Pharmacokinetics of moxifloxacin in patients undergoing continuous ambulatory peritoneal dialysis.
OBJECTIVE
To investigate the effect of continuous ambulatory peritoneal dialysis (CAPD) on plasma and peritoneal fluid concentration and pharmacokinetics of moxifloxacin after administration of one 400 mg dose orally to end-stage renal failure patients undergoing CAPD.


METHODS
Blood and peritoneal samples were collected from 8 patients at standard time intervals and concentrations of moxifloxacin were estimated by HPLC analysis with fluorometric and ultraviolet detection. Pharmacokinetic parameters were estimated using standard noncompartmental methods.


RESULTS
Median maximum plasma moxifloxacin concentration was 5.86 mg/L at a median time of 1.25 hours. In serum, median area under the concentration-time curve (AUC(0-->inf)) was 157.95 +/- 100.34 mg.hour/L, median t(1/2) 25.00 hours, median clearance 2.54 L/hour, and median distribution volume 94.90 L. Median peritoneal fluid-to-plasma ratio of moxifloxacin ranged between 0.84 and 1.00, denoting adequate penetration and lack of considerable moxifloxacin removal during CAPD. Maximum moxifloxacin concentration/minimum inhibitory concentration (MIC) and AUC(0-->24)/MIC ratios were above the cutoff points that indicate clinical success.


CONCLUSIONS
A single 400 mg oral dose of moxifloxacin is safe, presents rapid peritoneal fluid penetration, has similar plasma and peritoneal fluid pharmacokinetics, and should therefore be efficacious in the treatment of CAPD-induced peritonitis.
Department of Nephrology, Laikon General Hospital, Greece.
Chrysanthi
C
Skalioti
Thomas
T
Tsaganos
Dimitrios
D
Stamatiadis
Evangelos J
EJ
Giamarellos-Bourboulis
John
J
Boletis
Kyriaki
K
Kanellakopoulou
D000284:Administration, Oral; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001202:Ascitic Fluid / Q000737:chemistry; D001372:Aza Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002851:Chromatography, High Pressure Liquid; D024841:Fluoroquinolones; D006801:Humans; D000077266:Moxifloxacin; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011804:Quinolines / Q000008:administration & dosage / Q000493:pharmacokinetics*
D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin