Norrby S R, Ljungberg B
Department of Infectious Diseases, University of Lund, Lund University Hospital, Sweden.
Rev Infect Dis. 1989 Jul-Aug;11 Suppl 5:S1102-6. doi: 10.1093/clinids/11.supplement_5.s1102.
Differences between the pharmacokinetics of the new fluoroquinolones in the young and in the elderly have been demonstrated for ciprofloxacin, enoxacin, norfloxacin, and ofloxacin. Comparative studies of the young and the elderly are still lacking for pefloxacin. With ofloxacin and norfloxacin, the age-related pharmacokinetic differences seem for the most part to be due to differences in the renal handling of the drugs. With ciprofloxacin and enoxacin more profound differences have been reported. The peak concentrations of ciprofloxacin and enoxacin in serum increase with age, without a concurrent increase in serum half-life. This cannot be explained by differences in the distribution of the drug or by reduced metabolism. The most probable explanation for the age-related differences in the disposition of ciprofloxacin is a more efficient absorption of the drug in the elderly. With enoxacin, an increase in the nonrenal clearance of the drug with age has been demonstrated. The clinical consequence of the age-related differences in the pharmacokinetics of ciprofloxacin and enoxacin is that these antibiotics should be administered at lower doses to the elderly.
环丙沙星、依诺沙星、诺氟沙星和氧氟沙星已证实新氟喹诺酮类药物在年轻人和老年人中的药代动力学存在差异。培氟沙星仍缺乏年轻人和老年人的对比研究。对于氧氟沙星和诺氟沙星，与年龄相关的药代动力学差异似乎在很大程度上归因于药物肾脏处理方面的差异。对于环丙沙星和依诺沙星，已报道有更显著的差异。环丙沙星和依诺沙星在血清中的峰值浓度随年龄增加，而血清半衰期没有同时增加。这无法用药物分布差异或代谢降低来解释。环丙沙星处置方面与年龄相关差异的最可能解释是老年人对该药物的吸收更有效。对于依诺沙星，已证实该药物的非肾清除率随年龄增加。环丙沙星和依诺沙星药代动力学与年龄相关差异的临床后果是，这些抗生素应以较低剂量给予老年人。
