title: Chloramphenicol pharmacokinetics in hospitalized patients.
abstract: The apparent body clearance of chloramphenicol was investigated in 21 hospitalized adult patients on 27 occasions. Apparent body clearance was found to be significantly lower (1.99 +/- 1.49 ml/min per kg) in patients with total serum bilirubin concentrations of >1.5 mg/100 ml than in patients with serum bilirubin concentrations of </=1.5 mg/100 ml (3.57 +/- 1.72 ml/min per kg; P < 0.001). Serum protein binding of chloramphenicol was lower in cirrhotic patients (42.2 +/- 6.8% bound) than in normal adults (53.1 +/- 5.2% bound; P < 0.001). Low binding of chloramphenicol was also found in the serum of premature neonates (32.4 +/- 8.2% bound; P < 0.001). Reduced binding in neonates implies the need for a lower therapeutic range of total chloramphenicol concentration (3.5 to 13.9 mug/ml) compared with the usual adult range (5 to 20 mug/ml). Finally, three case reports are presented which demonstrate marked abnormalities and intrasubject variation in chloramphenicol clearance.
mesh_terms: D000293:Adolescent; D000368:Aged; D002701:Chloramphenicol / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D007223:Infant; D007700:Kinetics; D008297:Male; D011485:Protein Binding; D013997:Time Factors
chemical_list: D002701:Chloramphenicol