More on cephalosporin interference with creatinine determinations.
نویسندگان
چکیده
Several cephalosporin antibioticscephalothin, cephaloglycine, cephaloridine, cephacetrile, and cefoxitinreportedly interfere positively with measurement of creatinine by the Jaff#{233} reaction. Others such as cefazolin, cephalexin, cephradine, cefamandole, and cephalpirin give negative or only very slight responses under the same in vitro conditions (1, 2). Rankin et al. (3) showed in vivo interference with assays for both plasma and urinary creatinine after cephalothin administration, but found that the creatinine clearance calculated from these erroneous creatine values was unaltered. They concluded that creatinine clearance is a valid indicator of renal function in the presence of concomitant cephalosporin administration. Durham et al. (4) also showed that values for serum and urinary creatinine were falsely increased after cefoxitin administration, especially at peak cefoxitin concentration, but they concluded that values for creatinine clearance, depending on the timing of the serum creatinine sample, could be falsely increased also. Thus, creatinine clearance, measured under these conditions, reportedly was clinically unreliable. Clinically, increases in apparent creatinine owing to cephalosporin interference could lead to inappropriate alteration of therapy. The magnitude of this interference could be appreciable in patients with compromised renal function, where large quantities of cephalosponins are allowed to accumulate due to the relatively large therapeutic index of cephalosporins. Additionally, interference with urinary creatinine assay may cause spurious creatinine clearance calculations and consequently the calculation of excessive doses of drugs excreted renally. We designed in vitro and in vivo studies to investigate the interference with creatinine determinations of the Fig. 1. In vitro cephalosponin interference with plasma creatinine measurement
منابع مشابه
Table 1. Urinary Creatinine and Creatinine Clearance Values in Four Patients Receiving Cephalosporins
of cephalothin immediately post-infusion were 250 mg/L after a 2-g infusion, 100 mg/L after a 1-g infusion. The increase in apparent plasma creatinine declined more slowly with time than did cefoxitin. This is likely due to the higher concentrations of creatinine in plasma and to the additional interference by desacetylcephalothin. Cefoxitin is essentially unmetabolized. Two 24-h urine specimen...
متن کاملPositive interference with the Jaffé reaction by cephalosporin antibiotics.
Cephaloglycin, cephalothin, cephaloridine, cefoxitin, and cephacetrile are cephalosporin antibiotics that react with alkaline picrate solution to give a creatinine-like response. The mechanism of this reaction is not known, and several structurally similar compounds do not react under these same conditions. Because large quantities of a cephalosporin antibiotic may be administered to a patient ...
متن کاملA model for assessing interference.
Most studies of analytical interference indicate the magnitude but not the type of interference. We developed a model for interference that assesses the magnitude of the following types of interference: independent of analyte concentration, dependent on analyte concentration, and a combination of the two. The experimental design for the model is an orthogonally arranged matrix with progressivel...
متن کاملComparison of plasma creatinine determined with the Greiner Selective Analyser GSA II and the glomerular filtration rate.
1. Reference values for the plasma creatinine were established using the alkaline picrate method with the Greiner Selective Analyzer GSA II in relation to the Cr 51-EDTA Clearance. Individuals with normal GFR between 93 to 159 ml/min/1.73 m2 had creatinine values in men (n = 65) from 53.7 to 119.5 mumol/l (0.61 to 1.35 mg/100 ml) and in women (n = 59) from 37.7 to 107 mumol/l (0.42 to 121 mg/10...
متن کاملOn the Determination of Creatinine and Creatine in Urine
Ever since the introduction of the calorimetric method for the determination of creatinine, potassium bichromate, in half normal solution, has been used as the standard for measuring the color obtained in the reaction of creatinine with picric acid and sodium hydroxide. That the bichromate has been serviceable for the purpose is evidenced by the fact that no other standard has ever been propose...
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ورودعنوان ژورنال:
- Clinical chemistry
دوره 28 3 شماره
صفحات -
تاریخ انتشار 1982