The effects of posture on the pharmacokinetics of intramuscular benzylpenicillin

Summary Previous reports have produced conflicting results as to whether changes in posture affected the pharmacokinetics of the penicillins.We have studied the pharmacokinetics of intramuscularly administered benzylpenicillin in normal subjects during bedrest and ambulation and compared it with data obtained following intravenous administration of the same dose to the same subjects under the same conditions. The values of area under the curve, total clearance, mean residence time and renal clearance found during ambulation were 1175 (min·min·l^–1), 488 (ml·min^–1), 101 (min), and 264 (ml·min^–1) (means). The corresponding values for bedrest were 1032 (min·mg·l^–1), 544 (ml·min^–1), 96.7 (min), and 315 (ml·min^–1).There was a significant difference between the areas under the curve with change of posture but not between any of the other pharmacokinetic variables. The differences observed in this study are unlikely to be of clinical relevance.We suggest that the differences between the results of this study and those of previous studies may be related to the level of exercise undertaken by the subjects in the various studies.