Leeder J S, Spino M, Isles A F, Tesoro A M, Gold R, MacLeod S M
Clin Pharmacol Ther. 1984 Sep;36(3):355-62. doi: 10.1038/clpt.1984.187.
Ceftazidime disposition after an intravenous dose of 50 mg/kg infused over 20 min was followed in 10 subjects with cystic fibrosis (CF) hospitalized with acute pulmonary exacerbations and in 10 healthy subjects. Serum ceftazidime elimination t 1/2 decreased from 105.3 +/- 12.4 min (mean +/- SD) in controls to 90.0 +/- 11.1 min in subjects with CF. Calculated distribution volumes were both larger in subjects with CF. When normalized for body surface area, total body clearance (Cl) was 41.9% greater in the CF group (142.4 +/- 16.9 and 100.5 +/- 10.3 ml/min/1.73 m2). Normalization for body weight revealed 64.8% greater Cl in subjects with CF. Fraction of dose recovered in urine was of the same order for each group, while renal clearance (ClR) was 40.9% greater in the subjects with CF (130.1 +/- 11.4 and 92.7 +/- 11.6 ml/min/1.73 m2). Five subjects with CF were restudied while infection-free 119 to 219 days after the original study day. With the exception of a 10% increase in the volume of distribution at steady state while infection-free, kinetic parameters were much the same. No changes in Cl or ClR were evident from one study day to the next. Acute pulmonary infection does not appear to alter ceftazidime clearance in CF. The mechanism underlying increased ceftazidime Cl and ClR in CF is not apparent from the present data.
对10名因急性肺部加重住院的囊性纤维化（CF）患者和10名健康受试者静脉注射50mg/kg剂量的头孢他啶（输注时间为20分钟）后，对头孢他啶的处置情况进行了跟踪研究。血清头孢他啶消除半衰期从对照组的105.3±12.4分钟（均值±标准差）降至CF患者的90.0±11.1分钟。CF患者的计算分布容积均更大。以体表面积进行标准化后，CF组的总体清除率（Cl）高41.9%（分别为142.4±16.9和100.5±10.3ml/min/1.73m²）。以体重进行标准化后，CF患者的Cl高64.8%。每组尿中回收剂量的比例处于同一水平，而CF患者的肾清除率（ClR）高40.9%（分别为130.1±11.4和92.7±11.6ml/min/1.73m²）。对5名CF患者在原研究日之后119至219天无感染时进行了再次研究。除了在无感染时稳态分布容积增加10%外，动力学参数基本相同。从一个研究日到下一个研究日，Cl或ClR均无明显变化。急性肺部感染似乎不会改变CF患者中头孢他啶的清除率。从目前的数据来看，CF患者中头孢他啶Cl和ClR增加的潜在机制尚不明显。
