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Cephalexin pharmacokinetics in patients with cystic fibrosis.

Pharmacokinetics of cephalexin were studied in 7 pediatric and 4 adult patients with cystic fibrosis (CF) and 4 normal adult volunteers. Cephalexin, 250-500 mg, was given as a single dose in suspension. The area under the cephalexin serum concentration-time curve normalized for dose per kilogram averaged 0.185, 0.242, and 0.272 ml/min/kg-1 in pediatric CF patients, adult CF patients, and normal adults, respectively (p greater than 0.05). A threefold interindividual variation was observed in cephalexin renal clearance in CF patients. Renal clearance of cephalexin averaged 5.85 ml/min/kg in pediatric and 4.61 ml/min/kg in adult CF patients (p greater than 0.05). Elimination half-life of cephalexin averaged 0.74, 0.76, and 1.04 h in pediatric patients, adult patients, and normal adults (p greater than 0.05). Cephalexin was well absorbed based on a mean 24-hour urinary recovery of 89 and 93% in pediatric and adult patients. A trend for higher renal clearance of cephalexin was observed among pediatric compared to adult patients. These results indicate that clearance of cephalexin may not increase in patients with CF of minimal severity characterized by an excellent Shwachman score.