Comparative Pharmacokinetics and Protein Bindings of Cefazolin and Cephalothin in Patients with Impaired Liver Function

Abstract

The effects of liver disease on the pharmacokinetics and protein binding of cefazo lin and cephalothin were studied in patients variously with liver cirrhosis, chronic active hepatitis or fatty liver, and with normal liver function. The half life and mean residence time of cefazolin were significantly shorter in cirrhosis than in hepatitis or normal liver function. The clearance of cephalothin was also decreased by cirrhosis. Serum protein binding of cefazolin but not of cephalothin was significantly reduced in cirrhosis. It is suggested that the shorter half life of cefazolin in cirrhosis could be explained by its increased renal clearance, while decreased cephalothin clearance reflects diminished hepatic metabolism.