Abstract | OBJECTIVES: METHODS: A single-dose pharmacokinetic study in 14 female post- gastric bypass patients and 14 sex- and body mass index (BMI)-matched controls (mean age 44 years and BMI 36.4 kg/m(2)) was performed. Subjects were administered two 250 mg azithromycin tablets at time 0 and plasma azithromycin levels were sampled at 0.5, 1, 1.5, 2, 3, 5, 7 and 24 h. The AUC of the plasma azithromycin concentrations from time 0 to 24 h (AUC(0-24)) was the primary outcome. RESULTS:
Azithromycin concentrations were lower in gastric bypass patients compared with controls throughout the entire duration of sampling. Compared with controls, the AUC(0-24) was reduced in gastric bypass subjects by 32% [1.41 (SD 0.51) versus 2.07 (0.75) mg · h/L; P = 0.008], and dose-normalized AUC(0-24) was reduced by 33% [0.27 (0.12) versus 0.40 (0.13) kg · h/L; P = 0.009]. Peak azithromycin concentrations were 0.260 (0.115) in bypass subjects versus 0.363 (0.200) mg/L in controls (P = 0.08), and were reached at 2.14 (0.99) h in gastric bypass subjects and 2.36 (1.17) h in controls (P = 0.75). CONCLUSIONS:
Azithromycin AUC was reduced by one-third in gastric bypass subjects compared with controls. The potential for early treatment failure exists, and dose modification and/or closer clinical monitoring of gastric bypass patients receiving azithromycin should be considered.
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Authors | Raj S Padwal, Mohamed Ben-Eltriki, Xiaoming Wang, Lee-Ann Langkaas, Arya M Sharma, Dan W Birch, Shahzeer Karmali, Dion R Brocks |
Journal | The Journal of antimicrobial chemotherapy
(J Antimicrob Chemother)
Vol. 67
Issue 9
Pg. 2203-6
(Sep 2012)
ISSN: 1460-2091 [Electronic] England |
PMID | 22577100
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Bacterial Agents
- Azithromycin
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Topics |
- Adolescent
- Adult
- Anti-Bacterial Agents
(administration & dosage, pharmacokinetics)
- Area Under Curve
- Azithromycin
(administration & dosage, pharmacokinetics)
- Biological Availability
- Female
- Gastric Bypass
- Humans
- Middle Aged
- Plasma
(chemistry)
- Time Factors
- Young Adult
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