European Journal of Clinical Pharmacology

, Volume 45, Issue 2, pp 181–186

Decreased chloramphenicol clearance in malnourished Ethiopian children

Authors

  • M. Ashton
    • Department of Biopharmaceutics and PharmacokineticsUppsala University
  • P. Bolme
    • Department of Pediatrics, Karolinska InstituteHuddinge Hospital and St Görans Hospital
  • E. Alemayehu
    • Department of Pediatrics and Child HealthEthio-Swedish Childrens' Hospital
  • M. Eriksson
    • Department of Pediatrics, Karolinska InstituteHuddinge Hospital and St Görans Hospital
  • L. Paalzow
    • Department of Biopharmaceutics and PharmacokineticsUppsala University
Originals

DOI: 10.1007/BF00315503

Cite this article as:
Ashton, M., Bolme, P., Alemayehu, E. et al. Eur J Clin Pharmacol (1993) 45: 181. doi:10.1007/BF00315503

Summary

The disposition of chloramphenicol and chloramphenicol monosuccinate has been studied in thirty-four Ethiopian children of varying nutritional status.

After a single intravenous dose corresponding to chloramphenicol 25 mg per kg bodyweight, the plasma clearance of chloramphenicol monosuccinate was decreased only in severely malnourished children with kwashiorkor. Seventeen % of the dose (range 0–51%) was recovered in urine as intact prodrug, indicating incomplete and variable bioavailability of chloramphenicol.

Compared to underweight children, on average marasmic and kwashiorkor subjects exhibited a 2- and 3-fold increase, respectively, in the AUC of chloramphenicol. Elevated AUCs could be traced to reduced hepatic clearance of the drug. The unbound fraction both of chloramphenicol and its prodrug were slightly elevated in serum from kwashiorkor subjects.

The possibility of using a single point measurement of plasma chloramphenicol as a guide to individualized dosage are discussed.

Key words

MalnutritionChloramphenicolchildrenpharmacokineticskwashiorkormarasmus

Copyright information

© Springer-Verlag 1993