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Table 1 Patients with various renal function * Ccr, Creatinine clearance ml/min per 1. 48 m2 ** C.V.D., Cerebral vascular disease ; C.R F., Chronic renal failure ; H.D., Hemoclialysis ; D., Dialyzer ; B.F., Blood flow ml/mm; D.F., Dialysate flow ml/min. Fig. 1 Serum levels of cefotaxime (Bioassay) after i. v. administration of 1,000 mg in patients with various renal function

Table 2 Serum levels of oefotaxime and its metabolite after tingle i. v. administration of 1,000mg in patients with various renal function Ccr, Creatinine clearance milmin per 1. 48 m2; RD., from 3 to 8 hours after the administration. HPLC, High pressure liquid chromatography. Patient 9 and 10 received 5-hour hemodialysis n. d., Not detected.

CHEMOTHERAPY Fig. 2 Serum levels of celotaxime and its metabolite after i. v. adminimration of 1,000 mg Fig. 4 Serum levels of cefotaxime and its metabolite after i. v. administration of 1,000 mg Fig. 3 Serum levels of cefotaxime and its metabolite after i. v. administration of 1, 000 mg Fig. 5 Serum levels of cefotaxime and its metabolite after i. v. administration of 1, 000 mg

Table 3 Urine levels and recovery of cefotaxime and its metabolite after single iv. administration of 1, OW mg in patients with various renal function * Ccr, Creatinine clearance ml/min per 1.48 m2. ** n. d., Not detected

Fig. 6 Urine recovery of cefotaxime and its metabolite after single i. v. administration of 1, 000 mg in patients with various renal function

Table 5 Laboratory findings before and after treatment with cefotaxime B: before treatment, A: after treatment

1) HEYMES, R.; A. LUTZ & E. SCHRINNER Experimental evaluation of HR 756, a new ce- phalosporin derivative. SIEGENTHALER, W. & R. LUETHY (ed.) Current Chemotherapy, Proc. 10 th Int. Congr. Chemother : 823-824,1978 2) HAMILTON-MILLER, J. M. T. ; W.BRUMFITT & A. V. REYNOLDS : Cefotaxime (HR 756) a new cephalosporin with exceptional broad-spectrum activity in vitro. J. Antimicrob. Chemother. 4 : 437-444, 1978 3) JOHNSON, P. ; GLUMOT & M. KRAMER : HR 756-kinetics, metabolism and toxicology. 18 th Intersci. Conf. Antimicrob. 1978 Agents Chemother.

CLINICAL PHARMACOLOGY AND EVALUATION OF CEFOTAXIME YOSHIMARU USUDA, OSAMU SEKINE, NOBUKI AOKI, TAKEAKI SHIMIZU, NOBUHITO WAKABAYASHI, SEIICHI HAYASHI and KYOKO WATANABE Shinrakuen Hospital MIKIO OMOSU and KAZUHIRO KASAI Development Laboratories, Hoechst Japan Limited 1) Clinical pharmacological studies of cefotaxime (HR 756, CTX) were conducted in patients with various renal function. The results are shown in Tables 1, 2 and 3, and Fig. 1, 2, 3, 4, 5 and 6. Higher serum levels and a moderately prolonged serum half-life of cefotaxime as well as a longer period of higher serum levels of desacetylcefotaxime were observed in patients with more severely impaired renal function. Urine excretion of cefotaxime was prolonged and diminished in relation to the degree of renal failure. The total amount of desacetylcefotaxime excreted into urine within 24 hours increased in relation to the degree of renal dysfunction more than creatinine clearance (Ccr) 20 ml/min per 1.48 m2, but decreased in relation to the degree of renal dysfunction less than Ccr 20. 2) Cefotaxime was used in 13 cases. The results are shown in Table 4 and 5. Three cases (case 5, 9 and 11) were proven not to be suitable for treatment with cefotaxime and excluded from the evaluation of efficacy. Clinical efficacy was excellent in 4 cases, good in 5 cases, and poor in 1 case. No distinct serious side effects were observed.

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