The pharmacokinetics of temocillin in patients with normal and impaired renal function

The pharmacokinetics of temocillin was studied in 16 subjects with varying degrees of renal functional impairment. The subjects were divided into three groups, depending on their creatinine clearance: Group A greater than 70 ml/min/1.73 m2; Group B 20-70ml/min/1.73 m2 and Group C less than 20 ml/min/1.72 m2. Following intravenous administration the total serum clearance of temocillin was reduced in patients with renal insufficiency. The distribution of temocillin into the tissues was not affected by renal dysfunction, apparent distribution volumes being 15.11, 16.01 and 13.81 in Groups A, B and C respectively. The change in clearance was reflected in an increased area under the serum concentration versus time curve from 418 mg h/l in Group A to 1301 mg h/l and 1553 mg h/l in Groups B and C respectively. The beta elimination half-life was also prolonged from 3.5 h in Group A 12.7 h in Group B and 17.5 h in Group C. The urinary excretion of temocillin was both delayed and reduced according to the extent of kidney damage. The reduction in temocillin clearance was proportional to the extent of reduction from normal of the clearance of creatinine. This relationship has been used to suggest dosage schedules for temocillin in patients with renal insufficiency.