J vet Pharmacol Therap. 2020;00:1–6. wileyonlinelibrary.com/journal/jvp | 1 © 2020 John Wiley & Sons Ltd
1 | INTRODUCTION
Cefuroxime axetil (C
20
H
22
N
4
O
10
S) (CEFa) is an acetoxyethyl ester
prodrug of cefuroxime (C
16
H
16
N
4
O
8
S) (CEF) appropriate for oral
administration. It is hydrolyzed by esterases in the gastrointestinal
tract to the active CEF, which is absorbed into the systemic circula-
tion (Perry & Brogden 1996).
Cefuroxime has a broad spectrum of antimicrobial activity.
It is active against many gram-positive (e.g., Staphylococci and
Streptococci), gram-negative (Enterobacteriaceae), and some
Received: 5 September 2019
|
Revised: 15 January 2020
|
Accepted: 8 February 2020
DOI: 10.1111/jvp.12854
ORIGINAL ARTICLE
Effect of food on the pharmacokinetics of oral cefuroxime
axetil in dogs
Gabriela A. Albarellos
1
| Sabrina M. Passini
1
| Martín P. Lupi
1
| Silvia Aramayona
1
|
Paula M. Lorenzini
1
| Laura Montoya
1
| Maria F. Landoni
2
1
Facultad de Ciencias Veterinarias, Cátedra
de Farmacología, Universidad de Buenos
Aires, Buenos Aires, Argentina
2
Facultad de Ciencias Veterinarias, Cátedra
de Farmacología, Universidad Nacional de La
Plata, Buenos Aires, Argentina
Correspondence
Gabriela A. Albarellos. Facultad de Ciencias
Veterinarias, Cátedra de Farmacología,
Universidad de Buenos Aires, Chorroarín
280 (1427). Buenos Aires, Argentina.
Email: albarell@fvet.uba.ar
Funding information
Secretaria de Ciencia y Tecnica, Universidad
de Buenos Aires, Grant/Award Number:
UBACYT 2018-2020 20020170100574BA
Abstract
Cefuroxime axetil pharmacokinetic profile was investigated in 12 Beagle dogs after
single intravenous and oral administration of tablets or suspension at a dose of 20 mg/
kg, under both fasting and fed conditions. A three-period, three-treatment crossover
study (IV, PO under fasting and fed condition) was applied. Blood samples were with-
drawn at predetermined times over a 12-hr period. Cefuroxime plasma concentra-
tions were determined by HPLC. Data were analyzed by compartmental analysis. No
statistically significant differences were observed between formulations and feeding
conditions on PK parameters. Independently of the feeding condition, absorption of
cefuroxime axetil after tablet administration was low and erratic. The drug has been
quantified in plasma in 3 out of 6 and 5 out of 6 dogs in the fasted and fed groups.
For this formulation, the bioavailability (F), peak plasma concentration (C
max
), and area
under the concentration–time curve (AUC) of cefuroxime axetil were significantly en-
hanced (p < .05) by the concomitant ingestion of food (32.97 ± 13.47–14.08 ± 7.79%,
6.30 ± 2.62–2.74 ± 0.66 µg/ml, and 15.75 ± 3.98–7.82 ± 2.76 µg.hr/ml for F, C
max,
and AUC in fed and fasted dogs, respectively), while for cefuroxime axetil suspension,
feeding conditions affected only the rate of absorption, as reflected by the significantly
shorter absorption half-life (T
½(a)
) and time to peak concentration (T
max
) (0.55 ± 0.27–
1.15 ± 0.19 hr and 1.21 ± 0.22–1.70 ± 0.30 for T
½(a)
and T
max
in fed and fasted dogs,
respectively). For cefuroxime axetil tablets, T > MIC (≤1 µg/ml) was <2 hr in fasted and
≈4 hr in fed animals, and for cefuroxime axetil suspension, T > MIC (≤1 µg/ml) was
≈5 hr and for T >MIC (≤4 µg/ml) was ≈2.5 hr for fasted and fed dogs, respectively.
Cefuroxime axetil as a suspension formulation seems to be a better option than tablets.
However, its short permanence in plasma could reduce its clinical usefulness in dogs.
KEYWORDS
antimicrobials, cefuroxime, cephalosporins, dogs, pharmacokinetics