VANCOMYCIN DISPOSITION - THE IMPORTANCE OF AGE
VANCOMYCIN DISPOSITION - THE IMPORTANCE OF AGE
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DOI：
10.1038/clpt.1984.260
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发表时间：
1984-01-01
影响因子：
6.7
通讯作者：
POWER, M
中科院分区：
文献类型：
--
作者：
CUTLER, NR;NARANG, PK;POWER, M
年龄对万古霉素[一种抗菌抗生素]动力学的影响在12名正常健康男性（6名年轻人和6名老年人）中进行了检查，静脉输注6 mg/kg。在给药后2天内采集系列血液和尿液样本，并通过特异性放射免疫测定法测定原型药物。输注后万古霉素的血药浓度呈多相下降。血清和尿排泄数据同时用SAAM-27计算机程序用三室模型拟合。从药物分布特征的终末相获得的平均t1/2 [半衰期]估计值显示，老年受试者的t1/2长于年轻受试者（12.1和7.2 h）。虽然中心室的初始分布容积没有变化，但老年人的全身和肾脏总清除率降低，与肾功能无关。稳态时万古霉素分布容积的增加归因于老年人中药物的组织结合增强，因为年轻人和老年人全身合并液中结合万古霉素的平均分数无差异（0.53和0.56）。排泄数据的深入分析倾向于支持万古霉素仅通过肾小球滤过排泄的建议。这些数据强烈表明，需要调整或修改老年人推荐的万古霉素给药方案。
The influence of age on vancomycin [an antibacterial antibiotic] kinetics was examined in 12 normal healthy men (6 young and 6 elderly) after an i.v. infusion of 6 mg/kg. Serial blood and urine samples were collected for up to 2 days after dosing and were assayed for unchanged drug by a specific radioimmunoassay. Seurm concentrations of vancomycin after infusion declined in a multiphasic manner. Both serum and urinary excretion data were simultaneously fit by a 3-compartment model with SAAM-27 computer programs. Estimates of mean t1/2 [half-life] obtained from the terminal phase of the drug disposition profile showed the t1/2 to be longer in the elderly than in the young subjects (12.1 and 7.2 h). Although there was no change in the initial distribution volume of the central compartment, total systemic and renal clearances wre reduced in the elderly and did not correlate with renal function. The increase in the vancomycin volume of distribution at steady state was ascribed to enhanced tissue binding of drug in the elderly, since the mean fraction of vancomycin bound in systemic pool of the young and elderly did not differ (0.53 and 0.56). In-depth analysis of excretion data tends to support suggestions of vancomycin excretion solely by glomerular filtration. The data strongly suggest the need for adjustment or modification of recommended vancomycin dosing schedules in the elderly.