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Quinolones in the elderly

T Bergan1

  • 1Department of Medical Microbiology, Kaptein W. Wilhelmsen og Frues Bakteriologiske Institutt, Rikshospitalet, Oslo, Norway.

Drugs
|January 1, 1995
PubMed
Summary
This summary is machine-generated.

Elderly patients experience physiological changes affecting drug elimination, particularly renal function. Ofloxacin dosage adjustment is recommended due to prolonged half-life and increased adverse events in older adults.

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Area of Science:

  • Pharmacology
  • Geriatrics
  • Drug Metabolism

Background:

  • Aging alters physiological processes impacting drug disposition.
  • Reduced renal function in the elderly is a key factor for drug elimination.
  • Changes include decreased gastric acidity, motility, and lean body mass.

Purpose of the Study:

  • To examine the impact of aging on quinolone pharmacokinetics.
  • To identify age-related factors influencing drug elimination and adverse events.
  • To provide dosing recommendations for elderly patients receiving quinolones.

Main Methods:

  • Analysis of age-related physiological changes affecting drug disposition.
  • Comparison of renal elimination pathways for various quinolones.
  • Evaluation of drug half-life (t1/2) prolongation in the elderly.

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  • Assessment of adverse event frequencies in older patients.

    • Main Results:

    • Age-related decline in renal function significantly prolongs elimination half-life (t1/2) for renally excreted drugs.
    • Ofloxacin, with high renal elimination (80-90%), shows greater t1/2 increases than ciprofloxacin.
    • Norfloxacin, pefloxacin, and sparfloxacin exhibit less renal excretion, being less affected by renal impairment.
    • Ofloxacin use in the elderly is associated with higher adverse event rates due to prolonged t1/2 and elevated serum/tissue concentrations.

    Conclusions:

    • Renal function decline in elderly patients necessitates careful consideration of drug elimination pathways.
    • Dosage reduction for ofloxacin is advised in elderly patients to mitigate adverse events.
    • Ciprofloxacin, norfloxacin, and pefloxacin may not require dose adjustments solely based on advanced age due to alternative elimination routes.