THOMAS A. HOFFMAN, M.D.; RAFAEL CESTERO, M.D.; WARD E. BULLOCK, M.D., F.A.C.P.
The pharmacodynamics of carbenicillin were studied in 40 subjects after administration of a 2-g intravenous dose. The mean serum level of carbenicillin at 1 hr was 103 ± 29 µg/ml in five subjects with normal renal and hepatic function; the mean serum half-life (T½) was 1.0 ± 0.25 hr. The T½ was prolonged to 1.9 ± 0.6 hr in nine patients with hepatic disease, but this prolongation did not correlate well with the degree of hepatic impairment. In some of these patients renal function was moderately reduced and may have affected the persistence of carbenicillin. The serum T½ of carbenicillin was markedly prolonged to 15.7 ± 5.2 hr in 11 patients with oliguric renal failure. The serum T½ of carbenicillin was further prolonged to 23.2 ± 2.9 hr in five oliguric patients with evidence of concomitant hepatic dysfunction. Hemodialysis removed significant amounts of carbenicillin, and half-lives during dialysis were reduced by 53 to 70% of predialysis values. Modification of the usual large dosage is recommended in patients whose creatinine clearance is less than 30 ml/min.
HOFFMAN TA, CESTERO R, BULLOCK WE. Pharmacodynamics of Carbenicillin in Hepatic and Renal Failure. Ann Intern Med. ;73:173–178. doi: 10.7326/0003-4819-73-2-173
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Published: Ann Intern Med. 1970;73(2):173-178.
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