title: Cefepime pharmacokinetics in cystic fibrosis.
abstract: OBJECTIVE
  To determine the disposition of cefepime in patients with cystic fibrosis compared with healthy controls.
  
  
  METHODS
  Open-label, single-dose study.
  
  
  METHODS
  Laboratoire de Pharmacocinétique Clinique, Université Laval, Québec, Canada.
  
  
  METHODS
  Twelve patients with the confirmed diagnosis of cystic fibrosis (CF) and 12 healthy volunteers. One subject with CF withdrew for personal reasons; the data of another patient were excluded from the evaluation of renal values due to incomplete urine collection.
  
  
  METHODS
  A single 2000-mg dose of cefepime was administered as a 30-minute intravenous infusion. Healthy subjects did not use any other drugs throughout the study. Those with CF refrained from taking prophylactic antibiotics prior to and during the study, but continued to use pancreatic enzymes, multivitamins, and beta-agonist and/or steroid inhalers. One patient continued insulin treatment.
  
  
  RESULTS
  Cefepime's maximum concentration was approximately 150 micrograms/ml at the end of the infusion, half-life 2-2.5 hours, and urinary recovery 80% in both groups. No statistically significant difference was seen in any of the pharmacokinetic values between the groups, except for the mean residence time (2.03 +/- 0.26 vs 2.39 +/- 0.37 hrs; p < 0.02). Total clearance was 19% higher in patients with CF than in healthy volunteers (119.7 +/- 20.1 vs 103.5 +/- 19.8 ml/min), perhaps due to higher renal (95.1 +/- 12.4 vs 85.1 +/- 12.0 ml/min) and/or nonrenal (25.4 +/- 13.1 vs 18.4 +/- 12.0 ml/min) clearances in subjects with CF.
  
  
  CONCLUSIONS
  The disposition of cefepime is not significantly affected by CF, and dosage adjustment appears not to be necessary in these patients.
authors.affiliation: Laboratorie de Pharmacocinétique Clinique, Université Laval, Québec, Canada.
authors.forename: B A
authors.initials: BA
authors.lastname: Hamelin
authors.forename: N
authors.initials: N
authors.lastname: Moore
authors.forename: C A
authors.initials: CA
authors.lastname: Knupp
authors.forename: M
authors.initials: M
authors.lastname: Ruel
authors.forename: F
authors.initials: F
authors.lastname: Vallée
authors.forename: M
authors.initials: M
authors.lastname: LeBel
mesh_terms: D000293:Adolescent; D000328:Adult; D000077723:Cefepime; D002511:Cephalosporins / Q000008:administration & dosage / Q000493:pharmacokinetics*; D003550:Cystic Fibrosis / Q000378:metabolism* / Q000652:urine; D005260:Female; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008657:Metabolic Clearance Rate
chemical_list: D002511:Cephalosporins; D000077723:Cefepime