Pharmacokinetics of cefcapene pivoxil and AS-924 in gastrectomized patients

To investigate the effects of gastrectomy on the absorption of drugs, the blood concentrations or the active moieties, cefcapene (CCAP) and ceftizoxime (CTIZ), were determined in 36 gastrectomized patients after oral administration of cefcapene pivoxil (CCAP-PI) and AS-924, prodrug type cephem antibiotics with different solubility-profiles. In patients with gastrectomy, the C-max and AUC for CCAP-PI whose solubility depended on the acidity of gastric juice, were lower than in the controls; whereas those for AS-924 were comparable with values in the control group. The T-max was affected by the extent of gastrectomy; the T-max value was the lowest in patients who had undergone total gastrectomy Roux-Y, followed by Billroth It and Billroth I procedure of subtotal gastrectomy. These results indicate the need to select drugs and to instruct gastrectomized patients regarding dosage and administration, taking the pharmacokinetics of drugs into consideration. (C) 2001 Published by Elsevier Science B.V. and International Society of Chemotherapy.