Steady-State Pharmacokinetics of Oral Ciprofloxacin in Continuous Cycling Peritoneal Dialysis Patients: Brief Report

2018 ◽  
Vol 38 (1) ◽  
pp. 73-76
Author(s):  
Colin Lee ◽  
Sandra A.N. Walker ◽  
Lesley Palmay ◽  
Scott E. Walker ◽  
Sheldon Tobe ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Steady State ◽  
Serum Concentration ◽  
Half Life ◽  
Dialysis Patients ◽  
Maximum Serum ◽  
Continuous Cycling Peritoneal Dialysis ◽  
Continuous Cycling ◽  
Maximum Serum Concentration ◽  
Oral Ciprofloxacin

Steady-state pharmacokinetics of oral ciprofloxacin in 3 continuous cycling peritoneal dialysis (CCPD) outpatients given ciprofloxacin 750 mg b.i.d. for 5 doses was determined. Mean steady-state maximum serum concentration and half-life were 4.4 ±1.5 mg/L and 10.3 ± 2.6 hours, respectively. Mean maximum dialysate concentration in the daytime long dwell and overnight continuous cycling dwell were 7.4 ± 1.2 mg/L and 3.3 ± 1.2 mg/L, respectively. Oral ciprofloxacin 750 mg b.i.d. may be reasonable for bloodstream and peritoneal infections caused by susceptible bacteria in CCPD patients.

Pharmacokinetics of Oral Ciprofloxacin in Continuous Cycling Peritoneal Dialysis

2004 ◽  
Vol 24 (5) ◽  
pp. 447-453 ◽  
Author(s):  
Sharon M. Yeung ◽  
Scott E. Walker ◽  
Sandra A.N. Tailor ◽  
Linda Awdishu ◽  
Sheldon Tobe ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Concentration ◽  
Empirical Treatment ◽  
Klebsiella Species ◽  
Maximum Serum ◽  
Gram Negative ◽  
E Coli ◽  
Continuous Cycling ◽  
Maximum Serum Concentration ◽  
Oral Ciprofloxacin

Background In order to avoid aminoglycosides, the International Society for Peritoneal Dialysis recommends cefazolin and ceftazidime for empirical treatment of peritonitis. Ciprofloxacin covers relevant gram-negative pathogens without the resistance associated with ceftazidime. However, ciprofloxacin pharmacokinetic data in patients on continuous cycling peritoneal dialysis (CCPD) are lacking. Objectives ( 1 ) To determine the pharmacokinetics of oral ciprofloxacin in CCPD patients, ( 2 ) to compare serum and dialysate ciprofloxacin concentrations with minimum inhibitory concentrations (MIC) of the gram-negative bacteria associated with peritonitis, and ( 3 ) to establish oral ciprofloxacin dosing guidelines for the empirical treatment of peritonitis in patients receiving CCPD. Methods Eligible CCPD patients received 2 doses of ciprofloxacin: 750 mg orally every 12 hours. Serial blood and end-of-dwell dialysate samples were collected during the first 12-hour interval; an end-of-dwell dialysate sample from the overnight dwell and a final blood sample were collected at the end of the second 12-hour interval. Ciprofloxacin concentrations were determined using a liquid chromatographic (HPLC)-fluorescence method. Pharmacokinetic calculations were completed assuming a one-compartment model. Results Eight patients completed the study. The pharmacokinetic parameters determined for ciprofloxacin were (mean ± SEM) serum half-life 10.1 ± 1.2 hours, maximum serum concentration 2.7 ± 0.5 mg/L, time to maximum serum concentration 1.6 ± 0.1 hours after the first dose, and peritoneal clearance 1.2% ± 0.1% of the mean calculated total body clearance. While all patients achieved serum area under the concentration-time curve: MIC > 125 for Escherichia coli and Klebsiella species after the first dose, only 2 patients achieved this goal for Pseudomonas aeruginosa. End-of-dwell dialysate concentrations were above the MIC for E. coli, Klebsiella spp, and P. aeruginosa after the second dose. Conclusion Ciprofloxacin 750 mg orally every 12 hours in CCPD patients may be useful for empirical gram-negative coverage of CCPD peritonitis and for treatment of documented peritonitis caused by sensitive E. coli or Klebsiella species. While ceftazidime may be required for documented pseudomonal peritonitis, the oral ciprofloxacin regimen achieved adequate serum concentrations to treat systemic gram-negative infections caused by sensitive E. coli or Klebsiella species.

scholarly journals Disposition kinetics of ceftriaxone and determination of its therapeutic dose in dogs

2020 ◽  
Vol 19 (8) ◽  
pp. 1735-1758
Author(s):  
Ifeanyi G. Eke ◽  
Ukamaka U. Eze ◽  
Aruh O. Anaga ◽  
Kennedy F. Chah ◽  
Boniface M. Anene ◽  
...  
Keyword(s):  
Steady State ◽  
Serum Concentration ◽  
Half Life ◽  
Therapeutic Dose ◽  
Maximum Serum ◽  
Elimination Half Life ◽  
Disposition Kinetics ◽  
Elimination Half ◽  
Significant Difference ◽  
Kinetics Of

Purpose: To evaluate the disposition kinetics of ceftriaxone (CFZ) in dogs with a view to determining its therapeutic dose and dosing frequency.Methods: Twelve (12) Basenji dogs (n = 4), divided into 3 groups (A, B and C), were used for the study. Ceftriaxone was administered intramuscularly at doses of 12.5, 25, and 50 mg/kg once to groups A, B and C respectively. Plasma CFZ concentration was determined by agar well diffusion assay at 0.25, 0.5, 1, 2, 3, 4, 6, 8, 10, 12, and 24 h post-treatment, and the pharmacokinetic parameters were determined.Results: Intramuscular injection of CFZ to dogs resulted in rapid absorption, distribution and elimination (p < 0.05). The elimination half-life was short and did not change significantly with increase in dose. Serum concentration of CFZ changed significantly (p < 0.05) with increase in dose of CFZ. The maximum serum concentration (Cmax, 15.00 ± 1.18, 141.37 ± 15.87 and 259 ± 5.21 μg/mL) for groups A, B and C respectively were significantly (p < 0.05) different. The steady state CFZ concentrations; 0.94, 8.81 and 16.19 μg/mL for groups A, B and C, respectively, were significantly (p < 0.05) different. However, there was no significant difference in the time to reach steady state concentrations (Tmax, 00±0.021, 4.00±0.10 and 4.30±0.12 for groups A, B and C respectively). The therapeutic dose of CFZ was therefore determined to be 25 – 50 mg/kg every 4 h.Conclusion: Ceftriaxone undergoes rapid elimination in dogs with a short elimination half-life, thus making it an inconvenient prescription for out-patients in veterinary clinics. Keywords: Ceftriaxone, Pharmacokinetic profile, Dogs, Therapeutic dose, Veterinary clinic

Pharmacokinetics of Calcitriol and Maxacalcitol Administered into Peritoneal Dialysate Bags in Peritoneal Dialysis Patients

2005 ◽  
Vol 25 (6) ◽  
pp. 570-575 ◽  
Author(s):  
Chieko Hamada ◽  
Kayo Hayashi ◽  
Ichiyu Shou ◽  
Masanori Inaba ◽  
Yuuki Ro ◽  
...  
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Acidic Solution ◽  
Time Lag ◽  
Dialysis Patients ◽  
Maximum Serum ◽  
Vitamin D Analog ◽  
Maximum Serum Concentration ◽  
The Stability ◽  
Dialysis Solutions

Objectives It is well known that injection of calcitriol (CT) or maxacalcitol (OCT) is very effective in hemodialysis patients with secondary hyperparathyroidism (2HPT). However, it is difficult to use these drugs with peritoneal dialysis (PD) patients with 2HPT because these drugs must be injected two or three times per week. The objective of the present study was to evaluate the stability of physiological activities of CT and OCT in PD bags and to determine the CT or OCT dosage for intraperitoneal (IP) administration. Materials and Methods We added CT 1.5 μg or OCT 10 μg to Dianeal PD-2 (approximate pH = 5.0, calcium = 0.87 mmol/L; Baxter, Tokyo, Japan), Midpeliq 250 (approximate pH = 7.0, Ca = 1.0 mmol/L; Terumo Corporation, Tokyo, Japan), and Peritoliq 250 (approximate pH = 5.5, Ca = 1.0 mmol/L; Terumo Corp.). Dialysis solutions were collected from the PD bags at 0, 1, 4, 8, 12, 24, 48, and 72 hours after addition of CT and OCT. The activities of CT and OCT in the dialysis effluent were measured by radioimmunoassay. The levels of serum and effluent OCT after a single IP administration of 10 μg OCT were examined in 4 PD patients with advanced 2HPT. Results Although the levels of CT and OCT in PD bags made of polyvinyl resins decreased by 70% – 75% immediately after injection, levels in PD bags made of polypropylene resins decreased only slightly. The concentration of CT mixed into the acidic solution in glass containers was stable; the decreased concentration of CT in the PD solution might be due to adsorption onto polyvinyl resins. The maximum serum concentration after IP administration of 10 μg OCT was 750 pg/mL after 5 minutes, and remained at 500 pg/mL at 60 minutes. These results show good peritoneal transport of OCT but not rapid disappearance, unlike intravenous administration. Conclusions If peritoneal administration of vitamin D derivatives is contemplated, it is important to select the composition of PD bag resins, type of vitamin D analog, and time lag to use when deciding the dosage of injectable vitamin D preparations, such as OCT or CT, for IP administration to PD patients. It appears that IP administration in overnight dwells might be useful for PD patients as a complementary vitamin D preparation.

scholarly journals Outbreak of sterile peritonitis among continuous cycling peritoneal dialysis patients

1998 ◽  
Vol 54 (4) ◽  
pp. 1367-1371 ◽  
Author(s):  
Alicia J. Mangram ◽  
Lennox K. Archibald ◽  
Mark Hupert ◽  
Jerome I. Tokars ◽  
L. Christine Silver ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Continuous Cycling Peritoneal Dialysis ◽  
Continuous Cycling

Five years' experience with continuous ambulatory or continuous cycling peritoneal dialysis in children

1987 ◽  
Vol 111 (4) ◽  
pp. 513-518 ◽  
Author(s):  
Tassilo von Lilien ◽  
Isidro B. Salusky ◽  
Ines Boechat ◽  
Robert B. Ettenger ◽  
Richard N. Fine
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Cycling Peritoneal Dialysis ◽  
Continuous Cycling

Continuous Cycling Peritoneal Dialysis Wet Is Better Than Dry

1990 ◽  
pp. 259-263 ◽  
Author(s):  
J. A. Diaz-Buxo ◽  
C. D. Farmer ◽  
J. T. Chandler ◽  
P. J. Walker ◽  
W. P. Burgess
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Cycling Peritoneal Dialysis ◽  
Continuous Cycling ◽  
Better Than

scholarly journals Pharmacokinetics of Once Daily Intraperitoneal Cefazolin in Continuous Ambulatory Peritoneal Dialysis Patients

2000 ◽  
Vol 11 (6) ◽  
pp. 1117-1121
Author(s):  
CHAI LUAN LOW ◽  
KAMANI GOPALAKRISHNA ◽  
WAI CHOONG LYE
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Half Life ◽  
Volume Of Distribution ◽  
Hplc Method ◽  
Dialysis Patients ◽  
Suitable Alternative ◽  
Once Daily ◽  
Cefazolin Sodium ◽  
Plasma Half Life

Abstract. This study determined the pharmacokinetic characteristics of once daily intraperitoneal (IP) cefazolin in continuous ambulatory peritoneal dialysis (CAPD) patients. Each of the 10 volunteer CAPD patients without active peritonitis received a single IP dose of 1 g of cefazolin sodium for a 6-h dwell. All patients underwent a fixed CAPD regimen comprising a first 6-h dwell followed by two 3-h dwells and a final 12-h overnight dwell. Blood and dialysate samples were collected at 0, 0.5, 1, 2, 3, 6 (end of first dwell), and 24 h after the administration of IP cefazolin. Any urine produced was collected over the 24-h study period. A validated HPLC method was used to analyze cefazolin in plasma, dialysate, and urine. The bioavailability was found to be 77.9 ± 3.1%, volume of distribution 0.20 ± 0.05 L/kg, and plasma half-life 39.9 ± 25.4 h. Mean total, renal, and peritoneal clearances were 4.5 ± 2.3, 1.4 ± 1.1, and 3.5 ± 1.8 ml/min, respectively. Mean plasma and dialysate concentrations at 24 h were 42.8 ± 14.3 and 31.8 ± 11.7 mcg/ml, respectively, well above the minimum inhibitory concentrations (MIC) of susceptible organisms. A once daily IP cefazolin dose of 500 mg/L gave desirable pharmacokinetic attributes for use as a suitable alternative to vancomycin for empiric treatment of CAPD-associated peritonitis.

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