Dosage adjustment of quinolone antibiotics and angiotensin-converting enzyme inhibitors in patients with renal dysfunction.
The aim of this study was to verify an approach for calculating pharmacokinetic parameters suitable for adjusting dosage regimens in patients with renal dysfunction. We carried out a retrospective analysis of the pharmacokinetic profiles of 12 new quinolone antibiotics and 11 angiotensin-converting enzyme inhibitors (ACEIs) in patients with normal and impaired renal function to obtain the renal excretion ratio (R(renal)) of each drug. We demonstrated that the pharmacokinetics of each drug in a patient with renal dysfunction can be adequately estimated using the R(renaI) value of each drug together with the creatinine clearance as an index of the individual's renal function. Using the R(renaI) value obtained, we could successfully simulate pharmacokinetic profiles of the drugs in publications other than that used to obtain the R(renal) values. On the other hand, age-related changes in the pharmacokinetics of new quinolone antibiotics are not always adequately predicted using the R(renal) value compared to using creatinine clearance alone as an index, and the reasons for this are not fully understood. These results demonstrate that dosage regimens of quinolone antibiotics and ACEIs in patients with renal dysfunction can be adequately optimized using the R(renal) value for each drug using the present approach.
Ohtani
H
H
Laboratory of Drug Informatics, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Japan.
Kinoshita
Y
Y
Nagasaki
Y
Y
Sata
H
H
Miki
A
A
Tsujimoto
M
M
Sawada
Y
Y
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D003404:Creatinine / Q000378:metabolism; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy / Q000378:metabolism*; D015363:Quinolones / Q000493:pharmacokinetics* / Q000627:therapeutic use
D000806:Angiotensin-Converting Enzyme Inhibitors; D000900:Anti-Bacterial Agents; D015363:Quinolones; D003404:Creatinine