Pharmacokinetics of intravenous and intraperitoneal cefotaxime in chronic ambulatory peritoneal dialysis.
We investigated the kinetics of cefotaxime in eight subjects undergoing continuous ambulatory peritoneal dialysis (CAPD). A single 1 gm iv dose was injected and a 1 gm dose was given intraperitoneally in the CAPD fluid during a 4-hour dwell time. Cefotaxime and desacetylcefotaxime were assayed by HPLC. After intravenous injection the cefotaxime serum kinetic parameters were as follows: plasma t 1/2, 2.31 +/- 0.20 hours; volume of distribution, 0.35 +/- 0.04 L/kg; total plasma clearance, 118.7 +/- 12.3 ml/min; and peritoneal clearance, 6.7 +/- 1.3 ml/min. Dialysate cefotaxime concentrations rose rapidly, but only 5% of the dose was eliminated by the peritoneal route. After intraperitoneal instillation, cefotaxime appeared in the serum rapidly and the peak serum concentrations ranged from 9 to 20 micrograms/ml between 1 and 3 hours. The absorption of cefotaxime from peritoneal space was 58.7% +/- 5.4%. Data suggest that cefotaxime has bidirectional exchange characteristics through the peritoneal membrane. Instillation of cefotaxime in CAPD fluid may permit rapid absorption to achieve therapeutic serum concentrations.
D000042:Absorption; D000328:Adult; D000368:Aged; D001711:Biotransformation; D002439:Cefotaxime / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism* / Q000627:therapeutic use / Q000652:urine; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006207:Half-Life; D006801:Humans; D007263:Infusions, Parenteral; D007275:Injections, Intravenous; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010531:Peritoneal Dialysis, Continuous Ambulatory
C029281:desacetylcefotaxime; D002439:Cefotaxime