Steady-state pharmacokinetics of cefoperazone and sulbactam in patients with acute appendicitis.
OBJECTIVE
To determine the steady-state pharmacokinetics of intravenously administered cefoperazone and sulbactam when given in combination to patients with acute appendicitis.


METHODS
Six patients with normal renal and hepatic function received cefoperazone 2 g with sulbactam 1 g prior to appendectomy and then every 12 hours. Serial blood samples were collected after each patient received at least three doses of cefoperazone/sulbactam.


RESULTS
Cefoperazone and sulbactam could be best described by a two-compartment model. Mean +/- SD values for cefoperazone steady-state volume of distribution (Vssd), elimination half-life (t1/2 beta), clearance (Cl), and area under the curve (AUC0-t) were 19.8 +/- 8.0 L, 3.97 +/- 1.06 h, 62.6 +/- 16.3 mL/min, and 556.9 +/- 122.0 mg.h/L, respectively. Sulbactam Vssd, t1/2 beta, Cl, and AUC0-t were 34.7 +/- 13.9 L, 1.39 +/- 0.4 h, 288.6 +/- 68.2 mL/min, and 64.8 +/- 24.5 mg.h/L, respectively.


CONCLUSIONS
Compared with data from healthy volunteers, cefoperazone exhibited a decreased Cl and increased Vssd and t1/2 beta in patients with acute appendicitis. An increased Vssd also was observed for sulbactam. The disposition of cefoperazone/sulbactam is altered in this group of patients; however, these changes are not likely to warrant a dosage reduction.
Danziger
L H
LH
Department of Pharmacy Practice, University of Illinois at Chicago (UIC) 60612.
Piscitelli
S C
SC
Occhipinti
D J
DJ
Resnick
D J
DJ
Rodvold
K A
KA
D000208:Acute Disease; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000378:metabolism*; D002438:Cefoperazone / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D013407:Sulbactam / Q000008:administration & dosage / Q000493:pharmacokinetics*
D002438:Cefoperazone; D013407:Sulbactam