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Penicillin pharmacokinetics in kwashiorkor
The American Journal of Clinical Nutrition
|November 1, 1979
Summary
Penicillin clearance significantly increases in children recovering from kwashiorkor, indicating improved kidney function. This suggests adjusted drug dosages are crucial for renally excreted medications in malnourished patients.
Area of Science:
- Pharmacokinetics
- Pediatrics
- Nutritional Science
Background:
- Kwashiorkor, a severe form of malnutrition, can significantly alter drug metabolism and excretion.
- Understanding drug kinetics in kwashiorkor is vital for effective treatment and preventing adverse effects.
Purpose of the Study:
- To investigate the pharmacokinetic changes of intravenous penicillin in children with kwashiorkor.
- To determine how these kinetics change during nutritional rehabilitation.
- To propose an approach for dosing renally excreted drugs in kwashiorkor.
Main Methods:
- Studied intravenous penicillin pharmacokinetics in eight children with kwashiorkor.
- Measurements were taken upon hospital admission and after rehabilitation.
- Analyzed changes in penicillin clearance and half-life.
Main Results:
- Penicillin clearance increased by 75% with recovery.
- Associated with a decrease in penicillin's half-life.
- Improvements in renal plasma flow and tubular function are likely contributors.
Conclusions:
- Nutritional rehabilitation significantly impacts renal drug handling in children with kwashiorkor.
- Renal function recovery necessitates adjustments in drug dosage for renally excreted medications.
- The study proposes a framework for optimizing drug dosing in this vulnerable population.