Objective The aim was to investigate if the severity of illness affects the pharmacokinetics of cefuroxime in children with diagnoses of multiple organ system failure (MOSF).
Methods The pharmacokinetics of cefuroxime were studied in 11 children with MOSF and malnourished. The patients were assigned as severely ill (group 1) and very severely ill (group 2), a control group (group 0) was included for the study. Blood samples were taken and concentrations of cefuroxime were measured in plasma by the high-performance liquid chromatography method after the first intravenous infusion of 100 mg cefuroxime per kg of body weight.
Results The pharmacokinetic profile of cefuroxime exhibited both one and two compartmental distribution. Statistical differences between the pharmacokinetics parameter of severe (group 1) and very severe patients (group 2) were found: the comparison of the pharmacokinetics parameter between groups 1 and 2 versus the control group showed significant differences (p<0.05) in most of the parameters analysed; however, when clearance was compared between group 1 and the control group, no statistical difference was found.
Conclusions Our data indicate that the pharmacokinetic differences determined by severity of disease are determinant for establishing an individualised regimen dosage in children with MOSF.