Pharmacokinetics of Aztreonam Administered loP o in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients
The pharmacokinetics of Aztreonam (AZT) administered i.p. in six stable patients undergoing continuous ambulatory peritoneal dialysis (CAPD) for end-stage renal disease (ESRD) were studied. One gram of AZT was added into a 2 L bag of dialysate (Medital-Bieffe®) just prior to infusion into the peritoneal cavity. The dwell time was 8 h. The serum maximum concentration of AZT was 42.5 ± 12.4 mg/L (x ± SD), achieved in 4.6 ± 1.0 h. The elimination half-life was 2.4 ± 0.8 h, almost equal to that found in normal subjects (1.7–2 h). The pharmacokinetic parameters of elimination, as elimination rate constant and clearance of AZT from peritoneal cavity were found 0.305 ± 0.101 h-1 and 10.05 ± 3.7 mL/min, respectively, while the bioavailability via the peritoneal mem brane was 90.8 ± 3.05% of administered dose. It is concluded that AZT is eliminated from dialysate at a high rate after i.p. administration and its dialysate and serum levels exceed the MIC for the majority of sensitive organisms including Pseudomonas species. Aztreonam appears to be a potentially useful antibiotic for CAPD peritonitis.