Роль цефиксима в терапии обострения хронической обструктивной болезни лёгких

Клиническая Микробиология и Антимикробная Химиотерапия. 2008; 10(3):270-282

​ Гучев И.А., Рафальский В.В., Мелехина Е.В.
цефиксим цефалоспорины хроническая обструктивная болезнь лёгких
Раздел
Антимикробные препараты
Тип
Журнальная статья
Публикация
Клиническая Микробиология и Антимикробная Химиотерапия. 2008; 10(3):270-282

Аннотация

Цефиксим, являющийся первым пероральным цефалоспорином III поколения, обладает хорошей биодоступностью (40–50%); максимальная концентрация препарата в сыворотке (Cmax) достигается через 4 ч, в тканях — через 6,7 ч. Cmax цефиксима (доза 400 мг) составляет 2,6–4,8 мкг/мл, концентрация в слизистой бронхов и бронхиальном секрете соответственно 35–40% и 10–20% от Cmax. Препарат характеризуется наиболее длительным периодом полувыведения (3–4 ч) среди пероральных цефалоспоринов, что позволяет назначать его 1 раз в сутки. Цефиксим активен в отношении основных возбудителей обострения нетяжёлой хронической обструктивной болезни лёгких (ХОБЛ) — Haemophilus spp., Moraxella catarrhalis, Enterobacteriaceae и Streptococcus pneumoniae. По антигемофильной активности цефиксим практически не уступает респираторным фторхинолонам, его активность значительно превышает таковую цефуроксима и цефаклора. Частота нежелательных реакций (НР) при применении цефиксима достигает 3–49%. Как правило, они связанны с системой органов пищеварения и не требуют прекращения терапии. В реальной же клинической практике частота значимых НР не превышает 1–2%, а длительность основных симптомов — не более 3–4 сут. В большинстве клинических исследований клиническая эффективность цефиксими составила 80–85%, этот показатель не отличается от показателей, полученных при оценке эффективности респираторных фторхинолонов и ко-амоксиклава.

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