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Absence of a pharmacokinetic interaction between chloramphenicol and acetaminophen in children
Insights
Acetaminophen (APAP) did not affect chloramphenicol (CAP) pharmacokinetics in febrile children. This study found no significant interaction between APAP and CAP during treatment.
Area of Science:
- Pediatric Pharmacology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Chloramphenicol (CAP) is an antibiotic used for severe infections.
- Acetaminophen (APAP) is commonly used for fever reduction in children.
- Potential drug interactions between CAP and APAP require investigation.
Purpose of the Study:
- To evaluate the pharmacokinetic interaction between chloramphenicol (CAP) and acetaminophen (APAP) in acutely ill febrile children.
- To determine if APAP administration affects CAP elimination, half-life, volume of distribution, or clearance.
Main Methods:
- Pharmacokinetic analysis of CAP in 26 febrile children (3-58 months).
- Patients were divided into groups receiving (n=18) or not receiving (n=8) APAP.
- CAP serum levels were measured using high-performance liquid chromatography at first dose and steady state.
Main Results:
- No significant differences in CAP elimination rate constant, serum half-life, volume of distribution, or serum clearance were observed between APAP and non-APAP groups.
- Concomitant APAP use did not alter CAP pharmacokinetics at either first dose or steady-state evaluations.
- CAP elimination was similar regardless of APAP presence or serum levels.
Conclusions:
- A pharmacokinetic interaction between chloramphenicol and acetaminophen was not demonstrated in this cohort of acutely ill febrile children.
- Concomitant administration of APAP does not appear to significantly alter CAP pharmacokinetics in pediatric patients.
- This finding supports the co-administration of these agents when clinically indicated.
Abstract:
The pharmacokinetics of chloramphenicol (CAP; administered intravenously as chloramphenicol succinate, CAPS) was studied in 26 acutely ill febrile children 3 to 58 months of age who either did (n = 18) or did not (n = 8) receive acetaminophen (APAP) for antipyresis. CAP pharmacokinetics were evaluated after the first dose and at steady state. CAP serum levels were quantitated by high-performance liquid chromatography. There were no significant differences between groups (APAP vs non-APAP) or between first dose and steady-state evaluations for the elimination rate constant, serum half-life, apparent volume of distribution, and serum clearance of CAP. Likewise, there were no statistically significant differences when the APAP group was evaluated according to the presence or absence of APAP in serum before the first dose of CAP. Elimination of CAP in subjects with serum CAPS level less than 1 microgram/ml was similar in the first dose and steady-state evaluations and in the APAP and non-APAP groups. The presence or absence of CAPS or APAP did not affect the estimation of CAP elimination. Thus a pharmacokinetic interaction between CAP and APAP was not demonstrated in acutely ill febrile children during concomitant therapy.