[Effect of various types of liver diseases on the behavior of cefoperazone]

Cefoperazone is a third generation cephalosporin mainly excreted by the biliary route. Hepatic dysfunction may have a pronounced effect on its pharmacokinetic behaviour. Sixty liver patients (acute viral hepatitis, alcoholic fatty liver and liver cirrhosis), without overt renal disease, have been studied and compared to controls. In liver disease the total clearance of cefoperazone is markedly decreased by reduction of extrarenal clearance, which is variable for each type of liver injury. Renal clearance does not change or may even increase, when hypoalbuminemia is present and compensates the reduction in extrarenal clearance.