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Single-dose ceftriaxone kinetics in functionally anephric patients.

K Stoeckel, P J McNamara, G Hoppe-Seyler

    Clinical Pharmacology and Therapeutics
    |May 1, 1983
    PubMed
    Summary
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    Ceftriaxone dosing in anephric patients showed nonlinear kinetics. Most patients required no dose adjustment, but those with impaired nonrenal clearance needed minor modifications.

    Area of Science:

    • Pharmacokinetics and Pharmacodynamics
    • Nephrology
    • Infectious Diseases

    Background:

    • Ceftriaxone is a widely used antibiotic.
    • Renal impairment significantly affects drug disposition.
    • Understanding ceftriaxone pharmacokinetics in anephric patients is crucial for safe and effective dosing.

    Purpose of the Study:

    • To investigate the disposition profile of ceftriaxone in functionally anephric patients.
    • To determine if dose adjustments are necessary for ceftriaxone in patients with severe renal impairment.

    Main Methods:

    • Studied 12 functionally anephric patients (creatinine clearance < 10 ml/min).
    • Administered intravenous bolus injections of ceftriaxone at 150, 500, and 1500 mg.
    • Analyzed drug kinetics, plasma protein binding, and nonrenal clearance.

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    Main Results:

    • Ceftriaxone kinetics were nonlinear for total drug and linear for free drug in uremic patients, similar to healthy subjects.
    • Reduced plasma protein binding led to a doubled free fraction.
    • Ten patients had normal nonrenal clearance and minor increases in half-life, requiring no dose adjustment.
    • Two patients showed decreased nonrenal clearance and prolonged half-life, necessitating minor dose adjustments.

    Conclusions:

    • Most anephric patients can receive standard ceftriaxone dosing without modification.
    • A subset of anephric patients with impaired nonrenal elimination require adjusted ceftriaxone dosages.
    • Individualized pharmacokinetic assessment may be beneficial for certain anephric patients.