title: Disposition of cefmetazole in healthy volunteers and patients with impaired renal function.
abstract: The disposition of cefmetazole was studied in 25 subjects with various degrees of renal function after a 1,000-mg, constant-rate, 30-min intravenous infusion of cefmetazole sodium. In six subjects with creatinine clearance (CLCR) of greater than 90 ml/min per 1.73 m2 (group 1), the terminal elimination half-life (t1/2 beta) was 1.31 +/- 0.54 h (mean +/- standard deviation), cefmetazole total body clearance (CLP) was 132.8 +/- 25.1 ml/min per 1.73 m2, and volume of distribution at steady state was 0.165 +/- 0.025 liter/kg. The fraction of dose excreted unchanged in the urine was 84.0% +/- 26.1%. Subjects with CLCRS of 40 to 69 (group 2, n = 6) and 10 to 39 (group 3, n = 6) ml/min per 1.73 m2 demonstrated prolongation of the t1/2 beta (3.62 +/- 1.06 and 5.93 +/- 1.81 h, respectively) and significant reductions in cefmetazole CLP (52.8 +/- 14.3 and 30.2 +/- 10.2 ml/min per 1.73 m2, respectively), compared with group 1. In seven subjects on chronic hemodialysis (group 4) studied during an interdialytic period, the cefmetazole t1/2 beta was increased to 24.10 +/- 8.12 h and the CLP was reduced to 6.8 +/- 2.1 ml/min per 1.73 m2. Cefmetazole CLP correlated positively with CLCR (r = 0.951, P less than 0.001): CLP = (1.181 . CLCR) -- 0.287. The disposition of cefmetazole was also assessed in six group 4 subjects during an intradialytic period. The t1/2 beta during hemodialysis (2.09 +/- 0.69 h) was significantly shorter than that observed during the interdialytic period. The hemodialysis clearance of cefmetazole was 86.1 +/- 20.1 ml/min, and the fraction of cefmetazole removed during hemodialysis was 59.8% +/- 5.9%. It is recommended that patients with renal insufficiency received standard doses of cefmetazole at extended intervals and patients on maintenance hemodialysis received standard doses after hemodialysis.
authors.affiliation: Drug Evaluation Unit, Hennepin County Medical Center, Minneapolis, Minnesota 55415.
authors.forename: C E
authors.initials: CE
authors.lastname: Halstenson
authors.forename: D R
authors.initials: DR
authors.lastname: Guay
authors.forename: J A
authors.initials: JA
authors.lastname: Opsahl
authors.forename: C A
authors.initials: CA
authors.lastname: Hirata
authors.forename: L S
authors.initials: LS
authors.lastname: Olanoff
authors.forename: E
authors.initials: E
authors.lastname: Novak
authors.forename: H
authors.initials: H
authors.lastname: Ko
authors.forename: K S
authors.initials: KS
authors.lastname: Cathcart
authors.forename: G R
authors.initials: GR
authors.lastname: Matzke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015311:Cefmetazole / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine; D005260:Female; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D007674:Kidney Diseases / Q000378:metabolism*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D006435:Renal Dialysis
chemical_list: D015311:Cefmetazole