadroxil groups, respectively (P > 0.05). Satisfactory clinical responses (cure or improvement) were more likely to occur in cefuroxime axetil recipients than in cefadroxil recipients (97.8 versus 90.3%; P < 0.05). Both regimens were equally well tolerated, with adverse events occurring in 7.9 and 6.1% of cefuroxime axetil and cefadroxil recipients, respectively. There were more patients who refused to take cefuroxime axetil (7 of 189) than there were who refused to take cefadroxil (0 of 98), but the difference was not statistically significant (P = 0.1). In this study, cefuroxime axetil was at least as effective as cefadroxil in resolving skin and skin structure infections in children.Cefuroxime is an expanded-spectrum cephalosporin with improved P-lactamase stability and a broad spectrum of activity against clinically important gram-positive and gramnegative pathogens. The lowest concentrations that inhibited the growth of 90% of the Staphylococcus aureus and Streptococcus pyogenes strains tested are 1 to 2 and <0.125 ,ug/ml, respectively (2).Cefuroxime axetil, the acetyloxyethyl ester of cefuroxime, is a prodrug that is suitable for oral administration. After oral ingestion, cefuroxime axetil is deesterified in the intestinal mucosa and appears as cefuroxime in the blood. Peak concentrations in serum increase in proportion to dose and are 3.3 and 5

Quantification and prediction of skin pharmacokinetics of amoxicillin and cefuroxime

“…In order to achieve this goal the distribution between plasma and dermis of two model antibiotics, amoxicillin (AMX) and cefuroxime (CFX), was studied in a rabbit model by concurrent measurement of skin concentrations via microdialysis and plasma levels via serial sampling. AMX is usually administered orally to treat skin infections such as cutaneous anthrax [6][7][8], while CFX is administered intravenously or intramuscularly to treat skin and skin structure infections such as impetigo, folliculitis and cellulitis caused by Staphylococcus aureus and Streptococcus pyogenes [9,10]. The linearity of the distribution between plasma and skin was first assessed by administering increasing doses of the antibiotics.…”