Bioavailability of ciprofloxacin after multiple enteral and intravenous doses in ICU patients with severe gram-negative intra-abdominal infections.
BACKGROUND
Few data are available on the pharmacokinetics of multiple enteral dosing of ciprofloxacin in critically ill intensive care patients and none for those with severe gram-negative intra-abdominal infections (GNIAI).


OBJECTIVE
To determine the bioavailability of enteral ciprofloxacin in tube-fed intensive care patients with severe GNIAI.


METHODS
A randomized crossover study.


METHODS
University-based medical center.


METHODS
5 critically ill intensive care patients with GNIAI and an estimated creatinine clearance > 25 ml/ min who received continuous tube feeding.


METHODS
Multiple doses of enteral 750 mg b.i.d. versus 400 mg b.i.d.i.v. ciprofloxacin.


METHODS
The calculated 12-h area under the serum concentration versus time curve after 750 mg b.i.d. enteral dosing was equivalent to that after 400 mg b.i.d.i.v. The mean bioavailability of enteral dosing was 53.1% [95% confidence interval (CI) 43.5-62.8]. In seven additional patients, the mean serum steady-state concentration at 2 h after enteral administration was 3.9 microg/ml (95% CI 1.9-5.9), not significantly different from that found in the crossover study (p = 0.4).


CONCLUSIONS
In tube-fed intensive care patients with severe GNIAI, the bioavailability of enteral ciprofloxacin is adequate.
de Marie
S
S
Erasmus University Medical Center, Rotterdam/Dijkzigt Hospital, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands. demarie@bacl.azr.nl
VandenBergh
M F
MF
Buijk
S L
SL
Bruining
H A
HA
van Vliet
A
A
Kluytmans
J A
JA
Mouton
J W
JW
D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D001682:Biological Availability; D002939:Ciprofloxacin / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D016638:Critical Illness; D018592:Cross-Over Studies; D016903:Drug Monitoring; D004750:Enteral Nutrition; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D010538:Peritonitis / Q000188:drug therapy* / Q000378:metabolism
D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D003404:Creatinine