Disposition of Roxithromycin in Patients with Normal and Severely ...

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point, erythromycin-induced ototoxicity has been associated with elevated erythromycin concentrations in serum (7;. Mery and Kanfer, Letter). Ototoxicity has not ...
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Mar. 1990,

p.

Vol. 34, No. 3

385-389

0066-4804/90/030385-05$02.00/0 Copyright © 1990, American Society for Microbiology

Disposition of Roxithromycin in Patients with Normal and Severely Impaired Renal Function CHARLES E. HALSTENSON,l.2* JOHN A. OPSAHL,"2'3 MICHAEL H. SCHWENK,1'2 JOHN M. KOVARIK,1'2

SURENDRA K. PURI,4 I. HO,4 AND GARY R. MATZKE'2 The Drug Evaluation Unit, Department of Medicine, Hennepin County Medical Center,l* and College of Pharmacy2 and School of Medicine,3 University of Minnesota, Minneapolis, Minnesota 55415, and Hoechst-Roussel Pharmaceuticals Inc., Somerville, New Jersey 088764 Received 19 June 1989/Accepted 8 December 1989

The disposition of roxithromycin, an investigational macrolide antibiotic, was evaluated in 20 subjects, 10 with normal renal function (creatinine clearance [CLCR] of 116 + 17 ml/min [mean + standard deviation]) and 10 with severely impaired renal function (CLCR of 10.2 2.6 ml/min) after a single 300-mg oral dose. Plasma concentration-time data were analyzed in terms of a one- or two-compartment oral absorption model utilizing nonlinear regression analysis. The terminal elimination half-life was significantly prolonged in the group with severely impaired renal function (15.5 4.7 h) compared with that of the group with normal renal function (7.9 2.5 h). Apparent total body clearance was significantly reduced in the renally impaired (25.3 10.5 ml/min) in relation to the group with normal renal function (48.8 11.1 ml/min). The first-order absorption rate constants and apparent volumes of distribution did not differ between the two groups. These data indicate that the disposition of roxithromycin is significantly delayed in subjects with CLcRs of