Authors: Ballow C.H.¹; Amsden G.W.²; Highet V.S.³; Forrest A.¹

Source: Clinical Drug Investigation, Volume 15, Number 2, 1 February 1998 , pp. 159-167(9)

Publisher: Adis International

Abstract:

Two open-label studies were conducted to assess the serum, urine, polymorphonuclear (PMN) and red blood cell (RBC) pharmacokinetics of a 5-day course (1500mg total) of oral azithromycin. Inflammatory and non-inflammatory blisters were also induced to study the propensity of azithromycin to preferentially concentrate at a model infection site. 14 subjects participated in the two studies and tolerated azithromycin and the study methods well. Comodelling of the serum and urine data demonstrated very extensive distribution into peripheral compartments, low renal clearance (7% of total oral clearance) and an extended terminal half-life (79 hours). PMN leucocyte concentrations peaked at 119 mg/L following the final dose and remained above 60 mg/L 7 days after the final dose. The ratio of blister to serum AUCs was significantly higher in inflammatory (2.2) vs non-inflammatory (1.2) blisters (p < 0.02). The extensive uptake of azithromycin into PMNs coupled with the accumulation of azithromycin into an inflammatory compartment (e.g. infection site) support the hypothesis that PMN leucocytes laden with azithromycin migrate to sites of inflammation, thereby enhancing local concentrations. These studies further demonstrate the unique pharmacokinetic properties of azithromycin and its preferential delivery by phagocytes to the site of infection.

Keywords: Azithromycin, pharmacokinetics; Antibacterials, pharmacokinetics

Document Type: Original article

Affiliations: 1: The Clinical Pharmacokinetics Laboratory, Millard Fillmore Hospital and The State University of New York at Buffalo School of Pharmacy, Buffalo, New York, USA 2: The Clinical Pharmacology Research Center and The Departments of Pharmacy and Medicine, Bassett Healthcare, Cooperstown, New York, USA 3: The University of Rhode Island College of Pharmacy, Providence, Rhode Island, USA

Publication date: 1998-02-01

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