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Related Experiment Videos

Quinolones in the aged.

L E Nicolle1

  • 1University of Manitoba, Winnipeg, Canada. lnicolle@hsc.mb.ca

Drugs
|December 20, 1999
PubMed
Summary
This summary is machine-generated.

Elderly patients may experience altered fluoroquinolone pharmacokinetics due to decreased lean body mass and renal function. However, age alone doesn't necessitate dose changes, except for renally cleared drugs in frail individuals.

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Area of Science:

  • Pharmacology
  • Geriatric Medicine
  • Infectious Diseases

Background:

  • Fluoroquinolone pharmacokinetics can differ in elderly populations compared to younger adults.
  • Common pharmacokinetic changes include increased peak plasma concentrations and area under the curve, linked to reduced lean body mass.
  • Renal excretion of fluoroquinolones is affected by age-related decline in creatinine clearance, prolonging elimination half-life.

Purpose of the Study:

  • To review pharmacokinetic alterations of fluoroquinolones in the elderly.
  • To assess the impact of aging on fluoroquinolone efficacy and safety.
  • To provide guidance on potential dosage adjustments in geriatric patients.

Main Methods:

  • Review of pharmacokinetic studies comparing elderly and younger populations.

Related Experiment Videos

  • Analysis of factors influencing fluoroquinolone disposition, including body composition and renal function.
  • Evaluation of clinical data on efficacy and adverse events in elderly patients.

    • Main Results:

    • Increased maximal plasma drug concentration and area under the concentration-time curve are common in the elderly, primarily due to decreased lean body mass.
    • Renally excreted fluoroquinolones show prolonged elimination half-life correlating with reduced creatinine clearance.
    • Alterations due to aging alone are minor; dosage adjustments may be needed for renally eliminated drugs (e.g., ofloxacin, levofloxacin) in frail elderly individuals with decreased creatinine clearance.
    • No significant age-related differences in adverse effects or efficacy compared to younger populations were reported.

    Conclusions:

    • While pharmacokinetic changes occur in elderly patients, they do not consistently warrant age-based dosage adjustments for all fluoroquinolones.
    • Fluoroquinolones remain effective in the elderly, with no reported increase in adverse events compared to younger individuals.
    • Careful consideration of renal function is necessary for dosing renally excreted fluoroquinolones in the very elderly or frail elderly.