Pharmacokinetics of Intraperitoneal Cefalothin and Cefazolin in Patients Being Treated for Peritoneal Dialysis-Associated Peritonitis

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
Darren M RobertsJason A Roberts

Abstract

♦ The standard treatment of peritoneal dialysis (PD)-associated peritonitis (PD-peritonitis) is intraperitoneal (IP) administration of antibiotics. Only limited data on the pharmacokinetics and appropriateness of contemporary dose recommendations of IP cefalothin and cefazolin exist. The aim of this study was to describe the pharmacokinetics of IP cefalothin and cefazolin in patients treated for PD-peritonitis. ♦ As per international guidelines, IP cefalothin or cefazolin 15 mg/kg once daily was dosed with gentamicin in a 6-hour dwell to patients with PD-peritonitis during routine care. Serial plasma and PD effluent samples were collected over the first 24 hours of therapy. Antibiotic concentrations were quantified using a validated chromatographic method with pharmacokinetic analysis performed using a non-compartmental approach. ♦ Nineteen patients were included (cefalothin n = 8, cefazolin n = 11). The median bioavailability for both antibiotics exceeded 92%, but other pharmacokinetic parameters varied markedly between antibiotics. Both antibiotics achieved high PD effluent concentrations throughout the antibiotic dwell. Cefazolin had a smaller volume of distribution compared with cefalothin (14 vs 40 L, p = 0.003). The media...Continue Reading

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Citations

Jul 26, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Darren M RobertsTom N Lea-Henry
Jul 13, 2019·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Ann Mancini, Beth Piraino
Sep 18, 2020·International Journal of Antimicrobial Agents·Suzanne L ParkerJason A Roberts

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Methods Mentioned

BETA
urine collection

Software Mentioned

GraphPad Prism
GraphPad

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