Multiple-dose pharmacokinetics of lomefloxacin: Rationale for once-a-day dosing

Abstract

Six dosage regimens of oral lomefloxacin, a new difluorinated quinolone, were given to healthy volunteer subjects for 7 days in a randomized, placebo-controlled trial to evaluate pharmacokinetics and tolerability and to determine the optimum dosage schedule. Single daily doses of lomefloxacin up to 800 mg and multiple doses up to 600 mg twice daily (1,200 mg/day) were well tolerated. At all dose levels and schedules, lomefloxacin was well absorbed and achieved peak plasma concentrations approximately 1 hour after administration. Urine concentrations were approximately 100 times the plasma concentrations. Elimination half-lives of 7–8 hours were found for all dosage regimens. Steady-state was achieved on the second day of dosing. Little accumulation was observed. A 400 mg oral dose provided a mean peak plasma concentration of 3.43 μg/mL, and trough concentrations at steady state that were above the minimum inhibitory concentration for 90% (MIC 90) of most common Enterobacteriaceae. The 400 mg dose produced a urine concentration of >80 μg/mL during the 12- to 24-hour period after the dose, thus exceeding the MIC 90 for clinical isolates such as Pseudomonas aeruginosa, Serratia marcescens, and methicillin-susceptible and -resistant Staphylococcus aureus. There was good agreement between the results of this study and previously reported single-dose data. In summary, lomefloxacin's rapid absorption, long half-life, and high sustained plasma and urine concentrations should permit effective once-daily administration in many clinical situations.