Relationship between cefpirome clearance, serum creatinine, weight and age in patients treated for infection

Abstract
Cefpirome serum concentrations were measured by microbiological assay in 30 patients after five to nine days of treatment with 1 or 2 g bd for moderate to severe infection of presumed bacterial origin. Patients with serum creatinine (SCr) > 220 μmol/L were excluded. The age of patients ranged from 34–86 years. Creatinine clearance (Clcr) was calculated from age, sex, weight and SCr The range of SCr was 63–220 μmol/L and the range of Clcr was 18–169 mL/min. The correlation coefficient with cefpirome clearance was 0·464 for SC, and 0·747 for Clcr More than half of the patients with Clcr < 50 mL/mm had SCr within the normal range of 70μ150 μmol/L. Mean cefpirome clearance in patients with Clcr 18–50 mL/min was 42·7 mL/min, which is very similar to the figure of 43·5 mL/min reported in a single dose volunteer study in patients with renal failure. Mean cefpirome clearance in patients with Clcr > 80 mL/min was 107·6 mL/min. In conclusion, these data on cefpirome clearance obtained after multiple dose treatment of patients with presumed bacterial infection are consistent with data previously obtained from single dose volunteer studies and support the currently recommended dose regimens. Clinicians should take account of age, weight and sex when estimating renal function from SCr.

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