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Xenobiotica
the fate of foreign compounds in biological systems
Volume 23, 1993 - Issue 11
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Research Article

Preferential elimination of pivalate with supplemental carnitine via formation of pivaloylcarnitine in man

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Pages 1255-1261 | Published online: 22 Sep 2008
 

Abstract

1. To evaluate the effectiveness of carnitine administration in aiding the elimination of pivalate liberated from pivampicillin, studies were undertaken on seven paediatric patients treated for 7 days with combined pivampicillin and molar excess of carnitine.

2. A 22-fold increase occurred in urinary carnitine ester excretion on the last day of treatment (2967±604 versus 134±50μmol/day, p<0.05); the pivaloylcarnitine was identified with 13C-n.m.r. Only pivalate was detected in the urinary carnitine ester g.l.c. profile, the amount of this ester was equal to 92% of the daily pivalate intake.

3. The renal clearance rate of carnitine esters significantly exceeded that of creatinine indicating that the carnitine ester was eliminated by active transport.

4. The plasma concentration and urinary output of free carnitine were not changed significantly by the treatment, and the free and esterified carnitine concentrations in red cells remained unchanged indicating that carnitine deficiency was prevented.

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