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Journal of Antimicrobial Chemotherapy (1981) 8, 277-281
© 1981 The British Society for Antimicrobial Chemotherapy

research-article

Clindamycin elimination in patients with liver disease

Robert H. K. Eng, Sandy Gorski, Audrey Person, Carolina Mangura and Herman Chmel

Infectious Diseases Section, Medical Service, East Orange Veterans Administration Medical Center East Orange, New Jersey 07019, U.S.A. Department of Preventive Medicine and Community Health, New Jersey College of Medicine and Dentistry, School of Medicine Newark, New Jersey 07103, U.S.A.

accepted 20 May 1981

Correspondence to: Dr Robert H. K. Eng., Infectious Diseases Section, Medical Service (III), East Orange Veterans Administration Medical Center, Tremont Avenue, East Orange, New Jersey 07019, U.S.A.

The appropriate dose of clindamycin in patients with liver disease has not been determined. There are reports of progressive liver disease with the recommended doses of the drug. Fifteen patients without ascites or biliary obstruction were given intravenous clindamycin for a variety of infections and had serum concentrations of the drug determined by the agar diffusion method at 2 and 3 h post-infusion. The half-life of the drug (T1/2) which represents the ability of the liver to eliminate the active form of the drug in each patient was correlated with his serum liver profile: SGOT, SGPT, albumin, globulin, alkaline phosphatase, total bilirubin, and indirect bilirubin. The T1/2 varied from 0.63 to 4.7 h The correlation coefficients for alkaline phosphatase, SGPT, total bilirubin, and indirect bilirubin were –0.61, –0.6l, 0.86 and 0.925 respectively. The best estimate of clindamycin T1/2 was by the equation: T1/2=3.2 (indirect bilirubin)+0.48. No correlation was found with SGOT, albumin, or globulin. The use of the above equation should help in calculating the dose of the drug in patients with liver disease but without ascites or biliary tract obstruction.


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