Effect of gastric bypass surgery on azithromycin oral bioavailability

The Journal of Antimicrobial Chemotherapy
Raj S PadwalDion R Brocks

Abstract

Azithromycin is used widely for community-acquired infections. The timely administration of azithromycin in adequate doses minimizes treatment failure. Gastric bypass, a procedure that circumvents the upper gut, may compromise azithromycin plasma levels. We hypothesized that azithromycin concentrations would be reduced following gastric bypass. A single-dose pharmacokinetic study in 14 female post-gastric bypass patients and 14 sex- and body mass index (BMI)-matched controls (mean age 44 years and BMI 36.4 kg/m(2)) was performed. Subjects were administered two 250 mg azithromycin tablets at time 0 and plasma azithromycin levels were sampled at 0.5, 1, 1.5, 2, 3, 5, 7 and 24 h. The AUC of the plasma azithromycin concentrations from time 0 to 24 h (AUC(0-24)) was the primary outcome. Azithromycin concentrations were lower in gastric bypass patients compared with controls throughout the entire duration of sampling. Compared with controls, the AUC(0-24) was reduced in gastric bypass subjects by 32% [1.41 (SD 0.51) versus 2.07 (0.75) mg · h/L; P = 0.008], and dose-normalized AUC(0-24) was reduced by 33% [0.27 (0.12) versus 0.40 (0.13) kg · h/L; P = 0.009]. Peak azithromycin concentrations were 0.260 (0.115) in bypass subjects versus...Continue Reading

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Citations

Feb 8, 2014·Current Opinion in Infectious Diseases·Hasan M Al-DorziYaseen M Arabi
Aug 22, 2014·Clinical Pharmacokinetics·Célia Lloret-LinaresXavier Declèves
Sep 25, 2012·Expert Opinion on Drug Metabolism & Toxicology·Dion R BrocksRaj S Padwal
Apr 29, 2015·British Journal of Clinical Pharmacology·Ina GesquierePatrick Augustijns
Mar 16, 2013·Biomedical Chromatography : BMC·Mohamed Ben-EltrikiDion R Brocks
May 15, 2013·Journal of Clinical Pharmacology·Judith Aron-WisnewskyMarion Buyse
Aug 1, 2014·Alimentary Pharmacology & Therapeutics·J SteinR Weiner
Dec 10, 2013·British Journal of Clinical Pharmacology·Pieter ColinKoen Boussery
Oct 11, 2014·Journal of Clinical Pharmacy and Therapeutics·B L da S GuedesE Kimura
Jun 24, 2016·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·Carmil AzranArik Dahan
Jun 6, 2014·Thérapie·Elodie FayeCélia Lloret-Linares
Jul 2, 2016·British Journal of Clinical Pharmacology·Ina GesquierePatrick Augustijns
Aug 24, 2018·European Journal of Clinical Pharmacology·Manuela Moreno SantamaríaPilar Utrilla Navarro
Sep 4, 2020·Journal of Clinical Medicine·Carmil AzranDror Dicker
May 16, 2021·British Journal of Clinical Pharmacology·Jurjen S KingmaCatherijne A J Knibbe
Oct 15, 2021·Médecine sciences : M/S·Cécile Ciangura, Anne Bachelot

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