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Age and ceftriaxone kinetics.

J R Luderer, I H Patel, J Durkin

    Clinical Pharmacology and Therapeutics
    |January 1, 1984
    PubMed
    Summary
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    Elderly individuals showed slightly decreased renal clearance and increased ceftriaxone free fractions, but overall pharmacokinetic changes were minimal. Dosage adjustments are likely unnecessary for older adults receiving ceftriaxone.

    Area of Science:

    • Pharmacology
    • Geriatric Medicine
    • Clinical Pharmacy

    Background:

    • Ceftriaxone is a widely used antibiotic.
    • Age-related changes in drug pharmacokinetics can affect efficacy and safety.
    • Understanding ceftriaxone's behavior in elderly populations is crucial for appropriate dosing.

    Purpose of the Study:

    • To investigate the pharmacokinetic differences of ceftriaxone between elderly and young adults.
    • To determine if age significantly impacts ceftriaxone elimination and protein binding.

    Main Methods:

    • Intravenous infusion of 1 gram ceftriaxone over 30 minutes in elderly (mean age 70.5) and young (mean age 28.9) subjects.
    • Serial plasma and urine sample collection for 48 hours to measure unchanged drug.
    • Protein binding determined by equilibrium dialysis in selected plasma samples.

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    Main Results:

    • No significant differences observed in maximum plasma concentration, elimination rate, half-life, volume of distribution, plasma clearance, nonrenal clearance, or urinary excretion.
    • Significant decrease in renal clearance (24%) and increase in plasma free fractions in elderly subjects.
    • Elderly renal clearance decrease correlated with reduced creatinine clearance.

    Conclusions:

    • Age-related pharmacokinetic changes for ceftriaxone are minimal.
    • Despite reduced renal clearance and increased free fractions, dosage adjustments are likely not required for elderly patients.
    • Ceftriaxone appears safe and effective in the elderly without dose modification.