Pharmacokinetic studies of cefuroxime in patients with liver cirrhosis

Blood levels and urinary excretion of 6R,7R-3-carbamoyloxy-methyl-7-(2Z)-2-methoxyimino-(fur-2-yl)-acetamido-ceph-3-em-4-carboxylate sodium salt (cefuroxime) were determined in cirrhotic patients without ascites and in healthy volunteers after an i.m. injection of 750 mg and an i.v. injection of 1 g. An average peak serum level of 23.9 micrograms/ml in the case of cirrhotic patients and 22.5 micrograms/ml in the case of volunteers was reached 0.5 h after the i.m. dose, followed by a gradual decrease. An average serum level of 78.8 micrograms/ml in the case of cirrhotic patients was obtained 5 min after i.v. injection. During the first 6 h after administration of the 750 mg i.m. dose and the first 4 h after the administration of the 1 g i.v. dose, 90% of the administered dose were excreted in the urine, in the case of both cirrhotic patients and volunteers. These results show that the pharmacokinetic features of cefuroxime are not affected in cirrhotic patients without ascites; therefore the antibiotic is particularly suitable for acute infections in hospital, and also for cirrhotic patients without ascites without any difference in the dosage.