Spika J S, Davis D J, Martin S R, Beharry K, Rex J, Aranda J V
Arch Dis Child. 1986 Nov;61(11):1121-4. doi: 10.1136/adc.61.11.1121.
Acetaminophen has been reported either to prolong or not to affect the clearance of chloramphenicol. To confirm one of these findings we studied the clearance of chloramphenicol and its metabolites using high pressure liquid chromatography in five patients (ages 2.5 to 5 years) before and during oral treatment with acetaminophen (50 mg/kg/day). Significant differences were observed in mean (SD) peak serum chloramphenicol concentration (-9.7 (3.2) mg/l), mean (SD) apparent volume of distribution (+225 (162) ml/kg), mean (SD) chloramphenicol half life (-1.9 (1.1) hours), mean (SD) chloramphenicol clearance (+236 (94) ml/kg/h), mean (SD) area under the curve (-83.5 (33.0) mg/l/h), and mean (SD) elimination constant (+0.34 (0.13) h-1) between samples obtained before and during treatment with acetaminophen. Acetaminophen, when given orally for several days, increased the clearance of chloramphenicol, perhaps by increased glucuronidation. This report re-emphasises the need for therapeutic drug monitoring whenever these two drugs are used together.
据报道，对乙酰氨基酚要么会延长氯霉素的清除时间，要么不会影响其清除。为了证实这些发现中的一个，我们在5名患者（年龄2.5至5岁）口服对乙酰氨基酚（50mg/kg/天）之前和期间，使用高压液相色谱法研究了氯霉素及其代谢物的清除情况。在对乙酰氨基酚治疗前和治疗期间采集的样本之间，观察到平均（标准差）血清氯霉素峰浓度（-9.7（3.2）mg/l）、平均（标准差）表观分布容积（+225（162）ml/kg）、平均（标准差）氯霉素半衰期（-1.9（1.1）小时）、平均（标准差）氯霉素清除率（+236（94）ml/kg/h）、平均（标准差）曲线下面积（-83.5（33.0）mg/l/h）以及平均（标准差）消除常数（+0.34（0.13）h-1）存在显著差异。口服对乙酰氨基酚数天后，可能通过增加葡萄糖醛酸化作用，提高了氯霉素的清除率。本报告再次强调，当这两种药物一起使用时，需要进行治疗药物监测。
