[Elimination of desacetyl cefotaxime in geriatric patients with multiple diseases]

Plasma concentrations of cefotaxime and desacetyl cefotaxime were determined by HPLC in geriatric patients with multiple diseases. Comparison with a younger control group of healthy volunteers showed a prolongation of half-life of CTX and dCTX in the older patients. A significant correlation between pharmacokinetic parameters of dCTX and other clinical and chemical parameters was found. Half-life of dCTX was positively correlated with age of the geriatric patients (P less than 0.05). There was also a significant relationship between CHE in serum and plasma peak concentrations of dCTX. Time until reaching plasma peak concentrations correlated closely with total bilirubin (P less than 0.01), CHE (P less than 0.001), cholesterol (P less than 0.01), and urea (P less than 0.01). Accumulation of the pharmacologically active metabolite dCTX could not be excluded in one patient with kidney disease. In accordance with other investigators it is recommended to reduce the dose of cefotaxime in geriatric patients with kidney diseases.