Pharmacokinetics of teicoplanin in patients undergoing continuous ambulatory peritoneal dialysis.
OBJECTIVE
To achieve concentrations of teicoplanin in serum and dialysate within the therapeutic range in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).


METHODS
Pharmacokinetic study.


METHODS
A tertiary-care hospital.


METHODS
Eight hospitalized anuric patients undergoing CAPD.


METHODS
One single dose of 10 mg/kg teicoplanin was administered intravenously, and blood and dialysate were sampled at regular time intervals for 48 hours post drug infusion. Concentrations of teicoplanin were determined by microbiological assay.


RESULTS
Teicoplanin serum levels above 10 microg/mL, the level desired to treat systemic infections, were detected for 24 hours after administration. All dialysate concentrations were very low. Teicoplanin presented two phases of elimination: an early first phase and a late second phase. Mean maximum serum concentration was 75.56 microg/mL, mean half-life (t 1/2) of the early elimination was 3.34 hours, mean t 1/2 of the late elimination was 61.68 hours, mean area under the serum-concentration-time curve was 1491.92 mg x hr/L, mean clearance rate was 10.68 mL/ minute, mean apparent volume of distribution was 0.80 L/kg, and mean volume of distribution at steady state was 0.22 L/kg. Mean dialysate excretion was 3.16% and mean peritoneal clearance rate was 0.023 mL/minute.


CONCLUSIONS
Based on the time period with the achieved serum levels and on the prolonged t 1/2, it is proposed that teicoplanin might be administered at 10 mg/kg every 24 hours for the therapy of systemic infections in patients undergoing CAPD. However, its intravenous administration should be avoided in the treatment of peritonitis, because the achieved dialysate concentrations were very low.
Stamatiadis
Dimitrios
D
Department of Nephrology, Athens Laiko General Hospital, Athens Medical School, Athens, Greece.
Papaioannou
Maria G
MG
Giamarellos-Bourboulis
Evangelos J
EJ
Marinaki
Smaragda
S
Giamarellou
Helen
H
Stathakis
Charalambos P
CP
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000032:analysis* / Q000493:pharmacokinetics*; D001002:Anuria / Q000209:etiology / Q000378:metabolism* / Q000628:therapy*; D001202:Ascitic Fluid / Q000737:chemistry*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D017334:Teicoplanin / Q000008:administration & dosage / Q000032:analysis* / Q000493:pharmacokinetics*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D017334:Teicoplanin