title: Roxithromycin Pharmacokinetics in Hospitalized Geriatric Patients: Oral Administration of Whole Versus Crushed Tablets.
abstract: BACKGROUND
  Drug administration as tablets to debilitated elderly patients in crushed form can modify the pharmacokinetic characteristics of the active components. Only scarce information is available on the pharmacokinetics when administered in such form. The aim of this study was to evaluate the pharmacokinetics of roxithromycin administered in crushed form and to compare it with the pharmacokinetics of a group of geriatric patients receiving it in the conventional tablet form.
  
  
  METHODS
  Twenty patients from the acute ward of the Shmuel Harofeh Geriatric Medical Center in stable, clinical, and hemodynamic condition were studied. Patients in group 1 (n = 10) received medications orally in tablet form. Group 2 (n = 10) included age- and disease-matched patients from the same department, who received oral roxithromycin in crushed tablet form. The mean daily dose was the same in both groups: 300 mg (150 mg twice daily). The patients received the drug for 3 days before the initiation of the study. Blood samples for determination of the roxithromycin concentration were taken at the baseline, 1 hour before the drug administration, and at 1, 3, 4, 6, 8, and 10 hours after drug administration. Roxithromycin concentration was measured by a liquid chromatography-tandem mass spectrometry method.
  
  
  RESULTS
  Pharmacokinetic parameters of roxithromycin were significantly different between the 2 groups: the Cmin and Cmax were significantly higher, the tmax significantly longer, AUC0-10 larger, and CL/F smaller in group 2.
  
  
  CONCLUSIONS
  Roxithromycin pharmacokinetic parameters were significantly different between the 2 patient groups resulting in higher drug serum concentrations in the crushed tablets group. The impact of the increased drug exposure is unclear.
authors.affiliation: *National Residue Control Laboratory, Kimron Veterinary Institute, Ministry of Agriculture; †Clinical Pharmacology Unit, Assaf Harofeh Medical Center; and ‡Shmuel Harofeh Geriatric Medical Center, Sackler School of Medicine, Tel-Aviv University, Israel.
authors.forename: Malka
authors.initials: M
authors.lastname: Britzi
authors.forename: Matitiahu
authors.initials: M
authors.lastname: Berkovitch
authors.forename: Stefan
authors.initials: S
authors.lastname: Soback
authors.forename: Arthur
authors.initials: A
authors.lastname: Leibovitz
authors.forename: Rafael
authors.initials: R
authors.lastname: Segal
authors.forename: Marina
authors.initials: M
authors.lastname: Smagarinsky
authors.forename: Emily
authors.initials: E
authors.lastname: Lubart
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D015575:Roxithromycin / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D013607:Tablets
chemical_list: D000900:Anti-Bacterial Agents; D013607:Tablets; D015575:Roxithromycin