desacetylcefotaxime and Urinary-Tract-Infections

Serum cefotaxime and desacetylcefotaxime concentrations and their tissue concentrations in the kidney were determined at 30 minutes after cefotaxime (80 mg/kg) bolus intravenous infusion in rabbits when the urinary tract was obstructed. Serum concentration was highest in bilateral ureteral obstruction (BUO) animals (142.1 +/- 25.4 mg/L), followed in order by unilateral ureteral obstruction (UUO) animals (92.6 +/- 10.4 mg/L) and sham-operated animals (50.4 +/- 9.9 mg/L). Both serum cefotaxime and desacetylcefotaxime concentrations were highly correlated with serum creatinine levels. Conversely, the renal tissue/serum concentration ratio of cefotaxime and its metabolite was lowest in BUO animals, which was in accordance with physiological evidence that renal blood flow was reduced in BUO. Indomethacin pretreatment exaggerated cefotaxime and desacetylcefotaxime accumulation in the obstructed kidney of the UUO model, indicating that this drug inhibits renal elimination of cefotaxime when urinary tract obstruction exists.

Topics: Animals; Cefotaxime; Disease Models, Animal; Indomethacin; Kidney; Male; Rabbits; Ureteral Obstruction; Urinary Tract Infections

Plasma concentrations of cefotaxime and desacetyl cefotaxime were determined by HPLC in geriatric patients with multiple diseases. Comparison with a younger control group of healthy volunteers showed a prolongation of half-life of CTX and dCTX in the older patients. A significant correlation between pharmacokinetic parameters of dCTX and other clinical and chemical parameters was found. Half-life of dCTX was positively correlated with age of the geriatric patients (P less than 0.05). There was also a significant relationship between CHE in serum and plasma peak concentrations of dCTX. Time until reaching plasma peak concentrations correlated closely with total bilirubin (P less than 0.01), CHE (P less than 0.001), cholesterol (P less than 0.01), and urea (P less than 0.01). Accumulation of the pharmacologically active metabolite dCTX could not be excluded in one patient with kidney disease. In accordance with other investigators it is recommended to reduce the dose of cefotaxime in geriatric patients with kidney diseases.

Topics: Aged; Arteriosclerosis; Cefotaxime; Diabetes Complications; Diabetes Mellitus; Diabetic Angiopathies; Female; Half-Life; Heart Failure; Humans; Hypertension; Kidney Diseases; Kinetics; Male; Pneumonia; Urinary Tract Infections