Mühlberg W, Platt D
Klin Wochenschr. 1982 Dec 15;60(24):1497-500. doi: 10.1007/BF01716101.
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.
采用高效液相色谱法测定患有多种疾病的老年患者血浆中头孢噻肟和去乙酰头孢噻肟的浓度。与较年轻的健康志愿者对照组相比，老年患者中头孢噻肟（CTX）和去乙酰头孢噻肟（dCTX）的半衰期延长。发现dCTX的药代动力学参数与其他临床和化学参数之间存在显著相关性。dCTX的半衰期与老年患者的年龄呈正相关（P<0.05）。血清中胆碱酯酶（CHE）与dCTX的血浆峰浓度之间也存在显著关系。达到血浆峰浓度的时间与总胆红素（P<0.01）、CHE（P<0.001）、胆固醇（P<0.01）和尿素（P<0.01）密切相关。在一名肾病患者中不能排除具有药理活性的代谢产物dCTX的蓄积。与其他研究者一致，建议在患有肾病的老年患者中减少头孢噻肟的剂量。
