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Age-associated changes in ceftriaxone pharmacokinetics.

W L Hayton, K Stoeckel

    Clinical Pharmacokinetics
    |January 1, 1986
    PubMed
    Summary
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    Ceftriaxone half-life varies significantly with age, being longest in neonates and the elderly. Dosage adjustments are crucial for neonates and the very old to ensure effective ceftriaxone concentrations.

    Area of Science:

    • Pharmacology
    • Clinical Pharmacy
    • Pediatric Pharmacology

    Background:

    • Ceftriaxone is a widely used third-generation cephalosporin antibiotic.
    • Understanding its pharmacokinetic profile across different age groups is essential for optimizing therapeutic outcomes.
    • Age-related physiological changes can significantly impact drug disposition.

    Purpose of the Study:

    • To compile and analyze ceftriaxone pharmacokinetic parameters from recent literature.
    • To describe age-associated changes in ceftriaxone half-life, clearance, and protein binding.
    • To provide guidance on appropriate ceftriaxone dosing strategies for various age groups.

    Main Methods:

    • Systematic compilation of pharmacokinetic data from published studies.
    • Analysis of ceftriaxone half-life, systemic clearance, renal elimination, and plasma protein binding.

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  • Inclusion of subjects ranging from neonates to the elderly with normal organ function.

    • Main Results:

    • Ceftriaxone half-life is prolonged in neonates (avg. 19 hours) and the elderly (14 hours), compared to children (6.3 hours).
    • Age-related changes in half-life correlate with alterations in systemic clearance and renal elimination fraction.
    • Plasma protein binding increases from ~70% in neonates to 90-95% in adults.

    Conclusions:

    • Ceftriaxone dosage requires significant reduction in neonates (<1 week) and potentially in the elderly.
    • Standard dosing per unit surface area is applicable for children and adults with normal renal and hepatic function.
    • Gender does not appear to influence ceftriaxone pharmacokinetic parameters significantly.