Kanfer A, Stamatakis G, Torlotin J C, Fredj G, Kenouch S, Méry J P
Clin Nephrol. 1987 Mar;27(3):147-50.
As erythromycin ototoxicity appears to be favored by renal insufficiency, its pharmacokinetics were assessed in chronic uremic patients treated by maintenance hemodialysis in comparison with normal subjects. Two groups of 8 patients each were studied, the first one on an interdialytic day, the second immediately after the end of an hemodialysis session. All subjects ingested a single dose of 1 gram of erythromycin ethylsuccinate. Times of peak serum concentration and biological half-lifes were similar in patients and in controls. Maximum serum concentrations and areas under the serum concentration time-curve were higher in patients than in controls whereas apparent oral clearances were lower in the former. The differences between the two groups of patients were not significant. These pharmacokinetic changes are suggestive of an enhanced bioavailability of erythromycin in chronic renal failure which might predispose uremics to the ototoxicity of the drug.
由于肾功能不全似乎会增加红霉素耳毒性的发生风险，因此对维持性血液透析治疗的慢性尿毒症患者的红霉素药代动力学进行了评估，并与正常受试者进行比较。研究了两组各8名患者，第一组在透析间期，第二组在血液透析结束后立即进行研究。所有受试者均单次口服1克琥乙红霉素。患者和对照组的血清浓度峰值时间和生物半衰期相似。患者的最大血清浓度和血清浓度-时间曲线下面积高于对照组，而前者的表观口服清除率较低。两组患者之间的差异不显著。这些药代动力学变化提示慢性肾衰竭患者中红霉素的生物利用度增加，这可能使尿毒症患者易发生该药的耳毒性。
