pmedpharmФармация и фармакологияPharmacy & Pharmacology2307-92662413-2241Pyatigorsk Medical and Pharmaceutical Institute - branch of Volgograd State Medical Univer10.19163/2307-9266-2026-14-4-423-438pmedpharm-1938Research ArticleОБЗОРЫREVIEWЦефодизим: профиль безопасности у пациентов с коморбидной патологиейCefodizime: safety profile in patients with comorbiditieshttps://orcid.org/0000-0002-6348-6867ЗыряновС. К.ZyryanovS. K.

доктор медицинских наук, профессор, заведующий кафедрой общей и клинической фармакологии медицинского института ФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы» Минобрнауки России; главный внештатный специалист по клиническим исследованиям ГБУЗ г. Москвы «ГКБ № 24 ДЗ г. Москвы». 

1. Россия, 117198, г. Москва, ул. Миклухо-Маклая, д.6.

2. Россия, 127015, г. Москва, ул. Писцовая, д.10.

Doctor of Sciences (Medicine), Professor, Head of the Department of General and Clinical Pharmacology, People’s Friendship University (RUDN University); clinical pharmacologist of City Clinical Hospital No. 24. 

1. 6 Miklukho-Maklaya Str., Moscow, Russia, 117198.

2. 10 Pistsovaya Str., Moscow, Russia, 127015.

zyryanov-sk@rudn.ruhttps://orcid.org/0000-0003-3013-5697БайбулатоваЕ. А.BaibulatovaE. A.

кандидат медицинских наук, доцент кафедры общей и клинической фармакологии ФГАОУ ВО «Российский университет дружбы народов имени Патриса Лумумбы» Минобрнауки России. 

Россия, 117198, г. Москва, ул. Миклухо-Маклая, д.6

Candidate of Sciences (Medicine), Assistant Professor of the Department of General and Clinical Pharmacology, People’s Friendship University (RUDN University). 

6 Miklukho-Maklaya Str., Moscow, Russia, 117198.

baybulatova-ea@rudn.ru1. Федеральное государственное автономное образовательное учреждение высшего образования «Российский университет дружбы народов имени Патриса Лумумбы» Министерства образования и науки Российской Федерации. 2. Городское бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница № 24 Департамента здравоохранения города Москвы».Россия1. Peoples’ Friendship University (RUDN University). 2. City Clinical Hospital No. 24.Russian FederationФедеральное государственное автономное образовательное учреждение высшего образования «Российский университет дружбы народов имени Патриса Лумумбы» Министерства образования и науки Российской Федерации.РоссияPeoples’ Friendship University (RUDN University).Russian Federation202620072026144423438Copyright © Зырянов С.К., Байбулатова Е.А., 20262026Зырянов С.К., Байбулатова Е.А.Zyryanov S.K., Baibulatova E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pharmpharm.ru/jour/article/view/1938Цель

Цель. Оценить профиль безопасности цефодизима в сравнении с цефтриаксоном и амоксициллином/клавулановой кислотой на основе анализа актуальных литературных данных.

Материалы и методы

Материалы и методы. Поиск литературы проводили среди рандомизированных контролируемых исследований, когортных исследований, метаанализов и клинических рекомендаций за период с 2021 по 2026 гг. в базе данных PubMed.

Результаты

Результаты. В результате анализа публикаций и одной клинической рекомендации выявлено, что профиль безопасности цефодизима у коморбидных пациентов более благоприятен по сравнению с цефтриаксоном и амоксициллином/клавулановой кислотой. Применение цефтриаксона сопряжено с дозозависимым и зависящим от длительности терапии риском развития билиарного псевдолитиаза, холестатического гепатита, нефролитиаза и кристаллурии, особенно у пациентов с такими факторами риска, как декомпенсированные сопутствующие заболевания, дегидратация, голодание и полипрагмазия. Амоксициллин/клавулановая кислота остаётся одной из ведущих причин лекарственно-индуцированного поражения печени, включая холестатические формы, а также демонстрирует клинически значимые взаимодействия с антагонистами витамина K и прямыми пероральными антикоагулянтами. Для цефодизима не обнаружено убедительных данных о гепато- и нефротоксичности или клинически значимых взаимодействиях с пероральными антикоагулянтами, в том числе у пациентов с патологией гепатобилиарной и мочевыделительной систем. Вместе с тем ограниченный объём клинических исследований требует дальнейшего изучения его безопасности в расширенных когортах.

Заключение

Заключение. Цефодизим, цефтриаксон и амоксициллин/клавулановая кислота эффективны у коморбидных пациентов, однако их профиль безопасности различается. Цефодизим характеризуется отсутствием данных о гепато- и нефротоксичности и не демонстрирует клинически значимых лекарственных взаимодействий с пероральными антикоагулянтами, в отличие от цефтриаксона и амоксициллина/клавулановой кислоты. В то же время ограниченное число клинических исследований цефодизима требует дальнейшего изучения его профиля безопасности в расширенных когортах коморбидных пациентов.

The aim

The aim. To evaluate the safety profile of cefodizime in comparison with ceftriaxone and amoxicillin/clavulanic acid based on an analysis of current literature data.

Materials and methods

Materials and methods. A literature search was conducted among randomized controlled trials, cohort studies, meta-analyses, and clinical guidelines for the period from 2021 to 2026 in the PubMed database.

Results

Results. The analysis of publications and one clinical guideline revealed that the safety profile of cefodizime in comorbid patients is more favorable compared to ceftriaxone and amoxicillin / clavulanic acid. The use of ceftriaxone is associated with a dose-dependent and duration-dependent risk of developing biliary pseudolithiasis, cholestatic hepatitis, nephrolithiasis, and crystalluria, especially in patients with risk factors such as decompensated comorbidities, dehydration, starvation, and polypharmacy. Amoxicillin/clavulanic acid remains one of the leading causes of drug-induced liver injury, including cholestatic forms, and also demonstrates clinically significant interactions with vitamin K antagonists and direct oral anticoagulants. No convincing data on hepatotoxicity or nephrotoxicity or clinically significant interactions with oral anticoagulants were found for cefodizime, including in patients with hepatobiliary and urinary system pathology. However, the limited volume of clinical studies requires further investigation of its safety in larger cohorts.

Conclusion

Conclusion. Cefodizime, ceftriaxone, and amoxicillin / clavulanic acid are effective in comorbid patients; however, their safety profiles differ. Cefodizime is characterized by a lack of data on hepatotoxicity and nephrotoxicity and does not demonstrate clinically significant drug interactions with oral anticoagulants, unlike ceftriaxone and amoxicillin / clavulanic acid. At the same time, the limited number of clinical studies on cefodizime requires further investigation of its safety profile in larger cohorts of comorbid patients.

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The authors declare that there are no conflicts of interest present.