Pharmacokinetics of intravenous imipenem/cilastatin during intermittent haemofiltration.
The pharmacokinetics of a single iv dose of imipenem/cilastatin (500/500 mg) were studied during and after intermittent haemofiltration (IHF) treatment in six patients with chronic renal failure. The elimination half-lives of imipenem and cilastatin during the IHF treatment were almost identical, 1.4 +/- 0.3 and 1.5 +/- 0.3 h, respectively. Accordingly, approximately 75% of the given dose was eliminated during a 3-h IHF session. However, there was a great difference between the elimination half-lives of the two drugs in the post-treatment period, 3.4 +/- 1.0 and 16 +/- 10 h for imipenem and cilastatin, respectively. The haemofiltration clearance of imipenem was 134 +/- 41 ml/min and that of cilastatin 109 +/- 8 ml/min. On the basis of our results, we suggest that a supplementary dose of imipenem/cilastatin (500/500 mg) should be given directly after the IHF treatment. This dose should be the starting dose for a period of 12-h dosing intervals until the next IHF procedure.
Department of Medicine, University Hospital, Uppsala, Sweden.
A A
AA
Alarabi
O
O
Cars
B G
BG
Danielson
T
T
Salmonson
B
B
Wikström
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D015377:Cilastatin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000077728:Cilastatin, Imipenem Drug Combination; D004338:Drug Combinations; D005260:Female; D006207:Half-Life; D006440:Hemofiltration; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000493:pharmacokinetics*; D007275:Injections, Intravenous; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination