Influence of Fever on Cefazolin Pharmacokinetics

• Published in: Journal of chemotherapy (Florence) Vol. 11; no. 1; pp. 40 - 45
• Main Authors: Beović, B., Mrhar, A., Karba, R., Zupančič, T., Grabnar, I., Belič, A., Marolt-Gomišček, M.
• Format: Journal Article
• Language: English
• Published: Firenze Taylor & Francis 01-02-1999; EIFT
• Subjects: Adult; Aged; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Area Under Curve; Biological and medical sciences; Cefazolin - blood; Cefazolin - pharmacokinetics; Cephalosporins - blood; Cephalosporins - pharmacokinetics; Chromatography, High Pressure Liquid; Computer Simulation; Female; Fever - metabolism; Humans; Male; Medical sciences; Middle Aged; Models, Chemical; Pharmacology. Drug treatments; Prospective Studies; Software; Human; Antibiotic; Cephalosporin derivatives; Compartmental model; Cefazolin; Intraindividual comparison; β-Lactams; Antibacterial agent; Pharmacokinetics; Modeling; Fever
• ISSN: 1120-009X; 1973-9478
• DOI: 10.1179/joc.1999.11.1.40

The influence of fever on the pharmacokinetics of cefazolin was investigated in patients with acute febrile diseases. Nine patients were included in the study. Antibiotic serum concentrations were determined using high performance liquid chromatograpy (HPLC). An analog computer and the SIMULINK software package were used to identify the pharmacokinetic model and PCNONLIN software package to obtain the secondary parameters. In 6 patients a two-compartment pharmacokinetic model of cefazolin was observed during fever and after defervescence. In 2 patients a two-compartment model changed to a one-compartment after defervescence, and a one-compartment model was observed in one patient during both periods. Cefazolin-treated patients with a two-compartment model (6/9) had higher C
max
, mean steady state serum concentrations (C
ss
), and area under the plasma concentration-time curve (AUC
0→∞
) smaller central compartment volume (V
1
), and lower clearance (Cl) during fever. The varying distribution of antibiotics during fever probably reflects different hemodynamic responses to fever.