[Pharmacokinetics and clearance of ciprofloxacin and amikacin in continuous hemodialysis].
We studied the pharmacokinetic and clearance of a 200 mg ciprofloxacin and a 500 mg amikacin intravenous dose during 5 continuous hemodialysis procedures in 5 patients with acute oliguric renal failure. Hourly blood and ultrafiltrate drug concentrations were measured during 8 hours. Dialysate flux (Qd) was 16.6 ml/min during the first hours and 33.2 ml/min thereafter. For each Qd, total ciprofloxacin clearance was 1.13 +/- 0.99 and 2.8 +/- 1.71 ml/min (p < 0.001), diffusive clearance was 0.96 +/- 0.87 and 2.47 +/- 1.56 ml/min (p < 0.005) and convective clearance was 0.16 +/- 0.17 and 0.33 +/- 0.2 ml/min (p < 0.05). Likewise, total amikacin clearance was 3.47 +/- 1.31 and 4.18 +/- 0.53 ml/min (p < 0.001), diffusive clearance was 2.97 +/- 1.24 and 3.86 +/- 0.52 ml/min and convective clearance was 0.50 +/- 0.47 and 0.32 +/- 0.29 ml/min (p = NS). Protein binding was 84% for ciprofloxacin and 77% for amikacin. It is concluded that during continuous hemodialysis with cuprofan membrane, the main transport mechanism of ciprofloxacin and amikacin is diffusive. Very low amounts of ciprofloxacin are depurated by the dialyser. Likewise, the shortening of amikacin half life suggests the presence of other elimination pathway and the need to use supplementary doses every 24 hours.
Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Hospital José Joaquín Aguirre, Santiago de Chile.
A
A
Cotera
R
R
Aguila
L
L
Gaete
A
A
Saffie
E
E
Lorca
S
S
Thambo
D058186:Acute Kidney Injury / Q000628:therapy; D000583:Amikacin / Q000493:pharmacokinetics*; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics*; D000890:Anti-Infective Agents / Q000097:blood / Q000493:pharmacokinetics*; D001798:Blood Proteins / Q000378:metabolism*; D002939:Ciprofloxacin / Q000493:pharmacokinetics*; D017583:Hemodiafiltration; D006801:Humans; D011485:Protein Binding; D006435:Renal Dialysis
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D001798:Blood Proteins; D002939:Ciprofloxacin; D000583:Amikacin
Farmacocinética y aclaramiento de ciprofloxacina y amikacina en hemodiálisis continua.