PMID: 3319914Jan 1, 1987Paper

High dose treatment with antibiotics in cystic fibrosis--a reappraisal with special reference to the pharmacokinetics of beta-lactams and new fluoroquinolones in adult CF-patients

Infection
Fritz SörgelM Geldmacher von Mallinckrodt

Abstract

In this review we analyzed the pharmacokinetic basis for high dose treatment with antibiotics of patients with cystic fibrosis. Both our results and those from other well designed pharmacokinetic studies do not support the view that low blood levels of antibacterials are a common feature of CF. We were unable to detect a decrease in absorption, nor could we find evidence for enhanced elimination of antibacterials in CF. Both these factors have been considered responsible for reducing the plasma (and tissue) levels of antibiotics. Most recent studies on kidney function are in agreement with these findings, since neither inulin nor creatinine clearance differ between CF-patients and healthy volunteers. In contrast to previous discussion, the volume of distribution (Vdss) was not elevated for any compound. The rational of weight correction of volume terms like Vdss or total clearance has never been clearly demonstrated and should therefore not be used without prior proof of relevance. Since the variability of pharmacokinetic parameters of antibiotics in CF-patients may be considerable, we suggest that a dose increase of 20-30% may be justified, but cannot agree with two to fourfold increases in dosage as previously proposed and ap...Continue Reading

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Citations

Sep 29, 2001·Pharmazie in unserer Zeit·F SörgelM Kinzig-Schippers
Jan 1, 1986·Infection·S W BenderH G Posselt
Apr 1, 1991·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·M LeBel
Nov 1, 1992·Antimicrobial Agents and Chemotherapy·B A ChristenssonB Strandvik
Mar 1, 1989·British Journal of Clinical Pharmacology·J W Bins, H Mattie
Oct 26, 2016·Medizinische Klinik, Intensivmedizin und Notfallmedizin·F SörgelU Holzgrabe

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