title: Pharmacokinetics of levofloxacin during continuous venovenous hemodiafiltration and continuous venovenous hemofiltration in critically ill patients.
abstract: OBJECTIVE
  To assess the pharmacokinetics of levofloxacin during continuous venovenous hemodiafiltration (CVVHDF) and continuous venovenous hemofiltration (CVVH).
  
  
  METHODS
  Nonrandomized pharmacokinetic evaluation.
  
  
  METHODS
  University surgical intensive care unit.
  
  
  METHODS
  Six critically ill patients.
  
  
  METHODS
  Five patients received levofloxacin 500 mg/day and one patient received levofloxacin 125 mg/day All patients received continuous renal replacement therapy: CVVHDF on day 1 and CVVH on day 2, using an acrylonitrile hollow-fiber 0.9-m2 filter, constant blood flow rate of 90 ml/minute, substitution flow rate of 1 L/hour predilution, and dialysate flow rate of 1 L/hour (CVVHDF).
  
  
  RESULTS
  Serum, ultrafiltrate, and dialysate concentrations of levofloxacin were determined by high-performance liquid chromatography. Extracorporeal clearance was 26.05 +/- 4.66 ml/hour during CVVHDF and 15.71 +/- 2.73 ml/hour during CVVH (p<0.05). Elimination half-life was 28.08 +/- 4.5 hours and 45.9 +/- 17.7 hours, and distribution volume was 1.51 +/- 0.52 L/kg and 1.42 +/- 0.42 L/kg for CVVHDF and CVVH, respectively. Saturation was 0.76 +/- 0.13 for CVVHDF versus a sieving coefficient of 0.77 +/- 0.16 for CVVH.
  
  
  CONCLUSIONS
  Marked extracorporeal elimination of levofloxacin occurs, requiring a dosage adjustment that can be calculated from the characteristics of CVVH and CVVHDF.
authors.affiliation: Department of Surgery, Luebeck Medical University, Germany.
authors.forename: Sven G
authors.initials: SG
authors.lastname: Guenter
authors.forename: Heiko
authors.initials: H
authors.lastname: Iven
authors.forename: Carsten
authors.initials: C
authors.lastname: Boos
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Bruch
authors.forename: Elke
authors.initials: E
authors.lastname: Muhl
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D019540:Area Under Curve; D002851:Chromatography, High Pressure Liquid; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D006207:Half-Life; D017583:Hemodiafiltration / Q000379:methods*; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*
chemical_list: D000890:Anti-Infective Agents; D064704:Levofloxacin; D015242:Ofloxacin