Serum and urine concentrations of cefoperazone in severe chronic renal failure

Two studies evaluating the efficacy of cefoperazone in patients with chronic renal failure are described. In study A, 10 patients with severe chronic renal failure were given 1 g of cefoperazone intravenously over 3 minutes. The mean serum cefoperazone concentration at 30 minutes was 119.3 +/- 15.7 microgram/ml, and at 6 hours was 35.9 +/- 5.7 micrograms/ml. The mean serum half-life using the method of least squares was 6.6 +/- 1.15 hours (range, 2.5 to 15.1). The mean half-life from 2 hours onwards was 12.2 +/- 3.51 hours (range, 2.3 to 42.9). The mean peak urinary concentration of cefoperazone was 192 microgram/ml with a very wide individual range of 20 to 920 microgram/ml which was reached 0.5 to 9 hours after injection. In study B, 8 patients with chronic renal failure were treated with 1 to 2 g of cefoperazone intravenously every 12 hours for 5 to 14 days for complicated urinary tract infections. Serum and urine concentrations of cefoperazone were measured 6 hours after each morning dose. The mean 6-hour serum and urine concentrations of cefoperazone for the 4 patients treated with 2 g daily were 63 +/- 11.7 and 87 +/- 11.1 microgram/ml, respectively. The corresponding values for the 4 patients treated with 4 g daily were 106 +/- 20 and 258 +/- 32 microgram/ml. No drug accumulation occurred in any patient. No deterioration in renal function was noted. In conclusion, cefoperazone promises to be an effective and safe broad-spectrum antibiotic for patients with all degrees of renal function impairment. A dosage schedule of 2 to 4 g daily will not lead to significant drug accumulation in the presence of severe renal failure.