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Antimicrobial Agents and Chemotherapy, February 1998, p. 325-331, Vol. 42, No. 2
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Stereoselective Disposition of Sulbenicillin in Humans

Tomoo Itoh,1,* Naoko Watanabe,1 Mariko Ishida,1 Yasuyuki Tsuda,1 Shinichi Koyano,1 Tomoko Tsunoi,1 Hideyo Shimada,2 and Hideo Yamada1,dagger

Department of Pharmacokinetics and Biopharmaceutics, School of Pharmaceutical Sciences,1 and Center for Clinical Pharmacy,2 Kitasato University, Minato-ku, Tokyo 108, Japan

Received 19 November 1996/Returned for modification 16 June 1997/Accepted 29 October 1997

Stereoselective disposition of sulbenicillin (SBPC) epimers in healthy human volunteers was studied in order to clarify the differences in pharmacokinetic behavior between the epimers. Stereospecific high-performance liquid chromatography was used for the determination of SBPC epimers. Plasma protein binding was measured in vitro with an ultrafiltration method. The binding was stereoselective, with the unbound fraction (fu) of the R-epimer being approximately 1.3-fold greater than that of the S-epimer. SBPC was administered intravenously to human volunteers, and concentrations of SBPC in plasma and urinary excretion rates were measured. Renal clearance (CLR) for the unbound drug (approximately 400 ml/min) was greater than the glomerular filtration rate (GFR) (approximately 109 ml/min) for both epimers, suggesting that both epimers are secreted at the renal tubules. Renal tubular secretion appeared to be greater for the S-epimer. When probenecid was coadministered, the CLR values of both epimers were significantly reduced and were approximately equal to the GFR values. CLR was greater for the S-epimer (37.5 and 49.8 ml/min for R-SBPC and S-SBPC, respectively), which was simply due to the greater fu of the S-epimer in plasma. In contrast, total body clearance was greater for the R-epimer (67.8 and 56.3 ml/min for R-SBPC and S-SBPC, respectively) because of the stereoselective degradation of the R-epimer in plasma. It was revealed that stereoselective degradation in the body had significant influence on the disposition of SBPC epimers.


* Corresponding author. Department of Pharmacokinetics and Biopharmaceutics, School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108, Japan. Phone and fax: (81)-3-3445-9238. E-mail: itoht{at}pharm.kitasato-u.ac.jp.

dagger Present address: Musashino Women's College, Hoyashi, Tokyo 202, Japan.


Antimicrobial Agents and Chemotherapy, February 1998, p. 325-331, Vol. 42, No. 2
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.