Jacobs R F, Kearns G L, Brown A L, Trang J M, Kluza R B
Eur J Clin Microbiol. 1984 Oct;3(5):471-4. doi: 10.1007/BF02017378.
Imipenem renal clearance was studied in six children (three males, three females; 2.9-11.2 years of age) following a single intravenous dose (21.7 +/- 5.1 mg/kg) of imipenem/cilastatin (1:1). In an approximately six-hour period following drug administration, 65.3 +/- 9.7% of the imipenem dose was excreted in the urine unchanged. The renal clearance (280.03 +/- 24.34 ml/min/1.73 m2) of imipenem was found to account for 69.2% of the corresponding plasma imipenem clearance (404.89 +/- 24.83 ml/min/1.73 m2). Contrary to existing adult data, the imipenem renal clearance in our subjects was 1.95-fold greater than the estimated creatinine clearance, suggesting significant tubular secretion of imipenem in children. Examination of urinary imipenem excretion rate versus plasma concentration relationships in three of the children revealed a potential renal tubular reabsorption component for imipenem in children. Comparison of renal imipenem clearance data in these children to similar data from adults suggests that quantitatively important developmental differences may exist for the renal handling of imipenem.
在6名儿童（3名男性，3名女性；年龄2.9 - 11.2岁）单次静脉注射剂量为（21.7±5.1mg/kg）的亚胺培南/西司他丁（1:1）后，对亚胺培南的肾脏清除率进行了研究。在给药后的大约6小时内，65.3±9.7%的亚胺培南剂量以原形经尿液排出。发现亚胺培南的肾脏清除率（280.03±24.34ml/min/1.73m²）占相应血浆中亚胺培南清除率（404.89±24.83ml/min/1.73m²）的69.2%。与现有的成人数据相反，我们研究对象中亚胺培南的肾脏清除率比估计的肌酐清除率高1.95倍，这表明儿童中亚胺培南存在显著的肾小管分泌。对3名儿童尿液中亚胺培南排泄率与血浆浓度关系的检查显示，儿童中亚胺培南存在潜在的肾小管重吸收成分。将这些儿童中亚胺培南的肾脏清除率数据与成人的类似数据进行比较表明，在亚胺培南的肾脏处理方面可能存在重要的发育差异。
