title: Pharmacokinetics of once daily intraperitoneal cefazolin in continuous ambulatory peritoneal dialysis patients.
abstract: This study determined the pharmacokinetic characteristics of once daily intraperitoneal (IP) cefazolin in continuous ambulatory peritoneal dialysis (CAPD) patients. Each of the 10 volunteer CAPD patients without active peritonitis received a single IP dose of 1 g of cefazolin sodium for a 6-h dwell. All patients underwent a fixed CAPD regimen comprising a first 6-h dwell followed by two 3-h dwells and a final 12-h overnight dwell. Blood and dialysate samples were collected at 0, 0.5, 1, 2, 3, 6 (end of first dwell), and 24 h after the administration of IP cefazolin. Any urine produced was collected over the 24-h study period. A validated HPLC method was used to analyze cefazolin in plasma, dialysate, and urine. The bioavailability was found to be 77.9 +/- 3.1%, volume of distribution 0.20 +/- 0.05 L/kg, and plasma half-life 39.9 +/- 25.4 h. Mean total, renal, and peritoneal clearances were 4.5 +/- 2.3, 1. 4 +/- 1.1, and 3.5 +/- 1.8 ml/min, respectively. Mean plasma and dialysate concentrations at 24 h were 42.8 +/- 14.3 and 31.8 +/- 11. 7 mcg/ml, respectively, well above the minimum inhibitory concentrations (MIC) of susceptible organisms. A once daily IP cefazolin dose of 500 mg/L gave desirable pharmacokinetic attributes for use as a suitable alternative to vancomycin for empiric treatment of CAPD-associated peritonitis.
authors.affiliation: Department of Pharmacy, National University of Singapore, Singapore.
authors.forename: Chai Luan
authors.initials: CL
authors.lastname: Low
authors.affiliation: Department of Pharmacy, National University of Singapore, Singapore.
authors.forename: Kamani
authors.initials: K
authors.lastname: Gopalakrishna
authors.affiliation: National University Hospital, Singapore.
authors.forename: Wai Choong
authors.initials: WC
authors.lastname: Lye
mesh_terms: D000042:Absorption; D019540:Area Under Curve; D001682:Biological Availability; D002437:Cefazolin / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D002511:Cephalosporins / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D002851:Chromatography, High Pressure Liquid; D015314:Dialysis Solutions; D005260:Female; D006207:Half-Life; D006801:Humans; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory
chemical_list: D002511:Cephalosporins; D015314:Dialysis Solutions; D002437:Cefazolin