Steady-State Pharmacokinetics of Cefoperazone and Sulbactam in Patients with Acute Appendicitis

Abstract

OBJECTIVE:

To determine the steady-state pharmacokinetics of intravenously administered cefoperazone and sulbactam when given in combination to patients with acute appendicitis.

METHODS:

Six patients with normal renal and hepatic function received cefoperazone 2 g with sulbactam 1 g prior to appendectomy and then every 12 hours. Serial blood samples were collected after each patient received at least three doses of cefoperazone/sulbactam.

RESULTS:

Cefoperazone and sulbactam could be best described by a two-compartment model. Mean ± SD values for cefoperazone steady-state volume of distribution (V^ss _d), elimination half-life (t_1/2β), clearance (Cl), and area under the curve (AUC_0-t) were 19.8 ± 8.0 L, 3.97 ± 1.06 h, 62.6 ± 16.3 mL/min, and 556.9 ± 122.0 mg·h/L, respectively. Sulbactam V^ss _d, t_1/2β, Cl, and AUC_0-t were 34.7 ± 13.9 L, 1.39 ± 0.4 h, 288.6 ± 68.2 mL/min, and 64.8 ± 24.5 mg·h/L, respectively.

CONCLUSIONS:

Compared with data from healthy volunteers, cefoperazone exhibited a decreased Cl and increased V^ss _d and t_1/2β in patients with acute appendicitis. An increased V^ss _d also was observed for sulbactam. The disposition of cefoperazone/sulbactam is altered in this group of patients; however, these changes are not likely to warrant a dosage reduction.