Population Pharmacokinetics and Safety of Solithromycin following Intravenous and Oral Administration in Infants, Children, and Adolescents

作者：Gonzalez Daniel; James Laura P; Al Uzri Amira; Bosheva Miroslava; Adler Shohet Felice C; Mendley Susan R; Bradley John S; Espinosa Claudia; Tsonkova Eva; Moffett Kathryn; Marquez Lucila; Simonsen Kari A; Stoilov Stefan; Boakye Agyeman Felix; Jasion Theresa; Hornik Christoph P; Hernandez Robert; Benjamin Daniel K Jr; Cohen Wolkowiez Michael^*

来源：Antimicrobial Agents and Chemotherapy, 2018, 62(8).

DOI：10.1128/AAC.00692-18;e00692-18

• solithromycin
• pharmacokinetics
• pediatrics
• antibiotics
• safety

Solithromycin is a novel fluoroketolide antibiotic which was under investigation for the treatment of community-acquired bacterial pneumonia (CABP). A phase 1 study was performed to characterize the pharmacokinetics (PK) and safety of solithromycin in children. Eighty-four subjects (median age, 6 years [age range, 4 days to 17 years]) were administered intravenous (i.v.) or oral (capsules or suspension) solithromycin (i.v., 6 to 8 mg/kg of body weight; capsules/suspension, 14 to 16 mg/kg on days 1 and 7 to 15 mg/kg on days 2 to 5). PK samples were collected after the first and multidose administration. Data from 83 subjects (662 samples) were combined with previously collected adolescent PK data (n = 13; median age, 16 years [age range, 12 to 17 years]) following capsule administration to perform a population PK analysis. A 2-compartment PK model characterized the data well, and postmenstrual age was the only significant covariate after accounting for body size differences. Dosing simulations suggested that 8 mg/kg i.v. daily and oral dosing of 20 mg/kg on day 1 (800-mg adult maximum) followed by 10 mg/kg on days 2 to 5 (400-mg adult maximum) would achieve a pediatric solithromycin exposure consistent with the exposures observed in adults. Seventy-six treatment-emergent adverse events (TEAEs) were reported in 40 subjects. Diarrhea (6 subjects) and infusion site pain or phlebitis (3 subjects) were the most frequently reported adverse events related to treatment. Two subjects experienced TEAEs of increased hepatic enzymes that were deemed not to be related to the study treatment.

• 出版日期2018-8